Sensory Integration definition
a clinical frame of reference for the assessment and treatment of people who have functional disorders in sensory processing
trademark developed for Jean Ayres Sensory Integraiton
sensory integration defined by Ayres
organization of sensation for use
when a child organizes a successful, goal directed action on the environment.
motor planning that depends of somatosensory processing and influences one's interactions with the physical world.
Effects on development, learning, and behavior
Sensory input must be actively organized and used by the child to act on and respond to the environment.
passive versus active participation
A child does not passively absorb sensations. Rather, they actively select the sensation most uselful at the time and organize them in a fashion that facilitates accomplishing goals.
speculated to be generated by the limbic system, refers to idea that adaptive response comes from within a child.
hierarchic model of CNS
neurobiologist prior to Ayres, views the nervous system in terms of vertically arranged levels when higher levels regulate lower levels with "descending inhibition"
Ayres hierarchic view of CNS
Increased efficiency at the brainstem and thalmus enhance higher order functioning
Age of 7 or 8
on standardized tests of sensory integrative capabilites reflect near adult maturity
Proximal versus distal
in infancy proximal senses dominate
Influences of identity
family and culture, interpretations given by others, talents and abilities, and chance events
Prenatal period sensory development
tactile stimuli by 5 1/2 weeks gestation, moro reflex at 9 weeks, followed by other primitive reflexes. Stress in early pregnancy can have diminished responses to vestibular input.
Touch, smell, and movement. Cuddling and phasic movements of limbs generate proprioceptive input that leads to body scheme. Rocking and carrying soothe infant. Being raised to caregivers shoulder increased alertness. Pull of gravity against neck muscles begins to develop righting responses. Attracted to high contrast visual stimuli. Begins to use eye contact to interact with caregivers.
ability of child to regulate responses to changing stimuli by initiating behaviors that will be calming or energizing.
begins 4-6 months. from increased interest in the world and vestibular-proprioceptive-visual connections. Infants have an inner drive to rise up against gravity. begins with child in prone position with neck and trunk extensors and evolves into weight bearing positions.
Somatosensory development 1st 6 months
primitive grasp, brings hands to midline, evolves into hand-eye coordination, neonatal reflexes no longer dominate behavior. Rolls from prone to supine. Behavior becomes goal directed.
Midline hand play
a significant milestone in the integration of sensations from 2 sides of the body
marker of beginning of occupational engagement.
Second 6 months
mobility, more sophisticated integration of somatosensory, vestibular, and visual inputs. Body scheme and spatial perception begin. Develops fine pincher grasp. Transfers objects from one hand to the other. Auditory processing and babbling begins. Self feeding initiates. Chewing and swallowing develop. use of spoon begins end of the 1st year and dining as an occupation.
balance and dynamic posture control, body scheme and motor planning evolve, symbolic or imaginary play begins, praxis begins.
strong inner drive, play and games, crafts, constructional play, and video games, playground equipment, motor planning games, cultural tools.
Fine motor tasks
requires coordinating visual and somatosensory information to position hands and maintaing a stable postural base.
When problems occur in sensory integration
children develop a tendency to avoid or reject simple sensory or motor challenges. Refusal or tantrums may occur when pushed to perform.
1st group of tests developed by Ayres. Later revised and renamed SIPT (sensory integration and praxis test). Measure aspects of visual, tactile, kinesthetic, and vestibular sensory processing and motor planning.
used to develop typology of sensory integrative dysfunction.
groups of associated test scores
use of factor analysis and this statistical technique led to development of groups of children with similar SIPT profiles, used to define diagnostic groups used today. Critical to interpretation of SIPT scores.
prinicple of ASI theory
patterns of sensory integrative problems represent neural dysfunction rather than developmental lag
1. visual and tactile perception with praxis 2. vestibular and proprioceptive processing with bilateral functions 3. attention and tactile defensiveness 4. visual and tactile discrimination
sensory integrative dysfunction, sensory integrative disorder, and sensory integrative problems
refers to a heterogenous group of problems that reflect subtle neural differences involving multisensory and motor systems, assumes that peripheral function is normal
3 main types of sensory processing disorders by Miller, Anzalone, Lane, Cermak, and Osten
sensory modulation disorder (overresponsivity, underreponsivity, and sensory seeking), sensory-based motor disorder, and sensory discrimination disorder
4 types defined by text
sensory modulation problems, poor sensory discrimination and perception, problems related to vestibular-prorioceptive functions, difficulties related to praxis
the tendency to generate responses that are appropriately graded in relation to incoming sensory stimuli (rather than to over or under react as in dysfunction)
Circular relationship of responses
child who is extremely defensive may be overloaded to the point of shutting down and become underresponsive
Dunn's 4 patterns of sensory responding
low registration, sensation seeking, sensitivity to stimuli, and sensation avoiding. 4 quadrants figure 11-9 pg 344
Miller's ecologic view
figure 11-10 includes internal and external dimensions affecting sensory modulation
sensory registration problem
difficulties of the person who frequently fails to attend to or register relevant environmental stimuli. May be overfocused on irrelevant stimuli.
underresponsive to incoming stimuli, seek large quantities of intense stimulation
hyperresponsive or sensory defensiveness includes tactile defensiveness, gravitational insecurity, and may include sound, odors, or tastes
charecterized by slow cautious movements, try to keep feet in contact with ground, avoids tilting head in different planes (especially backward), ability to play is seriously effected
different from gravitational insecurity, tend to slump posturally, not because of hypersensitivity to vestibular input but because they lacked adequate motor control to perform many activities without falling
impaired fine motor skills, associated with visual perception, hand-eye coordination problems, important for development of body scheme which becomes foundation for praxis
cannot be measured by standardized tests, appear clumsy and akward, with poor tactile perception they often rely on visual cues and cognitive strategies, seen with use of too little or too much force in activities, seek firm pressure to their skin or joint compression and traction
figure-ground perception, spatial orientation, depth perception, and visual closure; associated with problems with grasp, balance, locomotion, construction, and cognition. Low scores on visual perception does not necessarily indicate sensory intregration problem. May chose to work with child on other approaches like visual perception training, use of compensatory strategies, or skill training in specific activities.
involves motor functions that are outcomes of vestibular processing, seen with poor equilibrium reactions, low muscle tone especially of extensor muscles, slouching posture, poor postural stability, and difficulty keeping head upright
postural and bilateral integration
seen with vestibular processing problems includes low muscle tone, immature righting and equilibrium reactions, poor right-left discrimination, and lack of a clearly defined hand dominance
vestibular-bilateral integration disorder
depressed postrotary nystagmus scores, suggests inefficient central processing of vestibular function, poor bilateral coordination and difficulty sequencing actions
projected action sequences
child anticipates how to move as spatial relationship to environment changes
problems related to vestibular processing disorders
attention, organization of behavior, communication, and modulation of arousal