13663165 sensory integration therapy new

7/29/2019 13663165 Sensory Integration Therapy New

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Sensory Integration Therapy Some Aspects

Sadhana P. Joshi

Head O.T. Department C.O.H.


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Introduction

Definition

Sensory Integration is defined as a neurological process that organizes

sensation of ones own body and the environment in the brain to makeadaptive response and makes it possible to use the body efficiently withinthe environment.

Sensory Integration function will include the awareness, discriminationand recognition of sensory stimuli from the environment and from theC.N.S and use of this sensory information to direct motor behaviour.

Background

S.I. Therapy was conceived and developed by Dr. Jean Ayers anOccupational Therapist and psychologist. It explains the relationshipbetween behaviour and neural function, especially sensory processes andintegration.

It describes and predicts relationship among neural functioning, sensorymotor behaviour and academic learning.


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Sensory Integration (Figure 1)

Input

Feedback/ PreviousExperience

Sensory

Stimuli

AdaptiveResponse

Output

CNS Integration


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Figure 2


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Assumption of Sensory Integration

a. Neural PlasticityPlasticity refers to the ability of brain to modify and change from 2 to 7

years of age.

b. Occurs in developmental sequencesc. Brain functions as an integrated whole though it consists of parts that are

hierarchically arrangedd. Adaptive response

Requires the child to organize the sensation, accurately judge therequirement of the situation and execute response completely.[Controlled sensory input can be used to elicit adaptive response.]

Adaptive response contribute todevelopment of S.I

Motor ability is a powerfulorganizer of sensory inputs.

e. Inner driveChild has inner drive to develop S.I. through participation in sensory

motor activity.


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Sensory Integration and Praxis test (SIPT)

Sensory Integration and Praxis test (SIPT) includes:

a. Tactile and vestibular proprioceptive sensory processing test

i. Kinesthesia

ii. Finger identification

iii. Graphesthesia

iv. Localization of tactile stimuli

v. Post rotatory Nystagmus

vi. Standing and walking balance

b. Form and space perception and visio-motor coordination test

c. Praxis Test

i. Design copying

ii. Constructional praxis

iii. Postural praxis

iv. Praxis on verbal commands

v. Sequential praxis

vi. Oral praxis


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Sensory Integration and Praxis test (SIPT)

d. Bilateral integration and sequencing test

i. Oral praxis

ii. Sequencing praxis

iii. Graphesthesia

iv. Bilateral motor coordination

v. Space visualization

vi. Contralateral and preferred hand use

e. Bilateral motor coordination

Requires the child to imitate smoothly executed movements of hand andfeet after they are demonstrated by examiner. Reciprocal interaction ofright and left are used.


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Signs and symptoms reflecting sensory integrativeroot problems

Signs and symptoms reflecting sensory integrative root problems:

Tactile sensitivity (Hyper)a. Express distress during grooming

b. Prefers long sleeved clothing when it is warm and short sleeved when it iscold.

c. Avoid going barefoot especially sand or grass.

d. React emotionally or aggressively to touch.

e. They desist from splashing water.f. Has difficulty standing in line or close to other people.

g. Rub or scratch out a spot that has been touched.

Movement sensitivity (Vestibular)

a. Become anxious or distressed if feet leave the ground.

b. Fear of falling or height.

c. Dislike activities if head is upside down (e.g. somersaults)

Taste/ Smell sensitivity

a. Avoid certain tastes or food smell

b. Limit self to particular food, texture or temperature.


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Auditory filtering

a. Is distracted or has trouble functioning if there is lots of noise aroundb. Appear to not hear what you say

c. Cant work with background noise

d. Has trouble completing task when the radio is on

e. Has difficulty paying attention

Low energy / Weak motor signs

a. Seems to have weak muscle

b. Tires easily

c. Has a weak grasp

d. Cant lift heavy objects

e. Poor endurance

f. Poor handwritingg. Problem in tying shoe laces

h. Poor sense of rhythm

i. Poor A.D.L

j. Articulation problem in speech


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Visual / Auditory sensitivity

a. Prefers to be in the darkb. Responds negatively to unexpected sound or bright lightc. Holds hands over ears to protect ears from soundd. Watches everyone when they move around the roome. Becomes frustrated when trying to find object in competing background

(e.g. cluttered drawer / shoes from rack)f. Difficulty in puzzles

Emotional and Behaviourala. Low self esteem, lack of self confidence, insecure, frustrated, irritable,

moody, aloofb. Self injury, temper tantrum, No peer relationship, impulsive, aggressivec. Resistant to change and stubbornCognitive / Academica. Attention problems, distractible, cannot refocus, lazy, slow, forgets

assignments/ directionb. Poor organization, sequencing and memory

Development Dyspraxia is a brain dysfunction that hinders theorganization of tactile and sometimes vestibular and proprioceptivesensation and interferes with ability to motor plan.


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Central Principles of Therapy

Central idea of this therapy is to provide and control sensory inputespecially the input from the vestibular system, muscles and joints andskin in such a way that a child spontaneously forms the adaptiveresponses that integrate those sensations.

Sensory integration occurs when a child spontaneously plans and executesa successful adaptive response to sensory input (e.g. reaching for anobject)

Child must actively participate with the environment to improve theorganization of his nervous system.

Therapist designs an environment that enables the child to interact moreeffectively than has ever done before. Therapist must encourage, cajole,lure and manipulate the child into choosing the activities that will help hisbrain develop. She cannot organize the childs brain for him. He must do ithimself, but it is evident that he cant do without her help.


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Direct Treatment ActivitiesDirect treatment activities to assist adaptation to sensory sensitivity

(Tactile processing) include-

a. Application of heavy pressure / Joint compression

b. Brushing

c. Localization of touch

d. Work with tactual modalities Lotion paint, beans, rice, clay, foam

e. Water play

f. Rolling on textured surface

g. Swimming

Perception of proprioception plus modulation of high activity leveland hypersensitivity through use of heavy work

a. Increase weight of object

b. Use of heavy weight pattern (pushing, pulling and stabilizing)

c. Jumping with impact

d. Carrying heavy object

e. Use of resistive activity

f. Riding equipments which require muscle activation

g. Climbing activities ropes, ladder, ramps.


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Treatment of vestibular processing-a. Graded experience in movement through mobile surface e.g. Swing or

scooter board

b. Graded experience in use of vision to perceive moving target and flowc. Stabilizing postural control activities which facilitates head, neck and

extensor controld. Incorporate visual motor activities which assist the child to stabilize their

gaze, localize object shift between visual frame of references, track andscan their environment while moving.

Treatment of arousal-

a. Quality of sensory information can shift level of arousal.b. Taste and smell

i. Salt, Sour, bitter, hot taste Alertingii. Sweet and warm Relaxingiii. Citrus, smoke Alertingiv. Vanilla Relaxing

c. Oral motor

i. Sucking Calmingii. Blowing, chewing, licking Arousingiii. Crunchy food Alertingiv. Smooth food Calming


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d. Touch may be calm or alerti. Light touch Alertingii. Deep pressure Organizing and centering

iii. Temperature can increase or decrease the awarenessiv. Cool temperature Alertingv. Warm temperature Calming

e. Movementsi. Fast movement Alertingii. Slow movement Relaxingiii. When body moves in space with orient head in difference plane Alerting

iv. Horizontal position conductive to sleepv. Vertical Alert

f. Visuali. Subdued and dark environment Relaxingii. Bright light Alertingiii. Open space, subdued colors Calmingiv. Changing and moving visual information can increase alerting response

g. Soundi. Speech pattern, rhythm, sing-song pattern help children organize

themselves. Sound can be hypnotic, amusing, relaxing as well as alerting andexcessively stimulated.

ii. All sensory motor information can alert nervous system depending on modeof delivery, quality of information, context and state in which it is delivered.


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Sensory Integrated Equipmentsa. Tactile Equipments Different pillows, rugs, textures, sand pit, water poolb. Non suspending moving equipments Balls, barrels, tilt-boards, jumping

board.c. Hanging equipments Hammocks, platform swings, suspended ladders.d. Motor planning equipment Variety of obstacles, Jungle gym etc.

ConclusionSensory Integration approach is having a. Non cognitive emphasisb. Flexible sequencesc. Exploration and creativityd. Childs controle. Therapist guidedf. One to one inter-reactiong. Improve brain processing

h. Suspended equipment mandatory.


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Thank You

13663165 sensory integration therapy new

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