1 building blocks for development understand the basic principles of sensory processing understand...

SENSORY PROCESSING

BUILDING BLOCKS FOR DEVELOPMENT

Understand the basic principles of sensory processing

Understand the components involved in sensory processing

Understand the benefits of addressing sensory needs

Considerations in assessment and treatment

LEARNING OBJECTIVES

3April 2010, Tanya O'Callaghan OTD, OTR/L & Amanda Saliba OTR/L

WHAT IS SENSORY PROCESSING?

IT IS THE USE AND SYNTHESIS OF RAW DATA YIELDINGCOMPLEX BEHAVIOR AND LEARNING

INFORMATION GATHERED FROM ALL SENSORY CHANNELS IS REGISTERED, PROCESSED AND INTERPRETED BY THE BRAIN IN ORDER TO MAKE SENSE OF THE ENVIRONMENT ALLOWING AN INDIVIDUAL EFFECTIVE AND SUCCESSFUL INTERACTION IN THE ENVIRONMENT

SENSORY PROCESSING


Sensory Input

Filter

InterpretationFeedback

Output response

Cognitive processes

proprioceptionhearing smell taste touchsight

Vestibular sensation


HIGH

LOW

OPTIMAL AROUSAL


Sensory processing disorders impact many areas of a child’s emotional and physical functioning

47% did not go through the “terrible two’s” or did so late

37% have a brief or absent crawling phase 33% have strong positioning preferences as

infants 32% have sleep problems 31% have feeding problems 28% were hesitant/delayed going down stairs

NORMAL DEVELOPMENT


Interpreting behavioral responses

Establishing patterns of interaction in the environment

Evaluating functional outcomes related to activities of daily living

IDENTIFICATION OF SENSORY PROCESSING DYSFUNCTION


Inclusion in DSM V as a separate condition

Comorbid condition inherent in other diagnoses

Current research looking at physiological and neurological impact as a result of SPD

SENSORY PROCESSING DISORDER


Patterns over time Specific triggers can be identified Problems with

Attention and behavior Social skills or self-esteem Play Skills Fine,/gross/oral motor skills Daily living skills (i.e. eating or dressing) Sleep/ eating/ elimination

SENSORY OR BEHAVIOR?


REGI STRATI ON OF SENSORY I NPUT: VI SUAL AUDI TORY OLFACTORY GUSTATORY TACTI LE VESTI BULAR PROPRI OCEPTI VE

MUSCLE TONE REFLEX

INTEGRATION

Sensory motor skills

MODULATION DISCRIMINATION

POSTURAL CONTROL

BODY SCHEME

POSTURAL SECURITY LATERALITY

MOTOR PLANNING

Perceptual motor skills

COORDINATION OF MOVEMENT

OCCULAR MOTOR CONTROL

MIDLINE CROSSING

BILATERAL INTEGRATION

SPATIAL PERCEPTION

AUDITORY-LANGUAGE

SKILLS

SOCIAL INTERACTION

SKILLS

EMOTIONAL EXPRESSION

SENSORY INTEGRATION

COMPLEX, ADAPTI VE BEHAVIOR I NCLUDI NG LANGUAGE AND COMMUNI CATI ON, ACADEMIC LEARNI NG AND I NTEGRATED SKI LLS


REGISTRATION OVER MODULATION /

DEFENSIVENESS

MODULATION

INTEGRATION

Decreased

postural tone

Poor balance

Uses too much

force

Craves

movement

Clumsy

movements,

drops things/

knocks things

over

Mouths things

Distractible

Over active

Hypervigilance

Unpredictable

emotional

outbursts

Avoidance

behaviors

Resistance to

participation in

activities

Unusual eating

behaviors

Poor sleeping

patterns

Distractibility

Hyperactivity or

hypoactivity

Fidgety

Upset by change

Take time to

repsond

Seeking

behaviors

Shutdown or

complete

withdrawal

Poor motor

planning

Poor sense of

body

Poorly controlled

motor responses

Impaired bilateral

co-ordination

Poor

generalization of

skills

Impaired visual perception and motor control Dyspraxia

problem in regulating responses to sensory

input

problem in recognizing/ interpreting the qualities

of stimuli

UNDER MODULATION/

DORMANCY

Sensory Processing Problems

problem in regulating responses to sensory

input

13

Process of taking in and filtering incoming information

Over registration- allows too much information to pass through the filter

Hypersensitive, hypervigilant

Under registration- too little information is allowed to pass through the filter

Hyposensitive, decreased awareness of self and surroundings

REGISTRATION


Process of regulating behavioural responses to be proportionate to the stimuli

Allows flexibility and adaptability to environmental demands

Over modulation / defensiveness- increased responsiveness to sensory input

Under modulation / dormancy- decreased responsiveness to sensory input

MODULATION


The organisation of sensory input to produce appropriate responses

Allows individuals to fully experience the environment

Relies on registration and modulation

INTEGRATION


Use knowledge of normal development, neurological constructs and development, behavior and sensory processing.

Influence the nervous system by providing sensory input and facilitate processing and integration through play and activities of daily living

Influence, adapt or change the environment to meet the needs of the sensory system

Utilize the power of the vestibular and somatosensory (tactile and proprioceptive) systems

INTERVENTION


THERAPY PROCESSAchieved throughdevelopmental activities graded according

to functional abilityStructuring and activity modificationStrategies and techniques grounded in

neuro-development and sensory motor exploration

PLAY - the work of a child

What parents can expect

Fully functional at birth, sensitive system effects of input can last up to 48 hrs

Respond to gravity, motion and changes in direction of movement

Impacts balance, bilateral motor control, reciprocal movement, arousal level, occular motor control, aspects of language development

VESTIBULAR SYSTEM


Tactile and proprioceptive stimuli, first system to respond and most mature at birth

First means of environmental interaction, basis for reflex activity

Protection (spinothalamic) Discrimination (light touch, kinesthesia,

vibration)- timing and sequencing influencing feed forward responses

Basis for body schema and body awareness Essential for grading and coordinating

movement Significant influence on calming and

organizing of sensory system

SOMATOSENSORY SYSTEM


For the individual

Maintenance of an optimal arousal levelMaintenance of a state of well being Improve tolerance of a variety of stimuliDecrease fear and anxietyPrevent episodes of extreme behaviourAllow for learning and appropriate

interaction in the environment

The benefits of addressing Sensory Needs


For families and Service Providers

Reduce the need to manage extreme behaviour

Decrease the incidence of injuryOptimize the opportunity of

participation and learning Increase spontaneous interaction Increase positive interaction Improve morale through the experience

of successful outcomes

The benefits of addressing Sensory Needs


Stage 1 Observation within the natural environment

Stage 2 Data collection

Stage 3 Establish patterns of behaviour

Stage 4 Problem solve the incorporation of appropriate sensory

strategies

Stage 5 Monitor and adapt for ongoing needs

Addressing Sensory Processing Needs


How does the child respond to sensory input?◦ Arousal level (band of arousal)◦ Adaptive responses (obvious, subtle)◦ How are the systems interacting◦ What sensory demands are we making

Changes over timeTake time and allow time to notice

responses

CONSIDERATIONS


Sensory profile – interpretation gained from interview, compared to clinical observations

Clinical Observations (structured/ unstructured)

Charting behavioral responses over time SIPT (4 yrs +) Sensory Processing Measure Standardized testing (motor skills)

ASSESSMENT TOOLS


3 Year old male

Diagnosed with Autism

Received birth to three services

Significant sensory processing difficulties

Case Study Example 1

April 2010, Tanya O'Callaghan OTD, OTR/L & Amanda Saliba OTR/L

2 year 7 month old girl

Significant history of reflux

Feeding issues

Sensory processing issues

Began OT services in October 2009



6 year 3 month old girl

Diagnosed with Left Hemiplegia

Motor and sensory processing concerns

Began receiving OT services at 10 months

of age

Focus initially was NDT, however sensory

difficulties affected motor development



Ayres, J.A. (1979). Sensory Integration and the Child. Los Angeles, CA Western Psychological Services.

Case- Smith, J. et. Al. (2005) Occupational Therapy for Children (5th Ed). St. Louis, MO: Mosby Publishers

Fischer, A; Murray, E; & Bundy, A. (1991). Sensory Integration: Theory and Practice. Philadephia, PA: Davis Company

Hanshu, B (1997). Autism and Attention Deficit Disorder/ Hyperactivity: A sensory perspective. Phoenix, AZ: Developmental Concepts

Kranowitz, C.S. (1998). The out of sync child. New York, NY:

Berkley publishing group

Shellenberger, S. & Williams, M. (1996). How does your engine run? A leaders guide to the alert program for self-regulation. Albuquerque, NM: Therapy Works, Inc

References


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