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FOUNDATIONS OF SI
INTRODUCTION TO SENSORY PROCESSING AND SENSORY INTEGRATION
| Term | Definition | Definition 2 |
|---|---|---|
| Different models focusing on sensory processing: | • Development models • Classification of disorders • Interventions | |
| • SI Theory is based on several disciplines: • Developed by Jean Ayres | ■ Neuroscience ■ Behavioral Sciences ■ Occupational Therapy Occupational Science | |
| CONCEPTUAL MAP | ● Ways to frame sensory processing (umbrella term) ● Strategies examples: sensory diets, snoezelen rooms, chewy necklace, decluttering | |
| KEY NEUROBEHAVIORAL AND ORGANIZATIONAL PROCESSES | ● Sensory processing: Unimodal, multimodal ● Sensory detection and sensory registration ● Sensory modulation ● Sensory discrimination ● Organization of behavior and executive functions | |
| Sensory processing: Unimodal, multimodal | ○ Daily life activities is usually multimodal ○ Ex: audio while listening to class, proprio in sitting for posture, etc. | |
| Sensory detection and sensory registration | ○ Detection: We only know if it is there or not there ○ Registration: Perception | |
| Sensory modulation | ○ Arousal ○ Emotional regulation | |
| Sensory discrimination | ○ Body schema ○ Praxis | |
| Organization of behavior and executive functions | ○ Everything above contributes to having this | |
| SENSORY PROCESSING | ● Overarching construct to summarize various neuronal interactions in the brain associated with incoming sensory signals from the environment or body and the subsequent responses resulting from that input | |
| SENSORY PROCESSING ● In SI Theory: | Detection, modulation, and integration of sensory input are components of sensory processing. | |
| SENSORY REGISTRATION ● In occupational therapy: | A behavioral orientation to sensory input, also defined as the ability “..to record or notice and respond to salient environmental information” | |
| SENSORY REGISTRATION ● In neuroscience: | Term not routinely used; instead use sensory detection | |
| sensory detection | the firing of one or more neurons in response to a single sensory event | |
| SENSORY REGISTRATION ● In behavioral science: | Conscious and non-conscious response to sensory events and subsequent behavior | |
| SENSORY INTEGRATION | ● The organization of sensory information for use | |
| Multisensory Integration ○ In Neurosciences: | Combination of unisensory inputs that produce greater neuronal responses than individual sensations alone | |
| Multisensory Integration ○ In Occupational Therapy: | Historically, used intersensory integration | |
| intersensory integration: | the combination of information from different sensory modalities, leading to enhanced perception | |
| AROUSAL | ● Physiological state of awareness/awakeness ● A state of responsiveness to sensory input ● A state of behavioral or physiological activation | |
| AROUSAL ● In SI: | Neural reactions linked to the detection of input activating the sympathetic nervous system | |
| AROUSAL ● In Neuroscience: | Process observable in an individual's response to sensory events, motor activity, and emotional reactivity → Fight or flight | |
| AROUSAL ● In behavioral sciences: | Linked to personality characteristics, anxiety, attention, behavioral responses | |
| AROUSAL ● Heterogenous process: | Wakeful arousal, autonomic arousal, and affective arousal | |
| How babies show arousal: 1st | ○ 1st: Crying, kicking, turning away, grimace, arched back, red skin tone, closed eyes → elevated arousal | |
| How babies show arousal: 2nd | ○ 2nd: Looking towards something/someone, hands in midline relaxed posture, flexed posture, skin tone more regulated, quiet alert state → lower arousal | |
| SENSORY MODULATION ● In occupational therapy: | The excitatory and inhibitory functions of the central nervous system (CNS) in response to incoming sensory signals (Ayres, 2005) | |
| SENSORY MODULATION ● In neurosciences: | Term not routinely used; instead use neuromodulation | |
| neuromodulation: | physiological process by which- nerve activity is regulated (Katz & Calin-Jageman, 2009) | |
| SENSORY MODULATION | ● Requires filtering of sensory information ● Linked to arousal level (may be too low or too high) ● Contributes to self-regulation | |
| Filtering: | "Ability to process relevant sensory information and exclude irrelevant/distracting sensory information" | |
| self-regulation | ○ Ability to monitor one’s own behavior | |
| SELF-REGULATION | ● Complex construct describing an interplay between performance, stress, internal and external sensory events, and multimodal CNS activity (Mayes, 2000) | |
| According to Martini (2016) in occupational therapy, | it is linked to: Sensory strategies to control the level of alertness/arousal, sensory processing, and sensory integration intervention | |
| SELF-REGULATION ● In behavior sciences: | Observable behaviors linked to behavior, emotions, social competence, psychopathology, cognition, and executive functions | |
| SELF-REGULATION ● Brazelton’s Neonatal Behavioral Assessment: | Habituation, orientation, motor, range of state, regulation of state, autonomic stability, and reflexes | |
| Behavioral states: | Quiet sleep, active sleep, quiet alert, active alert, crying, drowsiness | |
| SENSORY SEEKING | ● Often seen in conjunction with hyporesponsiveness, with sensory regulation, with typical development, or with stress ● May be many different reasons for why children seek out different kinds of sensory experiences | ● May have adaptive purposes ● In assessment, the OT needs to consider WHY sensory seeking behavior may be happening |
| Vestibular input: | Child in a jumper, going up and down. Child riding on a zipline. | |
| Tactile input: | Child lying on dried corn | |
| Proprioceptive input: | Child hanging from a tree from shoulders and arms | ○ In all these cases, the search for sensory input is typical. The children are regulated, they are seeking input as a fun activity that they enjoy. |
| RESPONSE TO SENSORY INPUT | ● We start with an isolated input, the response can either be registered or not registered. | |
| E.g. if a bug lands on your hand, you can notice that it’s there or not notice. ○ If registered: | input needs to be modulated/filtered, if not modulated, the person will respond with a flight, fight, or freeze (FFF) autonomic nervous system response. If this happens repeatedly, a person may present with behavioral and emotional regulation issues. | |
| E.g. if a bug lands on your hand, you can notice that it’s there or not notice. ■ If modulated: | it also needs to be discriminated from other information so it can be used to produce an appropriate response. If the person can’t discriminate, they may present motor performance and organizational issues. | |
| E.g. if a bug lands on your hand, you can notice that it’s there or not notice. ○ If NOT registered or needs more intensity to be registered: | depending on a person's sensory system, their arousal can be impacted. ■ Underresponsiveness in all systems can result in motor performance and behavioral organization diffi culties. ■ No way for you to be able to interact with input. | |
| SENSORY DISCRIMINATION ● In occupational therapy: | Refers to interpreting and giving meaning to sensory information. Often linked to the development of motor skills and praxis | |
| SENSORY DISCRIMINATION ● In neuroscience: | Refers to the central nervous system’s neuronal response properties. Often linked to the identification of cellular and molecular functions | |
| SENSORY DISCRIMINATION ● In behavioral science: | Sensory perception refers to the act of giving meaning to detected sensations. Often linked to cognitively-mediated responses | |
| Discrimination: | where it is and what it is | |
| Perception: | what it means for you | |
| SENSORY DISCRIMINATION | ● Discrimination includes detection and recognition ● Linked to attention, cognition and memory ● Related to CNS processes of distinguishing between organizing temporal and spatial characteristics of sensory stimuli | |
| Detection: | Ability to discriminate between a positive stimulus and a null stimulus | |
| Recognition: | Ability to distinguish btwn diff stimuli | |
| Body Schema: | Internal sensorimotor representation of the body — used to guide movement ○ Not the same as body Image | |
| Body percept | - perceptual judgement abt body | |
| Body concept | - conceptual judgement abt body | |
| Body affect | - emotional judgement abt body | |
| proprioceptive and tactile | body schema as postural schema dependent on ______________________ input | |
| Postural Schema: | Cont. update representation of body in space, depending on proprioceptive signals. Also referred to as body schema. | |
| Body image: | thoughts and feelings of your body being positive or negative (emotional level) | |
| BODY SCHEMA ● In Sensory Integration Theory: | In Sensory Integration Theory: ○ Sensory-motor map of physical self ○ Product of intersensory integration of visual, tactile, vestibular, and proprioceptive information ○ Important contributor to motor planning | |
| BODY SCHEMA Key brain structures: | thalamus and parietal lobe | |
| PRAXIS ● In Adult Neuroscience: | ○ “Praxis is the ability to plan and perform skilled movements using a movement scheme based on stored complex representations and previous learned movements” | |
| PRAXIS ● In Pediatrics, some think that: | ○ Developmental Coordination Disorder and Dyspraxia should be considered the same | |
| PRAXIS ● In Sensory Integration Theory: | ○ An intelligence of doing (Ayres, 1985) ○ Cognitive processes of ideation and motor planning | |
| Ideation: | Ability to conceptualize a novel action, generate an idea of WHAT to do | |
| Motor planning: | Ability to organize a novel action, know HOW to do it or the organization of action in space and time | |
| ORGANIZATION OF BEHAVIOR | ● An executive function ● Ability to organize actions in the present time and space as well as in the future time and space | |
| PROCESSING SENSORY INFORMATION ● Impacted by: | ○ CNS functions ○ Environment ○ Genetic make up | |
| DEVELOPMENT OF THE SENSE OF TOUCH ● Importance: | Motor control and emotional development | |
| DEVELOPMENT OF THE SENSE OF TOUCH ● Contributes to: | ○ Primitive reflexes: Rooting, sucking, grasping ○ Emotional development: Bonding ○ Body scheme and motor skills ○ Oral motor skills ○ Hand skills ○ Protection (not protective reactions) | |
| DEVELOPMENT OF THE SENSE OF TOUCH | ● Embedded in different layers of skin, allowing specific touch sensations ● Tactile input on leg leads to child looking up ● Thumb sucking for regulation, emotional regulation | |
| PROPRIOCEPTIVE SYSTEM | ● Enables awareness of body position ● Regulates direction and amount of force during active movement ● May contribute to self-regulation | ● “Tells the brain when and how the muscles are contracting or stretching, and when and how the joints are bending, extending, or being pulled or compressed. This information enables the brain to know where each part of the body is and how it is moving“ |
| DEVELOPMENT OF THE SENSE OF BODY POSITION AND MOVEMENT ● Importance: | Modulation of sensations (contributes to emotional regulation) and discrimination (motor control) | |
| DEVELOPMENT OF THE SENSE OF BODY POSITION AND MOVEMENT ● Contributes to: | Discrimination and localization of body parts in space, grading the force of the contraction, timing of the movement, feedback from active motor responses | - internalization of movement patterns, postural reactions, proximal joint stability, hand functions, oral motor control |
| VESTIBULAR SYSTEM - CONTRIBUTOR TO THE SENSE OF MOVEMENT AND GRAVITY | ● Detects head movement through space ● Integrated w/ proprio and vision to regulate balance ● Able to detect their position in relation to gravity ● Adjust body position to prevent falling or swinging from the rope | |
| VESTIBULAR SYSTEM - CONTRIBUTOR TO THE SENSE OF MOVEMENT AND GRAVITY ● Importance: | Emotional stability, postural control, motor coordination | |
| VESTIBULAR SYSTEM - CONTRIBUTOR TO THE SENSE OF MOVEMENT AND GRAVITY ● Contributes to: | ○ Establishing a bond with mother earth ○ Postural control and ability to assume different positions against gravity ○ Muscle tone, mainly antigravity extensor tone ○ Coordinated use of both sides of the body ○ Compensatory eye movements | |
| OLFACTORY AND GUSTATORY SYSTEM | ● Caregiver-infant bonding ● Protection from noxious substances ● Attraction to potentially nurturing substances | |
| VISUAL SYSTEM ● Bonding | ○ Caregiver and child | |
| VISUAL SYSTEM ● Spatial orientation | ○ Understand what other objects are in our environment or how close or far it is from us | |
| VISUAL SYSTEM ● Movement through space | ○ Can’t avoid running into something if we can’t see it | |
| VISUAL SYSTEM ● Social skills | ○ Read one another faces or body language | |
| VISUAL SYSTEM ● Communication | ○ Raising of eyebrow, changing facial expressions | |
| AUDITORY SYSTEM ● Language development | ○ And communication with others | |
| AUDITORY SYSTEM ● Spatial orientation | ○ Being able to locate where sounds are coming from | |
| AUDITORY SYSTEM ● Modulation | ○ Calming music can help bring arousal down | |
| Vision | = info about distant stimuli via light waves, facilitating spatial orientation and social communication | |
| Audition | = info about distant stimuli via sound waves, facilitating spatial orientation and language development | |
| Olfaction | = protective chemoreception, and experience-based identification of objects & substances (e.g., food flavor, caregiver-infant bonding) | |
| Gustation | = detection and seeking or rejection of specific substances (e.g., sodium, carbohydrates, toxins) | |
| Audition (hearing) | → pitch, loudness, timbre | |
| Vision (sight) | → color, form, movement | |
| Olfaction (smell) | → quality (e.g., floral, fruity) | |
| Gustation (taste) | → quality (e.g., sweet, sour, salty, bitter, savory) | |
| Touch | → temperature, pressure, movement | |
| WHAT IS SENSORY INTEGRATION? | ● A process in the brain ● A theoretical framework for understanding human behavior originated by A. Jean Ayres | ● A clinical framework for evaluation and intervention originated by A. Jean Ayres and continued by other researchers. Sometimes referred to as Ayres Sensory Integration (ASI). |
| SENSORY INTEGRATION ● Includes: | ○ Models of sensory development ○ Classifications of disorders ○ Interventions | |
| A PROCESS IN THE BRAIN | ● Sensory integration occurs at multiple levels of the nervous system ● Ability to organize sensory information for use: Umbrella term encompassing many CNS processes | ● Involves CNS processes of modulation and perceptual organization (neurotransmitters and neuromodulators) ● Neuroscientists use of term “multisensory integration” |
| convergence | Axons from a number of different neurons terminate on one neuron | |
| divergence | axons of one neuron terminate on many neurons | |
| A THEORETICAL FRAMEWORK OF SI Founder: | Jean Ayres ○ Neuroscientist, clinician, researcher, teacher | |
| A THEORETICAL FRAMEWORK OF SI | ● A theory that provides an understanding of human behavior | |
| A THEORETICAL FRAMEWORK OF SI ● SI defined as: | “The neurological process that organizes sensations from one’s body and from the environment and makes it possible to use the body effectively in the environment” A.J. Ayres, 1989 | |
| Teacher: | Mentored many OT clinicians, teachers and researchers | |
| Clinician: | Invented most of the basic SI equipment used today by occupational therapists (OTs) | |
| Researcher: | ○ Used test development to develop theory ■ SIPT (Sensory Integration and Praxis Tests) ○ Published some of the earliest treatment effectiveness studies in occupational therapy (OT) | |
| SENSORY INTEGRATION | “The spatial and temporal aspects of input from different sensory modalities are interpreted, associated, and unified. Sensory integration is information processing... | The brain must select, enhance, inhibit, compare and associate the sensory information in a flexible, constantly changing pattern: in other words, the brain must integrate it.” |
| IMPACTS ON OUR CHOICES OF OCCUPATIONS | ● Sensory experiences must be organized and interpreted in order to participate in occupations | |
| SENSORY INTEGRATION INTERVENTION? | ● A clinical framework for intervention based on the work of A. Jean Ayres ● Systematic assessment to identify specific patterns of SI problems & strengths ● Intervention aimed at improving SI capacities through active engagement by the child | |
| SENSORY INTEGRATION TREATMENT | ● Occupational therapy is the third most often utilized intervention with children with ASD in the USA (after Speech and Language Therapy and “Other”) | ● In the “Other” category, sensory integration was the third most often utilized intervention (15.46%) after social skills and academic support |
| ASSUMPTIONS OF SI THEORY | 1. SENSORY NOURISHMENT: SENSORY INPUT IS REQUIRED FOR HEALTHY BRAIN FUNCTION 2. DEVELOPMENTAL PROCESS 3. ADAPTIVE ENVIRONMENTAL INTERACTION 4. EXISTENCE OF THE INNER DRIVE AND INTRINSIC MOTIVATION 5. NEUROPLASTICITY | |
| SENSORY NOURISHMENT: SENSORY INPUT IS REQUIRED FOR HEALTHY BRAIN FUNCTION | ● Sensory deprivation experiments: Use it or lose it! ● Proximal sensory systems ○ Vestibular ○ Tactile ○ Proprioceptive | ● Certain types of sensory input are especially infl uential for: ○ Regulation of arousal and attention ○ Formation of attachment and social relationships ○ Organization of actions in the physical world |
| DEVELOPMENTAL PROCESS | ● More complex behaviors rely on the foundation provided by more simple behaviors; development is a spiraling process and sensory integration follows a developmental sequence. | ● Normative data show that children’s scores on standardized tests of SI are almost equivalent to adults’ by age 7. ● SI → adaptive response → increased SI → more complex adaptive response |
| first 7 years of life | Ayres believed that the ______________ is a period of rapid development of sensory integration. | |
| ADAPTIVE ENVIRONMENTAL INTERACTION | ● A successful environmental interaction both promotes sensory integration, and is evidence of sensory integration | |
| Adaptive responses: | Successful responses to environmental challenges | ○ Drive development forward – each AR lays the groundwork for more complex integration ○ May occur in the motor, cognitive, language, or social-emotional areas ○ No challenge = no adaptive response |
| REQUIREMENTS OF AN ADAPTIVE RESPONSE | ● Environment that presents sensory information ● Challenges to child that are neither too great nor too small (just right challenge) ● Sensory integration within the child | ● Motivation to meet challenge that comes from the child ● Organization of a response that meets the challenge |
| EXISTENCE OF THE INNER DRIVE AND INTRINSIC MOTIVATION ● Inner Drive: | A drive towards development develop sensory integration is apparent in people | |
| EXISTENCE OF THE INNER DRIVE AND INTRINSIC MOTIVATION ● Intrinsic Motivation: | Motivation emerges from the satisfaction and enjoyment derived from performance and not from extrinsic rewards | |
| NEUROPLASTICITY | ● Potential for brain structure or function to change as a result of experience ● Represents the biological basis for development, learning, and recovery from brain injury ● Occurs throughout the lifespan, but is especially robust in young organisms | |
| ● SI is based on several principles of brain function | ○ Neuroplasticity ○ Response and transmission of sensory events occurs at different levels ○ Integration ○ Feedback | |
| Neuroplasticity: | Ability of the nervous system to undergo changes in structure and function | |
| Response and transmission of sensory events occurs at different levels: | Neuronal transmission, system organization | |
| Integration: | Coordination of different types of input leads to higher-order functions (e.g., cognition, motor control) | |
| Feedback: | Experience shapes the behaviors and sensations associated with it | |
| IMPORTANCE OF ADAPTIVE RESPONSES IN NEUROPLASTICITY | ● Neurological structures have the potential for change as results of experience. ● Changes in organization that occur throughout life in response to normal as well as abnormal conditions | |
| THE BRAIN FUNCTIONS AS A WHOLE | ● “Low level" central nervous system functions are important (lay the foundation) for "higher level" central nervous system functions. | |
| MOTIVATION-CHALLENGE-SENSORY EXPERIENCE AND THE ENVIRONMENTAL AFFORDANCES | ● Sometimes the issue is not a problem in sensory integration but a mismatch between the person and the environment | |
| EVIDENCE BASE FOR SENSORY PROCESSING DISORDERS | ● Began with Ayres’s research in the 1960s-1980s | |
| EVIDENCE BASE FOR SENSORY PROCESSING DISORDERS ● Sensory Modulation Disorders | - arousal ○ Tactile defensiveness ○ Gravitational Insecurity | |
| Gravitational Insecurity | - poor modulation of vestibular input | |
| EVIDENCE BASE FOR SENSORY PROCESSING DISORDERS ● Sensory Discrimination Disorders | - discrimination ○ Began with the development of a standardized visual perception test, then expanded to a published set of sensory integration tests ○ Challenges with motor planning and praxis | |
| SENSORY REGISTRATION DISORDERS | ● Less studied ● Sometimes included with modulation problems - arousal ● Sometimes included in discrimination problems | |
| RESEARCH PROCESS FOR IDENTIFYING TYPES OF DYSFUNCTION | ● Ayres collected data on children with and without learning problems using standardized tests and quantified observations ● Analyzed data using techniques such as factor analysis to identify tests that are associated with each other | ● Results of analyses were used to construct and revise sensory integration theory ● Other researchers have used parent questionnaires to identify patterns of sensory processing |
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avemaria