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FOUNDATIONS OF SI
1.2: INTRODUCTION TO SENSORY PROCESSING AND SENSORY INTEGRATION
| Term | Definition | Definition 2 |
|---|---|---|
| DUNN’S (1997, 2014) MODEL | Relates sensory reactivity to hypothesized neurological processes | |
| Neurological Threshold for Sensation ● High (habituation) | Consistent w/ threshold (passive response) ● Poor registration Counteracts threshold ● Sensory seeking | |
| Neurological Threshold for Sensation ● Low (sensitization) | Consistent w/ threshold (passive response) ● Sensory defensive Counteracts threshold ● Sensation avoiding | |
| Neurological Threshold continuum ● HIGH | ● Brain acts in accordance with threshold ● PASSIVE ● Low registration ● Sensory sensitive | |
| Neurological Threshold continuum ● LOW | ● Brain counteracts threshold ● ACTIVE ● Sensory seeking ● Sensory avoiding | |
| High threshold: | needs a lot of sensation from the environment | |
| Low threshold: | they pick up a lot of sensory information that most people ignore, experiences a lot of registration in their environment | |
| Poor registration: | unaware of a lot of stimulation in their environment | |
| Sensory sensitive: | ? | |
| Sensory seeking: | actively seeking sensation need to meet the high threshold | |
| Sensation avoiding: | actively avoiding activities that produce sensations that are difficult for them to handle | |
| MILLER ET AL. (2007) | Characterizes a lot of what we see in ,,,, | |
| Sensory modulation disorder - | ||
| Sensory Discrimination - | difficulty when or when a person has been touched, discrimination between textures | |
| Sensory-Based motor disorder - | ||
| BARANEK (2001) OPTIMAL ENGAGEMENT BAND | ● In order to actively engage in our environment, we have to be noticing sensory input ● Ex: calling your name, can’t be too loud enough to reach your orientation threshold | ● Top line (aversion threshold) ● Be intense to orient, but not too intense that it becomes aversive |
| Top line (aversion threshold) | - so intense that it becomes negative | |
| BUNDY & LANE (2020) | ● Brian regions ● Represents ,,, | |
| Brian regions | - most primitive to most complex ○ Involved in the sensory dysfunctions that we see | |
| SENSORY PROCESSING DISORDERS BY AUTHORS | ● Seeking sensation is an active process because the person might receive a lot of sensation if they are passive but to seek it out it must be active ● Lays out who the researchers are in some of the patterns in sensory processing | ● Possible that a person has a high neurological threshold for one system and a low neurological threshold for a different system |
| Dunn, 1997, 2014 | Modulation/ Responsivity ● Sensory Seeking* ● Sensory Sensitivity ** ● Sensory Avoiding ** ● Registration*** | |
| Miller, et al., 2007 | Modulation/ Responsivity ● Sensory overresponsivity ** ● Sensory underresponsivity*** ● Sensory seeking/craving* Sensory-Based Disorders ● Dyspraxia Postural Disorders | Discrimination and Perception (SI and Praxis) ● Visual, Auditory, Tactile, Taste/Smell, Proprioception, Movement/vestibular |
| Bundy, Lane, & Murray (2002) Bundy & Lane (2020) | Modulation/ Responsivity ● Overeactivity (aversive/defensive reactions)** ● Underreactivity (poor registration)*** ● Fluctuating reactivity | Discrimination and Perception (SI and Praxis) ● Poor Postural-Ocular ● Disorders Poor ● Visual-Motor ● Performance Poor ● Body-Percept |
| SENSORY INTEGRATION PATTERNS OF DYSFUNCTION | ● If it's not impacting their daily function we do not consider it as a problem ● Registration and discrimination of sensory input impacts perception and motor control ● Mild discrimination problem | |
| Vestibular underresponsive | - lower arousal ○ Vestibular input is very important for arousal level | |
| Deficits in vestibular or/and proprioception = | bilateral integration deficits | |
| Tactile + Proprioceptive difficulties = | Somatodyspraxia | |
| Visual + tactile difficulties = | Visuodyspraxia | |
| SENSORY INTEGRATION PATTERNS OF DYSFUNCTION EVALUATION BASED ON ● Observations: | Structured and non structured | |
| Structured Observations | - asking a child to do a specific task then watching how they do it | |
| non structured Observations | - giving the child a free range of the environment ■ Observing in school, at playground, in clinic, etc ■ To see the quality of their movement, the sensations they gravitate towards and avoid | |
| SENSORY INTEGRATION PATTERNS OF DYSFUNCTION EVALUATION BASED ON ● Questionnaires/interviews: | Caretakers and teachers ○ To get a better idea on how a child functions in their daily life (24 hours rather than just the one hour we see the child) | |
| SENSORY INTEGRATION PATTERNS OF DYSFUNCTION EVALUATION BASED ON ● Standardized assessments: | Designed to collect sensory processing and/or sensory-motor information | |
| SENSORY INTEGRATION PATTERNS OF DYSFUNCTION EVALUATION BASED ON ● Clinical reasoning | ○ Gathering pieces of evidence on all these modes of evaluation and use clinical reasoning to interpret what the cx needs | |
| IMPORTANCE OF SENSORY INTEGRATION AND PRAXIS TEST (SIPT) | ● Published in 1989 ● 17 standardized, computer scored tests measure visual skills, bilateral integration, sequencing, praxis and vestibular-proprioceptive functions | |
| PURPOSE OF SIPT ● Clinical Use: | ○ Evaluation ○ Outcome Measure | |
| Outcome Measure | ■ Sensitive to change to child’s sensory processing so can be used either way | |
| PURPOSE OF SIPT ● Research tool | ○ Defined patterns of dysfunction: Factor Analysis, Cluster Analysis, Descriptive ○ Factor analysis was replicated in several studies with similar results | |
| PURPOSE OF SIPT | ● Psychometrically strong to support research in SI ● Figure ground perception ● Somatopraxis ● Both visual and somatodyspraxia | |
| Figure ground perception | - associated with visual praxis | |
| Somatopraxis | (Tactile.. To support feedback motor planning) | |
| both visual and somatodyspraxia | - studies are consistent | |
| PREDICTIVE VALIDITY RELATED TO ACADEMIC ACHIEVEMENT | ● Students who are having difficulty with SIPT tend to have difficulty in academic performance and participation in school ● Parham, L. D. (1998). The relationship of sensory integrative development to achievement in elementary students | ● SIPT scores not intended to predict response to treatment (will child benefit) |
| Parham, L. D. (1998). The relationship of sensory integrative development to achievement in elementary students: | ○ Strong association of sensory integration, especially praxis to arithmetic achievement | |
| SENSORY INTEGRATION AS A THERAPEUTIC FRAME OF REFERENCE ● Historical themes in Ayres’s work ○ Occupational therapy: | Focus on purposeful behavior and everyday activity | |
| SENSORY INTEGRATION AS A THERAPEUTIC FRAME OF REFERENCE ● Historical themes in Ayres’s work ○ Educational psychology: | Perceptual-motor treatment approaches, funding for research and treatment of learning disabilities | |
| SENSORY INTEGRATION AS A THERAPEUTIC FRAME OF REFERENCE ● Historical themes in Ayres’s work ○ Neuroscience: | Brain plasticity as the physiological basis of behavioral development | |
| SENSORY INTEGRATION AS A THERAPEUTIC FRAME OF REFERENCE ● Historical themes in Ayres’s work ○ An early pioneer in translational science, Ayres was in private practice while doing research | ■ Using research to help in clinical practice and vice versa ■ Ayres had a lot of historical themes together that help chain together every theory she used | |
| SENSORY INTEGRATION AS A THERAPEUTIC FRAME OF REFERENCE ● Ayres’ goal: | To help children by synthesizing and applying knowledge of nervous system development | |
| BASIC PRINCIPLES OF INTERVENTION IN SI | ● Sensory Integration Intervention is not the same as: ○ Perceptual-motor programs ○ Listening programs ○ Floortime or DIR programs ○ Sensory protocols (Wilbarger brushing, Astronaut program) ○ Group programs such as Alert Program | ○ These can be good in using in tandem with SI but they are not the same ● Result of sensory experience paired with the highest level of their adaptive response ● SI intervention |
| Group programs such as Alert Program | ■ Mix of sensory processing and top down cognitive processing | |
| SI intervention | - using sensory experiences then expecting adaptive response | |
| Perceptual-motor approaches | ○ Sessions are pre-planned and directed by the therapist ○ Activities are drilled to teach skills, usually in a group context ○ Focus of treatment is on motor execution ○ Setting resembles classroom model with repetitive drills | ■ Didactic learning experience ■ SI - more child led |
| Neuro-motor approaches | ○ Activities are planned and directed by the therapist ○ Focus of treatment is motor execution, but may not involve organization of whole-body movements in space | |
| Floor time | ○ Focus of treatment is on social relationships ○ Individual SI intervention is viewed positively as an adjunct treatment | ■ Be helpful to build therapeutic alliance then becomes a foundation to SI intervention |
| Sensory stimulation | ○ Non-contingent sensory stimulation is provided, with no adjustment for adaptive responses ○ Stimulation may not occur in the context of a meaningful activity | ■ Willbarger protocol, passive on part of child ■ Less opportunity to choose the challenge themselves in different experiences |
| Behavioral approaches | ○ Use extrinsic rewards or avoidance of punishment to elicit response ■ Ex: fav snack, access to fav toy, taking a break ■ Using rewards or avoidance to get specific response | ○ Child's ability to organize a novel response is not a goal ○ Goals emphasize specific behaviors over generalizable abilities |
| The decision to combine SI intervention with other models of treatment | is often influenced by differences in professional background or theoretical orientation. | |
| VIDEO EXAMPLES ● Child feet’s touching the grass – crying, using one foot to balance – it’s aversive | ○ Not typical for age, tactile defensiveness | |
| VIDEO EXAMPLES ● Sasha touching inside of pumpkins | ○ Tactile defensiveness ○ Grimacing, wiping hands to shirt right after, “yuck”, “i can’t” ○ Motivation to touch: external verbal cues, relationship w/ mom | ○ Current arousal level is ELEVATED but there’s no crying, screaming ■ She’s avoiding the tactile input so she can keep her arousal level optimal - cognitive control |
| VIDEO EXAMPLES ● Sasha household sensory problems | ○ Vacuuming - defensive to auditory system | |
| VIDEO EXAMPLES ● Touching the same spot he touched while his vision is occluded (Touch localization) | ○ By 4-5 years old, we expect them to be able to localize touch to a certain degree | |
| GROUNDED IN RESEARCH | ● Factor Analytic Studies and other descriptions of sensory processing issues ● Research on traditional SI (with fidelity measures) ● Research on Sl intervention (without fidelity measures) | ● Research on sensory strategies applied to the community ● Research on combined approaches |
Created by:
avemaria