Post on 01-Apr-2015
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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
5April 2010, Tanya O'Callaghan OTD, OTR/L & Amanda Saliba OTR/L
Sensory Input
Filter
InterpretationFeedback
Output response
Cognitive processes
proprioceptionhearing smell taste touchsight
Vestibular sensation
6April 2010, Tanya O'Callaghan OTD, OTR/L & Amanda Saliba OTR/L
HIGH
LOW
OPTIMAL AROUSAL
7April 2010, Tanya O'Callaghan OTD, OTR/L & Amanda Saliba OTR/L
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
8April 2010, Tanya O'Callaghan OTD, OTR/L & Amanda Saliba OTR/L
Interpreting behavioral responses
Establishing patterns of interaction in the environment
Evaluating functional outcomes related to activities of daily living
IDENTIFICATION OF SENSORY PROCESSING DYSFUNCTION
9April 2010, Tanya O'Callaghan OTD, OTR/L & Amanda Saliba OTR/L
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
10April 2010, Tanya O'Callaghan OTD, OTR/L & Amanda Saliba OTR/L
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?
11April 2010, Tanya O'Callaghan OTD, OTR/L & Amanda Saliba OTR/L
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
12April 2010, Tanya O'Callaghan OTD, OTR/L & Amanda Saliba OTR/L
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
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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
14April 2010, Tanya O'Callaghan OTD, OTR/L & Amanda Saliba OTR/L
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
15April 2010, Tanya O'Callaghan OTD, OTR/L & Amanda Saliba OTR/L
The organisation of sensory input to produce appropriate responses
Allows individuals to fully experience the environment
Relies on registration and modulation
INTEGRATION
16April 2010, Tanya O'Callaghan OTD, OTR/L & Amanda Saliba OTR/L
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
17April 2010, Tanya O'Callaghan OTD, OTR/L & Amanda Saliba OTR/L
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
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
23April 2010, Tanya O'Callaghan OTD, OTR/L & Amanda Saliba OTR/L
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
24April 2010, Tanya O'Callaghan OTD, OTR/L & Amanda Saliba OTR/L
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
25April 2010, Tanya O'Callaghan OTD, OTR/L & Amanda Saliba OTR/L
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
26April 2010, Tanya O'Callaghan OTD, OTR/L & Amanda Saliba OTR/L
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
27April 2010, Tanya O'Callaghan OTD, OTR/L & Amanda Saliba OTR/L
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
28April 2010, Tanya O'Callaghan OTD, OTR/L & Amanda Saliba OTR/L
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
29April 2010, Tanya O'Callaghan OTD, OTR/L & Amanda Saliba OTR/L
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
Case Study Example 2
31April 2010, Tanya O'Callaghan OTD, OTR/L & Amanda Saliba OTR/L
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
Case Study Example 3
32April 2010, Tanya O'Callaghan OTD, OTR/L & Amanda Saliba OTR/L
33April 2010, Tanya O'Callaghan OTD, OTR/L & Amanda Saliba OTR/L
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
34April 2010, Tanya O'Callaghan OTD, OTR/L & Amanda Saliba OTR/L