sensory integration and sensory processing disorder

what is sensory integration therapy (SI)

address sensory processing and the motor and perceptual impairments of children w/ learning disabilities

What is motor learning dependent on

• ability to properly take in sensory information from our environment and mvmt of our bodies

• process this input w/ in or CNS

• use the information to plan and produce organized mvmt

Why is sensory processing disorder so difficult to dx

it is not a recognized dx on the DSM-5

• is clumped in w/ ASD

What can SI therapy addresss

1. motor dysfunction linked to impairments in motor planning, postural control, or sensory discrimination

2. related behavioral problems w/ attention or emotions

common behavioral problems

• distractibility

• impulsivity

• disorganization

• anxiety

• aggression

• tantrum behaviors

• tactile defensiveness

Who will typically identify behavior issues first

teachers

define modulation

ability to regulate information int he interest of generating an appropriate response to specific stim

parts of modulation

• habituation

• sensitization

define habituation

behavioral response that involves a decrease in attention and response to a stim after repeated exposure

What is considered the simplest form of learning by the CNS

habituation

Why is habituation so important

so we can screen out familiar sensations to focus on something else

define sensitization

heightened sensitivity to environmental and social stimuli

how does sensitization work

the CNS recognizes the stim and important/alarming/potentially harmful creating a heightened repsonse

define threshold

continuous interchange between habituation and sensitzation

What makes a threshold high

habituation

What makes a threshold low

sensitization

What are the presentations of poor modulation

• overly excitable/hyperactive

• overly lethargic/ inattentive

describe high threshold

takes a lot to through your body into alert mode

describe low threshold

easily startled, difficulty w/ filtering out background noise

What occurs if you pass your modulation threshold

behaviors begin

What are the 4 basic patterns of response to everyday sensory events

• sensation seeking

• low registration

• sensation avoiding

• sensory sensitivity

define senation seeking

• high neuro thresholds

• active self regulation strategy

define low registration

• high neuro thresholds

• passive self regulation strategy

define sensation avoiding

• low neuro thresholds

• active self regulation strategy

define sensory sensivitivity

• low neuro thresholds

• passive self regulation strategy

what category are sensory seekers

sensory seaking

what category are bystanders

low registration

what category are avoiders

sensation avoiding

what category are sensors

sensory sensitivity

describe sensory seekers

• very active, continuously engaging and excitable

• risk taking behaviors

When do sensory seekers become problematic

when they cannot participate in expected daily activities

how can we help sensory seekers

increase intensity of daily sensory experiences so the child does not have to stop engaging in daily life to get the extra sensory input they desire

describe bystanders

• appear uninterested, self-absorbed, and dull in affect

  • “easy-going”

When do bystanders become problematic

child does not notice things happening in their environment and misses cues that might guide their behaviors

how can we help bystanders

increase intensity of sensory input to improve the chance of noticing and responding to environment

describe avoiders

• often bothered by input more than others

• rule-bound, ritual driven, uncooperative

• create routine and order to have “sameness” to reduce unanticipated sensory input

When are avoiders problematic

child is presented w/ situations of unanticipated unput

• unable to organize and understand input when unprepared

how can we help avoiders

decrease sensory experience around them so they dont become overwhelmed

describe sensors

• detect more input than others

• appear distractible, hyperactive

• complainers

• very discerning and detect errors/patterns that others miss

when do sensors become problematic

child notices more sensory events than others do and comment about them w/ regularity

• allow things to happen and complain rather than removing themselves

how can we help sensors

provide more structured input, so that the individual does not become overwhelmed in everyday life

What are the 7 senses

• vision

• smell

• taste

• tactile

• hearing

• proprioception

• vestibular

What are the 2 groups of senses

far and near

describe far senses

response to external stimuli that comes from outside our body

describe near senses

response to what is happening inside out bodies

What are the far senses

• smell

• taste

• vision

• hearing

• basic touch

What are the near senses

tactile

proprioceptive

vestibular

define proprioception

unconscious awareness of body position

how does proprioception work

receptors in mm and joints tell us about the position of body parts, their relation to each other, and their relation to other people/objects

purpose of proprioception

help us grade our mvmts

develop motor planning skills

screen out uncomfortable sensations

What other sense does proprioception work closely w/

vestibular

describe hyposensitivity for proprioceptive dysfunction

• bumps/crashes into objects and people

• risky mvmts that provide intense sensory input

describe hypersensitivity for proprioceptive dysfunction

appears weak and is resistant to participating in heavy work activities

How does proprioceptive dysfunction present

• poor body awareness and motor skills

• difficulty playing ball, riding bike

• messy handwriting

describe the vestibular system

provides information about mvmt, gravity, and changing positions through receptors within our ears

how does the vestibular system work

• fluid moves through semicircular canals, utricle, saccule

  • hair cells detect the fluid changes creating a response to environment

what systems work closely w/ vestibular

auditory and visual

describe hypersensitivity for vestibular dysfunction

• overreacts to mvmt

• fearful w/ any change in position

• “gravitationally insecure”

describe hyposensitivity for vestibular dysfunction

• craves mvmts

• unable to sit still

• always on the go

• difficulty registering mvmt

• “risk taker” or “dare devil”

• poor attention span

how does the tactile system work

receives information about touch from receptor cells throughout our body in the skin

purpose of tactile system

protective

discriminative

body awareness and motor planning

describe the protective role of tactile system

alerts us when something is potentially harmful

describe the discriminative role of tactile system

lets us know what type of sensation we are feeling

describe hypersensitivity for tactile dysfunction

excessively registers tactile input and is hesitant to touch objects necessary for task completion

What are some of the triggers for tactile hypersensitivity

tags in clothes

getting messy

describe hyposensitivity for tactile dysfunction

requires intense tactile input and may have delayed response

what are some concerns for tactile hyposensitivity

safety concern

may not feel painful stim

What is the best sensory input to use to dampen tactile hypersensitivity

proprioception (deep pressure)

What program is used for testing/training vestibular system

astronaut program

What protocol is great for sensory integration for tactile dysfunctions

Wilbarger protocol

purpose of auditory system

sends information about sounds in the environment to the brain for interpretation

What categories can sound be interpreted into

calming or alarming

what are categorized as alarming sounds

loud, quick, unpredicable

what are categorized as calming sounds

slow, rhythmic sounds

describe hypersensitivity for auditory dysfunction

hears everything (not able to filter out unnecessary sounds)

easily distractable

frequently covers ears

describe hyposensitivity for auditory dysfunction

does not respond to input

appears to ignore others

delayed rxns

define therapeutic listening

electronically modified music to highlight the parts of the sound spectrum that naturally capture attention and activate body mvmts

describe visual system

send information to the brain about objects or people in the environment

purpose of visual system

know boundaries

know where we are in environment

know how to navigate environment

what are alerting visual stim

bright, bold colors

bright lighting

what are calming visual stim

soft, natural colors

pastels

dim lighting

describe hypersensitivity for visual dysfunction

• sensitive to busy rooms, bright lights/fluorescents

• dislike clutter

• wear sunglasses/tinted lenses

describe hyposensitivity for visual dysfunction

possibly visually impaired

may need enlarged font or increased contract

define visual acuity

sharpness of vision

when is visual acuity development crucial

first 6 mo

what are disorders that affect visual acuity

near/far sighted

glaucoma

cataracts

optic n damage

cortical vision impairments

field cuts

define visual efficiency

effectiveness of the visual system to clearly, efficiently, and comfortably allow an individual to gather visual information in all environments

what are some disorders that affect visual efficiency

accommodation disorder

binocular vision disorder

eye mvmt disorders

define accommodation disorder

interfere w/ any activity that requires concentration on small objects or print at a close distance

define binocular vision disorder

ability to fuse R and L eyes to form 1 image causing constant or intermittent double vision or eye strain

what are some binocular vision eye positions

esotropia

exotropia

hypertropia

define esotropia

eyes turn in

define exotropia

eyes turn out

define hypotropia

eyes turn down

define hypertropia

eyes turn down

define eye mvmt disorders

eye mvmts that interfere w/ individuals ability to process visual information

When do eye mvmt disorders develope

elementary years

list the eye mvmt disorders

fixation

saccadic

pursuits

nystagmus

define fixation disorder

ability to keep eyes still, maintain visual gaze on a single location is interupted

define saccadic disorder

ability to quickly and accurately shift from 1 target to another is disrupted