Assessment of Sensory Processing

Lecture Info from a Lab Day!

Dr. A Jean Ayres

the originator of sensory integration theory, assessment, and treatment.

Dr. A Jean Ayres Belief

believed that practice of SI by an OT should take place only at the postgraduate level; SI theory and treatment are extremely complex although the activities appear easy because they are playful in nature.

Sensory Processing

the means by which the brain receives, detects, and integrates incoming sensory information for use in producing adaptive responses to one’s environment.

Sensory Processing Dysfunction

causes a cluster of symptoms that are believed to reflect a problem in the central nervous system processing of sensory input rather than a primary sensory deficit such as hearing or visual impairment.

Sensory Integration Frame of Reference

the provision of controlled sensory input, through activities presented by the therapist, to elicit adaptive responses from the child, thereby bringing about more efficient brain organization.

Sensory Processing Dysfunction (w other diagnoses)

children with this disorder often have a primary diagnosis; there is a range of levels of severity from mild to severe exist.

Signs and Symptoms - Babies

lack of cuddling behavior, failure to make eye contact, oversensitivity to sound or touch, difficulty with oral-motor demands of suckling and chewing food; poor self-regulation of arousal states, irritability, and colic.

Signs and Symptoms - Toddler

the motor, social, and self-care milestones may be delayed; may lack curiosity or may explore the world in a disorganized and destructive manner.

Signs and Symptoms - Preschool

unable to organize the body postures and gestures for nonverbal communication, continued delays in self-care; handle toys ineptly, constantly damaging or breaking them.

Signs and Symptoms - School Aged

difficulty with sitting at a desk, paying attention in class, reading, listening, using writing and art tools, and interacting with peers; avoid fine and gross motor activities, prefer sedentary activities.

OT/OTA Role for Screening/Assessment of Sensory Processing

the OTA may be trained to physically administer a number of sensorimotor screening test or structured assessments; the interpretation of the results should be performed by the OT.

Five Major Areas for Sensory Processing Eval

sensory modulation, perceptual discrimination ability, postural-ocular function, bilateral motor coordination (including organization at and across the midline of the body), and praxis.

Sensory Systems

tactile, vestibular, proprioceptive, visual, auditory, olfactory, and taste.

Praxis

the ability to internally visualize and plan skilled or unfamiliar movement actions.

SIPT

Sensory Integration and Praxis Test; include measures of vestibular, proprioceptive, and somatosensory processing; visual perceptual and visuomotor integration; integration between the two sides of the body; and praxis.

Praxis Portion of SIPT

includes postural imitation, motor planning in response to a verbal request, motor sequencing ability, imitation of oral movement, graphic reproduction and three-dimensional block construction.

The Sensory Profile

measures the child’s responses to sensory experiences as well as perceived movement competence by means of the parents’ report; there is also a School Companion Questionnaire along with this.

Sensory Modulation Disorder

sensory experiences that are so distorted that everyday sensations are uncomfortable, painful, frightening, or surreal in nature.

Normal Sensory Modulation

a regulatory process of the nervous system that controls the perceived INTENSITY of incoming sensations through the raising and lowering of neuronal thresholds to that sensory input.

Sensory Modulation Disorder Examples

over intensified would create an intolerance of such stimuli as clothing, food textures, imposed touch, and household noises; under intensified would make it to where they would not notice stimuli in their environment.

Sensory-Based Movement Disorder

refers to both postural system disorganization due to poor vestibular and proprioceptive processing and impairments of complex midbrain or cortically controlled internal visualization and motor planning.

Postural-Ocular and Bilateral integration Dysfunction

milder in severity; identified by atypical ocular pursuits, convergence and visual fixation, low duration of post rotary nystagmus, slow or irregular vestibular response to tilt, sluggish postural preferences for inactive positions and sedentary activities, impairments in midline crossing and delayed establishment of lateral dominance after age 4.

Postural-Ocular and Bilateral integration Dysfunction - Responses

poor protective, righting, and equilibrium responses during movement, immature gait patterns - results in poor ability to read across a page, copy from the board, cross body midline, poor posture due to low muscle tone, poor fine motor skills.

Dyspraxia

a neurological disorder that affects an individual’s ability to plan and process motor tasks.

Developmental Dyspraxia - 1st Major Process Involved

the ability to register and organize tactile, proprioceptive, vestibular, and visual input in order to assemble accurate internal cognitive maps of the body and environment with which the body typically interacts.

Developmental Dyspraxia - 2nd Major Process Involved

requires the ability to conceptualize internal images of purposeful action termed ideation.

Developmental Dyspraxia - 3rd Major Process Involved

the planning of sequences of movements within the demands of the task and environmental context, including the ability to program anticipatory action within the next few seconds.

Impairment in Praxis

can occur anywhere within its chain of events.