Exploring Health Equity/Intro to Disability Studies and Sensory Processing

What is one of the most reliable predictors of health?

Socioeconomic status (SES)

What are health disparities?

“preventable differences in the burden of disease, injury, violence, or opportunities to achieve optimal health that are experienced by socially disadvantaged people”

Social determinants of health have a major impact on?

people’s health, well-being, and quality of life

Social inequalities over the life course can?

accumulate and adversely affect health and occupational performance

What drives social inequalities?

chronic stress, poverty, SES

Intersectionality

gender, race, age, disability, sexual orientation, religion, and citizenship status

What is the OT’s role in addressing health disparities?

understand impact of early childhood life experiences

person-environment fit

learn about the people we serve

employ principles of occupational justice

Ableism

a set of beliefs or practice that devalue and discriminate against people with physical, intellectual, or psychiatric disabilities

Marginalization

treatment of a person, group, or concept as insignificant or peripheral

Stigma

a set of negative and unfair beliefs that a society or group of people have about something

What is the Social Progress Index?

how well a country provides for its people essential needs by measuring access to basic human needs, foundations of wellbeing, and opportunity

Disability Studies is an?

interdisciplinary field dedicated to the critical study of disability

Disability study models help to provide?

shortcuts for explaining phenomena

Medical and Rehab professionals tend to consider disability as an?

objective medical defect

Why do we talk about disability studies as OTs?

challenges the way we look and think about disability

don’t “own” disability

consider the way the models interact with our own understanding of disability

What is the Medical Model?

views disability as an individual, bodily impairment that should be fixed by medical treatment

The medical model suggests that a person should?

cure or minimize their physical and/or mental impairments in order to return to full participation in occupations

What is the Social model?

highlights the role of sociocultural and physical environment in creating many of the participation barriers

The social model explains that bodily and mental impairments are not?

inherently negative

Disability is not an individual issue, rather a?

political and social issue

What sensory system is Gustatory?

chemo/taste receptors and tactile receptors

What sensory system is Olfactory?

chemoreceptors

What sensory system is Tactile?

multiple kinds (pressure, stretch)

What sensory system is Visual?

photo/vision

What sensory system is Auditory?

sound waves…receptors (cochlea)

What are the three hidden senses?

proprioception, vestibular, interception

Proprioception

muscles, tendons, joints (static/dynamic)

detected body/parts position, direction, force, and velocity of motion

Vestibular

position and movement of head (lets you know that your body is moving)

detects pull of gravity, linear, angular, circular movement

Interoception

sensing from the internal organs (stomach — satiety, respiration, heartbeat)

awareness of body’s physiological state; information from internal organs

Sensory Processing

the “ability to take information in from the environment through our senses, organize and interpret that information, and create a meaningful adaptive response”

Sensory Processing Disorder

sensory input poorly detected, modulated, or interpreted atypical responses to sensory messages

What are the 3 phenotypes of SPD?

Sensory modulation disorder

Sensory based motor disorder

Sensory discrimination disorder

What are some factors that contribute to the etiology of SPD?

no specific identified cause

pre and postnatal stressors and neurodevelopmental difficulties

heredity, prenatal conditions, environment, perinatal complications

abnormal posterior white matter

low birth weight (< 4.5 Ibs)

prematurity (< 36 weeks)

Incidence and Prevalence of SPD

1 in 20 people of general population

5-16.5% school aged children

Incidence and Prevalence of SPD: Between ___ and ___ with neurodev. abilities

40% and 80%

Incidence and Prevalence of SPD: Between ___ and ___ of child with ASD

60% and 95%

Incidence and Prevalence of SPD: Between ___ and ___ of typically dev. children

2.8% and 6.5%

Sensory Modulation Disorder

Difficulty regulating and organizing external or internal sensory stimuli

What are the three subtypes of Sensory Modulation Disorder?

Sensory overresponsivity, sensory underresponsivity, and sensory craving

Sensory Overresponsivity

responses to stimuli that are more intense or have longer duration

avoidance, aggression, inflexibility, hyper vigilance

activation of the sympathetic nervous system

Sensory Underresponsivity

requires more intense and extended duration of sensory stimuli to reach optimal level of arousal

may appear lazy/unmotivated

difficulty with sustained performance

Sensory Craving

seek sensory input with an approach that results in erratic, disorganized behavior

often enjoys jumping, climbing, swinging, and twirling

need for “more and more” input

What are the subtypes for Sensory Based Motor Disorder

Postural disorders and dyspraxia

Postural Disorders

challenge processing of vestibular and kinesthetic input to maintain normal postural tone

smooth muscle control and endurance may be compromised

Dyspraxia

difficulty with motor planning

inability to plan unfamiliar or novel tasks

clumsy, awkward movements

Sensory Discrimmination

difficulty with qualitative processing of sensory stimuli

may impact processing of somatosensations

SPD Diagnosis/Evaluation: Behavior measures

sensory processing measure and sensory profile

interview based questionnaires (asking them about their experiences)

SPD Diagnosis/Evaluation: Sensory Integration and Praxis Test (SIPT)

used to be the Gold Standard

takes about 4 hours (break up in sessions)

SPD Diagnosis/Evaluation: EASI

Evaluation in Ayers Sensory Integration

How is SPD’s course across the lifespan?

may worsen without intervention

may improve with age

adults often develop compensatory strategies

SPD Treatment

using a sensory integrative approach that is occupation-based (child, family)

What are some possible medicines for SPD?

melatonin for poor sleep quality

methyplenidate may exacerbate sensory challenges