OCTH 5101 week 9 2024_ Sensory-Motor Control FOR
Sensory and Motor Frameworks for Occupational Therapy (OCTH 5101)
Week 9 - 2024
Instructor: Felicia Chew, MS, OTR/L, FAOTA
Page 2: Motor Control FOR
Reference: Cole MB, Tufano R. Applied Theories in Occupational Therapy: A Practical Approach © 2020 SLACK Incorporated.
Page 3: Theorists
Sensory Integration (Ayres, 1960’s)
Neurodevelopmental Theory (NDT) (Bobath, 1990)
Sensorimotor Approach (Rood, 1954)
Proprioceptive Neuromuscular Facilitation (PNF) (Knott and Voss, 1968)
Movement Therapy (Brunnstrom, 1970)
Page 4: Sensory Integration
Sensation impacts lived experiences.
Dysfunctions include:
Hypersensitivity
Tactile defensiveness
Vestibular issues
Postural control challenges
Page 5: Theoretical Base for Sensory Integration
CNS Neuroplasticity: The brain's ability to reorganize itself.
Staged Development: Development occurs in stages, with critical milestones.
Integrated Brain Function: The brain works as an integrated whole.
Adaptive Interactions: Engage with environment for sensory integration.
Inner Drive: Motivation to develop skills and behaviors.
Page 6: Sensory Integration Development Stages
Phase 1: Integration of tactile, vestibular, proprioceptive senses (1st year).
Phase 2: Establishing foundations for emotional stability and body perception (2nd year).
Phase 3: Incorporate auditory and visual inputs, purposeful activity (3rd year).
Phase 4: Dominance development through cooperation of brain and body (4-5 years).
Page 7: Function vs. Dysfunction
Function: Participation in self-directed activities.
Dysfunction: Responses to sensory stimuli—overreaction or underreaction.
Page 8: Evaluation - SIPT (Sensory Integration and Praxis Test)
Administration Time: ~2 hours for all tests; ~10 min for each test.
Methods: Norm-referenced, clinician-administered.
Subscales Include: Space Visualization, Figure Ground Perception, etc.
Requires specialist training in sensory integration.
Page 9: Intervention
Focus Areas:
Play
Equipment group dynamics
Sensory environments.
Page 10: Brunnstrom Approach
Emphasizes reflex modification in normal development.
Addresses dysfunction from CVA or brain damage.
Developmental Recovery Sequence: Progress from flaccidity to voluntary movements.
Page 11: Proprioceptive Neuromuscular Facilitation (PNF)
Balanced movement between antagonistic muscles.
Movement Progressions: Cephalocaudal, proximodistal.
Incorporation of natural movement patterns and goal-directed activities.
Page 12: Rood Approach
Initially for motor control issues (CP, etc.).
Movement emerges from subcortical reflex patterns.
Sensory stimulation impacts motor responses—either facilitory or inhibitory.
Importance of repetition in learning.
Page 13: Neurodevelopmental Therapy (NDT)
Objective: Restore skilled voluntary movements in individuals.
Focus on normal growth, motor milestones, and reflex hierarchies.
Recognizes various reflex types: primitive, righting, protective.
Page 14: Basic Assumptions of NDT
Motor control development is hierarchical:
Cephalocaudal,
Proximal to distal,
Gross to fine.
Children internalize movement sensations.
Stability must precede mobility.
Page 15: Philosophical Tenets of NDT
Treatment should be functionally oriented and integrative.
Evaluation and treatment are dynamic, collaborative processes.
Acknowledges the holistic nature of therapy and interdisciplinary cooperation.
Page 16: Function & Dysfunction in NDT
Functional motor control: Ability to perform voluntary skilled movements.
Dysfunctions include:
Lack of postural control,
Abnormal tone,
Sensory disturbances.
Page 17: Change & Motivation in Motor Learning
Change facilitated through techniques:
Handling,
Inhibition and facilitation.
Reflex-inhibiting patterns (RIPs).
Page 18: Evaluation and Intervention
Evaluation methods:
Observational assessment,
Collaborative goal setting.
Interventions focus on:
Functional movement practice,
Utilization of occupations as means and ends.
Page 19: Motor Learning and Task-Oriented Frames
Reference: Cole chapter 21.
Page 20: Motor Learning Theories
Integrated from various disciplines:
Psychology, neurology, behavioral sciences.
Focus on task performance as central to learning.
Page 21: Focus on Functional Movement
Aimed at a wide range of health conditions.
Emphasizes client-chosen meaningful tasks.
Page 22: Theoretical Base for Motor Learning
Grounded in:
Nonlinear science,
Neuroplasticity,
Social cognitive theory.
Page 23: Learning Theory Insights
Associative Learning: Procedural and declarative forms.
Nonassociative Learning: Habituation and sensitization principles.
Page 24: Function & Dysfunction Analysis
Continuum from function to dysfunction includes:
Cognitive, fixation, and autonomous stages.
Page 25: Change & Motivation Strategies
Learning through trial and error.
Importance of social and occupational motivators.
Page 26: Evaluation & Intervention Strategies
Holistic approach in evaluation and intervention:
Remediation,
Adaptation,
Compensation.
Page 27: Example Interventions
Weight Bearing Strategies
Aimed at normalizing muscle tone.
Use of dynamic reaching and forearm patterns.
Constraint-Induced Movement Therapy (CIMT)
Effective for stroke survivors.
Involves forced use of the affected limb with intense practice.
Page 28: Continued Example Interventions
Cognitive Orientation to Occupational Performance (CO-OP)
Targets children with motor-based learning challenges.
Focuses on skill acquisition, strategy use, and generalization.
Page 29: Cognitive Behavioral FOR Overview
Theoretical Foundations
Based on cognitive and behavioral theories; examines cognitive development levels.
Page 30: Behaviorism and Learning
Includes:
Operant and classical conditioning,
Learning as a process of behavior change focused on observable behaviors.
Page 31: Cognitive Behavioral FOR Constructs
Focus on:
Thinking influences behavior,
Behavior change via structured learning,
Populations served: Developmental disorders, neuro diseases, mental illnesses.
Page 32: Cognitive Behavioral FOR Function vs. Dysfunction
Evaluates cognitive abilities, social interaction skills, motivation, and stress management capabilities.
Page 33: Evaluation Techniques for Cognitive Dysfunction
Use of records, interviews, stress tests, and scales for analysis of cognition and behavior.
Page 34: Postulates on Change
Ongoing change linked to beliefs; useful with self-aware clients.
Page 35: Postulates on Intervention Techniques
Focused on psychoeducational and life skills groups, addressing self-regulation and critical thinking.
Page 36: Social Cognitive FOR Overview
Focus
Involves wellness, prevention, and social participation.
Page 37: Social Cognitive Concepts
Human agency, intentionality, and self-efficacy are central.
Page 38: Function & Dysfunction in Social Cognitive Theory
Emphasizes self-awareness and ability to manage health and achieve goals.
Page 39: Change & Motivation Principles
Explores the Transtheoretical Stages of Change (Precontemplation through Maintenance).
Page 40: Evaluation Techniques for Social Cognitive Framework
Informal behavioral analysis and creative media assessments.
Page 41: Intervention Strategies
Enhances self-identity and life goals through various therapeutic approaches, including Acceptance and Commitment Therapy.