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Sensory
Integration
Sensory
integration is the ability to take in information through the senses of
touch, movement, smell, taste, vision, and hearing, and to combine the
resulting perceptions with prior information, memories, and knowledge
already stored in the brain, in order to derive coherent meaning from
processing the stimuli.
The
mid-brain and brain stem regions of the central nervous system are early
centers in the processing pathway for sensory integration. These brain
regions are involved in processes including coordination, attention,
arousal, and autonomic function. After sensory information passes through
these centers, it is then routed to brain regions responsible for
emotions, memory, and higher level cognitive functions.
Sensory Processing Disorder
Classifications
There
are now three types of Sensory Processing Dysfunction, as classified by
Stanley I. Greenspan as supported by the research of Lucy J. Miller,
Ph.D., OTR. These new terms are meant to increase understanding between
Occupational Therapists and other professionals who frequently encounter
SID and physicians and other health professionals who approach sensory
integration dysfunction from a more neurobiological vantage.
Sensory
Processing Dysfunction is being used as a global umbrella term that
includes all forms of this disorder, including three primary diagnostic
groups:
-
Type
I - Sensory Modulation Disorder
-
Type
II - Sensory Based Motor Disorder
-
Type
III - Sensory Discrimination Disorder
Type
I - Sensory Modulation Disorder (SMD).
Over, or under responding to sensory stimuli or seeking sensory
stimulation. This group may include a fearful and/or anxious pattern,
negative and/or stubborn behaviors, self-absorbed behaviors that are
difficult to engage or creative or actively seeking sensation.
Type
II - Sensory Based Motor Disorder (SBMD).
Shows motor output that is disorganized as a result of incorrect
processing of sensory information.
Type
III - Sensory Discrimination
Disorder (SDD). Sensory discrimination or postural control challenges
and/or dyspraxia
seen in inattentiveness, disorganization, poor school performance.
This
information is adapted from research and publications by: Lucy, J. Miller,
Ph.D., OTR, Marie Anzalone, Sc.D., OTR, Sharon A. Cermak, Ed.D., OTR/L,
Shelly J. ,Lane, Ph.D, OTR, Beth Osten, M.S,m OTR/L, Serena Wieder, Ph.D.,
Stanley I. Greenspan, M.D..
Sensory
modulation
refers to a complex central nervous system process by which neural
messages that convey information about the intensity, frequency, duration,
complexity, and novelty of sensory stimuli are adjusted.
Behaviorally,
this is manifested in the tendency to generate responses that are
appropriately graded in relation to incoming sensations, neither under reacting
nor overreacting to them.
Sensory
Modulation Signs
-
Sensory
registration problems - This refers to the process by which the
central nervous system attends to stimuli. This usually involves an
orienting response. Sensory registration problems are characterized by
failure to notice stimuli that ordinarily are salient to most people.
-
Sensory
defensiveness - A condition characterized by over-responsivity in one
or more systems.
-
Gravitational
insecurity - A sensory modulation condition in which there is a
tendency to react negatively and fearfully to movement experiences,
particularly those involving a change in head position and movement
backward or upward through space.
(Case-Smith,
(2005)
Sensory
Based Motor Disorder
Praxis is the
ability to conceive, organize and carry out a sequence of unfamiliar
actions. Many people with Learning
Disabilities have Dyspraxia or Motor
Planning Dysfunction. You may be familiar with apraxia in association with
aphasia. This is the situation when a person is physically capable of
performing the action (automatically) but cannot do it on command
(voluntarily). This is the same thing that happens when a person has Stage
fright – you know all the lines, but as soon as you have to perform in
front of that audience, you forget everything!
Sensory
Based Motor Signs
-
Difficulty
learning new motor skills
-
Anxiety
in Physical Education Class
-
Difficulty
catching or throwing a ball
-
Has
not developed hand dominance
-
Difficulty
using both hands together
-
Difficulty
learning to ride a bike
Several
therapies have been developed to treat SID. At Capital Kids Occupational
Therapy, our state of the art clinic, includes specifically designed areas
and equipment that provide children with fun, just right challenges to
introduce new sensory experiences and assist them with modulation, motor
planning, timing skills, and core muscle development.
During
the session, the therapist works closely with the child to provide a level
of sensory stimulation that the child can tolerate, and encourage movement
within the room. Sensory integration therapy is driven by four main
principles:
-
Just
Right Challenge (the child must be able to successfully meet the
challenges that are presented through playful activities)
-
Adaptive
Response (the child adapts his behavior with new and useful strategies
in response to the challenges presented)
-
Active
Engagement (the child will want to participate because the activities
are fun)
-
Child
Directed (the child's preferences are used to initiate therapeutic
experiences within the session).
-
Therapeutic
Listening
Sensory Integration Therapy
All of the information we receive about the world comes to us through our sensory systems. Many sensory processes take place within the nervous system at an unconscious level, therefore we are not usually aware of them. Although we are all familiar with the senses involved in taste, smell, sight and sound, most of us do not realize that our nervous system also senses touch, movement, force of gravity, and body position. Just as our eyes detect visual information and relay it on to the brain for interpretation, all sensory systems have receptors that pick up information to be perceived by the brain. Cells within the skin send information about light touch, pain, temperature, and pressure. Structures within the inner ear detect movement and changes in the position of the head. Components of muscles, joints, and tendons provide awareness of body position.
There are seven senses that form the foundation of sensory integration, they are: visual, auditory, touch, smell, taste, vestibular (pull of gravity) and proprioception (body awareness and movement). These senses give us information about both our external environment and our internal environment. Our brain uses this information to form a composite picture of who we are physically, where we are, and what is going on around us. Sensory integration is the critical function of the brain that is responsible for producing this composite picture. Sensory integration is the foundation that allows for complex learning and behavior.
The Sense of Touch is critical in helping us to function in daily life. It makes it possible to locate a flashlight in a drawer when the lights have gone out. Tactile sensation also plays an important role in protection from danger.
The Sense of Movement is registered and coordinated through the vestibular sense. It coordinates the movement of one’s eyes, head, and body. It helps maintain muscle tone, coordinating the two sides of the body & holding the head upright against gravity.
The Sense of Body Position is registered through the sense of proprioception, which is closely related to the vestibular sense. It is proprioception that makes it possible for a person to skillfully guide his arm or leg movements without having to observe every action In therapy, your child will be guided through activities that challenge his or her ability to respond appropriately to sensory input by making a successful, organized response. Activities will provide vestibular, proprioceptive and tactile stimulation and are designed to meet your child’s developmental needs. Emphasis is placed on automatic sensory processes in the course of a goal-directed activity, rather than instructing or drilling the child on how to respond. Home programs are individually designed for each child for the family to assist with progress.
When this approach is successful, your child will automatically process complex sensory information in a more effective manner than previously. Very often, parents report that their child seems to be better put together, more self-assured and better organized.
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