@ SENSORY INT GRATION © Scusory Intepration is thks opyar We lean A sensation by the brain for use everyday ) ¥ Sensory int an inn:e neurobiological proce and refers to the integration by the h stimulation {1 cuvironny © Sort Integration is necessary for organization of behaviours and adapt to various demands and situats * Sersory Integration enabies infants to expiore near and far environment, ,__ Develop skills to engage in self-care, Play, school activities, social skills and self. “«laGon of emotions and arousal, Unders nding of sel Who am I? ihe ean do? iVheat is environment? Why it is like this? What is my capability with respect to environment? Y Child development is a process of adaptation of skilis developed inside utero, child uses mainly the body-centered senses — tactile, Proprioveption, vestibular with other senses for understanding of self und environment, Sensory Integration pr uses on these three senscs ~ tactile, Propriocepiion, and vestibular, Y Their interconnections start forming before birth and continue to develop as the tures racts with his/her environment, Interaction with environment comes on adaptive responses, which drive the development forward. Adaptive response is a suecesstll response fo environmental challenge, - (Ayres, 1979) ‘The motivation to meet challenge comes from within the child, Altending challeng es the behaviour (or) the adaptive response, which in tum leads to beiter Sensory Integration via neuroplasticily, ‘curoplasticity is the potential for the brain to change aya rosult of experience,gg ene C VISION _{ aupitory ‘(a onc | _— ~ | TASTE (GESTATORY) ft TACTILE ‘VESTIBULAR PROPRIOCEPTION SENSORY SYSTEM Contributions Tactile System © Primitive reflexes like Rooting, Sucking, Grasping, Body scheme. © Bonding with mother, caregiver. © Oro-molor skills, hand manipulation skills, motor planning skills. - (Ayers, 1979) Vestibular system © Emotional security in response to movement and gravity, postural tone, postural responses enabling the mastery of gravity. Coordinated use of both sides of the hody. Ability io project one’s own action sequences in space and time, — (Fisher, 1991) © Maintenance of sible visual field, Troprincee System Righting of body parts to midline maintaining alignment. Discrimination and localization of body parts in space, grading the force of contractions in muscles, timing of movement — (Fisher, 1991) Feedback to brain aboul active motor responses and joint positions © Hand functions and oro-motor control °- a pausyean _ aue (Sunny 8?) ») i ™\, anup aonpes J™ “| a Nom op imp smouRypg, i a J} a = pauapsuans ) are (Gunquup 3) é v eaup 29nped \ emp sMOUTY ae N AIOIT], SALI JO MALAIOAQ UYYS WVVUE eee YUUULEULELECEEEY Sensory Integration Dysfunction is « disorder it. which sensory input is not intograted appropriately in the brain and may provide varying degrees of problems in development, information processing und behaviour - (Cindy — Rasonnesen) : Dr. A. Jeun Ayres developed his theory of sensory integration based on olinival work and studies in the Neuroscicnoes. 4 Visual perveplual problems und tactile discrimination problems. + Sensory modulation disorders ~ under or over responding lo sensory stimuli — under responsiveness because of poor registration of sensory stimuli, cither passive or sensory seeking — oscillate between both extremes — over/hyper responsiveness — tactile defensiveness — gravitational insecurity 4 Praxis disorders — Dyspraxia (difficully in conceptualizing and planning of motor actions) — Links with wolile anid visual perceptual problems (Somalo dyspraxia, Visuo dyspraxia) ~ Bilateral Integration and Sequencing (V-P) Assesment methods © Observation (formal and informal) Engage in play Clinical observation © Parénts/ Teachers Questionnaires. @ Standardized assessments — SIPT Generali Goai % To provide chiid with sensory information which helps organize the c %& To assist child in modulating sensory information. * To assist child in organizing a better adaptive response to the challenges in the environment.. ae a & \ ~a ~~ petctiton yt a fe ' ‘ <\. ¥; % a wa nde marlong W : Found \ Ww Peeve? beugocy J { \ N TOUNAATOU a DenGOrY JWEsiaN ion - News q W March - April 1999 ‘ Volume 1, no. 2 a ice / ae eee Kiddies Rehab International website launched te a © Kiddies Rehob Inter- {y,iteare very proud to announce that you foundering wat itis impasse ds nationals website & a see aren eat on, able to vow oven eid ae Cereals ines ee Jaunchedi ational Foundation on {3 to make you familar withthe subje Ree aire eoctsatto: nib” Pease do be careful when you teat achid © Roxcs yeuen sen a kiodiesrehab.o. 3 an-3 you are able to read with a sensory integration dysfunction, be seryintegration W bots of information As itis a very new website aware of the effect the therspy can have. © Congresses and i we are still developing its concept, which You can always contact us for specific infor- couses in your W means that we are accessible (0 al! sorts of __mation on Sensory Integration. region remarks. You could send your comments by We errait into@Kidiasrohab or, by roguiar yy 7 mail or by fax. You can lookup the address Ss Je trimmers onthe stoane oe ies emer Rehab News "aan Roto Iforitonl provides (aio mao } Wy BSE are aware of the fact that this special ‘workshops on Sensory Integration. For more News subject is not a very easy one, we want ‘information just corttact us!” | ~~ Contents: Jw What is ST Kiddies Reb Tate 1 tational website b w —_ We observe the world around us through noticed the orange to feel squashy and over _leurche# ‘ the senses of touch, smell, taste, vision, ripe, and that nice citrus smell as @ horrible ¥ - ‘wy hearing and movement. That means that ‘smell, Surely you would avoid the orange. What « St 1 when you pick up an orange. your senses What if your senses were constantly GWViNg —jJormal development 2 gy fellyourbrain that this isan orange. Your you false information? Your view of te of. st eyes identify the color and the shape. Your world would be very different. In particular, it : 7 sox) touch feels the would be different from anyone else's. SE dystunction's 4 oiliness of the This is a sensory integrative dysfunction. tmasine what it isto peel as well as F / aluisabled chidren may expertence sen- pate si non 4 the smooth- é sory integrative dysfunction. These include, ness of the but are not limited to: stroke, C.P, Percep- Syrw;iomsond signs 5 skin. It feels a tual problems, brain injury at birth, ADD/ of ST Lysfunction's slightly heavy, anc ‘ADHD, speech, reading and leaming dis- of certainly Mot. eantyenoname thvngh the ables, fine and grass motor disabilities, therapy: be care: 6 hollow. Your senses ot teh rene troah = evelopmental disabilities, Down Syndrome ‘Mt sense of smel tend moveren and Autism. ~ identifies the “The senses pass the information from the petites oucels | 7 citrus smell It enconanent tb te bain, information at sree does not rattle or make ne ee antes ‘wrong or passed over a transformed chan-Orgriztimef ec- 9 skier nel will result in incorrect information to the tities ing helps you to realis ject. All these senses, combined with infor- mation, memories and knowledge stored in the brain, tell you that this is in fact an or- 7 ange. ~ What if your senses were not working - property? What if the orange felt like most i _ ofthe other objects you have encountered, it did not feel different? There was no heavy a of light feeling, no texture that you could ) identify. What if you could not identity that ~ citrus smell? Worse yet, what if your senses 4 enews brain, it will be misinterpreted. It is important to locate the sensory integrative dysfunction ‘Actoaties caregivers 9 to-onable the child o function at his orher Sn st heme: optimum level and to minimise confusion in ary woys te make 10 family life. eqimnent ‘Gossary => uw Books & Congresses = 12f N Ad +4 +444 MME ee rr e vey A a3 ee ee oe 77 ly eed AWAIT oY \ y ve vv ownhay a stable Held, a8 the boy Thied year incon mobile The vestibular proprioceptive-visual ‘ecile anid propioceptive sons.itions systoms dovelop further and the child Just after birth ao tng samusen!toynasp obec ‘hil bo abla To fine-tune the fine motor fone ve pvrruny mot pay bagi to rec or, wave Sh FS end went monmaton er Jet- devolgpa he motor planng comes Se ivuaraed. Th intograton Bi long Ufa te mote planning be ‘Montecito eaten sth Go am mor comp ing oo! cuntart As the tach sys. ning of the eyg-hend co-ordination (praxis.begins to emerge! This is the Cee a ie St Sheena refloxes nolonger Shite Fansetng @ symbol or an scat co it will play art impor, dominate the child's behaviour, tie ‘idea fo an action or an activity) First Pe any eer bina fo ga conta! vor ov tha child wi only Wave et, ate : ‘runt The ortes! phase of motor, wi be able ttalk about while cary. ing out the idea or plan. The develop- ‘ment of praxis plays an important role in the sell-concept ofa child planning occurs. the chi twit receive prepnocaptive in Second year formation. Thisvs the beginning of the The infants become mobile in vir seveiooment of the boayschene environments and at the beginning of Forth through eight years Tho vestbular systent is hilly fine. the Second year the child can move The children have strong inner kone at bith, although the integration from one place fo the other. AS tne in-- driyas. They can play together with withthe visual and proprioceptive sys- fant explores the environment it will other children, and share. Eine motor fers will Gevelop later on. Of athe _feam about odyscheme, space skillike building toys, sticking, paint- sensory systems, the vestibular system around it, and about how the bodys re- ing develop. Children also like (0 ex- is the frst lo mature. lationship is with space. plore their gross motor skils, ike The visual and auditory systems of ¢ The tactile system becomes further ‘swinging, jumping, siding, pulling, nestor are immature developed and wil play an important pushing, throwing, kicking and run- role in hand skils ring. At the end ofthis period thoy wall The child is now further developing be able to use fools such as pencil, First year The baty has much greater awaro- the midline skils by transferring 05- scissors, zipper, buttons, forks and 228s of and interest in the world, Devel. jects from one hand tothe other. ‘music instruments Sing vastbviarproproceptive-visia! Auditory information is integrsted _""Chiidren meet these challenges with ‘connections provide the besinnings of with tactile and proprioceptive sensa- diferent degrees of success. Some postural cont During the fst sx tons in and round the mouth es tna it~ gre more talented than others are, but ‘monins of histher life the baby shows 2 fant vocalises.. ‘most of them eventually achieve a de- Strong inner drive torise up against ‘Than the chid will start tying ta feed Gree that allows thom fo participate in Sraviy At six months head controls tse. This complex activity asks in tives of dally living. well and provides a stable base far con- mation form the lip, jaw, inside the trol of the eyo muscles. This reflects tne mouth fo guide oral movements in the growing integration of vestibular, pro- chewing and swallowing of food. Taste proceptive and visual systems, which and smell are also integrated become more and more important in The senses Integration of the information End products Prewerlcommun- "| Language sits foment taton evelopment of ud a tytnctons apoity to communicate Yerba, ] Semmens _, Pe [RE gravity) Integration of reflexes Bogvachemeimege: press, sooner: posture tation svdaton aa’ Balance Co-ordination of both Eyerhand co- amnee Proptioceptive bey pans eran Set-contl (aeep touch} Muscle tone Motor planning! prose Tactile Suck-evaliow-besth Mouth muscular ouch) ‘synchronisation movernent eating Acts two ‘ernest Motberdfar bound ore Emotional stabity me Tectia conto Tactile distinction Non-verbal conmnu- Volume 1 no. 2ee et | = = <<» tT! SI dysfunction's. All these senses pick ups important information and pass 110 our brn via the central nervous syster Inthe brain the information ia tegrated! So that we can respond to tho stimu in a good way. This process of orga COCe information is called sensory int tion, Because many sensory proc esses take place vathin the nervous system at an unconscious level, we are not always aware of them This concept was developed and re fined by the research of the late A ean Aytes, PhO, OTR, TW AS we look closer to the develop ment of sensory integration on page YW 3we can see that the normal devel ‘pment of for example grass motor Sw BIS. plays a very important role When a child, due to hisiher disabi- Sp isnot able to develop the gross ‘motor skils we can imagine that this » nt of sensory integrat The same happens of course when ® the child has diffcuities with ts vision or hearing So for some children, sensory inte- “Fe™ ssitshould. wen the process of Sensory integration is disordered, a “Pe umber of problems in ean, ge- yelopment or behaviour may occur. ~~ Basically there are two types of sen- rF PO Imagine what it is You have probably discovered, often without conscious thoughts, the things that help you relax, concentrate, or just fee! goodin various situations You probably use many diferent tech- Tr”. seuss. copending on tne circum. seD stances. Perhaps music helps you to concentrate whien working, but is dis- tracting during conversation. Some- times rough-and-tumble play makes you come alive. Other times you may ‘ot want fo have contact with anyone Mis very dificut to imagine what i TO must be tke for those who can not un- = derstand the input they get from their ——— tactile or vestibular systoms. The abil- ity 0 leam even the simplest things ~ and to benave appropnatey in differ- ent stations, howaver, depend cn > these abiities With the folowing ex- amples we hope we can demonstrate > 5 ttle more 3 Poge 4 > 3 4 sensitive or hyper-sensitive is (+/+) and under-ser ising, iterpreting and coping with this ¢-/). For example, children who are over- sensitive to noise (hyper-auditory) distract very easily. The slightest noise becomes a distraction and therefore they are considered to be ‘easily distracted and to have difficulty concentrating. The noises that we ‘normally fiter can be a sigri problem for them. As a result, one of the ways that they have to protect themselves from this auditory over- {oad is to disconnect themselves from their environment. The visual hypersensitive child has a {ow tolerance for sunlight and flores- cent lighting, For example, a child in RNG Could also have difficulties inthe a classroom under florescent light- gmtion does rot develop as efficiently sory dysfunction: the sense can be “inyper" (over active) or “type (under active), The normal sense Is (+), ov ive or hypo-sensitive mtd Stil This child has a need to feel pressure and therefore is usually faning on or aver things, can be ysically aggressive to other chi ‘dren, and has a high tolerance to pain, Other behaviour that could occur ‘An exanpe of tactile senses, Tnogine you enoys {your feet aching when you walk, thet you ‘onstonty feel al the clothes youre wearing, or tht you have anitehy feeling on some ports of your body These feslng will make it very difficult for you to concentrate on some ‘thing ele. When you have the feeling that you are waking ‘enn unstable flor, he the picture shows, wil rot much fun mowing sour, You wll probably re: dice 10 the minim, sy below ert {ue to a sensory dysfunction: ‘s06ial and/or emotional problems an activity leveValertness that is Unusually high.or unusually low, rnhysical clumsiness or apparent carelessness, + impulsive, tacking in self control, * difficuity making transitions from cone situation to another, i * the inability to unwind or calm one ‘ing using white paper will find glare self, = off of the paper causing what ap-__* a poor self concept, ears to visual distractibility, * delays in speech, language, or AA tactile- hypo-sensitive child is never _ motor skills, * delays in academic achievement, * a poor body awareness. to have a SI Dysfunction When you return home efter eng meeting or conversation with a group of people, you wil ‘robobly find aut thet you rather wont to be ‘lone for some tine before you are able to give yourself agin. This is because it costs ts of ‘enengy 0 Stay concentrated and alert ina group Be omar of your reaction when there is someone te "dieteb* you afer that meeting. when you need your rest or time-out so badMi ¥ Volume 1, no. 2, CcCececececcs ~~ tb st Ub La 4 rOFUOE Vb dy} yyy bwvs Symptoms and signs Auditory Hyner-sensitive (+/+) © Sensitive to loud noises © Distikes being ina group © Sometimes tums of in hisher own lite werk Relaxes when whispered to Frequent ear infections 9 Hears normally, but does not isten well © Language is delayed Hypo-sensitive (+) © Shouts or screams for no apparent reason © Hums constantly 9 Is avery noisy child © Likes to listen to music or televi- Sion with the volume set quite high © Bangs on tables, walls etc. to cre- ate noise Tactile: Hyper-sensitive (+/+) © Dislikes hair being combed or washed © Dislikes head and face being touched © Dislikes wearing hat © Dislikes being touched © Dislikes tight clothing .2 Always removing clothing ‘0 Rejects being held © Very picky eater © Difficult to get to sleep © Grinds teeth © Does not chew © Eats only soft food © Toe-walker Hypo-sensitive (4) © Difficulties sitting stil © High tolerance for pain © Places tongue or face against win- dow glass. © Always puts too much food in the mouth © Prolonged confusion over putting ‘on the right shoe on the right foot © Very delayed in toilet training © Clumsy andlor uncoordinated © Heavy walker Taste ’ Hyper-sensitive (+/+) © Likes or dislikes carbonated drinks © Very selective eater of SI Dysfunction © ats only bland food Liypo-sensiive (1) ® Chews on strings, clothing, fingers, etc © Does not discriminate food © Loves only strong tasting food © Puts everything in the mouth Smelt Hyper-sensitive (+/4) © Avoids the kitchen when fish or cabbage are cooked © Rejects being held 9 Hands are always in mouth or mouthinose area Hypo-sensitve (-/) © Smells everything © Will not eat unless he/she smells the food first © ‘Smears faeces © Loves the smell of cologne or per- fume Vision Hyper-seusitive (+/+) © Has difficulties to move from one service to another, i. from grass tosand 0 Poor eye contact © Appears to stare through people 0 Fascinated with fans, things that ‘spin © Eyes tire easily/quickly when read- ing © Oversensitive to sunlight © Everything must be in order, neatly organised Hypo-sensitive (1) ¢ Flaps hands, usually around eye level # Rocks © Rolls head usually from side to side # Loves water © Enjoys staring at lights © Enjoys turing lights on and off © Enjoys things that spin or tum © Plays with hands in frunt of eyes © Presses eyes with fingers, usually at comers © Loves tuming pages in a book! magazine © Loves shiny or reflecting objects Vestibular Hyper sensitive (+/) 0 Gels carsick easily @ Gels dizzy or vomits wth other moving expe.iences © Creeps and crawss early © Sits, stands or walks early 9 Quick to hop on one foot, skip, fide a tcycle 9 Seems to dislike gross motor ac- sities Hypo-sensitive (4) © Clumsy in movernents (Falls or trips often © Pushes doin things while doing an activity © Creeps or crawis late © Sits, stands or walks late © Late to hop on one foot, skip, ride atricycle © Head resting on the arm while playing on the ground or at a ta- ble 9 Slow in learning body-parts or left and right All these points seem so clear and ‘easy to observe, but a5.a matter of fact, the SI dysfunction is not All the information is woven with each other. One moment the child seems hypersensitive, the other moment it could seem hypo-sensttve. In the systems, tactile and auditory hang close together, when tactile is (+/+) auditory is also (+14), The vestibular is connected with the. aotness or lev el Rotten occurs that a child has a combination of difficulties; like tac- tie (++) together with a vestinular(- ++) ora tactile (1) with a vestibular (- ‘or (++). Tactile (+/#) and vestibu- lar (+!#) do not come together. ‘You can say that children carry out a certain behaviour to stay alert if you want fo change this, you wall have to offer the child another be- haviour that is alerting © Loves to open and close drawers of doorsHe oo v e AVANTE Sot e \\ The therapy: be carefull has atficutynteguat tad rer sm porta te tat the child #0 that i can parti pate nes of daily Wing Sensory integrat rapy Is giver bya peviainc onal, @ physteal or sometimes by @ speech fherapust, who specialized hirn/ Drerselfn this subyect By attending a course So any qualified therapist who has received traning and has expenence with sensory integration techniques, is able fo treat a child with problems in hus/her sensory in tegration The reason why iis so mportant {0 be caret anc that not jus! every ‘herapist can treat these chiidron is, that sensory input can be a very powerful force Children may react bby becoming excited or withdrawing from stimuli. Sensation can have a ‘dramatic effect on the nervous sys- tem. So be extra careful in what you Offer the child. Be sure to do a pre- ‘ise observation before starting ther- apy. ‘Observe how touch, movement, ‘Sights, sounds, smelis affect the child, or heights. Different situations will elicit different responses. Look for signs of excitement, esr, nerv- ‘ousness and change activities or ‘Situations based on the child's ro ‘sponses. Also during therapy, re- member that sensory integration is ‘nol the same as sensory stimulation Just as important as providing a van- ey of stimulation's, it may be neces- sary to reduce stimuli as well. Re- ‘sponses differ from child to child and individual responses from each child ‘may change from one day to the ‘next, or even during different times of the day. ‘Never push the child to do some- thing hafshe doss nat want to do, or 4 afraid of The child directs the therapy, it ‘generally gets to pick the activities rd be creative in its play. Children ‘often seek the types of sensory ex- erlences their nervous systems need If a child shows interest in Vanous sensations, try to provide this type of stimuli in their normal play activities. The therapy is usually done in a therapy room or place with very spe- Cialised equipment 1-3 times a Poge & This room oF place 1s usually heaven for most children and sibling be bogging to participato also. S that you don't get the idea that ther ‘apy 18 generally not something you hhave to drag your child in for. quite the contrary. Sensory Integration therapy ustually means @ tot of fun to children, i helps thern develop better sensory perception and more contro! over their bodies and their environ ment. Sensory input can involve both ac- ‘ive and passive involvement. When a child actively participates it must initiate, plan and execute movement. Passive activities may provide sen- sation, but not necessarily require a response. Active involvement pro- vides the best opportunity for Changes in the brain that lead (o growth, leaming, ancthetter organi- sation of behaviour. When a child is actively involved he/she has more control over the situation ‘An important part of the therapist's role is to help guide activities in such @ way as fo maximise the therapeu- {ic value of each treatment session and provide assistance for safety or when confidence may be lacking. Sensory Integration therapy does ‘not attempt to develop specific ski, but rather provides the sensory and motor activities which help the over- the nervous system “Sensory input can ba 8 powert force. Chiron may react by becoming excited or vinrawing trom stimu. Sensation con havo ‘9 chomatic effect on the nervous system.” (and hence enhances language, mo- {or skils, attention, behaviour, atc). ‘tis important that the caregivers understand their child's problems, so that they can also stimulate the nor- ‘mal sensory integration in their chil- dren. As a therapist you should give care- givers a home program of specific types of activities they can do at ‘home with minimal investment and ‘some special adaptations. You may also train caregivers in special strate- gies that can help with specific pro. Jems their child might have in every-" day life. While activities done at home are not the same as sensory integra- tion therapy, they can help a great deal and should be done even if you are getting profession" therapy in a clinic. The more a chits is stimulated to the suitable activities the faster it will progress. Some children with mild difficulties, which do not need profes- sional therapy, can benefit greatly from a home program and participa- tion in sensory integration related ‘community activities. Volume 1, no. 2LOL ee vob a ~ Activities you coul Tactile (+/*) For a chikd that is tactile hyper: Sensitive (+/+) the goals of therapy could be “being able to touch the child Child taking support on hands, fect and stomach Think of = Touch and take hold of the child with a firm nandgrip. (Do not push the child to touch things he! ‘she does not want to touch. ~The child is probably also auditory (+/+) ‘500 not talk to laud or to much. ‘Some gross motor activities: + Use a large plastic tub filed with sand, uncooked rice, small beans, uncooked small pasta, small (plastic) beads. Hide different objects, toys or shapes in the sand or other content. You could cover the tub with some- thing like a towel. Let the child search for the things within the tub. + Different kinds of sand and water play. ‘«*Fingerffoot-painting® with sand or mud # Let the child draw lettersinumbers/ shapes on your back with his fingers for you to guess what they were. Horseback 0 ‘ng on your bback ie Bandaging the child's arm, leg, foot fof when it wants whole body with {elastic) bandage, a piece of cloth or fs towel, Or rubbing the child's arns! legs with a towel after bathing. «+ The pizza backer; ask the child to lay down as hefshe wants. Then knead the dough (the child) by mas aging himmer only at the Body side which is on top. When the child does not like it, stop. Than top the pizza with vegetables (small bean! Sand bags) and sauce and what fever both of you like. After that the pizza has to go in the oven for a Couple of minutes (pull a blanket over the child - not the face, when rot wanted). And at the end; cut it and eatit \ «Different activities when the child (CD) d apply during therapy «Climbing a mountain and rolling. running, jumping down. Do not leave the child alone; supervision! «+ Tactile memory, Make “texture cards" by cutting pieces of ‘cardboard ‘and cover these cards in pairs, with cotton, corduroy, terry cloth, wool, sandpaper, fur, (whatever you have on hand texture). Then the child matches like pairs. You can make it more difficutt by placing one of the pair of cards in the “feely bag” and having the other match on the table or by having both matches of several different pairs in the bag at the same time... ‘Tactile domino: ‘* Play dough is another great material and you can hide objects within it, fays on its stomach in a hammock Saye ne Sree angerpaintng,, ——Caceachor re ieee ‘sandpaper or corrugated cardboard and ty using different materials to draw with, such as chalk, charcoal, Tactile (++) pastels, pencils, ete. When the child is tactile hypo- + Papier mache eenaitive (4) therapy goals could be: _» Searching things in rice/sand with or ‘improving the bodyscheme without looking. - and the motor planning Games you can play, oo 7 ‘¢ Have the child lay on its back or stomach in the centre of a blanket 2 Pick up two sides of the blanket and ‘* Balhbathvbox with filed with polysty- pull it slowly across the mom "Tactile trait; make curtains with rene foam or something soft. strips of lost of different materials, The child has to crawi/stak through. Contruing on page 8 Volume 1 no. 2 Page 7Think of Do not pus w child ito @ movement ‘Sing or hum songs duting the activities Have the chuld do something with his! ther hands dunng a vestibular activity (1's easiest and 3 most difcul Do not 90 0M to a higher level when the child 1s not ready for t) WUE rn e + Body-parts puzzles or drawing the Outlines of the body (part). After that the child could draw in the * Sitting on a tow swing with its feet on the ground moving: himvherset (1) back and for (2) sideways (3), Tum- ; ingislnning () being moved (3) clothes he/she is wearing Sasaming beng moved) + "Feely bags"; children feel (with their platform swing (3) ‘hands) objects that are hidden in the Position: sit (1), back (2), stomach bag, after that they describe what oy “} they feel and draw what they feel + Pretend to paint body-parts one by ~ one and adjust a sticker on the Painted parts. e 26 ° s 7 a Pr 2 o re '* After the child is comfortable just moving on the swing, you can add rT ‘ different games. Set up targets and _ hhave your child throw bean-bags at ays them wih hands of feet When the rT . ‘child has dif ties breathing (hokis Tre Beets pe at ated do ma - a Movements. Have. - i: tho onld do as any sepa tan Peres beeeine bubbles, batoons, TO sre bie to remember and com. : plete. You can use crawling, hop- TT — bina, skipping, . ong, and 8 variety of other de- 1 ‘Pending on how much space you T- Y- Vestibular (+/+) For a chid that is vestibular hyper- “ip, Sensitive (+) the goals of therapy > could be: = having fun moving around q AC Le ’ Think of: the development of trunk-stabiisatic slats in stomach and back lay pos. tons, then in siting and kneeling ~ better nat to have these chidren to st Bill for a longer time; they wil fall a sleep", thei attention span reduces, '* Stomach lay in the hammock play- ing games with hands; puzzie, child tends to fall out of the ham- ‘mock: lay some bean-bags on his! Tork boo fishing beanbags, truck driver with heavy load on the back. up at the Sides, or ona rope: ring down wath something in the hands to knock over pins. ‘Take a took at page 10 to find ways to make equipment. Ssi Coe! 7 DUS RARRAA Se ee ee 4 COCCECEEEE?EE an rersrs ,O¢€6€ ¥ LIVE | U WUbtT a At Organisation of activities Peeickeni iced eed eral guidelines for organising home activities for children with sensary prez essing disorders Keep routines in the home organised and structured as much as postitile lye be very helpful they e the child for what is For chilaten who n ne you could make a photo bock of *€5 yOu go with the child, and keep it 'n the car, $0 that when a daily sched le is disrupted, you can show the child This 1s where we have to stop today before we go to....." This may help t0 distress the child when the normal Schedule is not being followed child not yet reading, The system used old should highlight the daily and weekly routine and allow a visual presentation of the child's day. In that way, the child can be alerted to changes in advance. Perhaps the child can go over the Activities Caregivers can do at home Remember, it is important to observe {he child carefully and respect hisfher Preferences about doing these activi ties, ‘+ Gath time: scrub the child with ‘wash- cloth or bath brush, use a variety of ‘Soaps and lotions for bathin, Play on the wall with shaving cream or silly soap; rub body parts with lotion after bath (deep pressure like a mas- Sage); or sprinkle powder onto body Parts and either rub or brush into the ‘Skin, ‘+ Meal preparation or baking: let the ‘child help with mixing ingredients, especially if they are thick since this will work arm and hand muscles. If baking, let child help mix and roll dough and push it flat, if needed. Al- low the child to help carry pots of cold water for the stovetop (with su- Pervision of course). * Grocery shopping: have child Push the shopping cart, carry groceries and help put them away. ‘* Mealtime: encourage the child to drink from a straw and provide lots of very chewy and resistive foods, if they like it If you have trouble keep- ing your child seated because it ikes {© jump up for stimulation, let him/her ‘fan around the house or jump a cou- le of times before sitting down. + Around the house: let the child help lean the house. Read books to- Sether in a rocking chair. Provide a oun ae forthe tld who gets too up. This place should be used 88 a "time-out" spot (not as a punish- Quiet place now, you seem a litle ex- cited." The place should be quiet, com- fortable, soft, and dim. A bean bag chair under a small table with a blanket draped partly over it works well In- clude books, stuffed animals, or a tape player with soft music (whatever the child finds calming). Another activity for winding down isto play the “sandwich {game using coucn or bed pilows. ‘Sandwich your child between two pil lows and squish them. Apply pressure to their command (ask harder or softer). Some children like a lot more Pressure then we think they would. You Can make up obstacle courses around the house using ture, toys and other objects to reinforce sequencing body movements. Have the child do as many steps as itis able to remember ‘and complete. You can use crawling, hopping, skipping, climbing, rolling, and a variety of other movements de- ending on how much space you have available. + Neighbourhood: Go fo: 3 walk around the neighbourhood and have the child Pull a heavy wagon (perhaps with a sibling i this is safe to do) or push a doll carriage loaded with dolls and books. + In the garden: let the child help with digging for gardening; provide a sand- box; a swing set or jungle gym is great, as well as a mini trampoline. Swim- ming is great. ‘+ Bedtime: if your child has trouble sleeping you can try adjusting the lin- eens to add weight and texture. Also, heavier blankets and quits (even ift be) schedule forthe following day each ‘evening before bed. Create specific routines for cifficult times of the day or responsibilities (€ 4g.. bedtime, bath time, morning self care before schoo). The routine can be Givided into small steps and these can bbe posted in a checklist form or picture form for the child to look at each time the routine is performed. Ifthe child is enough, the checklist might help himiher be independent in the routine. (For example, for a bedtime routine you could write - get undressed, put on py- jamas, put clothes away, pick out 2 ook, brush your teeth etc. Each item could be checked off when “ satin etc.). You can ty rocking slowing and gently before bed to help calm for sleep. Massage prior to bedtime might also calm for ‘sleep. Things that are calming Deep touch: weighted vest, or bian- ket around the shoulders, ‘Sucking: a thick shake with a straw or hard candies. Slow rhythmic Movement: rocking or swinging. + Errands and appointments: Be- fore a trip to the dentist or the hair- Gresser (if these are a problem). try deep massage of the head, or ‘Wearing a very heavy hat (weight it down), and chewy foods or pres- Sure, Allow your child to wear a backpack to and from school. Let it bbe fairly heavy, but pad the strans Necessary so the shoulders don’t hurt” ‘Seems too ho!) may help. You can also tty different fabrics for the sheets and pillowcases (cotton jersey, flo~nel,I i BR US SS SS S| SS eS CECE SEELEY if € any things are easy to make with material you can find in and 4rourd the house. The goes thing of making equi- iment your sels that you can rept when ti Broken, du- plate twhen you need more of adjust it just the Way YOU rant forthe child that needs i ‘When you make tings yourself, be aware ofthe fact that the toy ov equipments sae and strong. As safety the most mportant thing duting therapy Bean-bag or blanket ‘Sew two pieces of cloth together and fil the bag with sand, beans, rice, etc. For extra tactile input, you could use differ- ent types of cloth/material, and different contents. So that you have different weights. You could also make a very big one, filed with polystyrene foam; this is then a nice cushion to jump in or to relax in. Trampoline ‘A piece of strong canvas or animal hide stretched tight over a large truck inner tube. You could also burrow the tube in the ground a little more so that it will stay in place. A bare along the side could help the child hold its balance. Have the area secured with mattresses or cushions. Never let children play on the trampoline alone. Scooter board Material: ~ Rectangle of 1/2 inch plywood; measure the child from the armpit to 1 inch above the knee. ~ Four wheels that tum in alll directions ~ Carpet or rubber to place on top of the plywood. Page 10 Easy ways to make equipment. Swings Hanging systems There are a couple of different ways to hang a swing. On one point (1); this is the most unstable swing; it can move to all directions, On two points (2); this can ether ‘go back and forth like a normal swing, or from side to rs « Types of swings ‘Swings come in a variety of shapes and sizes e.g. platform, horse, hammock, inner-tube, gummy bag filled with some kind of material. They can be used from either a ceiling fixed suspension point or a tree. First check if the swing is secure, and if it can carry the weight. Itis strong enough if ai least 2 adults can swing on it. They provide balance stimulation in a linear, circular or rotational plane. Padded wall and floor mats are essen- tial for the safety of the child. € Balance aids To improve balance and body control. An old barrel or drum coull make a good ‘rol. For balance boards you could cut an old tyre and attach it under a piece of ply- wood. Provide it with an upright stick so that the child can hold histher balance at first. Fallen frees or logs are ex- cellent balance beams Volume 1 an 7ee Cb Wh 1 = VW) L, ‘An ext ta {you could make it of foam shapes or cardboard boxes. aiget box OF OFILKS iS also Very nice to play with, it among others stimulates co-ordination of the body parts, and praxis, Covering them up with different tactile materials gives the bricks game an axtra dimension. XL cushions SS 7 Fill them up with pieces of = , Obstacle courses, huts and tents. Pee Ks | | e Building obstacle courses, huts and tents Things you can use for obstacle courses: everything where a child can go (crawl, walk, jump, etc.) over and under. Like inflatable mattresses. Things you can use to build tents and huts: umbrellas, clothes, pieces of wood, tables. Ball-bath Ifthe child is small you could fit it in a strong box, otherwise you could build a board box ‘When you situate and fix itin the comer of a room, you only need 2 pieces of board. Fill it up with polystyrene foam, or other fight materials. TTT RrtWiee eUYUYUUYE Glossary of SI Terms. Abstract thinking: the abilty to think theoretically, to talk or leam about things you can not see. vty leveVattention spanistate of arousal: the ability to attend, to leam, and behave ap- propriately in different situations. For example increasing during activities and decreasing when going to bed. ‘Auditory: the sense of hearing Balance: the ability to keep up the body against gravity in every thinkable position, 2 a child's idea of his/her body, the brain's map of the body and how its parts in- terrelate. Concentration: the ability of the brains to have full atten- tion on one activity. ‘Co-ordination: the fluent movement of muscles activi- ties, by which all senses play a role. Co-ordination of both body parts: the ability to use both body parts during one activity. Like holding the bottle in one hand and open the lid with the other one. Eye movements: haw do the eyes move, for example following an object with the eyes. Fine motor skits: small body movements like writing, — Colouring, buttoning, shoe lacing. im Gross motor skills: big body movements like jumping, - .__ funning, catching, throwing. im, 'mitation: the ability to copy movements or things. Imita- — tion is an aspect of praxis and forms the basis > for developing later motor skills and communi- You can use them for many different activities ike next to the trampoline to jump in, or asa pile to climb on. “Tactile trail” For a tactile trail you can use: ”” 4) curtains with strips of lost of dif- ferent materials. Like strings with pieces of foam, glit- tery things like Christmas decoration or aluminium foil, strips of cloth. 2) tactile carpets; big enough for children to walk, craw! w of sta'k over. Materials like wood, plastic, foam, door- SS Mouth muscular movement: movements of mouth and tongue muscles are the basis for eating and communicative abilities. ‘Muscle tone: the tension or strength in muscles Non-verbal communication: non-spoken language, by which we use our face or hands. Posture: position of the body Posture safety: the feeling of safety during movements Posture un-safety: the “wrongful” fear for moving. The child has severe fear for moving or for accept- ing movement. Praxis/motor planning; is what allows us to organise, plan, carry out and execute skills of all kinds in ar ined and efficient manner. Proprioceptive: Proprioceptive input tells our brains when. and how our muscles are moving and our joints are bending. Settconcent the image or idea that we have of our- selves. ‘Self-control: the ability to manage our behaviour in differ- ent situations. Self-confidence: the believe, or trust that we have in ou- selves. Tactile: sense of touch on the skin Vestibular: The system that co-ordinates the position of the head in relation ‘2 gravity and movements of rest of body Visual: the sense of seeingUCC Cee € CCC CCUM MM ees rvations 4. Fore arm ait Wg movemenis 2, Sequential finger touching 3. Finger-to-nose test 4, Visual tracking 3. Convergence or divergence 6. Quick locatization 7. Visual fixaton with head inoving &. Schilders arm extension test 9. Supine flexion 10. Prone extension Ji. Weight bearing and proximal joint Stability (wheel barrow and quadripod) i2, Projected ari Sequences © Catching ° Jumping 2 Jumping jacks © Hopping 413.Biateral motor co-ordination 14.Neck flexion in supine(bridging) v ) Soe rr ASpace Visualization (SV) Figure-Ground Perception (FG) Design Copying (DC) Constuctonal Praxis (CPs) Motor Accuracy (MAC) Finger Identification (FI) Localization of Tactile Stimuli (LTS) ‘Manual Form Perception (MFP) Graphesthesia (GRA) ‘Sequencing Praxis (SPr) Postural Praxis (PPr) (Oral Praxis (Opr) Praxis on Verbal Command (PrVC) ‘Vestibular und proprioceptive Kinesthesia (KIN) processing. Postrotary Nystazmus (PRN) ‘Adapted from Ayres (1989) The SIPT were based on 12 tests from the South- €m California Sensory Integration Tests (SCSIT. Ayres, 1980) and the Southern Califomia Postro. tary Nystagmus Test (SCPNT: Ayres, 1975). In ad- dition, Ayres (1989) developed four new praxis tests. The SIPT were standardized on a sample of ap- proximately 2000 North American children. Chil- dren in the normative sample were representative of the population distribution characteristics from the 1980 US Census. A number of Canadian chil- dren were also included Preliminary analyses of the normative data in- dicated significant gender and age differences on All SIPT tests except Manual Form Perception and Postrotary Nystagmus, ‘Therefore, Ayres. (19S9) computed separate means and standard deviations for boys and girls in each of 12 age groups. Chil. dren's standard seores piovidle ais inde of the de. SIPT. Nas Sh Bilateral Motor Coordination (BMC) Standing and Walking Balance (SWB) Description Motor-free visual form and space perception, mental manipulation of objects Motor-free visual perception of figures on a rival background - i Ability to copy simple and complex 2-dimensional ‘designs and manner of approach for copying Ability to relate objects to each other in 3- dimensional space Bye-hand coordination and control of movement Discrimination of individual fingers Perception of specific stimuli applied to arms or hands Matching of block held in hand with visual ‘counterpart or block held in other hand Perception and replication of designs drawn on a hand Ability 10 move both hands and both feet in smooth and integrated patterns Ability to repeat a series of hand and finger Ability to plan and execute body positions demonstrated by the examiner Ability to plan and execute lip. tongue, and jaw movements, Ability to plan and execute postures on the basis of verbal commands Perception of passive haitd and arms movements. Static and dynamic balance on one or both feet with eyes open or closed Duration of vestibulo-ocular reflex Validity and Reliability of the SIPT Evidence of a test's validity and reliability deter- mines whether it is a “good” test. Validity is the ability to draw meaningful inferences from test Scores, and reliability is the consistency of scores We provide evidence for construct-related valid. ity and wo types of reliability (Le., interrater and test-retest), Evidence ot Construct Validity Construct validity is the conceptual or theoretical basis for using an assessment to make a particular interpretation (Burton & Miller, 1998). One of the Most common ways to examine construct validity fs with factor and cluster analyses, used to deter- mine how many factors (i.e.. test groupings: factor analysis) or clusters (i.e, roupings of people, clus a construct teranalysis) are included withinExpressions of Modulation Dysfunction CNS Sites of Processing for Expressions of Dyspraxia Avorsive Response ‘Sensory Prale (Ovnn) ESP (Pama) Gravitational insecurity Sensory Prot (Ou) ESP (Parham) Detensiveness Sensory Proto (Ounn) ESP (Panam) TE (Royeen) Under responsiveness FIGURE 7-10 Assessments associated with B Tawe 7-5 ‘SENSORY INT Age sears MAIC Subtest Manual Dexterity 16 Po Treading beals Bicycle wal \ Visual Vestibular Proprioceptive imbic/Reticular Tactile Auditory Sensation Hyporiesizen RELATIONSHIP OF MoTOR Assessment BATTERY F EGRATIVE CONSTRUCTS St sp sD sD SD or BIS, sp sp. ND bls, MABC Subtest Ball Skills Catehing bean bs SD oe bis, BOTMP Balance Clinical Observation Prone extonsion| Postal tabiy Headin supe Extensortone MABE" Posture Discrimination ‘SCSIT Tactile Tests, us, A ora MFP. ro constructs, sl Bis BOTWe: ister! Coorinaton Urpar ib coordination uring Speed and Agiy MABC Checklist 244 Mage ‘Somatodyspraxia Botwe: UL Speed & Destenty MABC: Cchochist1 82 MABC™ Cinical Observations: Supine eon FOR CHILDREN ITEMS TO. MARC subtest SI Bis Balance Posture BIS One-leg balance Posture SD'BIS ping ove: cord bis Walking heels raised Past Bis Stork, Posture SDor BIS Jumpig a ssuates bis Heclto.tve wath Post bis Oneshot Bohan SDow BIS Hoppme anseV VUUUUUt Ue eee ete © € eC ef Ce eee ere errr rT TCU er eh @ These observations ate helpful inthe evaluation of clients with suspected sensory integrative dysfunc. tion, Judgment of performance should be based on knowledge of normal development. 194 we Hh ASSESSMENT AND INTERVENTION EVALUATION OF SENSORY PROCESSING* { ESP Research Version 4 Always Chile's Name: _ a Occasionally Child's Age: years, months Sometimes Name of adult completing this form: ee Rarely Relationship to child — ei Date: Audlory System 1 Beso itv esi dsl wat a op wen yy oeig? Such as the vacuum, hairdryer, or toilet “2. Is your child bothered by any hovsehold or ordinary soun: flushing? 3. Does your child respond negatively 0 Toud noises “4 Dees your child appear to not hear certain sounds? Ss x your child distracted by sounds not usally not 6. Is your child frightened of sounds that donot usually convey alarm other children the same age? | 7. Does your child seem to underreact to loud noises? 8, Does your child have wouble interpreting the meaning of spe oF common words? 9. Is your child easly distracted by relevant noses such a a lawn mower ouside, children the back of the room, ernkling paper, an ar conditioner refiigeratr, or Ruorescent lights? 10, Does your child sem too sensitive to sounds? [ Gustatory or O¥factory System 1. Doss your child gag, vomit. or complain of nausea when smelling odors suchas Soap, perfume. oF ~~» > Equipment from the hourd? Two chairs and a table are required, as well as a copy of the instrument and three blocks male of poster board. Each block has one of the response = choices inscribed on it with large black letters: “tT. “No” on a 2-inch by 2-inch reponse card, “A lit- = LD te” ona 2-inch by 3-inch response card, and “A rr lot” on a 2-inch by 4-inch reponse card. - | = Procedure > The scale takes less than 10 minutes to admin- ae ister. The subject (S) and the examiner (Ex) sit across from each other. Ex uses a shield to cover the instument in order to reduce distrac- : > tion for S. 3 Ex orients S to the task. Ex explains that they "Twill be playing a gaine in which there are no “right” answers and no “wro! _ The oF ip his or her had back when Tooking at somthing oF someone? I ‘or mateling valor, shapes or izes? swer the following 3 questions | ‘via wrung oF copying oF ea words backwards 12. Does your child lose ts her place on puge while reading, copying, solving problems, oF 13. Tn school, does your child have difliculey shitimg gace from the board to the paper when Copying TOUCH INVENTORY FOR ELEMENTARY SCHOOL CHILDREN* game is being played so that the Ex can leam more about S. Ex explains the response format to S. Ex says: “Lovill ask you questions and you are to answer them saying cither ‘No,’ ‘A little,’ or ‘A lot’.” Ex is to point to each of the three blocks in- scribed with the phrases while saying them aloud. Ex continues, saying: “Let’s practice the game for you to learn how to play it. I will ask you a question—‘Do you like ice cream?" You answer by saying either ‘No,’ ‘A little,’ or ‘A lot’.” Ex points to the blocks again when stating choices for response. Ex continues: “Remember to point to the block that is your choice. You don’t have to say which one itis, just point to it.” In the beginning, S is required to point to the block which is his or her choice. $ may also stateSSL ASSESSING SLSSORY INTEGRATIVE DYSFUNCTION 9 197 TOUCHINVENTORY FOR ELEMENT vie) SCHOOL VE CHILDREN CHE) Ry Charlotte Brasie Royeen | Init sets, Rea of "No" 1 eosed "1s a response of “A Lite” | and atespouse at! V1 ot" \ Response —— | (Check) No Question | 1 Does it bother you to go horefooted? Botuzey shits bother you? socks Inthe you? 1otd toot Por fiooid Doturtleneck shits bother you? f)oot4 25 you to have your face washed? t1oty ther you to have Your nails cur? hood to have Your hair eonihed by someone ese? thot 8 1 300 to play ona toot » ce touches you, do you fe! like scratching that spot? t)oofd cone touches you. do you fel like rubbing that spot? fhootd Does it butter you to walk barefooted inthe grass and sand? i)ootd Doss getting sty butler you? t l 1] Do you tind it hard to pay at t 1 Docs it hotier you i you cannot see who is touching you? to yom ity By t1 4 thot it bothers you when they touch you back? i)ootd come from behind? thot ‘ou to be kissed by someone other than your parents? (11 jou tobe hugged or held? trot ou to play games with your fect? tit Does it hotier you to have yuur face touched? f) ott Does it bother you to be touched if you don’t expect it? ft) 1 Do you have difficulty making friends? t) ot Doss it bother you to stand in fine? fy) Does it bother jou when someone is close by? (no. of reponses scored “1") x +0) (no. of reponses scored “2")X + 1 1 (no. of reponses scored Once S$ understands the task and the required response style, Ex says: his or her answer aloud but that is not required. The purpose of the blocks is to aid S in remem- bering the three response items. Thus, it is all right if after doing the test for a few items the Subject stops pointing to the blocks. The purpose of the practice session is to teach the child the Tesponse format. Therefore, the procedures Should be repeated until Ex is certain that S un- derstands how to answer the questions. Sug- Sested questions to use if further practuce is re- quired follow: “Do you like snakes?”, “Do you like turtle “Do you like vegetables?”, “Do you like school? “Now we will play the game.” Ex may restate or explain the item until S un- derstands it. If S asks Ex to repeat an item or states that he or she does not understand the ques- tion. Ex should read the question and wait for S to respond. If $ does not respond or needs prompt- ing, Ex may say: “Which answer do you want?” and then point to the three answers on the response cards, “No,” “A Little,” or “A Lot.” Ex records S's answers and notes any pertinent—_—_——wrumwOrlU WY ASSESS Talsey S tor Potion Scoring and interpreting the tie The TIE ts easily scored by sume Tesponse scores (1.¢.. adding the scores tron items | through 26). The child's score is then compared to the normative data supplied in Table 7 Proper interpretation of Table 7-A is contin- gent upon understanding that a high raw score does not mean a better performance on part of the child. Recall that the response format for the TIE is |=no, 2=a little, and 3=a lot. Therefore, a child who responds with “a lot” for many of the test items will receive a higher raw score than the child who answers with “a little” for many of the test items. Thus. she higher the score, the more the child's self-reported behaviors are ussoci- ated with behaviors indicative of tactile defen- Siveness. Conversely, the lower the score, the less the subject's self-reported behaviors are axsoci- ated with behaviors indicative of tactile defen- siveness. Conversion of raw scores into corresponding percentile scores using Table 7~A provides a stan- ng the child's @ @ Taste 7-A_ DATA FoR ScorING THE ToucH INVENTORY FOR ELEMENTARY SCHOOL CHILDREN Percentile Score Raw Score 100 CA ow 31 5 45 so 40 25 35 10. 31 0 25 Percentile Score 0.1025 5075.90 100 Raw Score 25 3035.40 45 50.60 ‘Mean sco.e = 41; standard deviation = 7.8; standard error ofthe mean = 0.38 dard reference for how a given child responds to test items compared to the normative sample. Again, it is important to note that a higher per- centile score does not mean a better test perform- ance. Rather, a higher percentile score, for exam- ple, the range of the 75th percentile and above, means that at least 75 percent of the normative sample answered the responses less associated with tactile defensiveness: Only 25 percent of the nor- mative sample answered with responses more as- sociated with tactile defensiveness.v v v v SENSORIMOTLOR PLANN WORK SH ye'Smell Oral Tactile Voshbubir | Vestibular Vinual Auditory | — Texture Moventent Gravity | WeetVanitla | Suck Blow Jone and Jomband | Verteal Ligh Dark Vibration | » muscle activ anuiscle colour sounds | Cool wo neutral activity | Loud soft | » Warmth \ » \ ' a Bane | Bite’ | Deep Pressune {Oscillation | Horizontal | Form Rhythm Music | » | Crunch | | Bouncing) | | (boundaries) | Sing-song » | | | Speech ; | Rhyme i » | | { | | mur Citrus | Chew | Touch pressure | Linea) Outof Place Vocalisation/ Spice | Modertie | movement | sinaignt | Cocation) | Speech sounds | temperature | (winging) | planes | ' | | | (diagonals) | | | | | | Lick "Light touch | Rotary |” Upside” | Movement} Language (maybe | moventent | down! | though | j Unexpected) | (spinning or | backwards | time and | Extreme | partiot | Space| space | i | temperatures | rotation) | Lae Wilbacyer Sensory modalilion Coucye .PENTIMA PEIN VTIUINIVIEIN E Moving 4 Stable « Jump into a huta hoop Throw bean bag at stationary target while prone over a barrel Bat al a suspended ball that is still ] Jump up-and-down on bounce pad Catch a thrown ball or kick a rolled ball while standing in place | Bat al a pitched ball while standing in a stationary position 7 Shoot at a moving target with a squirt gun while standing in piace Throw bean bags at moving target while prone over barrel CLIENT » Moving | | Push or kick large stationary ball away while swinging in net | | Grab bean bags from \ mat while swinging |-] Propel scooter board around obstacle course ©] Swing on a trapeze into a stack of inner tubes 1°] Throw bean bags at moving target while swinging prone in net |] Shoot at a moving target with a squirt gure while swinging Bat at a swinging target while holding on to a T swing |_| Catch a thrown ball while swinging prone ona swing 4 no g 2 2 ej a 3 3 g ——+ jeneds SLNSW3HINDAY TwWHOdWAL-TVILWdSSensory integration Basic concepts i Meaningful registation of the stimuli must occur before the brain can make a response to it and therefore allow higher functioning to occur including adaptive responses. Lack of registration © Inefficiency in detecting * Under arousal of whole system Masking of response by over arousal of other syste reanized to program the person to seek out stimulation that is 2.Brain is innately organizing or beneficial in itself Sul ‘aput from one serisory system can facilitate or inhibit the state of the entire organism. 4Plasticity within the central nervous system. SSensory input from skin and joints heips to develop the model or internal scheme of the body's design as a motor instrument (A yres,1972,p168). 6 If information which the body receives from somatosensory receptors is not precise , the brain has a poor basis on which to build its scheme of the body(Ayres,1972,p170).Characterstics of sensory integration procedures to be administered by a trained therapist(OT&PT) e Active participation Child directed Individualized treatment Purposeful activity Play fui and funfui context Balance between structure and function Emphasis on elicting adaptive response Input varies based on child’s response Activity rich in proprioceptive , vestibular and tactile input ® Implicd or stated goal of improving processing and e¢eeoeoevee organization of sensation(not the teaching of specific skills )Se ay et a re ae a ata eee AEA eh reten retest CE IEEE Focus of postural abnorr Adjustments and Moveinent patierns In Children with CP Enhancing motor output for functional Performance sensory integrative dystunction Enhancing sensory nd integration @ adaptive Assessment Clinical observations Standardized assessment ‘Toots — SPT Role of therapist Controls direction and Planning of the se Ina functional context controls the environment and guides the child, ‘Treatment is child centred. Treatment mment Utilizes therapeutic self, ic surfaces suspended equipment textured equipments, large inited possibilities] [PPE nerve] SENSORY INELG SENSORY IN EEG ATION Feedforward Postural patterns & muovements ‘Vask