Sensory integration definition
- Organization of sensory input for use
- Foundation for adaptive responses to challenges of environment and learning
- Provides foundation for meaningful and purposeful participation in daily activities
- Dynamic interaction between abilities and environmental interaction
Sensory input/stimulation
- CNS differentiates between input that is related and non-related
- internal/external feedback
When feedback to be processed is increased in frequency and variety the more difficult adaptive response is to organize
Sensory input importance
- Gives information on environmental affordances
- Important for motor learning
- Point of correctness or anatomical alignment
- Must have sensory experience in posture before activity in the posture.
Definition of sensory integration
The ability to organize and process information from the environment and body to produce an adaptive, goal oriented response
Tactile, vestibular, and proprioceptive information in first years of life
Outcomes of Effective SI
Motor planning Balance Bilateral coordination Postural stability Body schema Self image Eye-hand coordination
Movement disorders in children with SI dysfunction
Poor posture Extension/flexion vs gravity Rotation Cocontraction Wt Bearing/shifting In hand manipulation and grasping Oral motor
SI problems with neuromotor disorders
- Poor proprioceptive feedback
- Inability to make postural adjustments
- Difficulty with bilateral coordination
- Tactile defensiveness, discrimination, hyporesponsive
- Vestibular problems: GI, adverse reaction to movement
- Praxis: execution vs Praxis
- Alertness and arousal
Types of sensory stimuli
Vestibular, proprioceptive, tactile, vision, auditory, and gustatory
Channels of delivery: no system is inherently facilitative or inhibitive
0-12 months sensory response evaluation
Is baby irritable?
Does infant put toys in mouth?
Sleep patterns
Does infant like to be held?
12-18 months sensory response evaluation
Explore new textures, finger feed
Follow directions
Is child stuck in certain type of play
18-36 months sensory response evaluation
How does child play Changes activity level appropriate for play Excessive need to move Explore new toys/environments Remains focused on task Transitions well.
How to choose sensory stimulation
Select naturally occuring
Use stimuli that pt has to respond outside therapy
Appropriate to activity and muscles
Use vestibular to elicit postural adjustments
Consider muscle tone
Identify preferred sensory input
Impaired systems may interpret things differently
Caution for overstimulation
Can change daily
Decrease sensory input with adaptation
Often start with proprioception
Proprioceptive input
Quick stretch
Vibration
Jt approximation, compression, traction
Guidance, assistance, resistance
Tactile input
Watch for tactile defensiveness
Vestibular input
used to arouse postural extensors and increase or decrease level of alertness
Auditory input
- may become dependent on verbal feedback
- May have to change tone, volume, rate, or rhythm if child startles easily
- Consider effects of musical toys
Visual input
In impaired in other systems, may use visual to compensate: consider use of contrasts, lights, mirrors.
May require more tactile or vestibular information
Characteristics of treatment procedures
Active participation of child Child directed Individualized Purposeful Need for adaptive response
Levels of adaptive response
- Response to passive stimuli
- Hold on and stay
- Alternate contraction/relaxation
- Move independently through the environment in a familiar way.
- Complicated, unfamiliar activity with difficult timing
Treatment procedures
Activities should include proprioception, vestibular, and tactile input
Input varies on pt response
Goal is to improve processing and organization, not teaching a specific skill
Behavioral considerations for SI
Protect self-esteem
Let child avoid tasks that appear threatening
Provide consistent positive and negative consequences as motivation
identify end product for child
Therapist responsibility
Choose skill
Modify the environment correctly.
use sensory systems to increase or decrease alertness.
initially provide visual and auditory assists.
offer limited choices.
Model as needed, and reduce modeling as you progress.
use spontaneous movement.
use real life situation.
Learning vs. performance
Learning: retention, carryover, and limited feedback (kids need more than adults tho)
Performance: not permanent, lots of feedback, dependent on environment
Alertness or arousal activities: vestibular
rolling rocking-rocking horse/chair running tricycle sit and spin slides hammocks scooters
Increase mobility during the day
