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– Some Aspects
Sadhana P. Joshi
Head O.T. Department C.O.H.
Introduction
Definition
• Sensory Integration is defined as a neurological process that organizes
sensation of one’s own body and the environment in the brain to make
adaptive response and makes it possible to use the body efficiently within
the environment.
• Sensory Integration function will include the awareness, discrimination and
recognition of sensory stimuli from the environment and from the C.N.S
and use of this sensory information to direct motor behaviour.
Background
• S.I. Therapy was conceived and developed by Dr. Jean Ayers an
Occupational Therapist and psychologist. It explains the relationship
between behaviour and neural function, especially sensory processes and
integration.
• It describes and predicts relationship among neural functioning, sensory
motor behaviour and academic learning.
Sensory Integration (Figure 1)
Sensory
Input
Stimuli
Feedback/ Previous
CNS Integration
Experience
Adaptive
Output
Response
Figure 2
Assumption of Sensory Integration
a. Neural Plasticity
Plasticity refers to the ability of brain to modify and change from 2 to 7
years of age.
b. Occurs in developmental sequences
c. Brain functions as an integrated whole though it consists of parts that are
hierarchically arranged
d. Adaptive response
Requires the child to organize the sensation, accurately judge the
requirement of the situation and execute response completely.
[Controlled sensory input can be used to elicit adaptive response.]
a. Inner drive
Child has inner drive to develop S.I. through participation in sensory
motor activity.
Sensory Integration and Praxi’s test (SIPT)
Sensory Integration and Praxi’s test (SIPT) includes:
a. Tactile and vestibular proprioceptive sensory processing test
i. Kinesthesia
ii. Finger identification
iii. Graphesthesia
iv. Localization of tactile stimuli
v. Post rotatory Nystagmus
vi. Standing and walking balance
b. Form and space perception and visio-motor coordination test
c. Praxi’s Test
i. Design copying
ii. Constructional praxis
iii. Postural praxis
iv. Praxis on verbal commands
v. Sequential praxis
vi. Oral praxis
Sensory Integration and Praxi’s test (SIPT)
d. Bilateral integration and sequencing test
i. Oral praxis
ii. Sequencing praxis
iii. Graphesthesia
iv. Bilateral motor coordination
v. Space visualization
vi. Contralateral and preferred hand use
e. Bilateral motor coordination
Requires the child to imitate smoothly executed movements of hand and
feet after they are demonstrated by examiner. Reciprocal interaction of
right and left are used.
Signs and symptoms reflecting sensory integrative
root problems
Signs and symptoms reflecting sensory integrative root problems:
Tactile sensitivity (Hyper)
a. Express distress during grooming
b. Prefers long sleeved clothing when it is warm and short sleeved when it is
cold.
c. Avoid going barefoot especially sand or grass.
d. React emotionally or aggressively to touch.
e. They desist from splashing water.
f. Has difficulty standing in line or close to other people.
g. Rub or scratch out a spot that has been touched.
Movement sensitivity (Vestibular)
a. Become anxious or distressed if feet leave the ground.
b. Fear of falling or height.
c. Dislike activities if head is upside down (e.g. somersaults)
Taste/ Smell sensitivity
a. Avoid certain tastes or food smell
b. Limit self to particular food, texture or temperature.
Signs and symptoms reflecting sensory integrative
root problems
Auditory filtering
a. Is distracted or has trouble functioning if there is lots of noise around
b. Appear to not hear what you say
c. Can’t work with background noise
d. Has trouble completing task when the radio is on
e. Has difficulty paying attention
Low energy / Weak motor signs
a. Seems to have weak muscle
b. Tires easily
c. Has a weak grasp
d. Can’t lift heavy objects
e. Poor endurance
f. Poor handwriting
g. Problem in tying shoe laces
h. Poor sense of rhythm
i. Poor A.D.L
j. Articulation problem in speech
Signs and symptoms reflecting sensory integrative
root problems
Visual / Auditory sensitivity
a. Prefers to be in the dark
b. Responds negatively to unexpected sound or bright light
c. Holds hands over ears to protect ears from sound
d. Watches everyone when they move around the room
e. Becomes frustrated when trying to find object in competing background
(e.g. cluttered drawer / shoes from rack)
f. Difficulty in puzzles
Emotional and Behavioural
a. Low self esteem, lack of self confidence, insecure, frustrated, irritable,
moody, aloof
b. Self injury, temper tantrum, No peer relationship, impulsive, aggressive
c. Resistant to change and stubborn
Cognitive / Academic
a. Attention problems, distractible, cannot refocus, lazy, slow, forgets
assignments/ direction
n. Poor organization, sequencing and memory
Conclusion
Sensory Integration approach is having –
a. Non cognitive emphasis
b. Flexible sequences
c. Exploration and creativity
d. Child’s control
e. Therapist guided
f. One to one inter-reaction
g. Improve brain processing
h. Suspended equipment mandatory.
Thank You