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SENSORY PROCESSING
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  1. SENSORY PROCESSING BUILDING BLOCKS FOR DEVELOPMENT

  2. LEARNING OBJECTIVES Understand the basic principles of sensory processing • Understand the components involved in sensory processing • Understand the benefits of addressing sensory needs • Considerations in assessment and treatment April 2010, Tanya O'Callaghan OTD, OTR/L & Amanda Saliba OTR/L

  3. WHAT IS SENSORY PROCESSING?

  4. SENSORY PROCESSING • IT IS THE USE AND SYNTHESIS OF RAW DATA YIELDINGCOMPLEX BEHAVIOR AND LEARNING • INFORMATION GATHERED FROM ALL SENSORY CHANNELS IS REGISTERED, PROCESSED AND INTERPRETED BY THE BRAIN IN ORDER TO MAKE SENSE OF THE ENVIRONMENT ALLOWING AN INDIVIDUAL EFFECTIVE AND SUCCESSFUL INTERACTION IN THE ENVIRONMENT April 2010, Tanya O'Callaghan OTD, OTR/L & Amanda Saliba OTR/L

  5. Sensory Input taste touch hearing smell sight proprioception Vestibular sensation Filter Cognitive processes Feedback Interpretation Output response April 2010, Tanya O'Callaghan OTD, OTR/L & Amanda Saliba OTR/L

  6. OPTIMAL AROUSAL HIGH LOW April 2010, Tanya O'Callaghan OTD, OTR/L & Amanda Saliba OTR/L

  7. NORMAL DEVELOPMENT Sensory processing disorders impact many areas of a child’s emotional and physical functioning • 47% did not go through the “terrible two’s” or did so late • 37% have a brief or absent crawling phase • 33% have strong positioning preferences as infants • 32% have sleep problems • 31% have feeding problems • 28% were hesitant/delayed going down stairs April 2010, Tanya O'Callaghan OTD, OTR/L & Amanda Saliba OTR/L

  8. IDENTIFICATION OF SENSORY PROCESSING DYSFUNCTION • Interpreting behavioral responses • Establishing patterns of interaction in the environment • Evaluating functional outcomes related to activities of daily living April 2010, Tanya O'Callaghan OTD, OTR/L & Amanda Saliba OTR/L

  9. SENSORY PROCESSING DISORDER • Inclusion in DSM V as a separate condition • Comorbid condition inherent in other diagnoses • Current research looking at physiological and neurological impact as a result of SPD April 2010, Tanya O'Callaghan OTD, OTR/L & Amanda Saliba OTR/L

  10. SENSORY OR BEHAVIOR? • Patterns over time • Specific triggers can be identified • Problems with • Attention and behavior • Social skills or self-esteem • Play Skills • Fine,/gross/oral motor skills • Daily living skills (i.e. eating or dressing) • Sleep/ eating/ elimination April 2010, Tanya O'Callaghan OTD, OTR/L & Amanda Saliba OTR/L

  11. April 2010, Tanya O'Callaghan OTD, OTR/L & Amanda Saliba OTR/L

  12. REGISTRATION Process of taking in and filtering incoming information  • Over registration- allows too much information to pass through the filter • Hypersensitive, hypervigilant • Under registration- too little information is allowed to pass through the filter • Hyposensitive, decreased awareness of self and surroundings April 2010, Tanya O'Callaghan OTD, OTR/L & Amanda Saliba OTR/L

  13. MODULATION • Process of regulating behavioural responses to be proportionate to the stimuli • Allows flexibility and adaptability to environmental demands • Over modulation / defensiveness- increased responsiveness to sensory input • Under modulation / dormancy- decreased responsiveness to sensory input April 2010, Tanya O'Callaghan OTD, OTR/L & Amanda Saliba OTR/L

  14. INTEGRATION The organisation of sensory input to produce appropriate responses • Allows individuals to fully experience the environment • Relies on registration and modulation April 2010, Tanya O'Callaghan OTD, OTR/L & Amanda Saliba OTR/L

  15. INTERVENTION • Use knowledge of normal development, neurological constructs and development, behavior and sensory processing. • Influence the nervous system by providing sensory input and facilitate processing and integration through play and activities of daily living • Influence, adapt or change the environment to meet the needs of the sensory system • Utilize the power of the vestibular and somatosensory (tactile and proprioceptive) systems April 2010, Tanya O'Callaghan OTD, OTR/L & Amanda Saliba OTR/L

  16. THERAPY PROCESS Achieved through • developmental activities graded according to functional ability • Structuring and activity modification • Strategies and techniques grounded in neuro-development and sensory motor exploration • PLAY - the work of a child

  17. What parents can expect

  18. What parents can expect

  19. VESTIBULAR SYSTEM • Fully functional at birth, sensitive system effects of input can last up to 48 hrs • Respond to gravity, motion and changes in direction of movement • Impacts balance, bilateral motor control, reciprocal movement, arousal level, occular motor control, aspects of language development April 2010, Tanya O'Callaghan OTD, OTR/L & Amanda Saliba OTR/L

  20. SOMATOSENSORY SYSTEM • Tactile and proprioceptive stimuli, first system to respond and most mature at birth • First means of environmental interaction, basis for reflex activity • Protection (spinothalamic) • Discrimination (light touch, kinesthesia, vibration)- timing and sequencing influencing feed forward responses • Basis for body schema and body awareness • Essential for grading and coordinating movement • Significant influence on calming and organizing of sensory system April 2010, Tanya O'Callaghan OTD, OTR/L & Amanda Saliba OTR/L

  21. The benefits of addressing Sensory Needs For the individual • Maintenance of an optimal arousal level • Maintenance of a state of well being • Improve tolerance of a variety of stimuli • Decrease fear and anxiety • Prevent episodes of extreme behaviour • Allow for learning and appropriate interaction in the environment April 2010, Tanya O'Callaghan OTD, OTR/L & Amanda Saliba OTR/L

  22. The benefits of addressing Sensory Needs For families and Service Providers • Reduce the need to manage extreme behaviour • Decrease the incidence of injury • Optimize the opportunity of participation and learning • Increase spontaneous interaction • Increase positive interaction • Improve morale through the experience of successful outcomes April 2010, Tanya O'Callaghan OTD, OTR/L & Amanda Saliba OTR/L

  23. Addressing Sensory Processing Needs Stage 1 • Observation within the natural environment Stage 2 • Data collection Stage 3 • Establish patterns of behaviour Stage 4 • Problem solve the incorporation of appropriate sensory strategies Stage 5 • Monitor and adapt for ongoing needs April 2010, Tanya O'Callaghan OTD, OTR/L & Amanda Saliba OTR/L

  24. CONSIDERATIONS • How does the child respond to sensory input? • Arousal level (band of arousal) • Adaptive responses (obvious, subtle) • How are the systems interacting • What sensory demands are we making • Changes over time • Take time and allow time to notice responses April 2010, Tanya O'Callaghan OTD, OTR/L & Amanda Saliba OTR/L

  25. ASSESSMENT TOOLS • Sensory profile – interpretation gained from interview, compared to clinical observations • Clinical Observations (structured/ unstructured) • Charting behavioral responses over time • SIPT (4 yrs +) • Sensory Processing Measure • Standardized testing (motor skills) April 2010, Tanya O'Callaghan OTD, OTR/L & Amanda Saliba OTR/L

  26. Case Study Example 1 • 3 Year old male • Diagnosed with Autism • Received birth to three services • Significant sensory processing difficulties April 2010, Tanya O'Callaghan OTD, OTR/L & Amanda Saliba OTR/L

  27. Case Study Example 2 • 2 year 7 month old girl • Significant history of reflux • Feeding issues • Sensory processing issues • Began OT services in October 2009 April 2010, Tanya O'Callaghan OTD, OTR/L & Amanda Saliba OTR/L

  28. Case Study Example 3 • 6 year 3 month old girl • Diagnosed with Left Hemiplegia • Motor and sensory processing concerns • Began receiving OT services at 10 months of age • Focus initially was NDT, however sensory difficulties affected motor development April 2010, Tanya O'Callaghan OTD, OTR/L & Amanda Saliba OTR/L

  29. April 2010, Tanya O'Callaghan OTD, OTR/L & Amanda Saliba OTR/L

  30. References Ayres, J.A. (1979). Sensory Integration and the Child. Los Angeles, CA Western Psychological Services. Case- Smith, J. et. Al. (2005) Occupational Therapy for Children (5th Ed). St. Louis, MO: Mosby Publishers Fischer, A; Murray, E; & Bundy, A. (1991). Sensory Integration: Theory and Practice. Philadephia, PA: Davis Company Hanshu, B (1997). Autism and Attention Deficit Disorder/ Hyperactivity: A sensory perspective. Phoenix, AZ: Developmental Concepts Kranowitz, C.S. (1998). The out of sync child. New York, NY: Berkley publishing group Shellenberger, S. & Williams, M. (1996). How does your engine run? A leaders guide to the alert program for self-regulation.Albuquerque, NM: Therapy Works, Inc April 2010, Tanya O'Callaghan OTD, OTR/L & Amanda Saliba OTR/L