COGNITIVE AND
PERCEPTUAL THERAPY
Areas a Pediatric Occupational Therapist treats
- Visual discrimination - finding the similarities & differences
- Visual spatial relationships - being able to identify reversals of objects
& symbols
- Visual sequential memory - to recall a shape from 4 choices after 4-5
seconds
- Visual memory - identifying a shape that has been memorized from the
previous page
- Visual form constancy - finding the same shape when it is resized or
rotated
- Visual figure ground - finding an object within a busy background
What to look out for in your child
- Inattention and distractability to written and or reading tasks
- Difficulty in letter recognition and letter reproduction
- Reversal of letters such as b for d or p for q
- Difficulty copying from a blackboard or a whiteboard
- Poor orientation of puzzle pieces - "gives up"
- Poor at following instructions Congnitive and Perceptual
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SELF
CARE
Areas a Pediatric Occupational Therapist treats
- Orientate clothing, shoes & socks
- Right & left discrimination while dressing
- Back & front discrimination while dressing
- Strategies, techniques & ideas for cues when dressing (visual, physical
or verbal)
- Feeding: grasp, bilateral co-ordination (knife & fork), strength, control
- Bathing: includes back care techniques for parents. Sequencing body
parts to wash (rhyme)
- Hygiene: toileting, grooming (hair & teeth brushing), nail care
What to look out for in your child
- Dressing: clothes or shoes on backwards
- Dressing: shoes on wrong feet
- Food is pushed off plate
- Messy eaters
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SOCIAL
SKILLS
Areas
a Pediatric Occupational Therapist treats
- Co-operative play / sharing skills
- Develop self concept / self esteem
- Attention
- Listening skills
- Following directions
What to look out for in your child
- Withdrawal from social situations
- Lack of group interaction (avoidance)
- Lack of confidence in oneself
- Poor eye contact
- Poor body language
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FINE
MOTOR
Areas a Pediatric Occupational Therapist treats
- Finger, hand strength, position & stability
- Pencil grip & control
- Wrist &/or forearm control
- Copying shapes
- Fluency / finger movements
- Spatial organization (space & letter formation)
- Quality of work
- Visual perception skills
- Speed & dexterity
- Tweezers, scissors, finger isolated movements
What to look out for in your child
- No interest
in fine motor skills
- Gross pencil grasp
- Poor scissor skills
- Clumsy grasp & release skills
- Difficulty holding small objects, manipulating tools, pencils or scissors
- Unable to complete mazes, dot-to-dots, etc
- Difficulty copying text from whiteboard or blackboard
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GROSS
MOTOR
Areas a Pediatric Occupational Therapist treats
- Ball skills - throwing & catching, hitting ball
- Balance: Hopping, balancing on one leg, walking on a balance beam, walking
heel-toe
- Clumsiness
- Awkward running or jumping
- Co-ordination of body sides: difficulty skipping, doing star jumps
- Difficulty with dancing, Simon Says
What to look out for in your child
- Flinching or other responses when catching a ball
- Fear response to gross motor activities
- Level of avoidance or motivation to gross motor activities
- Unable to hop, skip, jump, run, etc
- Difficulty co-ordinating body sides
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Speech Language Pathology (Speech Therapy)
Through referral from a physician, speech language pathology services are provided to individuals from infancy through 18 years. Infants and toddlers may receive speech therapy if they have feeding and swallowing problems, or need assistance developing joint attention or verbal communication. Preschool children may require some extra help to learn basic skills such as communicating needs and wants and social skills. School-age children often go to speech therapy to learn to correct articulation errors and improve language skills.
If you, or your child, have any of the following symptoms you may benefit from speech therapy:
- developmental speech delay
- swallowing or feeding difficulties
- fluency (stuttering) disorders
- voice disorders
- articulation disorders
- language disorders
- oral motor deficits
- cognitive delays
Your speech therapist will offer assistance with:
- speech and language skills
- listening and understanding
- augmentative and alternative communication, such as sign language or using a communication device
- swallowing and feeding disorders
- cognitive skills including organization, memory, and word retrieval
Sensory Integration Therapy
The treatment concepts related to sensory integration come from a body of work developed by A. Jean Ayres, PhD, OTR in the 1950s and 1960s. As an occupational therapist, Dr. Ayres was interested in the way in which sensory processing and motor planning disorders interfere with daily life function and learning. This theory has been developed and refined by the research of Dr. Ayres, as well as other occupational and physical therapists. In addition, literature from the fields of neuropsychology, neurology, physiology, child development, and psychology has contributed to theory development and intervention strategies.
At Treehouse Pediatric Center, an occupational therapist that has had numerous hours of training in the theory and assessment of sensory integration disorders/sensory processing disorders will perform the evaluation.
What is Sensory Integration?
Signs of Sensory Integrative Dysfunction
Assessment
Treatment
Resources
Summary of Points
What is Sensory Integration?
Our senses give us the information we need to function in the world. The senses receive information from stimuli both outside and inside our bodies. The five senses of hearing, seeing, taste, smell and touch respond to external stimuli that come from outside our bodies. The vestibular, proprioceptive, and tactile senses are the three body-centered sensory systems that provide the sense of oneself in the world. To do their job well Ð so that we respond appropriately, the senses must work together. Together, they provide a well balanced diet for the brain. A brain that is nourished with many sensations operates well, and when our brain operates smoothly, so do we.
Sensory integration is the neurological process of organizing the information we get from our bodies and from the world around us for use in daily life. Sensory integration provides a crucial foundation for later more complex learning and behavior. For most children, sensory integration develops in the course of ordinary childhood activities. The organization of behavior, learning and performance is a natural outcome of the process, as is the ability to adapt to incoming sensations. But for some children, sensory integration does not develop as efficiently as it should. When the process is disorder, a number of problems in learning, development, or behavior may become evident to families and professionals.
Sensory integration dysfunction is a problem in processing sensations which causes difficulties in daily life. Sensory integration dysfunction is a complex neurological disorder, manifested by difficulty detecting, modulating, discriminating or integrating sensation adaptively. This causes children to process sensation from the environment or from their bodies in an inaccurate way, resulting in "sensory seeking" or "sensory avoiding" patterns or "dyspraxia", a motor planning problem. Carol Stock Kranowitz states the sensory integration dysfunction may affect 12% to 17% of children and throws some kids "out of sync" emotionally, socially, and behaviorally.
Signs of Sensory Integrative Dysfunction/Sensory Processing Disorder
When the process of Sensory Integration is disordered, a number of problems in learning, motor development or behavior may be observed:
- Overly sensitive to touch, movements, sights, or sounds.
Behavior issues: distractible, withdrawal when touched, avoidance of textures, certain clothes, and foods. Fearful reactions to ordinary movement activities such as playground play. Sensitive to loud noises. May act out aggressively with unexpected sensory input.
- Under-reactive to sensory stimulation.
Seeks out intense sensory experiences such as body whirling, falling and crashing into objects. May appear oblivious to pain or to body position. May fluctuate between under and over-responsiveness.
- Unusually high/low activity level.
Constantly on the move or may be slow to get going, and fatigue easily.
- Coordination problems.
May have poor balance, may have great difficulty learning a new task that requires motor coordination, appears awkward, stiff, or clumsy.
- Delays in academic achievement or activities of daily living.
May have problems in academic areas, despite normal or above normal intelligence. Problems with handwriting, scissors use, tying shoes, buttoning and zipping clothes.
- Poor organization of behavior.
May be impulsive, distractible, lack of planning in approach to tasks, does not anticipate result of actions. May have difficulty adjusting to a new situation or following directions. May get frustrated, aggressive, or withdraw when they encounter failure.
- Poor self concept.
May appear lazy, bored, or unmotivated. May avoid tasks and appear stubborn or troublesome.
Assessment
Our assessments are designed to answer some of the questions families have as they seek to provide and advocate for the child's special needs at home, in school and in the community. For many families, the initial assessment is the first step toward understanding the learning and behavior difficulties their children are experiencing. Assessments are individualized and may be a combination of standardized tests and functional observations of performance in a variety of activities. An interview with family members helps us understand how the child perceives and responds to sensation and what the child and family already know about what works and doesn't work to support or compromise activities of daily living. This information is most valuable in determining the child's abilities in sensory processing and sensory integration. The assessment process also includes trying some intervention strategies to determine whether treatment is warranted or not and what activities might be immediately implemented.
Treatment
Treatment services are varied and designed to address individual needs of children of all ages. Our philosophy is to support what the child already knows about the way their system processes and uses sensation and activity to interact with their environment. The sensory integration approach is rich in vestibular, proprioceptive, and tactile inputs; areas where many children with neurological issues have deficits. The approach seeks to encourage the nervous system to process and integrate sensory input in organized and meaningful ways, which will ultimately enhance the ability of the nervous system to function more adequately. Each adaptive response, as it provides feedback into the nervous system, encourages maturation and organization of the nervous system at increasingly higher levels. Ultimately the individual is able to interact with his/her environment in more successful and adaptive manners.
Resources
BOOKS:
- A Parent's Guide to Understanding Sensory Integration (1991) Torrance, CA, Sensory Integration International
- Anderson, E. and Emmons, P. (1996). Unlocking the mysteries of sensory integration. Arlington, TX: Future Horizons.
- Ayres, A.J. (1979) Sensory Integration and the Child. Los Angeles, CA. Western Psychological Services.
- Fisher, A.G. & Murray, E.A. (1991). Sensory integrative theory and practice. Philadelphia, PA: F.A. Davis.
- Greenspan, S.I. (1995). The challenging Child. New York, NY. Addison-Wesley.
- Greenspan, S.I. & Wieder, S. (1998). The child with special needs. Encouraging intellectual and emotional growth. MA. Amerloyd Lawrence Book, Addison- Wesley.
- Kranowitz, C.S. (1998). The out-of-synch child: Recognizing and coping with sensory integration dysfunction. New York: A Perigree Book.
- Quirk, N.J. & Dimatties, M.E. (1990). The relationship of learning problems and classroom performance to sensory integration. Cherry Hill, N.J.N. Quirk & M. DiMatties.
- Trott, M.C., Laurel, M.D. and Windeck, S.L. (1993). Senseabilities: Understanding sensory integration. Tuscon: Therapy Skillbuilders
Summary of Points
1. Sensory integration is the organization of sensations for use.
2. Sensory information is constantly entering your brain from all 7 of your senses. The sensory systems are inter-related.
3. A strong basis in sensory integration enhances development of higher level gross and fine motor skills. It also contributes to better self-esteem, self control and improved attention span.
4. Sensory integration therapy provides controlled sensory input with the goal being increased adaptive behaviors/responses.
5. Behaviors are in many cases involuntary and are reactions to the child's internal and external environments and their inability or attempt to sort out this information.
6. There is no cookbook recipe for intervention. Each child is unique in strengths, interests, deficits and degrees to which deficits manifest themselves.
7. SI is one treatment approach amongst many. Different treatment approaches address different deficit areas and different needs.
8. SI is not a profession. It is a treatment approach used by occupational and physical therapists who have special training in assessment and treatment of sensory processing disorders.
9. Sensory stimulative programs and SI therapy are two very different agendas. |
PICTURES
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