Sabtu, 19 Juni 2010

Sensory Integration

What is Occupational Theraphy?

Occupational Theraphy is a health profession concerned with how people function in their respective roles and how they perform activities. The profession focuses on the promotion restoration and maintenance of productivity in people with a wide range of abalities and disabilities.

Occupational Theraphists graduate from universities with a baccalaurcate or masters degree. They educated in the behavioural and neuroscienes and learn how to develop sklills and promote independentce through the use of meaningful activities. The Occupational Theraphists ( O.T ) may provide direct service to individual clients and organizations through consultation mediator training, education, program development, case management and advocacy. The OT may provide these services in individual homes, child care centres, schools, hospital, community and private agencies and clinics or industrial or residential facillities.

OT are able to analyze all internal and external factors that are necessary for individuals to perform activities. Consider the grade one student who is learning to print. To learn this task, the student must have good hand skills, good sitting posture and balance, adequate joint stability and muscle strength, good body awareness and motor planning, mature visual perceptual and visual motor skills, good attending abalities and adequate sensory integration.

If sensory integration impaired, the student could have difficulty printing because she may be uncomfortable with the touch of the paper against her arm and may have difficulty attending to the task as she is highly distracted by other activities that are occuring in the classroom. If the student has poor motor planning abalities, she may not be able to direct the movements of the pencil to approariately from the required letter shapes. If the student has immature sitting balance the height of the desk and chair will have to be analyzed and possibly altered to provide maximum stability.

Occupation al therapists are concerned with :

Abalities:
balance and postural reaction
muscle tone and strength
body awareness
fine motor abalities 9pinches and grasp, manipulative skills, pencil and scissors use hand writing)
gross motor abalities (running, jumping, climbing)
motor planning (abality to plan, initiate and execute a motor act)
visual perception (shape recognition, visual memory)
visual motor integration (copying shapes, copying block design)
sensory integration (response to sensory stimuli, discrimination of sensory input)
behaviour (arousal level, attention, problem solving skills)
Skills:
Self care skills ( eating, toileting, bathing)
community living skills( use of public transportation, money knowlage, shopping)
pre-academic skills
play skills (use of toys, types of play)
social skill
pre-vocational and vocational skill

Environmental Factors:
physical environment
family situation
community support

Occupational Therapists provide consultation in the following areas:
early intervention programs
home school and vocational settings
environmental and equipment adaptations
bahavioural strategies

WHAT IS SENSORY INTEGRATION?

Picture yourself at a cottage. You are standing on the dock, about to climb into a canoe. You put your foot down into the canoe and as you begin to step in, the canoe starts to rock. Automatically you adjust your body to keep yourself balanced and slowlly sit down, palacing yourself in the middle of the seat. THIS IS SENSORY INTEGRATION.

Sensory integration is a neurogical process that accurs in all of us. We all take in sensory information from our bodies and the world around us. Our brains are programmed to organize or “integrate” this sensory information to make it meaningful to us. This integration allows us to respond automatically, efficiently and comfortably in response to the specific sensory input we receive.

When stepping into that canoe, you recive information from various sensory channels. Your touch system tells you that your foot is on the bottom of the canoe. Your proprioceptive system tell you the position of your muscles and joint. Your vestibular system may be telling you that your centre of gravity is off and that you are on a moving surface. Your visual system determines that the canoe is lower that the dock.

If you good sensory integration, processing and organizing this information happens automatically. You do not become overly fearful when the boat moves because you are confident that you can maintain your balance. Unconsiously you make fine adjustment and regain your centre of gravity. You can lower self to the seat because you judge the distance of the canoe from the dock and the size of seat. You also have good sense of where to sit and how much to move to centre yourself on the seat.

For the child who does not have good sensory integration, climbing into a canoe can be a disaster. One child may be quite fearful about the prospect of climbing into about because they are uncomfortable with or hypersensitive to the feeling of movement. They are terrified of anything that moves and do not have the confidence to maintein their balance. Another child may be overconfident and may not appreciate what can happen when balancing on a moving object. That child may climb into the canoe quickly, tipping the boat because they have poor body awareness and place all their weight to one side of the canoe.
HOW DID THE THEORY OF SENSORY INTEGRATION DEVELOP?

Occupational therapist Dr A Jean Ayres first proposed the theory of sensory integration. She was practicing in a children's centre during the late fifties and early sixties and she developed a keen interest in how the brain works. Returning to university, Dr. Ayres attained a doctoral degree and pursued postdoctoral work. During her studies she formulated the theory of sensory integration based on established knowlage and theories found within the neuroscience field (Fisher, Muray & Bundy,1991)
In addition to her two books, Dr. Ayres also developed two test batteries to assist in identifying problem with sensory integration (ayers 1979 and Ayres 1985)

her theory discribes normal sensory integrative abilities, defines sensory integrative dysfunction and guides intervention program which use sensory integrative techniques (Fisher et al 1991). This theory continues to evolve and provides a framework for intervention with children and adults with a variety of special needs. The theory of sensory integration is an important frame of reference for the occup ational therapy profession but is also becoming a valuable perspective for other disciplines (Windeck&laurel 1989, Mora & Kasman, 1997)

HOW DOES SENSORY INTEGRATIN OCCURE?
Williamson and Anzelone (1996) identify five interrelated components that help to understand how sensory integration occurs. These components are :
1.Sensory Registration

Sensory integration occurs when we first become aware of a sensory event “ Something is touching me”. We may not be aware of certain types of sensory input untuil it reaches a certain threshold or intensity. your”sensory threshold” varies throughout the day, depending on your previous sensory an emotional experiances, how alert or stressed you are and what you expect.

You may not be aware of mosquito buzzing by the window but when it is flying around your head you hear something. You have experiances that sound before and you expect the mosquito to land, creating a bite that will itch for day.

When you are highly aroused or anxious, your sensory threshold is lower and you may register sensory input that may go ignored any other time. If you are awakened in the night by a loud 'bang” you may become highly aroused and hyper-vigilant. You may notice or “register” the sound of creaking stairs and humming fixtures that you never pay attention to during the day.

Examples of hyper-reactivity :
distress with certain sounds
sensitives to light
discomfort with certain textures
aversion to certain smell and tastes
irritional fear of height and movement
frequent startle reactions

Examples of hypo-reactivity :
disregard of sudden or loud sounds
unaware of painful bumps, bruises cuts, etc
lack of attention to environment, person or things
does not become dizzy with excessive spinning
delayed responses

2.Orientation

Sensory orientation allows you to pay attention to new sensory information being received. “something is touching my arm” or “ I hear something around my head”. We are able to determine what sensory information needs our attentions and what information can ignored. This happens through sensory modulation and the functions of inhibition and facilitation.

Our brains are programmed to modulate or balance incoming sensory information to function efficiently. We can not possible attend to all sensory stimuli in our environments. If all sensory input had equal importance, we could not select the relevant stimuli for the specific situation.



3.Interpretation
4.Organization of a Response
5.Execution of a Response

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