The following is a checklist of possible signs and symptoms that a child may be experiencing difficulties with sensory integration. This is not meant to be inclusive, but rather an overview of the more common indicators of possible sensory dysfunction:

• Overly sensitive to touch, movement, sights or sounds
• Under-reactive to touch, movement, sights or sounds
• Activity level that is unusually high or unusually low
• Difficulties with coordination
• Delays in speech or language skills
• Delays in motor skills (fine and/or gross)
• Difficulties with academic achievement
• Poor self-concept
• Difficulties with executive functioning
• Challenging behaviors

While the above checklist provides a starting point, conceptualize sensory integration and its dysfunction is on a continuum Sensory processing is complex because it is not an all or nothing thing. That is why it is critical that we begin looking at development more comprehensively. Therefore, if a parent or a teacher suspects that a child is struggling, then we encourage him/her to become a “detective” and begin to look at the whole child.

Historically, pediatricians, educators and parents have been taught to compartmentalize child development. For example, can a five- month -old baby drink out of a bottle? Can a Kindergartner print his/her first name independently? Traditionally, these questions have been answered by indicating that a skill was either “achieved” or “not achieved”. As a result, the developmental timeline may not necessarily reflect “qualitative” differences in performance when assessing skill development. It is our opinion that evaluators (parents, caregivers, daycare providers, teachers or pediatricians) need to be keenly aware of the “quality” of the skill that they are assessing. This is critical for the child with sensory issues. So let’s say the kindergartner is able to write his name independently. However, his grasp alternates from a mature to an immature grasp, he has a very light touch, the letters are huge, with many letters formed from the bottom up. Can we really say that this skill is really achieved? Not if we are looking at the quality of the skill.

As sensory “detectives” we look at the whole child, tease apart patterns of behavior, and look at the quality of skills across developmental domains such as cognitive, language and communication skills, adaptive skills, social and emotional skills and motor skills.

source : comeuiity.com

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email : judarwanto@gmail.com,

Copyright © 2009, Clinical Pediatric Online Information Education Network. All rights reserved.

Supported  by
CLINICAL PEDIATRIC ONLINE 

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phone : 62(021) 70081995 – 5703646 

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http://clinicalpediatric.wordpress.com/

Clinical and Editor in Chief :

WIDODO JUDARWANTO

email : judarwanto@gmail.com,

Copyright © 2009, Clinical Pediatric Online Information Education Network. All rights reserved.

SID is not a diagnosis, but it can be linked to conditions, including autism spectrum disorders, attention deficit disorder, dyslexia, Developmental Dyspraxia, Tourette syndrome, multiple sclerosis, and speech delays, among many others. It is considered a ‘soft sign’ of neurological dysfunction that does not require treatment.

Unfortunately, diagnosis is increasing by developmental pediatricians, pediatric neurologists, and child psychologists. There are no plans to include it in future editions of the American Psychiatric Association’s Diagnostic and Statistical Manual as a discrete diagnosis, Regulatory-Sensory Processing Disorder is an accepted diagnosis in Stanley Greenspan’s Diagnostic Manual for Infancy and Early Childhood and the Zero to Three’s Diagnostic Classification.

Classifications

There are now three types of Sensory Processing Dysfunction, as classified by Stanley I. Greenspan as supported by the research of Lucy J. Miller, Ph.D., OTR. These new terms are meant to increase understanding between Occupational Therapists and other professionals who frequently encounter SID and physicians and other health professionals who approach sensory integration dysfunction from a more neurobiological vantage.

This understanding is critical as physicians are responsible for diagnosing SPD, which is a necessary step in accessing reimbursement (eventually from insurance companies) for professional services to treat SPD.

Sensory Processing Dysfunction is being used as a global umbrella term that includes all forms of this disorder, including three primary diagnostic groups:

• Type I – Sensory Modulation Disorder
• Type II – Sensory Based Motor Disorder
• Type III – Sensory Discrimination Disorder

Type I – Sensory Modulation Disorder (SMD). Over, or under responding to sensory stimuli or seeking sensory stimulation. This group may include a fearful and/or anxious pattern, negative and/or stubborn behaviors, self-absorbed behaviors that are difficult to engage or creative or actively seeking sensation.

Type II – Sensory Based Motor Disorder (SBMD). Shows motor output that is disorganized as a result of incorrect processing of sensory information.

Type III – Sensory Discrimination Disorder (SDD). Sensory discrimination or postural control challenges and/or dyspraxia seen in inattentiveness, disorganization, poor school performance.

This information is adapted from research and publications by: Lucy, J. Miller, Ph.D., OTR, Marie Anzalone, Sc.D., OTR, Sharon A. Cermak, Ed.D., OTR/L, Shelly J. ,Lane, Ph.D, OTR, Beth Osten, M.S,m OTR/L, Serena Wieder, Ph.D., Stanley I. Greenspan, M.D..

All different types of SPD are diagnosed by a questionnaire.

Sensory modulation

Sensory modulation refers to a complex central nervous system process by which neural messages that convey information about the intensity, frequency, duration, complexity, and novelty of sensory stimuli are adjusted.

Behaviorally, this is manifested in the tendency to generate responses that are appropriately graded in relation to incoming sensations, neither underreacting nor overreacting to them.

[edit] Sensory Modulation Problems

• Sensory registration problems – This refers to the process by which the central nervous system attends to stimuli. This usually involves an orienting response. Sensory registration problems are characterized by failure to notice stimuli that ordinarily are salient to most people.
• Sensory defensiveness – A condition characterized by over-responsivity in one or more systems.
• Gravitational insecurity – A sensory modulation condition in which there is a tendency to react negatively and fearfully to movement experiences, particularly those involving a change in head position and movement backward or upward through space.

(Case-Smith, (2005)

Hyposensitivities and hypersensitivities

Sensory integration disorders vary between individuals in their characteristics and intensity. Some people are so mildly afflicted, the disorder is barely noticeable, while others are so impaired they have trouble with daily functioning.

Children can be born hypersensitive or hyposensitive to varying degrees and may have trouble in one sensory modality, a few, or all of them. Hypersensitivity is also known as sensory defensiveness. Examples of hypersensitivity include feeling pain from clothing rubbing against skin, an inability to tolerate normal lighting in a room, a dislike of being touched (especially light touch) and discomfort when one looks directly into the eyes of another person.

Hyposensitivity is characterized by an unusually high tolerance for environmental stimuli. A child with hyposensitivity might appear restless and seek sensory stimulation.

In treating sensory dysfunctions, a “just right” challenge is used: giving the child just the right amount of challenge to motivate him and stimulate changes in the way the system processes sensory information but not so much as to make him shut down or go into sensory overload.

The “just right” challenge is absent if the activity and the child’s perception of activity do not match. In addition, deep pressure is often calming for children who have sensory dysfunctions. It is recommended that therapists use a variety of tactile materials, a quiet, subdued voice, and slow, linear movements, tailoring the approach to the child’s unique sensory needs.

While occupational therapy sessions focus on increasing a child’s ability to tolerate a variety of sensory experiences, both the activities and environment should be assessed for a “just right” fit with the child. Overwhelming environmental stimuli such as flickering fluorescent lighting and bothersome clothing tags should be eliminated whenever possible to increase the child’s comfort and ability to engage productively. Meanwhile, the occupational therapist and parents should jointly create a “sensory diet,” a term coined by occupational therapist Anna Jean Ayres.

The sensory diet is a schedule of daily activities that gives the child the sensory fuel his body needs to get into an organized state and stay there. According to SI theory, rather than just relying on individual treatment sessions, ensuring that a carefully designed program of sensory input throughout the day is implemented at home and at school can create profound, lasting changes in the child’s nervous system.

Parents can help their child by realizing that play is an important part of their child’s development. Therapy involves working with an occupational therapist and the child will engage in activities that provide vestibular, proprioceptive and tactile stimulation. Therapy is individualized to meet the child’s specific needs for development. Emphasis is put on automatic sensory processes in the course of a goal-directed activity. The children are engaged in therapy as play which may include activities such as: finger painting, using Play-Doh type modeling clay, swinging, playing in bins of rice or water, climbing, etc.

Relation to other disorders

Autism spectrum disorders

Unusual responses to sensory stimuli are more common and prominent in autistic children, though there is no good evidence that sensory symptoms differentiate autism from other developmental disorders.Differences are greater for under-responsivity (for example, walking into things) than for over-responsivity (for example, distress from loud noises) or for seeking (for example, rhythmic movements). The responses may be more common in children: a pair of studies found that autistic children had impaired tactile perception while autistic adults did not.

Other disorders

Some argue that sensory related disorders may be misdiagnosed as Attention-Deficit/Hyperactivity Disorder (ADHD) but they can coexist, as well as emotional problems, aggressiveness and speech-related disorders such as apraxia. Sensory processing, they argue, is foundational, like the roots of a tree, and gives rise to a myriad of behaviors and symptoms such as hyperactivity and speech delay.

For example, a child with an under-responsive vestibular system may need extra input to his “motion sensor” in order to achieve a state of quiet alertness; to get this input, the child might fidget or run around, appearing ostensibly to be hyperactive, when in fact, he suffers from a sensory related disorder

Researchers have described a treatable inherited sensory overstimulation disorder that meets diagnostic criteria for both attention deficit disorder and sensory integration dysfunction

Sensory integration therapy

Several therapies have been developed to treat SID.Some of these treatments (for example, sensorimotor handling) have a questionable rationale and no empirical evidence. Other treatments (for example, prism lenses, physical exercise, and auditory integration training) have had studies with small positive outcomes, but few conclusions can be made about them due to methodological problems with the studies. Although replicable treatments have been described and valid outcome measures are known, gaps exist in knowledge related to sensory integration dysfunction and therapy. Empirical support is limited, therefore systematic evaluation is needed if these interventions are used.

The main form of sensory integration therapy is a type of occupational therapy that places a child in a room specifically designed to stimulate and challenge all of the senses.

During the session, the therapist works closely with the child to provide a level of sensory stimulation that the child can cope with, and encourage movement within the room. Sensory integration therapy is driven by four main principles:

• Just Right Challenge (the child must be able to successfully meet the challenges that are presented through playful activities)
• Adaptive Response (the child adapts his behavior with new and useful strategies in response to the challenges presented)
• Active Engagement (the child will want to participate because the activities are fun)
• Child Directed (the child’s preferences are used to initiate therapeutic experiences within the session).

Children with lower sensitivity (hyposensitivity) may be exposed to strong sensations such as stroking with a brush, vibrations or rubbing. Play may involve a range of materials to stimulate the senses such as play dough or finger painting.

Children with heightened sensitivity (hypersensitivity) may be exposed to peaceful activities including quiet music and gentle rocking in a softly lit room. Treats and rewards may be used to encourage children to tolerate activities they would normally avoid.

While occupational therapists using a sensory integration frame of reference work on increasing a child’s ability to tolerate and integrate sensory input, other OTs may focus on environmental accommodations that parents and school staff can use to enhance the child’s function at home, school, and in the community (Biel and Peske, 2005). These may include selecting soft, tag-free clothing, avoiding fluorescent lighting, and providing ear plugs for “emergency” use (such as for fire drills).Some occupational therapists also treat adults with this condition.

Reference :

Schaaf RC, Miller LJ (2005). “Occupational therapy using a sensory integrative approach for children with developmental disabilities”. Ment Retard Dev Disabil Res Rev 11 (2): 143–8. doi:10.1002/mrdd.20067. PMID 15977314. 

Hodgetts S, Hodgetts W (2007). “Somatosensory stimulation interventions for children with autism: literature review and clinical considerations”. Can J Occup Ther 74 (5): 393–400. PMID 18183774.

Rogers SJ, Ozonoff S (2005). “Annotation: what do we know about sensory dysfunction in autism? A critical review of the empirical evidence”. J Child Psychol Psychiatry 46 (12): 1255–68. doi:10.1111/j.1469-7610.2005.01431.x. PMID 16313426.

Sensory integrative therapy“. Research Autism. http://www.researchautism.net/interventionitem.ikml?print&ra=28&infolevel=4. Retrieved 2007-10-08. 

Baranek GT (2002). “Efficacy of sensory and motor interventions for children with autism”. J Autism Dev Disord 32 (5): 397–422. doi:10.1023/A:1020541906063. PMID 12463517.   

Ben-Sasson A, Hen L, Fluss R, Cermak SA, Engel-Yeger B, Gal E (2008). “A meta-analysis of sensory modulation symptoms in individuals with autism spectrum disorders”. J Autism Dev Disord. doi:10.1007/s10803-008-0593-3. PMID 18512135.

Williams DL, Goldstein G, Minshew NJ (2006). “Neuropsychologic functioning in children with autism: further evidence for disordered complex information-processing“. Child Neuropsychol 12 (4–5): 279–98. doi:10.1080/09297040600681190. PMID 16911973.   

 

 

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phone : 62(021) 70081995 – 5703646 

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http://clinicalpediatric.wordpress.com/

Clinical and Editor in Chief :

WIDODO JUDARWANTO

email : judarwanto@gmail.com,

Copyright © 2009, Clinical Pediatric Online Information Education Network. All rights reserved.

• Current Concepts in Sensory Processing Mental Health, Sensory Processing and Challenging Behavior
• Becoming a Sensory Detective: An intimate relationship exists between sensory motor function, the development of relationship, communication, speech and behavior
• Coaching Caregivers: An Essential Adjunct to Pediatric Practice
• Creating Movement: Complementary Approaches in Pediatric Movement Rehabilitation
• Putting the Pieces Together: A Blend of Neuro-Developmental Treatment and Sensory Processing Intervention
• Introduction to the Neuro-Developmental Treatment Approach
• Enhancing Upper Extremity Function in Pediatric Therapy
• Connections: Integrating the Neurobiology of Brain-Behavior into the Treatment of Sensory Processing Falling into Place: Assembling the Pieces of Pediatric Therapy Moving to Higher Ground Setting the Stage for Function
• Helping Hands: Facilitating the Development of Fine Motor Skills in Pediatric Therapy
• The ABC’s of Baby Treatment
• Sensory Processing Disorders affecting Adult Functional Performance
• Sensory Based Motor Dysfunction
• Collaborating Clinicians: Occupational and Speech Therapy Using a Sensory Motor Approach
• Beyond Weight Bearing: Developing Hand Function in Children and Adolescents
• There’s Always a Reason for the Behavior (Is it sensory or is it behavior?)
• Building the Brain:  A Neurobiological Approach to Treatment of the Adult Neurologically Impaired Patient

Supported  by
CLINICAL PEDIATRIC ONLINE 

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phone : 62(021) 70081995 – 5703646

email : judarwanto@gmail.com,

http://clinicalpediatric.wordpress.com/

Clinical and Editor in Chief :

WIDODO JUDARWANTO

email : judarwanto@gmail.com,

Copyright © 2009, Clinical Pediatric Online Information Education Network. All rights reserved.

Newer research has shown that these different regions of the brain may not be solely responsible for only one sensory modality, but could use multiple inputs to perceive what the body senses about its environment. Sensory integration is necessary for almost every activity that we perform because the combination of multiple sensory inputs is essential for us to comprehend our surroundings.

It has been believed for some time that inputs from different sensory organs are processed in different areas in the brain. Using functional neuroimaging, it can be seen that sensory-specific cortices are activated by different inputs. For example, regions in the occipital cortex are tied to vision and those on the superior temporal gyrus are recipients of auditory inputs. There are studies that show that there is new data that suggests that there are deeper multisensory convergences than those just at the sensory-specific cortices listed earlier. This convergence of multiple sensory modalities is known as sensory integration.

Sensory integration deals with how the brain processes sensory input from multiple sensory modalities. These include the five classic senses of vision (sight), audition (hearing), tactile stimulation(touch), olfaction(smell), and gustation(taste). There are other sensory modalities exist, for example the vestibular sense (balance and the sense of movement) and proprioception (the sense of knowing one’s position in space). What is important is that the representations of these different sensory modalities have to coincide. The sensory inputs themselves are in different electrical signals, and in different contexts. Through sensory integration, the brain can relate all of these different sensory modality inputs into coherent outputs that better prepare us to fully comprehend our environment

Unfortunately, in contrast to other areas of brain science, the study of “sensory integration” is in its infancy. There are few neuroscientists, neurologists, neuropsychologists, or neuropsychiatrists who actually consider it to be a condition. Instead, the term “sensory integration” is confined to the field of Occupational Therapy, which is not actually a brain-based field

The theory of Sensory Integration (SI) was developed in the 1960s by Dr. A. Jean Ayres, an occupational therapist who was a pioneer in the field of learning disabilities. 

In the 1930s, Dr. Wilder Penfield was conducting a very bizarre operation at the Montreal Neurological Institute^[8]. Dr. Penfield “pioneered the incorporation of neurophysiological principles in the practice of neurosurgery.^[2][9] Dr. Penfield was interested in determining a solution to solve the epileptic seizure problems that his patients were having. He used an electrode to stimulate different regions of the brain’s cortex, and would ask his still conscious patient what he or she felt. This process led to the publication of his book, The Cerebral Cortex of Man, in 2007^[8]. The “mapping” of the sensations his patients felt led Dr. Penfield to chart out the sensations that were triggered by stimulating different cortical regions^[10]. Mrs. H. P. Cantlie was the artist Dr. Penfield hired to illustrate his findings. The result was the conception of the first sensory Homunculus.

Homunculus: Diagram showing position of regions of the human cortex corresponding to the respective afferent/efferent nerve region of the body. Blue: sensory cortex. Red: motor cortex.

The Homonculus is a visual representation of the intensity of sensations derived from different parts of the body. Dr. Wilder Penfield and his colleague Herbert Jasper developed the technique of using an electrode to stimulate different parts of the brain to determine which parts were the cause of the epilepsy. This part could then be surgically removed or altered in order to regain optimal brain performance. While performing these tests, they discovered that the functional maps of the sensorimotor and motor cortices were similar in all patients. Because of their novelty at the time, these Homonculi were hailed as the “E=mc2 of Neuroscience.

She defined SI as the body’s capacity to organize sensory input, information and stimulation a person receives from his/her own body and the environment through the different sensory systems:

• tactile (touch)
• proprioceptive (joint and muscle impulses)
• vestibular (movement, visual, auditory)
• Vision
• hearing and listening/auditory

This sensory information is then processed by the central nervous system and used to help our body develop spatial awareness, muscle tone, postural stability and self-regulation. SI gives us the awareness of our body and the ability to use it as a tool to interact with others in our world.

For those with Sensory Integration Dysfunction, the brain is not processing organizing the flow of sensory impulses properly. This can impact on a person’s functional, developmental and learning processes.

Examples of sensory integration

One of the earliest sensations is the olfactory sensation. Evolutionary, gustation and olfaction developed together. This sensory integration was necessary for early humans in order to ensure that they were receiving proper nutrition from their food, and also to make sure that they were not consuming poisonous materials. There are several other sensory integrations that developed early on in the human evolutionary time line. The integration between vision and audition was necessary for spatial mapping. Integration between vision and tactile sensations developed along with our finer motor skills including better hand-eye coordination. While humans developed into bipedal organisms, balance became exponentially more essential to survival. The sensory integration between visual inputs, vestibular (balance) inputs, and proprioception inputs played an important role in our development into upright walkers.

Audiovisual system

Perhaps one of the most studied sensory integrations is the relationship between vision and audition. These two senses perceive the same objects in the world in different ways, and by combining the two, they help us understand this information better^[13]. Vision dominates our perception of the world around us. This is because visual spatial information is one of the most reliable sensory modalities. Visual stimuli are recorded directly onto the retina, and there are few, if any, external distortions that provide incorrect information to the brain about the true location of an object^[14]. Other spatial information is not as reliable as visual spatial information. For example, consider auditory spatial input. The location of an object can sometimes be determined solely on its sound, but the sensory input can easily be modified or altered, thus giving a less reliable spatial representation of the object. Auditory information therefore is not spatially represented unlike visual stimuli. But once one has the spatial mapping from the visual information, sensory integration helps bring the information from both the visual and auditory stimuli together to make a more robust mapping.

There have been studies done that show that a dynamic neural mechanism exists for matching the auditory and visual inputs from an event that stimulates multiple senses. One example of this that has been observed is how the brain compensates for target distance. When you are speaking with someone or watching something happen, auditory and visual signals are not being processed concurrently, but they are perceived as being simultaneous. This kind of integration can lead to slight misperceptions in the visual-auditory system in the form of the ventriloquist effect. An example of the ventriloquism effect is when a person on the television appears to have his voice coming from his mouth, rather than the television’s speakers. This occurs because of a pre-existing spatial representation within the brain which is programmed to think that voices come from another human’s mouth. This then makes it so the visual response to the audio input is spatially misrepresented, and therefore misaligned.

Sensorimotor system

Hand eye coordination is one example of sensory integration. In this case, we require a tight integration of what we visually perceive about an object, and what we tactilely perceive about that same object. If these two senses were not combined within the brain, then one would have less ability to manipulate an object. Hand-eye coordination is the tactile sensation in the context of the visual system. The visual system is very static, in that it doesn’t move around much, but the hands and other parts used in tactile sensory collection can freely move around. This movement of the hands must be included in the mapping of both the tactile and visual sensations, otherwise one would not be able to comprehend where they were moving their hands, and what they were touching and looking at. An example of this happening is looking at an infant. The infant picks up objects and puts them in his mouth, or touches them to his feet or face. All of these actions are culminating to the formation of spatial maps in the brain and the realization that “Hey, that thing that’s moving this object is actually a part of me.” Seeing the same thing that they are feeling is a major step in the mapping that is required for infants to begin to realize that they can move their arms and interact with an object. This is the earliest and most explicit way of experiencing sensory integration.

Problems with sensory integration

Sometimes there can be a problem with the encoding of the sensory information. This disorder is known as sensory integration dysfunction, or SID. This disorder can be further classified into three main types. Type 1 is when the patient exhibits a sensory modulation disorder, where he/she seek sensory stimulation due to an over or under response to sensory stimuli. Type 2 is when the patient exhibits a sensory based motor disorder. Patients who have this type of SID have incorrect processing of motor information that leads to poor motor skills. Type 3 sensory integration dysfunction occurs when the patient has a sensory discrimination disorder, which is characterized by postural control problems, lack of attentiveness, and disorganization. There are several therapies used to treat SID. Dr. A. Jean Ayres claimed that a child needs a healthy “sensory diet,” which is all of the activities that a child performs that gives him/her the necessary sensory inputs that he/she needs to get the brain into better performing sensory integration.

Signs of Sensory Integration Dysfunction include:

• Overly sensitive to touch, movement, sights or sounds
• Easily distracted
• Decreased awareness of surroundings
• Activity level that is unusually high or unusually low
• Impulsive, lacking in self-control
• Inability to unwind or calm self
• Poor self-concept
• Social and/or emotional problems
• Physical clumsiness or apparent carelessness
• Difficulty making transitions from one situation to another
• Delays in speech, language, or motor skills
• Delays in academic achievement
• Slow reaction to touch, movements, sights, or sounds
  

  ---

A Typical SI/OT Session

Providing the right kinds of sensory stimulation helps normalization of the sensory systems – tactile, vestibular, proprioceptive, auditory, and visual – to provide the optimal state of alertness and attention. In addition, it helps to develop an adaptive response for daily functioning.

A typical session includes:

• tactile and proprioceptive input using a technique such as ‘brushing’ & deep pressure stimulation
• vibratory input
• movement play (i.e. swings, balance beam, rock wall climbing, scooters, obstacle courses) for body awareness
• postural activities designed to increase strength, postural control, stability, coordination and motor planning
• visual motor/perceptual activities (puzzles, manipulatives, three-dimensional block designs, figure-ground activities, etc.)
• oral motor activities (blow toys, whistles, etc.) fine motor activities (Handwriting Without Tears)

Evaluations

A complete evaluation takes 3-4 hours and consists of a variety of assessment tools that measure key issues, including sensory processing, postural skills/strength, and motor planning. The most common standardized test used is the Sensory Integration and Praxis Texts (SIPT) for children between the ages of 4 to 8 years, 11 months; other tests include the Test of Sensory Integration (3-5 years), Bruininks Osteretsky Test of Motor Proficiency (5-15 years), and the PEERAMID (6-14 years).

An evaluation includes a formal report with assessment scores, a sensory motor history and clinical observations. Recommendations and long term goals and objectives are also included in this comprehensive report.

Screenings

Clients may choose a screening if they have had a previous and adequate evaluation and are looking to begin the therapeutic process, to make sure our approach fits yours, to get an overview and general verbal feedback when a full evaluation is not required. A screening is 2 hours and includes clinical observations of developmental and sensory-motor based issues. This is an overview and not meant to be a comprehensive evaluation.

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Clinical and Editor in Chief :

WIDODO JUDARWANTO 

email : judarwanto@gmail.com,

Copyright © 2009, Clinical Pediatric Online Information Education Network. All rights reserved.

Supported  by
CLINICAL PEDIATRIC ONLINE 

Yudhasmara Foundation

JL Taman Bendungan Asahan 5 Jakarta Indonesia

phone : 62(021) 70081995 – 5703646

email : judarwanto@gmail.com,

http://clinicalpediatric.wordpress.com/

Clinical and Editor in Chief :

WIDODO JUDARWANTO

email : judarwanto@gmail.com,

Copyright © 2009, Clinical Pediatric Food Allergy Information Education Network. All rights reserved.

Sensory experiences include touch, movement, body awareness, taste, sight, sound and the pull of gravity. The process of the brain organizing and interpretating this information is called sensory integration(SI). SI provides a crucial foundation for later, more complex learning and behavior.

For most children, sensory integration develops in the course of ordinary childhood activities. Motor planning ability 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 disordered, a number of problems in learning, development or behavior may become evident. SI is needed to perform self-help, social, community, motor and academic skills.

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Yudhasmara Foundation 

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phone : 62(021) 70081995 – 5703646

email : judarwanto@gmail.com,

http://clinicalpediatric.wordpress.com/

Clinical and Editor in Chief :

WIDODO JUDARWANTO

email : judarwanto@gmail.com,

Copyright © 2009, Clinical Pediatric Online Information Education Network. All rights reserved.

Sensory experiences include touch, movement, body awareness, taste, sight, sound and the pull of gravity. The process of the brain organizing and interpretating this information is called sensory integration(SI). SI provides a crucial foundation for later, more complex learning and behavior.

For most children, sensory integration develops in the course of ordinary childhood activities. Motor planning ability 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 disordered, a number of problems in learning, development or behavior may become evident. SI is needed to perform self-help, social, community, motor and academic skills.

Testing of SI problems can be done through clinical observations or administration of a standardized test, the SIPT (Sensory Integration and Praxis Tests). Here at NTS, we have both physical and occupational therapists certified to administer the SIPT.

Occupational Therapy provides treatment with sensory motor and developmental approaches. Treatment programs focus on functional independence through visual-perceptual motor, upper extremity strength and coordination, sensory integration, oral-motor and self-help activities. Additional training of staff includes handwriting, sensory integration, NDT, vision, serial casting/orthotics, augmentative communication accessing, adaptive equipment and therapeutic listening. Occupational Therapy will be done with parents, educators, physicians, psychologists and other behavior specialists. Common diagnoses treated include cerebral palsy, motor incoordination, autistic spectrum disorders (ASD), and sensory integrative dysfunction.

SENSORY INTEGRATION KIT

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Clinical and Editor in Chief :

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Copyright © 2009, Clinical Pediatric Online Information Education Network. All rights reserved.

Supported  by
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phone : 62(021) 70081995 – 5703646

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Clinical and Editor in Chief :

WIDODO JUDARWANTO

email : judarwanto@gmail.com,

Copyright © 2009, Clinical Pediatric Online Information Education Network. All rights reserved.

The family, of course, is the primary mediator of the child’s development. A parent’s constant grief or guilt because the child was born with a congenital defect, experienced a trauma, or if the child has contracted a chronic disease which may be genetically related, can have a negative impact on the child’s development. It is important that parents receive their own counseling and rehabilitation to provide them with enough emotional resources to cope with the situation. In turn, they can provide more positive feedback to their child, feedback that allows the child to grow and develop appropriately.

As a child reaches adolescence, body image becomes more important than at any age. When there is a disease or disability that makes the adolescent appear different, it can be very damaging to the long-term sense of self and the identity that an adolescent carries into adulthood. Peer interactions are particularly important for children who have disabilities. When these children are teased or taunted by other children who do not have physical problems or who do not understand, it can have a dramatic impact on the growing child’s self-concept. How a child is able to adapt physically, emotionally and intellectually is very important in overcoming their deficit or their difference and moving into independent living as an adult.

CLINICAL PEDIATRIC REHABILITATION MEDICINE

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