Information From Cerebralpalsy.org Direct Link
Children born with Cerebral Palsy may display an abnormal degree of sensory processing, whether decreased or increased. Sensory integrative dysfunction makes a child appear clumsy when he or she walks. Often fine motor skills are affected. Sensory dysfunction can also cause over-sensitivities or under-sensitivities that lead to mental and physical distraction or fatigue. Problems with sight, hearing, and balance are also addressed.
As humans, we rely on our senses to act and react.
Sensory processing is the information we receive and use that come through our senses. Our senses include not only sight, sound, touch, taste and smell, but also temperature, movement, gravity and body positioning. They inform our thoughts, feelings and physical reactions through complex receptors in the skin, muscles, joints and inner ear. These receptors process information collectively and unconsciously, which is then interpreted by the brain. The brain then uses the information for motor and social skills.
But imagine if one day, your ability to correctly perceive was compromised? If gentle touches seemed painful? If normal light seemed intolerably bright? If loud thunder was ignored? If the sound of heels against the floor was intolerable? And, if a normal sense of physical equilibrium was not achievable?
Sensory therapy uses specific strategies to help children sort through and process miscues that occur in the brain so that they can use their senses to develop knowledge, understand what is occurring around them, and function independently and appropriately.
Sensory integration therapy teaches children to use their senses in appropriate ways and with self regulation. Individuals with developmental disabilities and autism as well as premature infants are prone to sensory integration misfires.
Developed in the 1960s by occupational therapist and researcher Jean Ayers, Ph.D., sensory integration therapy is a process by which children build and strengthen the connections within the brain that most young people develop through childhood experiences. Therapy is designed to help children interpret sensory input, understand its relevance, and respond – especially to external stimuli that are often beyond their control.
For example, a child may be asked in therapy to pick up an object such as a ball. Though the child sees the ball, and understands what it’s used for, he or she may not be able to recognize or describe the ball because of visual miscues. The child may also inaccurately perceive the weight or texture of the ball due to over-sensitivity, or lack of sensitivity to touch.
The senses that sometimes are disordered in children with Cerebral Palsy are:
Vision
Auditory (Hearing)
Olfactory (Smell)
Tactile or Somosensory (Touch)
Oral (Taste)
Vestibular Processing (unconscious information obtained through the inner ear for equilibrium, position in space and gravity)
Prioprioception Processing (unconscious information obtained by the muscles and joints regarding your position in space, the weight of objects, the pressures felt, the stretch, body movement, and position changes)
A child’s sensory processing is problematic if they are:
Over-responsive – avoidance, caution and fearful
Under-responsive – withdrawn, passive or difficult to engage
Sensory seeking – impulsive and takes risks
The goals of sensory integration therapy are:
Determine how a child’s specific sensory perceptions affect their overall physical, social and human development
Identify and eliminate barriers caused by disordered perception
Implement new sensory processing approaches that organize multiple sensations, filter out background stimuli, and compensate for deficits in perception
Restore a child’s sense of body position and function (also known as vestibular and proprioception)
Restore motor planning (praxis) capabilities, so a child can focus on his or her senses to plan movement, respond to other’s movements, and understand the body’s relationship to space
Encourage activities that allow children to explore their environment, learn and develop their senses
Assist children with perception issues in sorting out mixed messages
Create a physical environment that fosters participation in activities that depend on the senses
Some signs that a child might be struggling with his or her sensory perception include:
Strong reactions to textures, food and sound
Discomfort sitting or standing
Feeling too hot or too cold
Over-sensitivity, or under-sensitivity, to touch
Little reaction to external events
High, or low, physical activity levels
Lack of physical coordination
Inappropriate physical responses
Inability to link a task with the necessary physical function
Restlessness and behavior issues
Reclusiveness
Speech delays
Low self-esteem
Children are the largest benefactors of sensory integration therapy, but parents and caregivers also benefit.
By providing coping strategies and treating the condition, therapists help children overcome these issues that, at least initially, may seem insurmountable. Success is achieved by implementing treatment that will help children build the mental and physical framework within their nervous system to properly perceive sensory input, regulate their responses, and understand the significance behind a particular, texture, movement, or sound.
All of these skills must be mastered for a child to maximally benefit from other therapies.
The physical benefits of therapy include:
Hand-eye coordination
Improved motor-planning
Gravitational security
Posture
Balance responsivity (over responsivity and under responsivity)
Improved sleep cycles
Language development
The psychological benefits of therapy include improvements in:
Socialization
Procrastination
Moodiness
Restlessness
Emotional outbursts and frustration
Confidence
Attention
Sensory integration therapy is advised by a professional after a qualified occupational therapist completes his or her assessment of a child. Therapy is usually advised early in a child’s development – sensory deficits should be dealt within infancy if possible to give a child the advantage of learning to adjust and compensate for his or her condition as he or she develops.
Addressing sensory deficits early improves:
Physical function
Cognitive function
Capacity to learn
Emotional well-being
Propensity to make friends and to socialize
Sensory integration therapy begins with a thorough evaluation and assessment of a child’s sensitivity to environment. This assessment is comprised of interviews with a child’s parents or caregivers, a health history, standard tests and observation in a clinical setting. The goal is to determine where deficits in a child’s sensory perception are and what interventions will help a child adapt and react to their environment.
A therapist will administer the Sensory Integration and Praxis Tests (SIPT). During the assessment, the therapist will evaluate:
Reaction to touch, sounds and textures
Body positioning in relation to space and objects
Movement perception
Motor planning (praxis)
Planning and sequencing actions
Modulation
Existing sensory-seeking behaviors
Visual perception and eye movement
Eye-hand coordination
Spontaneous activity and play
The therapist will determine activities that encourage organized responses to sensory input. Activities are practiced in a repetitive and continuous fashion so children can learn and retain the process. They learn how to self-regulate their responses, achieve a comfort level with sensations, and understand how the senses work collectively.
Sensory integration therapy is often disguised as “fun” for the child. The goal of therapy is to allow children to explore in an unencumbered environment to fine-tune their interpretations and responses. For example, a child that is uncomfortable with rough surfaces may play with grains of rice, so he or she can get used to its texture – which in turn neutralizes his or her discomfort with the sensations.
Therapy is ultimately successful when the child realizes the value of the outcome enough to continually use the learned process.
Other activities may involve:
Vision:
Neon, patterned and florescent papers
Colored, strung, flashing, holiday and strobe lights
Wind socks, wind-up toys, activity boxes and age-appropriate mobiles
Auditory (Hearing)
Water – fountains, faucets, waves, and waterfalls
Machines – lawn mower, washing machine, dishwasher and microwave
Music – radio, instruments, and chimes
Repetition – clocks, rap and drums
Instruments – drums, piano, guitar, keyboards and tambourines
Olfactory (Smell)
Air fresheners – lavender, pot pouri and sachets
Aromatherapy – candle and incense
Beauty aids – lotions, powders and perfumes
Vegetation – flowers and plants
Baking and cooking – breads, cookies, stews, bacon, onions and cabbage
Environments – bathrooms, kitchens, garages and locker rooms
Tactile or Somosensory (Touch)
Hard – rock, counters and floors
Soft – cotton ball, fur and feathers
Surfaces – picky, sticky, rough, pointy and smooth
Textures – sand, water, and paints
Items – beans, rice, beads and bolts
Interaction – stationary, pliable, moldable, bendable and breakable
Vibration – dryer, hair blower and blender
Pressure – push, tickle, rub, claw, pressing, pulling, holding and squeezing
Oral (Taste)
Fruits – strawberry, blackberry, grapes and bananas
Milk-based items – Yogurts, milk shakes and ice cream
Hot and cold items – Soups and popsicles
Candies – hard candy, soft candy, sour candy and licorice
Condiments – jelly, honey, spice and peanut butter
Cheese – Feta, cheddar, cottage and blue cheese
Vestibular Processing
Standing on one foot and standing on one foot with eyes closed
Throwing a ball
Shaking the head
Bouncing on bed, ball or parent’s knees
Swinging in blanket, in swings, or on a rope
Sommersaults and hand stands
Turning head left and right at rapid pace
Walk heel to toe without support
Sliding
Prioprioception Processing
Swinging
Dancing
Playing in boxes filled with balls, beans
Crawling through tunnels
Hitting balls
Spinning on chairs
Balancing on floor or beam
Rolling or crawling on a rug
Jumping, bouncing
Sensory integration therapy can take place at locations that practice occupational therapy, although specialized centers do exist. Where therapy takes place will be dictated by a child’s condition, the availability of therapy, and insurance coverage.
Therapy will often take place at:
chools
The setting for sensory integration therapy is extremely important because at the crux of sensory dysfunction is a child’s perception of his or her environment. For this reason, centers that offer sensory integration will have high- and low-tech equipment, from hug machines, to indoor swing sets.Outpatient clinics
Inpatient rehabilitation centers
Hospitals
Skilled nursing centers
A child’s home
The setting for sensory integration therapy is extremely important because at the crux of sensory dysfunction is a child’s perception of his or her environment. For this reason, centers that offer sensory integration will have high- and low-tech equipment, from hug machines, to indoor swing sets.
ensory integration may also include at-home work; the therapist will instruct the parent on how to complete exercises at home.
Sensory integration therapy services are typically provided by a licensed occupational therapist that has completed additional training in the sub-specialty of sensory integration therapy.
The practice is a relatively new specialty; certification is recommended, but not required. However, occupational therapy is regulated by all states.
At the time this site was published, Western Psychological Services (WPS) in California is the only certifying-body for therapists who practice sensory integration. However, the organization offers courses throughout the United States. Occupation therapists, physical therapists, and speech therapists have completed certification, according to WPS.
WPS’ certification program is made up of four courses, including:
Sensory perspective
Specialized techniques
Interpretation and assessment
Invention
In the occupational therapy industry, the certification is seen as a practical and desirable step for therapists that would like to offer sensory therapy
WPS has a list of sensory integration-certified therapists that have completed training in each state.
When a child begins sensory integrations therapy, he or she can receive too much sensory stimulation, which can result in reactions that could be disruptive, like willfulness or frustration. For this reason, a therapist – as well as parents or caregivers – must monitor a child’s reactions to counteract those reactions.
Additionally, some sensory integrations techniques might make a child uncomfortable.
All of these situations can be mitigated when a trained occupational therapist implements a highly-structured plan of intervention that is both well-organized and fun for the child.