Sensory Integration CS 9 – Flashcards
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            Ayres sensory integration definition
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        -"organization of sensation for use" -Involved more than neurological synapsis, but also the ability to register, process, and act upon sensation
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            Amelia is learning to ride a bike for the first time. She begins to understand how to balance, hold the handlebars, and pedal. How would sensory integration theorists describe this?
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        Adaptive response
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            Adaptive response
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        comes from within and allows the child to integrate sensations from a variety of systems (vestibular, proprioceptive, vision) to accomplish a given task (e.g., riding a bicycle). - Ex. Child successfully climbs up and slides down a slide.
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            Mary does not like getting her hands dirty, having her hair combed, or eating a variety of foods. She becomes irritable at the end of the day and sometimes in school. She prefers to wear the same pants each day. What do these observations suggest?
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        Defensiveness
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            Tactile defensiveness
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        involves a tendency to overreact to ordinary touch sensations. - Example: Child shows an aversion to textures of foods, certain clothing, and having hair brushed.
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            Which statement is not a basic assumption underlying occupational therapy using a sensory integration approach?
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        The more therapist-directed the activities, the greater potential for neural organization.
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            The more inner-directed a child's activities are,
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        the greater the potential for the activities to improve neural organization
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            What statement is NOT considered the occupational therapist's role when using a sensory integration approach?
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        Child's actions
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            The role of the therapist when using a sensory integration approach
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        -To set up the environment and activities so the child will choose to select activities that enhance his/her ability to make an adaptive response. -Leads the child but does not control the child's action.  -The goal is to allow the child to be inner directed and make adaptive responses that promote organization.
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            Max is a 12-month-old boy who is just learning to walk. He stands for short periods, sees his favorite toy, and takes one step and falls. The therapist places the favorite toy two steps away the next time. Which term describes this concept?
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        Just-right challenge
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            Which is the best example of an "adaptive response"?
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        Ability to hold on and pump a swing longer and higher
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            Charlie is a 10-year-old boy who will eat only mashed foods, does not like noises (e.g., he gets upset when the phone rings), and has difficulty sitting during meals. Charlie's parents report that he does not like new clothes and cannot wear jeans. What type of sensory integrative problem does Charlie have?
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        Sensory modulation problems
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            How did Ayres view sensory input?
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        Nourishment for the brain
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            Which statement is not true concerning dyspraxia?
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        Somatodyspraxia is a degenerative disorder.
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            Ramon is a 12-year-old boy who will not play on the swings or slides at school. He has difficulty climbing up the second floor staircase at school and cannot sit in the bleachers. What type of problem does this depict?
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        Gravitational insecurity
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            Which statement most closely reflects the ingredients to promote neural plasticity in children?
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        Child actively interacts with a meaningful and challenging environment.
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            Which principle is not part of Ayres Sensory Integration intervention?
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        It begins with sensory stimulation.
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            Lisa is an 8-year-old girl who bumps into things frequently, bears down hard on her pencil at school, and stands very close to her friends. Lisa gets in trouble in school because she is always "talking herself through" her handwriting homework. Lisa likes to play rough at home and is frequently called a bully by her younger brother. What type of dysfunction does this scenario depict?
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        Proprioceptive problems
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            Ayres initial concepts
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        -Sensory integration  -Adaptive response -Praxis
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            Sensory support for development and brain function
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        -Sensory nourishment -Sensory diet
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            Adaptive response
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        -Results in a more organized state, and the capacity for further sensory integration is enhanced -Implies that the child is an active participant -Uses the child's inner drive
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            Basic Assumptions Underlying  Ayers Sensory Integration Intervention
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        1. Sensory input can be used systematically to elicit and adaptive response. 2. Registration of meaningful sensory input is necessary before an adaptive response can be made. 3. An adaptive response contributes to the development of sensory integration. 4. Better organization of adaptive responses enhances the child's general behavioral organization. 5. More mature and complex patterns of behavior emerge from consolidation and simpler behaviors. 6. The more inner-directed a child's activities are, the greater the potential for the activities to improve neural organization.
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            Types of Sensory Integrative Problems
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        1. Sensory modulation problems 2. Sensory discrimination and perception problems 3. Vestibular-bilateral functional problems 4. Praxis problems
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            Modulation
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        -Refers to CNS regulation of its own activity
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            Sensory modulation
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        A continuum from hyporesponsivity (sensory registration problem) to hyperresponsivity (sensory defensiveness).
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            Sensory registration problems
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        -Person fails to attend to or register relevant sensory stimuli -Can be a safety concern, particularly if child does not register pain
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            Sensation-seeking behavior
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        -Child may appear active motorically but is hyporesponsive to vestibular input  -Child may seek excessive proprioceptive input  -Child may be disruptive or inappropriate in social situations
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            Over-responsiveness
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        -Tactile defensiveness -Gravitational insecurity -In other sensory modalities
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            Tactile defensiveness
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        -Tendency to overreact to ordinary touch sensations *Affect self-care activities *Social situations may be difficult *Usually light-touch stimuli are aversive
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            Gravitational insecurity
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        -Over-responsiveness to vestibular sensations  *Are fearful of movement or uneven surfaces *Playground activities can be difficult
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            Sensory discrimination and perception problems
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        -Tactile discrimination and perception problems -Proprioception problems -Visual perception problems -Other perceptual problems
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            Tactile discrimination and perception problems
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        -Difficulty interpreting tactile stimuli  -May cause problems in developing manipulative skills -May relate to visual perceptual problems
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            Proprioception problems
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        -Does not receive reliable information about body position -May be clumsy, awkward -May seek firm pressure and joint compression
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            Vestibular-proprioceptive problems
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        -Postural and bilateral integration -Vestibular-bilateral integration  -Bilateral integration and sequencing  -Projected action sequences
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            Praxis problems
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        -Developmental dyspraxia -Somatodyspraxia -Ideation dyspraxia
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            Secondary problems related to sensory integrative difficulties
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        -Problems are misinterpreted as behavioral or psychological issues -Problems can limit a child's participation -Problems can undermine self-esteem and self-confidence
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            Assessment of Sensory Integrative Functions
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        Sensory Profile Sensory Processing Measure
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            Standardized testing of Sensory Integrative Functions
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        -Sensory Integration and Praxis Tests -Bruininks-Oseretsky Test of Motor Proficiency -School Function Assessment
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            Individual Ayres Sensory Integration® (ASI) intervention
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        -Applied on an individual basis -Implies a relationship between the therapists and the child -Uses child's inner drive to actively explore the environment -Involves a balance between structure and freedom -Values child's active participation
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            Elements of Ayres Sensory Integration Intervention
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        1. Ensures physical safety 2. Presents sensory opportunities 3. Support sensory modulation for attaining and maintaining a regulated state 4. Challenges postural, ocular, oral and/or bilateral motor control 5. Challenges praxis and organization of behavior 6. Collaborates in activity choice 7. Tailors activity to present just-right challenge 8. Ensures that activities are successful 9. Supports child's intrinsic motivation to play 10. Establishes a therapeutic alliance with the child
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            Group Intervention for Interventions for Children with Sensory Integrative Problems
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        -The Alert Program -Can promote the development of social skills -Motor Labs
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            Consultation on modification of activities, routines, and environments
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        -Can demystify the child's problems -Can promote a better understanding of sensory integration -Can suggest ways to modify the environment to promote the child's participation -Education on sensory integration - parents, teachers -Sensory Diet -Strategies to change the environment or task *Hyperresponsive to lights - Dim the lights *Hyperresonsive to touch - Shirts without tags
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            Hyporesponsive and hyperresponsive observations for:
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        - Overall patterns - Tactile - Vestibular - Proprioceptive - Visual - Auditory - Taste/smell
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            Tactile discrimination and perception problems
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        -Difficulty interpreting tactile stimuli -On their body - where touched -Specifically related to hand function
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            Proprioception problems
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        Muscles and joints inform the brain about position of body parts
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            Visual perception problems
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        May be separate from SI dysfunction
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            Sensory Discrimination Observations for:
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        - Vestibular/ Proprioceptive - Tactile - Taste/smell - Auditory - Visual
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            Postural Disorder
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        - poor proximal joint stability - hypotonicity of extensor muscles - poor equilibrium and support reactions - poor bilateral coordination - difficulty crossing midline - no hand dominance
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            Dyspraxia
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        - Child has difficulty planning, organizing, and executing movements - difficulty with motor planning - inadequate body scheme - slowness with learning ADLs or gross motor skills - problems with constructive play - handwriting difficulties
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            Sensory Profile Versions
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        -Infant / Toddler - birth - 36 months -Child - 3 years - 10 years -School Companion - 3 years - 11 years 11 months -Adolescent / Adult - 11 years and older
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            Individual Ayres Sensory Integration
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        -Individual therapy -Remediate sensory integrative problems -Originally used with children with learning disabilities -Fosters inner drive to explore the environment and actively participate to master challenges -Balance between structure and degree of freedom 2, 45 minute sessions per week for 2 years
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            Specific Skill Development
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        Working on a specific skill - handwriting, dressing, etc  Vs waiting for generalized improvements as a result of ASI therapy
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            Vestibular
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        (Movement, balance, height) Posture / position of body -Vertical -Horizontal -Diagonal -Upside down / backwards  Movement -Joint and muscle activity - proprioception -Oscillation - bouncing -Linear movement - swinging -Rotary movement - spinning
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            Proprioception/ Vestibular
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        Maintaining balance: beam, swings, ball  State where body part has been moved/positioned  Practice grading force on a variety of objects -Don't break the ice -Cooking activities
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            Tactile Discrimination/ Visual Perception
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        -Stereognosis activities (vision occluded) -Have the child identify where they were touched -Have the child identify what touched them -Visual perception activities: form constancy, figure ground, visual discrimination, visual memory, visual-spatial relationships, visual sequential memory, visual closure
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            Taste / Smell
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        Sweet / vanilla Salt Sour / citrus Bitter / smoke
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            Oral Texture
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        Suck  Chew Bite / crunch Lick
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            Visual
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        (Perception, hand, head and body movement) Light/dark color Form (boundaries) Place (location) Movement through space
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            Auditory
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        (Discrimination of speech, noises) -Vibration sounds -Rhythmic music, sing-song speech, rhyme -Vocalizations, speech sounds -Language
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            Proprioception
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        (Force, body awareness, postural control) Posture / position of body -Vertical -Horizontal -Diagonal -Upside down / backwards  Touch -Joint and muscle activity - proprioception -Deep pressure -Touch Pressure -Light touch
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            Tactile
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        (Touch, praxis skills) Touch -Joint and muscle activity - proprioception -Deep pressure -Touch Pressure -Light touch  Temperature -Cool to neutral warmth -Moderate temperatures -Extreme temperatures
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            Motor planning
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        Conceptual and sensory motor process of planning a novel action or movement
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            Sensory defensiveness
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        Ex. Child dislikes smells of certain foods to the extent that it bothers the child all day.
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            Sensory seeking
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        Example: Child likes activities such as jumping up and down or turning in circles to an extent that is more than typical for children of the same age.
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            Sensory discrimination
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        Example: Child is able to distinguish the bell at school from a ringing telephone.
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            Sensory modulation
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        Process by which neural messages that convey information about the intensity, frequency, duration, and complexity of sensory stimulation are adjusted (Miller & Lane, 2000)
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            Sensory registration
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        Process of attending to stimuli (i.e., orienting response)
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            Somatosensory
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        Pertaining to the tactile and proprioceptive systems
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            Vestibular
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        Pertaining to the inner ear receptors, the semicircular canals, and the otolith organs that detect head position and movements as well as gravity
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            Sensory integration involved more than neurological synapsis, but also
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        the ability to register, process, and act upon sensation
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            Dyspraxia
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        - Ayres found a relationship between tactile perception and praxis. - Not all dyspraxia is sensory integrative in nature. - Dyspraxia is difficulty conceptualizing, planning, and executing movement.
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            Ayres Sensory Integration Intervention Principles
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        - It involves a balance between structure and freedom. - It is applied on an individual basis. - It requires the active participation of the child.
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            DSM-IV-TR PDD: 5 specific diagnoses
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        1. Autistic Disorder 2. Asperger's Disorder 3. Rett's Disorder 4. Childhood Disintegrative Disorder (CDD) 5. Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS)
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            DSM-V
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        only Autism Spectrum Disorder used and describes categories by severity of autism placing Rett's Disorder and CDD in a different category.
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            Rett's disorder
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        chromosomal syndrome, defined by a child having chromosomal differences
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            ASDs are defined by the presence or absence of behaviors in three areas
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        1. social reciprocity 2. communication 3. repetitive behaviors
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            Childhood Disintegrative Disorder (CDD)
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        -Heller's Syndrome -regressive autism because it is a severe form of autism where children have hallucinations and similar to psychosis -very low functioning
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            social reciprocity
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        being able to socially go back and forth and engaging with people
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            Sensory integration
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        -one of the most commonly used FoRs w/ pediatrics -least support from research
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            Sensory integration theory
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        explains maladaptive behaviors seen in children (many times with autism) as a result of not processing sensory information correctly. As a child develops, the child experiences sensory stimuli beginning in the prenatal period and on into adulthood and these sensory stimuli entice adaptive responses which in turn assist with development within the central nervous system. If children are not able to modulate sensory input or discriminate sensory input they will instead develop maladaptive responses to stimuli which then lead to maladaptive behaviors.
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            Child experiences sensory stimuli beginning about
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        5.5 weeks after conception
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            Assumptions of SI Theory
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        1. The central nervous system has plasticity 2. There are developmental progressions as the child attaches more meaning to and gains mastery to sensory inputs 3. Systems Theory and organization of the central nervous system is that the nervous system does not develop linear but instead skills and behaviors may develop simultaneously at various levels. 4. Adaptive responses occur as the child responds actively and appropriately to sensory and environmental demands. 5. There is an inner drive toward self-actualization (fulfillment of talents and mastery of challenges)
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            Sensory integration therapy
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        works toward the CNS will alter and change and adapt neurologically to that response so the child will start having a more normalized response
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            Praxis skills
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        ability to motor plan
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            Postural-ocular disorder
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        may see children who are slumped or display low tone
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            Treatment Interventions using Sensory Integration Theory
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        -Based on sensory dysfunctions found in assessments, specific areas of treatment intervention would focus on the areas of defect, using play and the child's interests, to elicit an adaptive response -Most often activities involve the use of suspended equipment inviting planning and providing various sensory inputs using activities which are meaningful to the child.
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            When using sensory integration, what is integrating according to SI theory?
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        Brain (CNS)
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            Sensory modulation
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        self-regulation of senses
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            Sensory discrimination
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        telling the differences between senses
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            What is the name of the program that helps empower the child to self-regulate?
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        How Does Your Engine Run?
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            Which approach would hold a demand until the child complied?
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        Applied Behavioral Analysis
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            Who is the primary focus when working with a child for DIR Floortime?
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        Parents
