Sensory Integration and Infant Mental Health

1. Sensory Integration and Infant Mental Health Helen L. Masin, PhD, PT

2. Sensory integration or sensory processing Neural process whereby information from one or more sensory sources is sorted, organized and altered in such a way that an adaptive response is produced for emotional, motoric and cognitive growth

3. Overview of Sensory Integration (SI) • Sensory registration • Sensory awareness • Adaptive responses • Body center interactions • Body space relationships • Body environment interactions

4. Sensory registration • Internal process to orient or attend to sensory stimulation upon input

5. Sensory awareness • Results from the registration of, orientation to and perception of sensory stimuli; provides foundation for sensations of: • Touch • Body sense (proprioception) • Motion and gravity • Taste, smell, seeing, and hearing

6. Adaptive responses • Behaviors that reflect the growth and maturation of the nervous system in response to environmental demands, leading to increased competence • Process of organizing the response as well as feedback from the response facilitates optimal development of the nervous system

7. Body-center interactions • Internal awareness of self and automatic control of one’s body which allows for comfortable interaction with people and the environment. Components include: • Body scheme • Kinesthesia • Postural control • Gravitational security • Bonding

8. Body space relationships • Multidirectional purposeful actions that contribute to lateralization of motor functions and generalized sequencing abilities. Incorporates both symmetrical and asymmetrical explorations and includes: • Bilateral integration • Crossing mid-line • Laterality • Right-left discrimination • Praxis

9. Body environment interactions • Intentional behaviors leading to specialization of abilities for skilled performance. Provides foundation for emotional, social, and intellectual maturity. Components include: • Attention and focus • Emotional control • Symbol manipulation • Form and space perception • Eye-hand coordination

10. SI flow charts (Ayres, 1987, Fisher and Bundy, 1991) • The senses • Integration of sensory inputs • End products

11. Parental perception of SI issues—letter and questionnaire • Children with SI dysfunction may manifest with one or more of the following problem areas: • Motor • Learning • Social/emotional • Speech/language • Attention disorders

12. SIPT development • Based on research of A J Ayres for over 30 years • Ayres was OT who had PhD in Ed Psych • Interested in basic sensory processing as well as process and function of praxis or motor planning • Began as SCSIT and SCPRT in 1970’s

13. Clinical observations • Clinical observations have been used by therapists for many years • Research related to these observations and SIPT test scores is limited • Clinical observations may only be utilized to the extent that therapists feel comfortable with their particular level of expertise • Testing and observing normal clients is invaluable and gives framework for judging performance during clinical observation of neuro-motor evaluations

14. DeGangi Berk Test of Sensory Integration for Preschoolers • 36 item test which assesses overall SI function for preschool children ages 3 to 5 • Measures sub-domains of postural control, bilateral motor integration, and reflex integration because of their clinical significance in the development of sensory integrative function in preschool children • Sensory channels most imp for SI fx are tactile,vestibular, and proprioceptive senses

15. Research • DeQuiros (1976) found that disorders in vestibular system are correlated with learning disabilities in both motor behavior and language acquisition • Ayres (1976) found that 50% of group of children with LD had vestibular dysfunction • Steinberg and Rendle-Short found that children with minor neuro dysfunction exhibit high proportion of deficits in postural reactions (esp in prone), vestibular fx, and visual spatial skills

16. Test of Sensory Functions in Infants (TSFI) Assesses sensory function in infants from 4 month to 18 months of age

17. TSFI • 24 item test designed to assess sensory processing and reactivity in infants • Reactivity to tactile deep pressure • Adaptive motor functions • Visual-tactile integration • Ocular-motor control • Reactivity to vestibular stimulation

18. Value of early intervention • Identifies children at risk for sensory processing disorders; if the child’s problems remain undetected until school-age years, problems in reading, writing, and math may emerge secondary to SI dysfunction • Educates families regarding sensory processing disorders • Provides children with learning opportunities in which they can be successful • Promotes development of self esteem in children with sensory processing disorders

19. Research • Ayres (1979) found that children with learning and emotional disorders are often described as demonstrating difficulties in regulating sleep/wake cycles, irritability, colic, and lack of cuddliness during infancy • Therefore, early ID of children who are hypo or hypersensitive to sensory stimulation may help to prevent more serious developmental disabilities

20. Research • Field’s research (1980, 1981) supports the theory that the ability to tolerate sensory stim occurs first within the mother-infant interaction and that sensory toleration is intimately connected with the regulation of arousal states and development of early interaction skills • Greenspan and Porges (1984) found that infants with sensory processing disorders appear to be unable to use the range of sensory experiences available to them for learning. This may result in maladaptive responses in forming affective relationships

21. Resources • Sensory Integration International, Torrance, California, www.info@sensoryint.com • Sensory Integration, Fisher and Bundy, 1991 • Sensory Integration and the Child, Ayres, 1987

22. Questions? • How might sensory integration impact the children and families whom you serve? • Thank you!