Sensory Processing

Anne H. Zachry, PhD, OTR/L

 Learning Objectives

´Identify each subtype of sensory processing disorder.

´Identify the 4 characteristic patterns of sensory modulation

disorder.
 Neuroplasticity
One of the key theoretical concepts of the sensory integration
frame of reference.

collective-evolution.com/assets
 Neurotransmitters
Chemicals that communicate information throughout the
brain and body. Relay signals between nerve cells.

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 Neurochemistry

Serotonin Dopamine
• Feel-good- + mood, sleep, • Sleep/wake cycle, pleasure &
appetite, satisfaction reward system, motor control
• Low levels: ADHD, Depression • Released with sex, praise, food,
• High levels: Bipolar (Manic) & learning
• Sensory input (proprioceptive) • Low levels: Depression, ADHD
believed to increase this • Exercise and rewarding sensory
experiences increase it- Need
high intensity input

Epinephrine Endorphins
• Adrenaline- fight-or-flight • Natural painkillers- runners high
response, represses • Released through prop and
parasympathetic N.S. vest. Input (exercise) and pain
(responsible for sleep, digestion, • Sometimes self-injurious
immune response) behaviors release this
• Increases cortisol levels (stress
hormone)
 Incoming Sensory Information
´Vision
´Smell- Olfactory…information goes directly to the
cortex
´Hearing (Auditory)
´Taste (Gustatory)
´The Proprioceptive Sense
´The Vestibular Sense
´Interoception
´Touch (Tactile)
 TACTILE SYSTEM
´ Touch, pain, temperature & pressure

´ Gives concrete feeling of body and the environment

´ Primary protective system

´ The most available and can be used for modulation

With the proprioceptive system makes up the SOMATOSENSORY SYSTEM

 The Proprioceptive System

´ Receptors present in all skeletal muscles

´ Gives information about movement

(Unconscious movement, not to be confused with kinesthesia-

conscious movement)
 The Vestibular System
Sends information back to:

´Muscles- for extension/fixing patterns

´Vestibular information also goes to the cerebellum

 Vestibular & Proprioceptive Systems
Help to develop:
´Posture
´Balance
´Muscle tone
´Gravitational security
´Movement of the eyes in coordination with head
and body
 The Interoceptive Sense
The Sense of Internal Organ Function.

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Western Psychological Services.
 Sensory Integration Frame of Reference

´Developed by A. Jean Ayres in the 60s & 70s

Sensory Integration Theory- adequate processing and

integration of sensory information is an important foundation
for adaptive behavior.

wikimedia.org/
 7 Theoretical Postulates form the the SI Frame of
Reference Foundation
1. Sensory information provides an important foundation for learning and behavior.

2. Sensory integration is a developmental process.

3. Successful integration of sensory information improves with adaptive responses.

4. The ‘‘just right challenge’’ provides the opportunity for sensory integration to occur.

5. Children have an internal drive to seek meaningful experiences from the environment.

6. Due to neuroplasticity, enriched experiences cause change in the nervous system.

7. Sensory integration is a foundation for physical and social engagement and

participation in daily life activities and routines.
 SI Term: Adaptive Response
´ The ability to make adaptive responses to constantly changing
sensory environments is key in the SI frame of reference.

´ Adaptive Response-‘‘appropriate action where the individual

responds successfully to an environmental demand’’.

´ The SI process facilitates successful responses to environmental

demands resulting in adaptive responses.

IndiIamart.com
 SI Term: Praxis
´The ability to conceive of, plan, and organize a sequence of
goal-directed motor actions.

´Enables us to adapt and react quickly to novel

environmental demands in a meaningful and efficient
manner.
 SI Term: “The Just Right Challenge”
Learning occurs when a child accomplishes a challenge.

´ The ‘‘just right challenge’’ is facilitated by the therapist & provides

the space where learning occurs.

Goal: craft intervention that provides the just right challenge.

holisticlc.com
 SI Treatment & Occupations
OT using a SI FOR improves sensory processing and
integration as a basis for enhancing successful
participation in daily occupations.

Sheknows.ocm friendshipcircle.org
SENSORY INTEGRATION: CURRENT UPDATES
The theory is constantly evolving and is informed and modified
as new research is generated.
Sensory Modulation

Spokanecpt.com
 Winnie Dunn’s Research
Children with sensory modulation deficits demonstrate over-
responsivity and/or under-responsivity to sensation and
display sensory behaviors in 4 characteristic patterns:

´Sensory Sensitivity
´Sensory Avoiding
´Sensory Registration
´Sensory seeking
 Level 1: Sensory Modulation Disorder
Low Brainstem: First point of entry!

Sensory Input- Is it safe? Do I recognize it?

Unable to compensate without help/therapy.

Unable to ATTEND, ENGAGE, INTERACT, Be PURPOSEFUL
Uses peripheral vision….safety

TREATMENT: Goal is to impact neurochemistry to get the sensory information to

move through the lower brain stem.
 Level 1: Sensory Modulation Disorder
Under-Responsivity Under-Responsivity

Under-Responsive / High Threshold

Bystander (Registration) Seeker
Under-responsive with Low Activity Under-responsive with High Activity

Needs Input, content, bored, leans, Tazmamnian Devil. How you try to
uninterested, close to floor, move when you are tired….seek
needs (Alerting INPUT) stimulation to bring yourself up.
(Goal-Directed Intense Alerting)
Passive Active

Over-Responsivity

Over-Responsive / Low Threshold

Over-Responsivity
Sensor Avoider
Over-responsive with Low Activity Over-responsive with High
Activity
Hides, covers eyes & ears, don’t touch me,
don’t look at me, stressed & trying to decrease
activity level….think about when Hits, bites, spits, runs away, injury to
you have a headache. High on cortisol & self or others. (Survival behavior,
adrenaline….needs dopamine. reflexes) (Calming Input)
DUNN Profile-“low threshold” (Calming Input)
Assessment
 Sensory Integration & Praxis Test
´ Comprehensive assessment of sensory integration- considered the
‘‘gold standard’’ for evaluating sensory integration and praxis

´ 17 standardized, computer-scored tests designed to measure visual

and tactile perception and discrimination, visual motor skills, bilateral
integration and sequencing, praxis and vestibular-proprioceptive
functions.

´ AGES: 4 years to 8 years, 11 months

PsychCorp
 Assessment
´The Sensory Profile- allows parents, caregivers, and teachers
to rate a child’s responses to sensory activities. (Dunn)
´Age Range: Birth–14:11

pearsonclinical.co
 Sensory Processing Measure
´Assesses how sensory processing problems manifest in various
settings.
´Ages: Ages 5 to 12 (Also a preschool version)

Therapro
´Diagnosis- Not in the ICD-10 or DSM-5

´Reimbursement is an issue
´ Star Institute- https://www.spdstar.org/basic/online-education
https://www.youtube.com/watch?v=D1G5ssZlVUw

https://www.youtube.com/watch?v=IkdmOVejUlI

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 References
O'Brien, J. C. & Kuhaneck, H. (Eds.). (2020). Case-Smith's occupational therapy for children and
adolescents (8th ed.). Elsevier.

Kramer, P., Hinojosa, J., & Howe, T. H. (Eds.) (2019). Frames of reference for pediatric occupational
therapy (4th ed.). Wolters Kluwer.