Course is designed to provide a introduction to sensory integration field; train learners on identifying students who may have sensory processing disorder, and administering sensory reactivity tools to assist in developing strategies to help students participate, engage and learn.
sensory integration, sensory reactivity assessment
Your curruculum developer: Dr. Anna Y. Len, PT, CSCS, ASI cert
Dr. Len has been in the Physical Therapy field for over 15 years and 23 years in the field of Autism. She received her Doctor of Physical Therapy degree from New York University in 2003. She has advanced training in Sensory Integration Framework and is ASI certified since 2006. She has been an adjunct faculty at New York University – Doctor of Physical Therapy Program since 2005 and frequently speaks on the topics of ASD, Sensory Integration framework, and visual supports in physical therapy. She has also served as Master Clinician for NYU's Physical Therapy Department since 2006.
Dr. Len has been speaking nationally and internationally on the topic of Sensory Integration for the past 15 years and has achieve an Expert Level in the field. She has also presented her own research on "Sensory Processing Dysfunction in Children with Idiopathic Toe-walking" at APTA Section on Pediatric Annual Conference (SoPAC) 2012 and APTA Combined Section Meeting (CSM) 2013. Dr. Len is currently involved with ASI Vision 2020 efforts including serving as one of the lead investigators for standardizing new Evaluation in Ayres Sensory Integration tool and becoming an Instructor for the ASI Certification course.
This Learning module was created from Dr. Len's lectures and introduces the work of prominent SI researchers and clinicians. It is meant to be as an introductory course for those insterested in learning about the Sensory Integration field. Course content will enable learners to apply gained knowledge to the classroom, therapy sessions and own edcational experience.
Learning Objectives:
*By the end of the course the Learners will be able to:
1. understand the improtance of sensory integration and praxis for development and learning
2. gain skills to identlify studnets with possible SPD
3. administer assessement of sensory reactivity, score and interprate the results
4. participate in discussions during interdisciplinary meetings on how best to support students' with SPD
5. demonstrate understanding of how to adapt the teaching approach or learning environment based on students' needs
Learning Outcomes:
*This learning module is most appropriate for educators and therapists, but can be beneficial for any health care professional or administraotor involved in creating best working environments.
*Course duration is 10 weeks.
*Basic understanding of anatomy and at least 1 year experience in learning settings is needed.
*Successfull completion of the course includes review of all presented materials, peer engagement through submisson of comments and participation in collective intelligence work through Learners updates prompted by Administrators Updates.
This Learning module was created from Dr. Len's lectures and introduces the work of prominent SI researchers and clinicians. It is meant to be a guide on how to introduce Sensory Integration field.
Learning Objectives:
*By the end of the course the Administrators will be able to:
Learning Outcomes:
*This learning module is most appropriate for educators who would like to teach other therapists, teachers or parents on the Sensory Integration field.
*Course duration is 10 weeks.
*Administrator trainning level: ASI Level 3: advanced level outcomes
Learning Objective:
Every individual has seven sensory systems which help with own body awareness as well as to assess the envrinment we are in.
[The Seven Sensory Systems image], Retrieved from https://momentousinstitute.org/blog/making-sense-of-sensory-processing
The senses are interconnected with each other, connected with other systems in the brain
and allow us to experience, interpret, and respond to different stimuli in our environment
Sensory systems interconnections start forming before birth and continue to develop as the person matures and interacts with the environment.
Sensory processing involves perceiving, organizing and interpreting information received through sensory systems (e.g., taste, touch, smell, sight, auditory, vestibular) in order to produce an adaptive response.
Sensory integration is organization of sensation for use. (Jean Ayres, 1979)
The term “sensory integration” as used by Jean Ayres, pioneer of this field in therapy, refers to the ability to produce appropriate motor and behavioral responses to stimuli.
(Pathways, 2013)
Components of Sensory Integration:
As stimuli is introduced, first step is to register it. We are able to observe an orientation to the stimuli in the individual, as they either inhibit or facilitate the input. If the individual is able to modulate or appropriately respond/react to the input, the next step would be to interprate what this stimuli means and put into the long term memory loop. This will allow for quick prediction of the response required when it is presented next time. When the input is interprated the response if formed and executed.
(Len, n.d.)
Below are the videos of the Sensory Milestones acquired in the first year of life:
(Pathways, 2016)
Additional reference materials:
Comment: Mention a stand-out idea, or new thought prompted by this material. Use @Name to speak with others about their thoughts.
Make an Update: Describe how early sensory milestones babies acquire maybe relevant later for learning in the classroom. Support your writing with at least one scholarly article. Include an annotated bibliography entry of your source.
Discussion prompts during live sessions could include:
Learning Objective:
Wikipedia contributors. (2019, September 3). Anna Jean Ayres. In Wikipedia, The Free Encyclopedia. Retrieved 23:28, October 13, 2019, from https://en.wikipedia.org/w/index.php?title=Anna_Jean_Ayres&oldid=913877311
In the video below, Lucy Jane Miller is speaking about Dr. A. Jean Ayres and her work.
(SPD, 2010)
Addtional References:
Jean Ayres - biography
2019 Article: Jean Ayres theories reviewed:
Kilroy, E., Aziz-Zadeh, L., & Cermak, S. (2019). Ayres theories of autism and sensory integration revisited: what contemporary neuroscience has to say. Brain Sciences, 9(3), 68. doi: 10.3390/brainsci9030068
Make an Update: Idtenify and review one scholarly article on the topic of Sensory Integration which maybe relavant to your practice setting or educational environment. Include an annotated bibliography entry of your source.
Wikipedia contributors. (2019, September 3). Anna Jean Ayres. In Wikipedia, The Free Encyclopedia. Retrieved 23:28, October 13, 2019, from https://en.wikipedia.org/w/index.php?title=Anna_Jean_Ayres&oldid=913877311
Learning Objective:
(Len, n.d.)
Sensory Reactivity is the brain’s ability to automatically respond and adjust to the intensity of sensory stimuli as well as disregard some stimuli depending on situation.
(Iles, 2016)
(Len, n.d.)
In order for an individual to effectively learn, work, play, they need to be able to attain the optimal zone of engagement.
(Len, n.d.)
Students who function in low arousal (sleepy state) or high arousal (anxious state) are not ready to learn. Below is a video demonstrating a child who is overwhelmed by the environment. He is hyperresponsive or hyperreactive to the sensory stimuli around him and is in high arousal state. Attemping him to learn during this state will not be appropriate.
(Jiron, 2015)
Student who are functioing in the low arousal state (sleepy) maybe erradically moving (high activity mode) in an attempt to wake themselves up or just sitting disingaged (low activity mode). In either case, they are also not ready to participate.
Students with sensory reactivity probelms will present with various maladaptive behaviors which should should be seen as a symptom of stuggle not defiance.
(Len, n.d.)
Addtional References:
Please see a list of literature used during the appliation process to include sensory reactivity in DSM-5.
Miller, L. J., Anzalone, M. E., Lane, S. J., Cermak, S. A., & Osten, E. T. (2007, March). Concept evolution in sensory integration: A proposed nosology for diagnosis. American Journal of Occupational Therapy, 61(2), 135–142.
Comment: Mention a stand-out idea, or new thought prompted by this material. Use @Name to speak with others about their thoughts.
Make an Update: Pick one sensory system, based on your experience as a learner or an educator discuss what kind of maladaptive behaviors maybe observed if they were 1. overresponsive to the input 2, underresponive to the input. How did this impact your learning or did it impact your students' learning experience.
Somatosensory Modulation Problems - Problems with balance, movements and body position
Vestibular Sensitivity (Gravitational Insecurity) - irrational fear of head moving through space
Difficulty negotiating stairs, fear of heights, fear of dynamic equipment, sensitive to motion in the car/train, tying shoes, moving objects from floor to shelf, negotiating changing in height surfaces
Proprioceptive Sensitivity = too linked to tactile but can present as:
Avoidance of gross motor activity
Arching away from cuddling
Tactile Defensiveness - Hypersensitivity to tactile sensations and involves tendency to overreact to ordinary touch sensations Ayres (1964, 1972b, 1979)
Example: Light touch sensations are aversive
Implications:
Other systems:
Visual Defensiveness - Hypersensitivity to light or avoidance of gaze
Example: Catching a ball, poor eye contact
Implications:
Auditory Defensiveness - Hypersensitivity sounds
Example: clapping their hands over their ears, produces excessive amount of repetitive noises with hands and mouth; fears and negative responses to vacuum cleaners, lawn mowers, hair dryers, leaf blowers, sirens, toilet flushing
Implications:
Olfactory Defensiveness - Hypersensitivity to odors
Learning Objective:
(Len, n.d.)
Sensory Perception is one’s ability to distinguish one sensory experience from another and allows us to judge if a stimuli is a threat or not.
Postural control is a great example of sensory perception. It relies on the individuals ability to interprate the information from multiple sensory systems before movement can take place or static control can be effectively executed.
(Len, n.d.)
Below is a chart demonstrating how sensory input is processed to allow for attention, organization and engagement in the classroom.
(Len, n.d.)
Difficulty processing or integrative sensory input will lead to problems with conceptration, organization, self esteem, self control, academic learning difficulties, coordianiton and stuggle with abstract thinking and reasoning. If the indvidual is unable to interpret sensory input they will not be able to organize and executre a response, which leads to praxis difficulters (next update).
Comment: Mention a stand-out idea, or new thought prompted by this material. Use @Name to speak with others about their thoughts.
Make an Update: Pick one sensory system, based on your personal expereince, discuss what kind of difficulties you had or your students displayed with the difficulty processing input or interpreting information from that system.
Processing Difficulties will lead to:
Auditory
Visual
Vestibular-Proprioceptive
Tactile
Gustatory/ Olfactory
Learning Objective:
Praxis is an intellegence of doing (Jean Ayres, 1985)
(Len, n.d.)
Praxis is one's ability to conceive, plan, and execute a novel action.
There are three components to praxis:
Ideation
Motor planning
Execution
Below is an ideation praxis challenge. A child is asked to figure out what he can to do with a chair. The number of ideas he came up with in 60 seconds is recorded.
(Len, n.d.)
Comment: Mention a stand-out idea, or new thought prompted by this material. Use @Name to speak with others about their thoughts.
Project: Create a video of adult or child engaging in ideation activity which may involve an object or just own body (directions below).
Link your obeservations to the expereince of learning. How would observed success or difficulties impact this student's learning, studying habbits, engagement with peers.
Learning Objective:
Sensory Integrative Dysfunction
1 in 6 children experiences sensory challenges sufficient to disrupt their academic, social, and/or emotional development (Ben-Sasson, Carter, Briggs-Gowen, 2009).
(WSJ, 2016)
Dr. Schaaf is describing the Sensory Integration dysfunction in the video below and speaks about the research in the field of SI.
(Schaff, 2008)
Below is a webinar: Sensory Issues in ChildrenL Developing your child's senses which will provide additional understanding on the topic.
(Pathways, 2014)
Comment: Mention a stand-out idea, or new thought prompted by this material. Use @Name to speak with others about their thoughts.
Learning Objective:
Developmental Dyspraxia is associated with difficulties in skill acquisition. Children usually present with:
Below is a video offering a inside look at the life with Dyspraxia.
(Fixers, 2013)
Below is a look at Developmental Coordination Disorder (DCD) which is often used interchangibly with Dyspraxia. DCD is a medical disagnsis which can be found in DSM - 5.
DSM-V (2013) Developmental Coordination Disorder (DCD) 315.4
(Oxford Brooks University, 2015)
Addtional Resources:
Developmental Coordination Disorder
Wikipedia contributors. (2019, October 8). Developmental coordination disorder. In Wikipedia, The Free Encyclopedia. Retrieved 23:43, October 13, 2019, from https://en.wikipedia.org/w/index.php?title=Developmental_coordination_disorder&oldid=920259466
Make an Update: Idtenify and review one scholarly article on the topic of Dyspraxia or Developmental Coordination Disorder which maybe relavant to your practice setting or educational environment. Include an annotated bibliography entry of your source. Discuss could you support the students' with praxis difficulties in class. Discuss activities that can be used to challedge and develop students' praxis abilities in class.
Learning Objective:
Assessment of sensory functions is outmost importance to ensure apprpriate intervention plan.
Below is an interview Dr. Zoe Malloiux gave in Turkey on SI, SI assessment and treatment.
(Arti TV, 2019)
Two of most popular standardized parent questionares used to assess sensory modulation ability and determine if the individual has sensory reactivity problems in comparison to age matched peers are: Sensory Profile authored by Winnie Dunn and Sensory Processing Measure authored by Dianne Parham.
Sensory Profile
(SP Image, Pearson); Video (Pearson, 2018)
Sensory Processing Measure
(SPM Image, WSP) ; Video (LSU, 2014)
Gold standard for assessing Sensory Processing and Praxis abilities is Sensory Intergration and Praxis Test (SIPT) authored by Jean Ayres.
SIPT
(SIPT Image, WSP)
Gold standard for assessing Developemtal Coordination Disorder is Movement ABC.
Movement ABC
(ABC-2 Image, Pearson); Video (Vanderpool, 2012)
Addtional Reference Materials:
Purchasing materials: Pearson (SP-2, Movement ABC-2) and WPS (SPM, SIPT)
Project DUE week 10 of the course: Pick one tool which assesses Sensory Reactivity to administer and score. Share your results via snapshot of the scoring sheet and written explantion of the findings or video of the administration with written explanation of your findings. Discuss how you can you adapt the environment or change your teaching approach to help the individual so then can participate and learn based on the assessment. Include at lease 2 scholarly references. Review work of 2 peers using provided rubric.
Purchase materials: Pearson (SP-2, Movement ABC-2) and WPS (SPM, SIPT).
Learners will pick one of the tools below to administer to a child or adult and score, sharing their results with snapshot of the scoring sheet or a video of the administration.
Learners will discuss their findings and share ideas on strategies to incorporate to promote learning in this individual which can include adaptation of the environment, changing pedagogical approach or other tools supported by the published literature. Sources have to be included in a PDF.
Create a presentation on completed project and share during lightining talk.
TOOLS:
Sensory Processing Measure:
Age group: Preschool, School aged
Environment: School vs Home
(SPM Image, WSP)
Sensory Profile:
Age group: 0-6 months, 7-36 months, school age, adult
Enviroment: School vs Home
(SPM Image, WSP)
SIPT
Learning Objective:
(Len, n.d.)
Ayres, A. J. (1972). Improving Academic Scoresthrough Sensory Integration. Journal of Learning Disabilities, 5(6), 338–343. https://doi.org/10.1177/002221947200500605
When considering SI treatment it is improtant to note a few concepts:
Below is a video discussing the treatment available for SI dysfunction.
(Pathways, 2013)
Not all Sensory Integration treatment is the same.
Ayres Sensory Integration® (ASI) = sensory integration intervention (Ayres, 1972) is a play based method that uses active engagement in sensory-rich activities to elicit the child’s adaptive responses and improve the child ability to successfully perform in meeting environmental challenges ( Ayres, 1972; Koomar & Bundy, 2002). It akes place in the clinic, using gross motor tasks that activate the vestibular and somatosensory systems aim to target specific objectives keeping in mind 10 essential elements described by (Ayres, 1972, Parham, et al, 2007, 2011; and in the Guide (Schaaf, Maillox, 2014)
Sensory-based interventions (SBIs) - consist of applying adult-directed sensory modalities to the child with the aim of producing a short-term effect of self-regulation, attention and behavioral organization (Watling, Koenig, Davies and Schaaf, 2011). It may include modalities such as Weighted vests, bouncing on a ball, adapted seating devices and provided in systematic manner as part of sensory diet.
Case Study: Ryder
(Pathways, 2012)
To ensure fidleity in sensory integration research, Fidelity measure was developed.
(Len, n.d.)
Treatment approach which does not demonstrate requried fidelity score is not considered Ayres Sensory Integration and should not be grouped with the ASI but instead place into SBT group when assessing treatment effectiveness.
(Len, n.d.)
Additional Resources:
(Len, n.d.)
Comment: Mention a stand-out idea, or new thought prompted by this material. Use @Name to speak with others about their thoughts.
Update: Identify research which demonstrates the use of ASI treatment or SBT in various populations. Duscuss the results. Include an annotated bibliography entry of your source.
See research on the following Diagnses where SPD has been found to frequently co-occur:
Share the following document with the Learners to assist with their Project
Rubrick for assessing the Project and student engagement
Learning Objective:
(Video, CL-ASI)
Below is the chart demonstrating the level of trainings agreed upon by international SI network (ICEASI) requried to move through the SI expertise levels.
(Expertise in ASI, Image, ICEASI)
Please fill out the course survery
Ayres, A. J. (1979). Sensory Integration and the Child: Understanding Hidden Sensory Challenges. Western Psychological Services (p. 211). Western Psychological Services. Retrieved from https://books.google.co.za/books/about/Sensory_integration_and_the_child.html?id=5GMQAQAAMAAJ&redir_esc=y
Ayres, A. J. (1972). Improving Academic Scoresthrough Sensory Integration. Journal of Learning Disabilities, 5(6), 338–343. https://doi.org/10.1177/002221947200500605
Ayres, A. J., Robbins, J., & McAtee, S. (2016). Sensory integration and the child: understanding hidden sensory challenges. Los Angeles, CA: WPS.
Kilroy, E., Aziz-Zadeh, L., & Cermak, S. (2019). Ayres theories of autism and sensory integration revisited: what contemporary neuroscience has to say. Brain Sciences, 9(3), 68. doi: 10.3390/brainsci9030068
Ermer, J., & Dunn, W. (1998). The sensory profile: a discriminant analysis of children with and without disabilities. American Journal of Occupational Therapy, 52(4), 283–290. doi: 10.5014/ajot.52.4.283
Ben-Sasson, A., Carter, A. S., & Briggs-Gowan, M. J. (2009). Sensory over-responsivity in elementary school: prevalence and social-emotional correlates. Journal of Abnormal Child Psychology, 37(5), 705–716. https://doi.org/10.1007/s10802-008-9295-8
Lane, S. J., & Schaaf, R. C. (2010). Examining the neuroscience evidence for sensory driven neuroplasticity: Implications for sensory-based occupational therapy for children and adolescents. American Journal of Occupational Therapy, 64(3), 375–390. https://doi.org/10.5014/ajot.2010.09069
Len, A.Y. (2003-2019) Sensory Integration, Autism, Lecture Series, [Power Point presentation]
May-Benson, T. A., & Koomar, J. A. (2010, May). Systematic review of the research evidence examining the effectiveness of interventions using a sensory integrative approach for children. American Journal of Occupational Therapy. https://doi.org/10.5014/ajot.2010.09071
Miller, L. J., Anzalone, M. E., Lane, S. J., Cermak, S. A., & Osten, E. T. (2007, March). Concept evolution in sensory integration: A proposed nosology for diagnosis. American Journal of Occupational Therapy, 61(2), 135–142.
Mailloux, Z. (1990). An overview of Sensory Integration and Praxis Tests. The American Journal of Occupational Therapy. : Official Publication of the American Occupational Therapy Association, 44(7), 589–594. https://doi.org/10.5014/ajot.44.7.589
Mailloux, Z., Parham, L. D., Roley, S. S., Ruzzano, L., & Schaaf, R. C. (2018). Introduction to the evaluation in ayres sensory integration® (EASI). American Journal of Occupational Therapy, 72(1). https://doi.org/10.5014/ajot.2018.028241
Parham, L. D., Cohn, E. S., Spitzer, S., Koomar, J. A., Miller, L. J., Burke, J. P., … Summers, C. A. (2007). Fidelity in sensory integration intervention research. American Journal of Occupational Therapy, 61(2), 216–227.
Parham, L. D., Roley, S. S., May-Benson, T. A., Koomar, J., Brett-Green, B., Burke, J. P., … Schaaf, R. C. (2011). Development of a fidelity measure for research on the effectiveness of the ayres sensory integration® intervention. American Journal of Occupational Therapy, 65(2), 133–142. https://doi.org/10.5014/ajot.2011.000745
Parham, L. D., Roley, S. S., May-Benson, T. A., Koomar, J., Brett-Green, B., Burke, J. P., … Schaaf, R. C. (2011). Development of a fidelity measure for research on the effectiveness of the ayres sensory integration® intervention. American Journal of Occupational Therapy, 65(2), 133–142. https://doi.org/10.5014/ajot.2011.000745
Schaaf, R. C., & Miller, L. J. (2005). Occupational therapy using a sensory integrative approach for children with developmental disabilities. Mental Retardation and Developmental Disabilities Research Reviews. https://doi.org/10.1002/mrdd.2006
Schaaf, R. C., Benevides, T. W., Kelly, D., & Mailloux-Maggio, Z. (2012). Occupational therapy and sensory integration for children with autism: A feasibility, safety, acceptability and fidelity study. Autism, 16(3), 321–327. https://doi.org/10.1177/1362361311435157
Schaaf, R. C., Dumont, R. L., Arbesman, M., & May-Benson, T. A. (2018, January 1). Efficacy of occupational therapy using ayres sensory integration®: A systematic review. American Journal of Occupational Therapy. American Occupational Therapy Association, Inc. https://doi.org/10.5014/ajot.2018.028431
Roley, S. S., Mailloux, Z., Miller-Kuhaneck, H., & Glennon, T. (2007, September 24). Understanding Ayres Sensory Integration?? OT Practice.
Tools to maximize child development. (n.d.). Retrieved from https://pathways.org/.
Wikipedia contributors. (2019, September 3). Anna Jean Ayres. In Wikipedia, The Free Encyclopedia. Retrieved 23:28, October 13, 2019, from https://en.wikipedia.org/w/index.php?title=Anna_Jean_Ayres&oldid=913877311
Wikipedia contributors. (2019, October 8). Developmental coordination disorder. In Wikipedia, The Free Encyclopedia. Retrieved 23:43, October 13, 2019, from https://en.wikipedia.org/w/index.php?title=Developmental_coordination_disorder&oldid=920259466
Wikipedia contributors. (2019, October 11). Sensory processing. In Wikipedia, The Free Encyclopedia. Retrieved 23:53, October 13, 2019, from https://en.wikipedia.org/w/index.php?title=Sensory_processing&oldid=920801726
Wikipedia contributors. (2019, September 24). Sensory processing disorder. In Wikipedia, The Free Encyclopedia. Retrieved 23:53, October 13, 2019, from https://en.wikipedia.org/w/index.php?title=Sensory_processing_disorder&oldid=917679942