Tag: practice

Posted on by — Leave a comment

Research Reminder: Sensory differences in Autism extend beyond reactivity and modulation.

Here is another study reminding us about the sensori-motor differences typically co-occurring in Autism.

Sensory registration and discrimination are necessary for praxis. Information from the vestibular system, tactile and proprioceptive systems are especially important, and work together with information from the visual and auditory systems to help us know what we are doing in any given moment. Then when we get new information (when something happens in our own body or from the world around us) this “happening” can triggers our sensory system into action “Right body, brain just registered things have changed – time to do something different”. And then our brain uses this new information, alongside what we already know from past to learning, to create and choose from a list of next possible actions, choose the one that is likely to result in best possible outcome. Then our brains help us and plan the sequence and orders the what we will do and the how. As we carry out and action our plan, the brain via the senses monitors the what and how do we adapt and alter our actions in the here and now, hopefully ensuring a successful outcome.

Difficulties registering and perceiving sensory input can interfere with and discombobulate that process as any step or stage, resulting in sensory motor challenges that can disrupt process that should ensure successful outcomes in a person’s participation in everyday life.

Assessment of sensory differences for clients with Autism should extend beyond Sensory Profiles, reactivity and modulation. Comprehensive testing with tools like the SIPT and EASI will help ensure comprehensive testing to identify strengths and difficulties to inform person specific intervention planning.

Read more here – the full article:

https://www.frontiersin.org/articles/10.3389/fneur.2016.00124/full

How does this research relate to adults with autism? https://pubmed.ncbi.nlm.nih.gov/27924217/

Posted on by — Leave a comment

Research for Practice: Sensory Integration and Dyslexia.

Ayres’ published her research findings, making a case for emerging patterns of sensory integration dysfunction including;   

  • developmental dyspraxia – this pattern linking motor planning difficulties with deficits in tactile perception
  • difficulties with integration of both sides of the body; poor right-left discrimination, difficulties crossing the midline, and  reduced bilateral motor coordination – impacting on posture and postural control, thought to related difficulties processing vestibular input 
  • visual perception, form and space perception deficits impacting on visual-motor functions
  • difficulties with visual figure-ground discrimination
  • deficits in auditory and language functions.
  • tactile defensiveness and related sensory reactivity difficulties impacting negatively on attention 

A key feature of Ayres’ Sensory Integration is the adaptive response;  “an adaptive response is a purposeful, goal-directed response to a sensory experience … play consists of a series of adaptive responses that make the sensory integration happen. In turn, as sensory integration develops, better organization and more complex skills are possible” Ayres 2005.

In 2013, Viana et al reported that children with dyslexia show poor performance and variability while relating visual and somatosensory information. Children with dyslexia showed less coherent and more variable body sway;  suggesting difficulties in multisensory integration from sensory cues coming from multiple sources.

 

man in brown jacket holding a book

Studies with adults and children found that there is reduced neurophysiological adaptation in adults and children with dyslexia. In 2016, Perrachione et al published research suggesting that people with dyslexia are likely to have differences in sensory integration and processing, noting significantly reduced adaptation to speech from a consistent voice and less adaptation to the repetition of words, objects, and faces. They provide evidence to support the hypothesis that reading skills in dyslexia are related to the degree of neural adaptation.

In 2017 Wandel and Le confirmed the importance of the effective processing of multiple sensory inputs, including successful sensory integration for competent reading. 

“Successful reading involves the ability to efficiently integrate visual signals with the sounds of speech and the language system; thus, diagnosing the reading circuitry requires testing the cortical and white matter regions that carry reading information from the visual, auditory, and language systems. Reading impairment can result from problems within neural circuits that are used for multiple purposes, not uniquely reading (Rayner et al., 2012, Seidenberg, 2017). Hence, we advocate assessing the circuitry broadly, not just portions that are highly specialized for reading.”

In clinical practice, some children with sensory integration difficulties benefit more from the use of coloured overlays. Research from Kriss and Evans (2005) suggests that 

“Children with dyslexia seem to benefit more from coloured overlays than non‐dyslexic children. MIS and dyslexia are separate entities and are detected and treated in different ways. If a child has both problems then they are likely to be markedly disadvantaged and they should receive prompt treatments appropriate to the two conditions. It is recommended that education professionals as well as eye‐care professionals are alert to the symptoms of MIS and that children are screened for this condition, as well as for other visual anomalies.”

Read the full article: The relationship between dyslexia and Meares‐Irlen Syndrome

Read more here:

Dyslexia link to eye spots confusing brain say scientists.

Dyslexia and Sensory Processing, is there a link?

Posted on by

Research Update: Sensory Modulation Disorder (SMD) and Pain: A New Perspective

Pain and sensory integration difficulties including sensory sensitivity are thought to be features in many disorders including CFS/ME and hyper mobility. Recent research and evidence is exploring the links.

Abstract “Sensory modulation disorder (SMD) affects sensory processing across single or multiple sensory systems. The sensory over-responsivity (SOR) subtype of SMD is manifested clinically as a condition in which non-painful stimuli are perceived as abnormally irritating, unpleasant, or even painful. Moreover, SOR interferes with participation in daily routines and activities (Dunn, 2007; Bar-Shalita et al., 2008; Chien et al., 2016), co-occurs with daily pain hyper-sensitivity, and reduces quality of life due to bodily pain. Laboratory behavioral studies have confirmed abnormal pain perception, as demonstrated by hyperalgesia and an enhanced lingering painful sensation, in children and adults with SMD. Advanced quantitative sensory testing (QST) has revealed the mechanisms of altered pain processing in SOR whereby despite the existence of normal peripheral sensory processing, there is enhanced facilitation of pain-transmitting pathways along with preserved but delayed inhibitory pain modulation. These findings point to central nervous system (CNS) involvement as the underlying mechanism of pain hypersensitivity in SOR. Based on the mutual central processing of both non-painful and painful sensory stimuli, we suggest shared mechanisms such as cortical hyper-excitation, an excitatory-inhibitory neuronal imbalance, and sensory modulation alterations. This is supported by novel findings indicating that SOR is a risk factor and comorbidity of chronic non-neuropathic pain disorders. This is the first review to summarize current empirical knowledge investigating SMD and pain, a sensory modality not yet part of the official SMD realm. We propose a neurophysiological mechanism-based model for the interrelation between pain and SMD. Embracing the pain domain could significantly contribute to the understanding of this condition’s pathogenesis and how it manifests in daily life, as well as suggesting the basis for future potential mechanism-based therapies.”

Read more here: Sensory Modulation Disorder (SMD) and Pain: A New Perspective

Posted on by

Research Update: Sensory Over-Responsivity as an Added Dimension in ADHD

Anecdotally many Occupational Therapists who use Ayres’ Sensory Integration to inform assessment and practice report the close links between ADHD and sensory integration challenges. This article by expert Sensory Integration researchers Shelley Lane and Stacey Reynolds offers research evidence and neuroscience in strong support of the links between differences in processing and integrating sensory input for those who meet criteria for a diagnosis of ADHD.

Abstract “Years of research have added to our understanding of Attention Deficit Hyperactivity Disorder (ADHD). None-the-less there is still much that is poorly understood. There is a need for, and ongoing interest in, developing a deeper understanding of this disorder to optimally identify risk and better inform treatment. Here, we present a compilation of findings examining ADHD both behaviorally and using neurophysiologic markers. Drawing on early work of McIntosh and co-investigators, we examined response to sensory challenge in children with ADHD, measuring HPA activity and electrodermal response (EDR) secondary to sensory stressors. In addition, we have examined the relationship between these physiologic measures, and reports of behavioral sensory over-responsivity and anxiety. Findings suggest that sensory responsivity differentiates among children with ADHD and warrants consideration. We link these findings with research conducted both prior to and after our own work and emphasize that there a growing knowledge supporting a relationship between ADHD and sensory over-responsivity, but more research is needed. Given the call from the National Institute of Health to move toward a more dimensional diagnostic process for mental health concerns, and away from the more routine categorical diagnostic process, we suggest sensory over-responsivity as a dimension in the diagnostic process for children with ADHD”.

Read the full article here: Sensory Over-Responsivity as an Added Dimension in ADHD

Posted on by

AOTA Article: Trauma and OT

Many Occupational Therapists using a sensory integration approach in their clinical practice have worked productively and mindfully with children, adults and older adults with trauma. Our unique education and training facilitates our practice in a range of settings- schools, mental health settings and hospitals, where as a profession we are tasked to address barriers to participation in everyday life.

Occupational Therapists are uniquely placed to be able to offer not only cognitive behavioural and occupation based activities.

Neuroscience now provides us with the evidence to support our practice of Ayres’ Sensory Integration with our clients with trauma – confirming our understanding about how trauma impacts early and ongoing sensory and motor development, underlying physiology and levels of arousal and attention.

Now and into the future, we will need to further consider the evidence for how inter-generational trauma manifests in underlying neurobiological processes that underpin function – the sensory, motor and cognitive building blocks of participation in everyday life.

To read the full article please follow this link. https://www.aota.org/~/media/Corporate/Files/Publications/CE-Articles/CE-article-May-2019-Trauma.pdf