Sensory processing disorder

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Sensory processing interruptions ( SPD , also known as sensory integration dysfunction ) are conditions that exist when multisensor integration is not adequately processed to provide an appropriate response to environmental demands.

The senses provide information of various modalities - vision, audition, tactile, smell, taste, proprioception, interoception and vestibular systems - that man needs to function. Sensory process disturbances are characterized by significant problems in regulating sensations derived from the body and the environment and manifested by difficulty in performance in one or more of the major areas of life: productivity, leisure and play or daily living activities. Different people experience difficulties when processing inputs of various senses, especially tactile (eg, finding itchy cloth and hard to wear while others are not), vestibular (eg, experiencing motion sickness) and proprioceptive holding pen to write).

Sensory integration was defined by occupational therapist Anna Jean Ayres in 1972 as "a neurological process that regulates sensations of the body itself and from the environment and makes it possible to use the body effectively within the environment". Sensory process disturbances gain recognition, though they are not yet recognized by the Diagnostic and Statistical Manual. Although its supporters are still debated, whether SPD is actually an independent disorder or symptom observed from a variety of other more established disorders.

Video Sensory processing disorder

Classification

Sensory process disorders are classified into three categories: sensory modulation disturbance, sensory motor disturbance and sensory discrimination disorder (as defined in the Diagnostic Classification) of Health Problems and Mental Development in Childhood and Early Childhood).

Sensor-based motor disturbance (SBMD)

Sensory-based motor disturbances show irregular motor output due to the misinformation of sensory information that affects postural control challenges, resulting in postural disorder, or developmental coordination disorder.

Subtipe SBMD adalah:

1. Dyspraxia
2. Gangguan postural

Gangguan Sensory discrimination (SDD)

Disturbance of sensory discrimination involves processing of the wrong sensory information. The incorrect processing of visual or auditory input, for example, can be seen in the lack of attention, disorganization, and poor school performance.

The SDD subtypes are:

1. Visual (sight)

• Points are used to distinguish colors, shapes, shapes, and sizes

2. Auditory (voice)

• The ear is used for viewing sounds

3. Tactile (touch)

• Skin receptors are used to distinguish shapes, sizes, textures, temperatures

4. Gustatory (taste)

• Tongue is used to determine textures and flavors

5. Smell (smell)

• The nose is used to interpret the smell

6. Vestibular (balance)

• The inner ear is used to determine the position of the body in relation to gravity and soil

7. Proprioception

• Receptors in muscles and joints are used to determine where body parts are in outer space

Maps Sensory processing disorder

Signs and symptoms

Symptoms may vary according to the type and subtype of the disorder. SPD may affect one sense or multiple senses. While many people may present one or two symptoms, a sensory processing impairment must have a clear functional impact on a person's life.

Signs of overload

• Dislikes textures such as those found in fabrics, food, care products or other materials found in everyday life, most people will not react.
• Avoid crowds and noisy spots
• drunk without a medical cause
• Refuse kissing, hugging, or embracing because of negative touch experience sensations (do not be confused with embarrassment or social difficulties)
• Discomfort, disease, or serious threats caused by normal sound, light, movement, smell, taste, or even inner sensations such as heart rate.
• Choose a meal
• Sleep disturbance (wake up due to small noise, sleep problems due to sensory overload)
• Difficulty with calming down, feeling constantly under pressure

Signs are less responsive

• Difficulty getting up
• Lethargy and lack of response
• Less awareness of pain or others
• Real deafness even when the auditory function has been tested
• Difficulty with toilet training, lack of wet or dirty consciousness

Sensory Addiction

• Restless
• Find or make a loud and annoying sound
• Hike, jump, and crash
• Look for "extreme" sensations
• Sucking or biting your fingers, clothes, pencils, etc.
• Impulsive

Sensory based problem

• Slow and uncoordinated moves
• Bad handwriting
• Bad posture
• Delays in crawling, standing, walking, or running.
• Verbosity to avoid motor task

Sensory discrimination issues

• Things you keep dropping
• Difficulty dressing and eating
• Unmatched power used to handle objects

Other signs and symptoms

• Less balanced balance and reflex straightening
• Low muscle tone patterns in extensor versus gravity and flexor versus gravitational muscle
• Bad core tone
• Low postural control
• Bad nistagmus
• The presence of an unintegrated reflex like ATNR
• heavy eye trackers
• Bad tactile astilognition
• Inadequate motor, ideational or construction praxis
• Difficulty with planning movements using feedback information
• Difficulty with planning movements using feedforward information

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Cause

The exact cause of SPD is unknown. However, it is known that the midbrain and brain stem of the region of the central nervous system is the initial center on the processing route for multisensor integration, this area of ​​the brain involved in the process including coordination, attention, arousal, and autonomic function. After sensory information passes through these centers, it is then passed on to areas of the brain responsible for higher levels of emotion, memory, and cognitive function. Disturbance of sensory processing not only affects the interpretation and reaction to stimuli in the midbrain area, but affects some of the higher functions. Damage to the part of the brain involved in multi-sensory processing can cause difficulties to process stimuli functionally.

Current research in sensory processing is focused on finding genetic and neurological causes of SPD. EEG and event-related potential measures (ERP) are traditionally used to explore the underlying causes of behavior observed in the SPD. Some of the fundamental causes proposed by current research are:

• The tactile and auditory differences to responsiveness show moderate genetic influences, with a touch above the responsiveness that demonstrates greater heritability. Bivariate genetic analysis suggests different genetic factors for individual differences in auditory and tactile SOR.
• People with a Sensory Processing Deficit have fewer gation sensors (electrophysiology) than a typical subject.
• People with sensory overload may have increased D2 receptors in the striatum, associated with rejection of tactile stimuli and reduced habituation. In animal models, prenatal stress significantly increases tactile avoidance.
• Studies that use child-related potential (ERP) sensitivity over the subtype of responsivity find atypical nerve integration from sensory input. Different nerve generators can be activated in the early stages of processing sensory information in people with SOR rather than in typically developing individuals. The auto association of causally related sensory inputs occurring at this initial sensory perception stage may not work well in children with SOR. One hypothesis is that multisensory stimulation can activate higher-level systems in the frontal cortex involving attention and cognitive processes, rather than the automatic integration of multisensor stimuli observed in adults who develop typically in the auditory cortex.
• Recent studies have uncovered abnormal white matter microstructures in children with SPD, compared with typical children and those with other developmental disorders such as autism and ADHD.

Research

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Diagnosis

Sensory processing disorders since 1994 were accepted in the Mental Health Diagnostic Classification and Early Childhood and Childhood Development Disorders (DC: 0-3R) and were not recognized as mental disorders in medical manuals such as ICD-10 or DSM-5.

Diagnosis mainly comes with using standardized tests, standardized questionnaires, expert observation scales, and free play observations at an occupational therapy center. Observation of functional activity can be done at school and at home as well. Some scales not exclusively used in SPD evaluation are used to measure visual perception, function, neurology and motor skills.

Depending on the country, the diagnosis is made by different professionals, such as occupational therapists, psychologists, learning specialists, physiotherapists, and/or speech and language therapy. In some countries it is advisable to have a complete psychological and neurologic evaluation if the symptoms are too severe.

Standard test

• Sensory Integration and Praxis Test (SIPT)
• Test DeGangi-Berk from Sensory Integration (TSI)
• Sensory Function Tests on Baby (TSFI)

Standardized Questionnaire

• Sensory Profile, (SP)
• Infant/Toddler Sensor Profile Adult/Adult Sensor Profile
• Classroom School School Friends
• Risk Signal Indicators (INDIPCD-R)
• Sensor Processing Size (SPM)
• Processing of the Preeschool Measurement Sensor (SPM-P)

Other tests

• Clinical Observations of Motor and Postural Skills (COMPS)
• Visual Perception Development Tests: Second Edition (DTVP-2)
• Beery-Buktenica Visual-Motor Integration Development Tests, 6th Edition (BEERY VMI)
• Miller & amp; Participation Scale
• Bruininks-Oseretsky Test Motor Skill, Second Edition (BOT-2)
• Inventory Value Behavior of Executive Functions (BRIEF)

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Treatment

Several therapies have been developed to treat SPD, but recent research on Sensory Integration Therapy (SIT) concludes that SIT is "ineffective and that its theoretical foundations and assessment practices are not validated." In addition, the authors warn that the SIT technique exists "beyond the boundaries of existing evidence-based practices" and that SIT is "highly likely to be a misuse of limited resources."

Sensory integration therapy

The main form of sensory integration therapy is the type of occupational therapy that places a child in a room specially designed to stimulate and challenge all the senses.

During the session, the therapist works closely with the child to provide a level of sensory stimulation that can be overcome by the child, and encourages movement in the room. Sensory integration therapy is driven by four key principles:

• The right challenge (the child must be able to successfully meet the challenges presented through fun activities)
• Adaptive responses (children adjust their behavior to new strategies and useful in response to challenges presented)
• Active engagement (child will want to participate because of fun activities)
• Child directed (child preferences used to start a therapeutic experience in a session)

Sensory processing therapy

This therapy maintains all four principles mentioned above and adds:

• Intensity (someone attending therapy every day for long periods of time)
• A developmental approach (therapists adapt to one's developmental age, against actual age)
• Systematic evaluation of retesting tests (all clients evaluated before and after)
• Process driven vs. driven activity (the therapist focuses on the "right" emotional relationship and the process that strengthens the relationship)
• Parental education (parent education sessions scheduled into the therapeutic process)
• "joie de vivre" (happiness is the ultimate goal of therapy, achieved through social participation, self-regulation, and self-esteem)
• Combination of best practice interventions (often accompanied by integrated listening system therapy, floor time, and electronic media such as Xbox Kinect, Nintendo Wii, Makoto II machine training and more)

Other methods

Some of these treatments (eg, sensorimotor handling) have reasonable grounds and no empirical evidence. Other treatments (eg, prism lenses, physical exercise, and auditory integration training) have had research with small positive results, but some conclusions may be made about them due to methodological problems with the study. Although immeasurable treatments have been described and valid outcome measures are known, there is a gap in knowledge relating to sensory integration dysfunction and therapy. Empirical support is limited, therefore systematic evaluation is required if this intervention is used.

Children with hypo-reactivity can be exposed to a strong sensation such as caressing with a brush, vibration or rubbing. Play can involve a variety of materials to stimulate the senses such as playing dough or painting with your fingers.

Children with hyper reactivity can be exposed to peaceful activities including quiet music and gentle shake in light-lit rooms. Treats and rewards can be used to encourage children to tolerate activities they normally avoid.

While occupational therapists use sensory sensory reference frames to improve a child's ability to process sensory input adequately, other OTs may focus on environmental accommodation that parents and school staff can use to improve the functioning of children at home, school and community.. This may include choosing soft, unmarked clothes, avoiding fluorescent lighting, and providing earplugs for "emergency" use (such as for fire extinguishers).

Adult

There is a growing evidence base that points and supports the idea that adults also show signs of sensory processing difficulties. In the United Kingdom, preliminary research and improvement of clinical outcomes for clients assessed as having sensory processing difficulties indicate that therapy may be the right treatment. Adult clients show a variety of presentations including autism and Asperger's syndrome, as well as developmental coordination disorder and some mental health difficulties. The therapist suggests that this presentation may arise from the difficulties adults with sensory processing difficulties face trying to negotiate the challenges and demands involved in daily life. It is important when caring for adults not only to focus on sensory regulation but also to help them develop and maintain social support. Sensitively responsive adults have an extremely high level of anxiety and depression correlated compared with adults who do not have higher sensory overload. This correlates with the perception of the absence of social supporters. Sensory process disturbances can also be correlated with sleep quality in adults. This correlation can be seen primarily in adults who have low neurological thresholds (sensory sensitivity and sensory avoidance). These people are more sensitive to touch, auditory and visual stimuli that often impact on their sleep quality.

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Epidemiology

It is estimated that up to 16.5% of primary school-aged children experience an increase in SOR behavior in tactile or auditory modalities. However, this figure may represent an underestimation of Sensory Over Responsivity, as this study excludes children with developmental or premature delivery disorders, who are more likely to present it.

This figure, however, is greater than previous studies with smaller samples showing: an estimated 5-13% of primary school age children. The incidence for the remaining subtype is currently unknown.

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Relationships with other annoyances

Due to common comorbid conditions with sensory integration problems, a person may have other conditions as well. People who receive a diagnosis of sensory process disorder may also have signs of anxiety problems, ADHD, food intolerance, behavioral disorders and other disorders.

Autism spectrum disorder and sensory processing difficulties

Sensory treatment disorders are common comorbidities with autism spectrum disorders and are now included as part of the symptoms in DSM-5.

The abnormal high sync between the sensory cortex involved in perception and the subcortical region that conveys information from sensory organs to the cortex shows a central role in hypersensitivity and other sensory symptoms that define autism spectrum disorders. Sensory modulation has been a major subtype studied. The bigger difference is to be less responsive (eg, walking to things) than over-responsivity (eg, distress from loud noise) or to sensory search (eg, rhythmic movements). The response may be more common in children: a pair of studies have found that autistic children have a tactile perception disorder while autistic adults do not.

The Sensory Experience Questionnaire has been developed to help identify the sensory processing patterns of children who may have autism.

ADHD

It is speculated that SPD may be a misdiagnosis for people with attention problems. For example, a student who fails to repeat what has been said in class (due to boredom or disorder) may be referred for evaluation for sensory integration dysfunction. Students can then be evaluated by occupational therapists to determine why they are having difficulty focusing and attending, and may also be evaluated by an audiologist or speech-language linguist for hearing processing problems or language processing problems. Similarly, a child may be mistakenly labeled "attention deficit hyperactivity disorder (ADHD)" because impulsivity has been observed, when in fact this impulsivity is limited to sensor search or avoidance. A child may regularly jump out of their chairs in the class despite many warnings and threats because their poor proprioception (body consciousness) causes them to fall out of their seats, and their anxiety over this potential problem causes them to avoid sitting whenever possible. If the same child can remain seated after a soft, wavy pillow to sit on (which gives them more sensory input), or, can remain seated at home or in a particular classroom but not in their main classroom, more evaluation is needed to determine the cause of their impulsivity.

Other comorbidities

Conditions may include SPD, such as obsessive compulsive disorder, schizophrenia, succinic semisuccinase dehydrogenase deficiency, primary nocturnal enuresis, prenatal alcohol exposure, learning difficulties and people with traumatic brain injury or who have had cochlear implants. and may have genetic conditions such as fragile X syndrome.

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Controversy

There is concern about the validity of the diagnosis. The SPD is not included in DSM-5 or ICD-10, the most widely used diagnostic source in health care. The American Academy of Pediatrics (AAP) states that there is no universally accepted framework for diagnosis and recommends caution against the use of "sensory" type therapy except as part of a comprehensive treatment plan. In fact, in a 2012 statement, the AAP stated that "Since there is no universally accepted framework for diagnosis, sensory processing disorders are generally not to be diagnosed." When an occupational therapist recommends sensory integration therapy, the AAP instructs that the therapist be aware that, "parents should be informed that the number of studies on the effectiveness of sensory integration therapy is limited and inconclusive." Thus, most health insurance consider sensory integration therapy as "investigation" and will not cover it. In the United States and the United Kingdom, sensory processing impairments are unlikely to qualify individuals for disability benefits, so proponents of sensory processing disorders recommend having children diagnosed for related disorders that would qualify them for disability insurance. A recent review of the Sensory Integration Therapy (SIT) concluded that SIT is "ineffective and that its theoretical foundations and assessment practices are not validated." In addition, the authors warn that the SIT technique exists "beyond the boundaries of existing evidence-based practices" and that SIT is "highly likely to be a misuse of limited resources."

Manual

The SPD is on the Diagnostic Manual for Foreign Age and Early Childhood Stanley Greenspan and as Sensory Process Disorder Settings section of the Zero to Three Classification Diagnostics . but not recognized in the ICD-10 manual or in the recently updated DSM-5. However, unusual reactivity to sensory input or unusual interest in the sensory aspect is included as a possible criterion but not necessary for the diagnosis of autism.

Misdiagnosis

Some states state that sensory processing disorders are different diagnoses, while others argue that differences in the sensory response are a feature of other diagnoses and it is not a stand-alone diagnosis. Neurologist David Eagleman has proposed that SPD may be a form of synesthesia, a perceptual condition in which the senses are mixed. Specifically, Eagleman points out that instead of the sensory input "connecting to the [color] color area [in the brain], it connects to an area involving pain or reluctance or nausea".

Researchers have described the treatment-sensitive overstimulation disorder that meets the diagnostic criteria for attention deficit disorder disorder and sensory integration dysfunction.

Distinguishing SPD from Autism

Recent studies have helped physiologically differentiate children who develop typically from children with SPD, and from children with autism. About 1% of the US child population has been diagnosed with autism, while around 5-16% of children have had difficulty processing sensory input. In a recent study conducted by Owen et al., TENSOR imaging diffusion (DTI) was used to test white matter in a group of children with a sensory impairment compared with a typical group of children. The results showed less white matter microstructures, especially in the posterior brain, in children with SPD compared with developing children. These findings illustrate physiological variations in areas of the brain involving sensory processing and integration, which may help explain some of the challenges children experience with SPD. This particular study shows that DTI can be used in the diagnosis and differentiation of SPD and autism.

In a follow-up study related to SPD differentiation from autism, Chang et al. examine differences in white matter tract in a group of children with SPD compared with a group of autistic children, and also in relation to a group of typically developing children. The results of this study indicate a significantly less white matter connectivity between the parietal and occipital lobes in children with SPD and ASD compared with children who develop typically. As stated above, this connection plays mostly in sensory perception and integration. However, this study found only reduced connectivity in the temporal lobe of a group of children with ASD. This area of ​​the brain contributes to the social-emotional process. These findings reveal a significant relationship between white matter circuits and cognitive progress, particularly in the areas of hearing integration, social skills, memory, and attention. These findings can help guide treatment and provide more personalized interventions for children with SPD, ASD, and other diagnoses. However, further research needs to be done with larger groups and more attention to changes in other neural circuits.

Research

A recent review of the Sensory Integration Therapy (SIT) concluded that SIT is "ineffective and that its theoretical foundations and assessment practices are not validated." In addition, the authors warn that the SIT technique exists "beyond the boundaries of existing evidence-based practices" and that SIT is "highly likely to be a misuse of limited resources."

History

Sensory processing disorders were first described in depth by occupational therapist Anna Jean Ayres (1920-1989). According to Ayres's writings, an individual with SPD will have a declining ability to organize sensory information when it comes through the senses.

Original model

Ayres's theoretical framework for what he calls sensory integration was developed after six analytic studies of population factors of children with learning disabilities, perceptual motor disabilities and normal developing children. Ayres creates the following noses based on the patterns that appear in his factor analysis:

• Dyspraxia: poor motor planning (more related to vestibular system and proprioception)
• Poor bilateral integration: inadequate use of both sides simultaneously
• Tactile defense: a negative reaction to tactile stimuli
• Perception of visual perception: poor perception of shape and space and visual motor function
• Somatodyspraxia: poor motor planning (associated with bad information coming from tactile and proprioceptive systems)
• Hearing language problem

Both visual and auditory language deficits are considered to have strong cognitive components and weak relationships with underlying sensory treatment deficits, so they are not considered central deficits in many sensory processing models.

In 1998, Mulligan conducted research on 10,000 sets of data, each representing a child. He conducted confirmatory factor analysis and exploration and found similar deficit patterns to his data as Ayres did.

Quadrant model

Dunn's physiology uses two criteria: the response type (passive vs active) and the sensory threshold to the stimulus (low or high) that creates 4 subtypes or quadrants:

• High neurological threshold

1. Low registration: high threshold with a passive response. Individuals who do not capture sensation and therefore take part in passive behavior.
2. Sensation search: high limit and active response. Those who are actively seeking a sensory-rich environment.

• Low neurological threshold

1. Sensitivity to stimuli: low threshold with passive response. Individuals who become disturbed and uncomfortable when exposed to sensations but do not actively limit or avoid exposure to sensations.
2. Sensation avoidance: low threshold and active response. Active individuals limit their exposure to sensations and therefore high self-regulators.

Sensor processing model

In Miller's syndrome "sensory integration dysfunction" is renamed "sensory process disorder" to facilitate coordinated research work with other fields such as neurology because "the use of the term sensory integration is often applied to neurophysiological cellular processes rather than behavioral responses to sensory input as connoted by Ayres. "The current sensory processing noise nosology was developed by Miller, based on neurological underlying principles.

Other models

Various approaches have included sensations to influence learning and behavior.

• The Standby Program for Self-Adjustment is a complementary approach that encourages cognitive awareness of frequent vigilance with the use of sensory strategies to support learning and behavior.
• Another approach primarily uses passive sensory experience or sensory stimulation based on certain protocols, such as the Wilbarger Approach and the Vestibular-Oculomotor Protocol.

Advocacy

American Occupational Therapy Association (AOTA) supports the use of various sensory integration methods for those with sensory processing impairments. The organization has supported the need for further research to increase insurance coverage for related therapies. They have also made efforts to educate the public about sensory integration therapy. Current AOTA practice guidelines support the use of sensory and educational therapy and interprofessional integration therapy to optimize treatment for those with sensory processing impairments. AOTA provides several resources related to sensory integration therapy, some of which include fact sheets, new research, and continuing education opportunities.

See also

References

• Van Hulle, C., Lemery-Chalfant, K. & amp; Goldsmith, H. H. (2015). Trajectory Sensory Over-Responsivity from Early to Middle Aged: Risk Factors Birth and Temperament. Plos ONE, 10 (6), 1-20. doi: 10.1371/journal.pone.0129968

Further reading

• "sensory processing interruption". Borders in Integrative Neuroscience - Research Topics . Retrieved August 24 2013 .

Source of the article : Wikipedia