Occupational therapists can assess an individual"s response
to sensory information from the body and the environment
using standardized and non-standardized tests, clinical
observation, and caregiver or teacher interviews. Emphasis
often is placed on the tactile (touch), proprioceptive (body
awareness, body position in space) and vestibular (perception
of movement) systems. Therapists also assess praxis,
the ability to come up with an idea involving action, and
to anticipate, time, plan, sequence, and execute unfamiliar
motor actions. This information, along with an analysis of
the sensory, motor, and cognitive demands of activities, the
social and physical characteristics of the environment, and
the effectiveness of the individual"s performance skills and
patterns in those activities, forms the basis of the occupational
therapy intervention plan.
Sensory integration and praxis dysfunction and sensory processing
disorders vary in type and severity. When a deficit is
found in sensory integration, praxis, or sensory processing,
occupational therapy practitioners can provide intervention
designed to address these concerns.
Some occupational therapists receive specialized postgraduate
education and training in theory, assessment, and
principles of sensory integration intervention. Certification
programs in sensory integration, which qualify a practitioner
to administer and interpret the Sensory Integration and
Praxis Tests (SIPT) are also available but not required.
Occupational therapy intervention to address sensory
processing concerns can be provided throughout the lifespan.
Early intervention focuses on infants and toddlers,
birth through 3 years of age, with disabilities or at-risk for
developmental problems and their families. Occupational
therapists use their unique expertise to identify sensory
related factors and provide interventions to facilitate effective
self-regulation (wake-sleep cycles, level of alertness,
self-quieting), sensory processing, motor development and
adaptive behavior.
School aged children may require occupational therapy
using a sensory integration approach to support educational
needs as well as life skills and community-based needs. In
addition to providing interventions that remediate the sensory
integration issues influencing behaviors in the classroom,
occupational therapy practitioners also make modifications
to the classroom environment in order to assist children in
participating and progressing at school, playing, making
friends, and focusing in order to learn. Examples might be
managing sensory information during school routines like
riding the school bus, tolerating smells and noise in the
cafeteria, and playing on the playground with others.
Occupational therapy strategies may help reduce stress
and inappropriate or disorganized behavior caused by poor
sensory registration, sensory defensiveness, sensory overload,
and poor praxis. Occupational therapy practitioners
who provide occupational therapy services using sensory
processing approaches work with children to remediate the
underlying sensory integration and praxis factors effecting a
student"s education and participation at school.
Adolescents and young adults may benefit from
strategies that help individuals understand their own sensory
processing systems and the impact on leisure activities,
vocational choices, and relationships. Individuals whose
participation in everyday activities is limited because they
are fearful of movement, sensitive to touch, or unaware of
body position in space and have not had the opportunity to
use their bodies to effectively explore the sensory (proprioceptive,
tactile, vestibular) and physical environment may
also benefit from occupational therapy using this frame of
reference.
