729 Final Study Guide PDF

729 FINAL STUDY GUIDE *Read and study all of your readings, class notes, PPTs, and other resources. Focus on the following objectives as you study: SENSORY INTEGRATION EVALUATION: 1. Demonstrate an understanding of testing procedures for the 19 items on the Clinical Observations evaluati...

729 FINAL STUDY GUIDE *Read and study all of your readings, class notes, PPTs, and other resources. Focus on the following objectives as you study: SENSORY INTEGRATION EVALUATION: 1. Demonstrate an understanding of testing procedures for the 19 items on the Clinical Observations evaluation and understand the significance of each item (i.e. what information does each item give you regarding sensory integration?; Madelyn in class) a. Clinical Observations are a group of non-standardized procedures used to assess sensory integration. i. The observations in 19 situations are made to assess the child’s functioning in the following areas 1. Muscle tone 2. Bilateral integration 3. Vestibular function 4. Primitive postural reflexes 5. Equilibrium reactions 6. Co-contraction 7. Extraocular muscular control SENSORY INTEGRATION & SENSORY PROCESSING INTERVENTION 1. Know 3-5 examples each of vestibular, proprioceptive, and tactile- based treatment activities. 2. Know correct terminology of sensory problems based on Ayres vs. Miller. Plus, know intervention strategies for different sensory processing problems (ASI vs SPD)  SPD o SMD (Under-responsive, Over-responsive, sensory craving) o SBMD  Dyspraxia  Postural Disorders o SDD  ASI o Vestibular-bilateral function o Sensory reactivity/modulation o Sensory discrimination and perception o Praxis 3. Going along with 2, know appropriate activities for each area of SI dysfunction as discussed in your SI treatment worksheet. Think about  how treatment would differ for one area of dysfunction versus the other.  How would you begin treatment with a child who is significantly gravitationally insecure? What would be some appropriate activities to do initially in treatment? How would you modify treatment as you noted progress (grade up the activities)? When encouraging involvement in vestibular-based activities, would you begin encouraging linear or rotary types of vestibular input?  How would you begin treatment with a child who is significantly tactile defensive? How would treatment progress as the child improved? Give examples of treatment, activities you would start with and then activities you would eventually work up to.  What are some of the major treatment strategies that you would apply when working with a child with dyspraxia? Be specific. o What are some difficulties associated with dyspraxia? o What are some strategies for the classroom?  What would some of your major treatment strategies be when working with a child who has bilateral integration and sequencing deficits? 4. What are the general guidelines for ASI treatment? 5. Know the difference and examples of compensatory and remedial SP interventions 6. What are SI intervention strategies appropriate for school settings? a. Examples of sensory-enriched classrooms SELF-REGULATION /EMOTIONAL-REGULATION OF AROUSAL FOR ALERTNESS & ATTENDING 1. The “How does your engine run” program by Shellenberger & Williams is comparing an engine to our state of arousal. Describe a person’s arousal state if the engine is high, low, and just right. 2. Give examples of how you would increase arousal with:  mouth activities  movement  touch  vision  and auditory 3. How would you decrease or inhibit arousal in the same areas (above)?  Additional suggestions on strategies for ALERTING and CALMING 4. Zones of Regulation program by Leah Kuypers; know purpose and summary of emotions included in the 4 different zones 5. Superflex – Superhero Social Thinking Curriculum; know purpose and what type of strategies are used 6. Self-regulation vs. Emotional regulation 7. Know the benefits of mindfulness and strategies to embed OTHER SPECIALIZED PROGRAMS Be familiar with benefits of the programs discussed in class: 1. Therapeutic Listening Program (TLP) 2. Craniosacral Therapy (CST) 3. Aquatic Therapy (AT) SENSORY DEFENSIVENESS (PAT WILBARGER) 1. Define sensory defensiveness and associated social and emotional disorders as described by P. Wilbarger 2. Study information on the Sensory Diet. What is the definition and purpose of a sensory diet? Where can it be applied (what kind(s) of setting(s)?) Be able to describe appropriate intervention activities or suggestions  Specific time-oriented routines  State changers or mood makers  Routines  Modify interactions  Structure the environment 3. Know some sensory diet resources (discussed and shown in class) 4. Specifically describe the procedure for applying Wilbarger’s deep pressure (brushing) protocol. 5. In your own words, explain why “brushing” is used. In other words, how does brushing impact the nervous system to decrease sensory defensiveness? SENSORY + ADULTS AND TRAUMA-INFORMED CARE 1. Know some strategies for sensory defensiveness in adults a. Coping strategies in adults w/sensory defensiveness i. Avoiding situations ii. Being controlling/perfectionistic iii. Mental preparation-getting ready for the stimuli iv. Talking through- making rationalizations v. Counteraction -engage in activities to negate the effect of stimulus vi. Confrontation- identifying a plan to overcome negative reaction. b. Treatment of sensory defensiveness in adults i. Pfeiffer and Kinnealey 1. Explored relationship b/w SD and anxiety, as well as impact of a SI tx protocol on normal adults. 2. 15 adults w. SD participated. Treatment protocol implemented a. Providing insight into SD  b. Regular daily and sensory input c. Engagement in activities of choice providing primarily prop., vestibular, and tactile sensory input d. Engaged in individualized self-treatment protocol for 1 month. 3. Results: there was a significant correlation found between anxiety and SD a. Results supported the use of a sensory treatment protocol to decrease sensory defensiveness and secondary anxiety. i. Sensory defensiveness can cause anxiety and depression *** 2. SI can be applied with varied populations (diagnoses). What are some? a. Anxiety b. Depression c. Autism d. Learning disabilities e. TBI, f. FAS 3. Sensory rooms in Mental Health a. Sensory room: An umbrella term used to categorize a broad variety of therapeutic spaces specifically designed and utilized to promote self-organization and positive change. i. Serve as a safe space ii. Facilitates the therapeutic alliance iii. Provides opportunities for engagement in prevention and crisis de-escalation strategies, as well as a host of other therapeutic exchanges (teach skills,) iv. Promote self-care/self-nurturance. Resilience, and recovery. b. There are three types i. Sensory modulation rooms ii. Sensory integration rooms iii. Snoezelen Rooms 4. Sensory approaches for acute psychiatric settings a. Study by Champagne 2005 i. Focus 1. The co-creation and use of nurturing and sensory supportive environments to support meaningful therapeutic interaction in acute care psychiatry. 5. Trauma-informed care and the Sensory Modulation Program (SMP)  Trauma, impact on body, in childhood, in adulthood o Impact on the body  Changes in neurological structures and functions   Affects the hippocampus, which influences learning and memory  Impacts multiople frontal limbic structures needed to regulate emotional responses to stress and fear  Impact s the hypothalamic pituitary adrena axis that controls regulation of body processes and response to stress  Results in difficulty integrating sensory info and regulating emotional stress  Become neurophysically reactive to events and situations. o Impact in Childhood  Can influence normal developmental process both structurally and functionally  Disrupts the formation of secure and healthy attachments  Patterns when a person has a low threshold for hyperarousal or the stress response  Decreased self-esteem  Anxiety/panic attacks  Sensory defensiveness  Emotional dystruglation  Difficulty developing healthy relationships  Intrusive thoughts/memories  Impulsivity  Decreased attention/concentration  Dissociative tendencies. o Trauma impact in adulthood  Can manifest in a variety of ways  Mental health disorder o How trauma impacts adult mental health  Those that experience trauma may compensate for deep emotional scares in dysfunctional ways:  Passive aggression  Victimhood  Presenting a false self  Interpersonal problems  General instability.  Occupational crises  Environmental modifications and sensory approaches o The Sensory Modulation Program  Organized to serve as guide to beginning to teach sensory modulation concepts o Sensory approaches in acute psychiatric settings   Focus: co-creation and use of nurturing and sensory supportive environments to support meaningful therapeutic interaction o Trauma-informed care  Organizational structure and treatment framework that involves understanding, recognizing, and responding to the effects of all types of trauma.  Defined as: mental health care that is grounded in and directed by a thorough understanding of the neurological, biological, psychological, and social effects of trauma and violence on humans and the prevalence of these experiences in persons who receive mental health services. o Trauma treatment has 3 phases:  Stabilization  Processing and grieving  Transcendence o Sensory approaches are used to foster safety, development, functional performance, and recovery. o TIC addresses the relationship b/w  Environmental/subjective triggers  Perceptions of danger  Distressed neurophysiologic states  Functional and behavioral problems o TIC acknowledges how trauma has impacted the person’s perception of emotional and physical safety, on perception and behaviors. o Dysregulation- the red alert  The person may experience overwhelming sensory stimuli, flooding with multi-sensory stimuli as if the trauma were happening again  Unwanted sounds, smells, bodily discomfort  Feelings- may feel numb or frozen. o Sensory approaches target intense physical manifestations of trauma  Provide experiential opportunities to help individuals  Recognize sensory experiences  Identify sensory preferences  Begin to heal mind trough physical sensation of the body. 6. What are ACEs and impact on health outcomes a. Adverse childhood experiences (ACEs) i. Traumatic experiences in a child’s life that have a negative lifetime effect on the child into childhood. ii. Not considered a condition per DSM-5  iii. Research shows that children who have ACEs have long term negative outcomes in social emotional development 1. And Emotional regulation iv. Children who experience ACEs may develop: 1. Long term negative heath outcomes 2. Chronic medical conditions 3. Dropping out of HS 4. Unemployment 5. Living below poverty level, 6. Suicide, drug use, heavy drinking. SYNTHESIS 1. Read and review case studies from Part I and Part II that were discussed in lab 2. Read and review case studies from trauma-informed care that were discussed in lab 3. Review the components for a well-written pediatric goal, as discussed in multiple labs 4. Linking occupation/participation to sensory (Case Study Part II)