The Effectiveness of Sensory Integration Therapy on Neuro ...

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British Institute for Learning DevelopmentBritish Institute for Learning Development

Increasing Cognitive Development Increasing Cognitive Development through through

Sensory Integration TherapySensory Integration Therapy

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Increasing Cognitive Development Increasing Cognitive Development

through through Sensory Integration Therapy Sensory Integration Therapy

byby

British Institute for British Institute for Learning DevelopmentLearning Development

Dubai Dubai

The Task: The Task: To Raise Learning Ability To Raise Learning Ability and Intelligence and Intelligence Intelligence is the ability to Intelligence is the ability to carry out rational thought.carry out rational thought.

Intelligence can be measured by the Intelligence can be measured by the degree of efficiency of rational thought degree of efficiency of rational thought – – which can be observed through:which can be observed through:

– The speed of deliberation The speed of deliberation – The extent of the deliberationThe extent of the deliberation– The outcome of the deliberation.The outcome of the deliberation.

Neurological FunctionNeurological Function

What we call ‘rational thought’ is What we call ‘rational thought’ is dependent upon neuro-physiology, dependent upon neuro-physiology, or neurological function.or neurological function.

While this may be referred to as While this may be referred to as ‘ ‘natural ability’, neurological function natural ability’, neurological function is the brains ability to think and is the brains ability to think and develops, or increases, from birth. develops, or increases, from birth.

The more we ‘think’, the more parts of the brain become involved The more we ‘think’, the more parts of the brain become involved and complex neighbourhood networks ofand complex neighbourhood networks of

neuron axion fibres are built and joined.neuron axion fibres are built and joined.

Diagram of Neurological Development

Neural Networks in Infants

at three months old

Neural Networks in Toddlers

at two years old

The number of neurons do not increase in our brain from birth. Neural fibre networks increase as our knowledge and ability increases and communication links are established between neurons.

Neural fibre network systems can be ‘trained’ to develop.

Concept of the ‘Learning’ BrainConcept of the ‘Learning’ Brain

Learning is implicitly a neurological function and the Learning is implicitly a neurological function and the capacity to learn is dependent upon neurological capacity to learn is dependent upon neurological efficiency.efficiency.

Unless there is a problem!Unless there is a problem!

Jean Ayres – Sensory Jean Ayres – Sensory Integration Paradigm Integration Paradigm Jean Ayres, an American occupational therapist, Jean Ayres, an American occupational therapist,

discovered a new paradigm for explaining a variety of discovered a new paradigm for explaining a variety of neurological disorders in children. neurological disorders in children.

We refer to this paradigm as sensory integration theory We refer to this paradigm as sensory integration theory and seek to use sensory integration therapy to stimulate and seek to use sensory integration therapy to stimulate the sensory system and thereby increase neurological the sensory system and thereby increase neurological function. function.

Sensory Integration Sensory Integration

Sensory Integration theory proposes that because Sensory Integration theory proposes that because there is plasticity within the central nervous there is plasticity within the central nervous system (the brain is moldable) and because the system (the brain is moldable) and because the brain consists of systems that are hierarchically brain consists of systems that are hierarchically organized, it is possible to stimulate and improve organized, it is possible to stimulate and improve neuro-physiological processing and integration neuro-physiological processing and integration and thereby increase learning capacity. and thereby increase learning capacity.

Learning DifficultyLearning Difficulty As the brain processes and As the brain processes and

integrates information through integrates information through its sensors, it is able to plan its sensors, it is able to plan and organize behaviour in and organize behaviour in order to make an adaptive order to make an adaptive response in the ongoing process response in the ongoing process of learning. of learning.

However, if the sensory system However, if the sensory system is not functioning as it should, is not functioning as it should, or where sensory information or where sensory information is not appropriately integrated, is not appropriately integrated, there is said to be a learning there is said to be a learning disorder. disorder.

Where learning difficulties are not Where learning difficulties are not addressed children will show addressed children will show problems in:problems in: Developmental ProgressDevelopmental Progress - falling behind in skills and capacity - falling behind in skills and capacity

MotivationMotivation - a lack of applied energy - a lack of applied energy

Creativity Creativity - a lack of initiative and sense of adventure - a lack of initiative and sense of adventure

Attention Attention - a lack of attentiveness and concentration - a lack of attentiveness and concentration

Desire to LearnDesire to Learn - a lack of interest in schooling - a lack of interest in schooling

Performance Performance - poor results in academics - poor results in academics

Intellectual ProgressIntellectual Progress - falling behind in intellectual application - falling behind in intellectual application and abilityand ability

DevelopmentDevelopment Development Delay and Development Delay and DysfunctionDysfunction PrimaryPrimary - Physiological Inefficiency- Physiological Inefficiency

- Neurological Inefficiency- Neurological Inefficiency- Developmental Delay- Developmental Delay

SecondarySecondary - Learning is Belated- Learning is Belated- Academic Difficulties- Academic Difficulties- Perception and - Perception and Comprehension is BelatedComprehension is Belated- Behaviour Problems- Behaviour Problems

TertiaryTertiary - Effect on Self Perception- Effect on Self Perception- Low Self Esteem- Low Self Esteem- Low Self Worth- Low Self Worth- Depression, Anxiety and - Depression, Anxiety and PsychosisPsychosis- Mental Health – Medication- Mental Health – Medication

British Institute StudyBritish Institute Study

The British Institute’s two year The British Institute’s two year study from 2006-08, aimed to test the study from 2006-08, aimed to test the effectiveness of our sensory integration programme in effectiveness of our sensory integration programme in improving the neuro-physiological development of improving the neuro-physiological development of children with learning difficulties. children with learning difficulties.

It was proposed that improving the brain’s ability to It was proposed that improving the brain’s ability to process and integrate sensory information would process and integrate sensory information would improve the children’s intelligence and learning improve the children’s intelligence and learning capabilitycapability..

DiagnosisDiagnosis

The specific sensory integration difficulties identified ranged The specific sensory integration difficulties identified ranged across 9 categories of sensory integration disorder:across 9 categories of sensory integration disorder:

Bilateral integration and sequencing difficulties Bilateral integration and sequencing difficulties Visuodyspraxia Visuodyspraxia SomatodyspraxiaSomatodyspraxia Vestibulosomatosensory dysfunctionVestibulosomatosensory dysfunction Somatosensory processing disorderSomatosensory processing disorder Form and space perceptual disorderForm and space perceptual disorder Visual and vestibular processing deficitVisual and vestibular processing deficit Dyspraxia on verbal commandDyspraxia on verbal command Generalized sensory integration disorder.Generalized sensory integration disorder.

Assessments – neuro-physiologyAssessments – neuro-physiology

Selection was based on the results of combined assessment comprising a Selection was based on the results of combined assessment comprising a sensory integration evaluation and possibly an educational assessment sensory integration evaluation and possibly an educational assessment and a speech and language assessment:and a speech and language assessment:

The Sensory Profile by Winnie Dunn The Sensory Profile by Winnie Dunn Jean Ayres Clinical Observations Jean Ayres Clinical Observations Sensory Integration Praxis Test – SIPT Sensory Integration Praxis Test – SIPT Visual Motor Integration Test – VMIVisual Motor Integration Test – VMI Test of Visual Perceptual Skills-Revised – TVPS-R Test of Visual Perceptual Skills-Revised – TVPS-R Test of Auditory Processing Skills –TAPS Test of Auditory Processing Skills –TAPS Clinical Evaluation of Language Fundamentals – CELF Clinical Evaluation of Language Fundamentals – CELF Wechsler Independent Attainment Test -WIAT (educational assessment)Wechsler Independent Attainment Test -WIAT (educational assessment) Wechsler Intelligence Scales – WISC IV Wechsler Intelligence Scales – WISC IV

TVPS-R Raw Scores: Cohort A 2006-07

0

2

4

6

8

10

12

14

16

4 5 6 7 8 9 10 11 12 13

Age

Scor

e

TVPS Mean Cohort A Predicted Score

Normal development and increase in capability for average-score children year-on-year

Improvement in neuro-physiology (the brain's functional ability) due to Sensory Integration coaching

Life-script development history of Cohort-A group before BILD sensory integration coaching

New life-script prediction due to sensory integration coaching

Predicted life-script without sensory integration coaching

TVPS-R Raw Scores: Cohort B 2007-08

0

2

4

6

8

10

12

14

16

4 5 6 7 8 9 10 11 12 13

Age

Scor

e

TVPS Mean Cohort B Predicted Score

TVPS-R Raw Scores: Cohort B 2007-08

0

2

4

6

8

10

12

14

16

4 5 6 7 8 9 10 11 12 13

Age

Scor

e

TVPS Mean Cohort B Predicted Score


Life-script development history of Cohort-B group before BILD sensory integration coaching



TVPS-R Raw Scores: Cohort C 2006-08

0

2

4

6

8

10

12

14

16

4 5 6 7 8 9 10 11 12 13

Age

Scor

e

TVPS Mean Group 2006-07 Group 2007-08

Life-script development history of Cohort-C group before BILD sensory integrayion coaching

Improvement in neuro-physiology (the brain's functional ability) due to Sensory Integration coaching - first year of coaching

Improvement in neuro-physiology (the brain's functional ability) due to Sensory Integration coaching - second year of coaching

VMI Raw Scores: Cohort A 2006-07

02468

10121416182022242628

3 4 5 6 7 8 9 10 11 12 13 14 15 16 17

Age

Scor

e

VMI Mean Cohort A Predicted Score


Life-script development history of Cohort-A group before BILD sensory integrayion coaching



Christopher Leonard Reynolds



Life-script development history of Cohort-A group before BILD sensory integrayion coaching





VMI Raw Scores: Cohort B 2007-08

02468

10121416182022242628

3 4 5 6 7 8 9 10 11 12 13 14 15 16 17

Age

Scor

e

VMI Mean Cohort B Predicted Score

Life-script development history of Cohort-B group before BILD sensory integrayion coaching



VMI Raw Scores: Cohort C 2006-08

02468

10121416182022242628

3 4 5 6 7 8 9 10 11 12 13 14 15 16 17

Age

Scor

e

VMI Mean Group 2007-08 Group 2006-07

Life-script development history of Cohort-C group before BILD sensory integration coaching


Improvement in neuro-physiology (the brain's functional ability) due to Sensory Integration coaching - first year of coaching


Life-script development history of Cohort-C group before BILD sensory integrayion coaching




Improvement in neuro-physiology (the brain's functional ability) due to Sensory Integration coaching -first year of coaching

Standardized Scores - Cohort C: 2006-08

40

50

60

70

80

90

100

110

120

130

140

150

3 4 5 6 7 8 9 10 11 12 13 14 15 16 17

Age

Scor

e

Average 100 Cohort C

Average '100' standardised score. No change expectation

throughout development

Improvement in neuro-physiology (the brain's

functional ability) due to Sensory Integration coaching -

first year of coaching

Improvement in neuro-physiology (the brain's functional ability) due to Sensory

Integration coaching - second year of coaching

New standard score prediction for Cohort-C

due to sensory integration coaching

Case Study – VMI ScoresCase Study – VMI ScoresVMI Case Study 4: Male - Age 10 Life-Script Change

02468

1012141618202224262830

3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18

Age

Scor

e

Normal development and increase in

capability for average-score children year-on-

year

Life-script development history of boy before BILD

sensory integration coaching

Improvement in neuro-physiology (the

brain's functional ability) due to

Sensory Integration coaching

New life-script prediction due to


Case Study – TVPS ScoresCase Study – TVPS ScoresCase Study 4: Male Age 10 Life Script Change

0

2

4

6

8

10

12

14

16

18

4 5 6 7 8 9 10 11 12 13

Age

Scor

e

Life-script development history

of boy ABOVE AVERAGE before

BILD sensory integration coaching

Normal development and increase in

capability for average-score children year-on-

year

Improvement in neuro-physiology

(the brain's functional ability) due to Sensory

Integration coaching

New life-script prediction due to


CASE STUDY 1Male: 7 years, 7 months

-4.0-4.0 -3.0-3.0 -2.0-2.0 -1.0-1.0 0.00.0 +1.0+1.0 +2.0+2.0 +3.0+3.0 +4.0+4.0

SBO

CML

KIN

DTS

FI

IP

BMC

SBC

CMLX

LTS

MFP

SV


GRA

FG

PS

LEGENDLEGEND Form & Space Form & Space PerceptionPerception SomatosensorySomatosensory MotorMotor OtherOther

RLD

SIPT

Neuro-physiological profile of child BEFORE sensory integration

coaching

Neuro-physiological profile of child AFTER sensory integration coaching


-4.0-4.0 -3.0-3.0 -2.0-2.0 -1.0-1.0 0.00.0 +1.0+1.0 +2.0+2.0 +3.0+3.0 +4.0+4.0

SBO

CML

KIN

DTS

FI

IP

RLD

BMC

SBC

CMLX

LTS

MFP

SV


GRA

FG

DC

PS

SIPT


coaching




Form & Space PerceptionForm & Space Perception SomatosensorySomatosensory MotorMotor OtherOther

-4.0 -3.0 -2.0 -1.0 0.0 +1.0 +2.0 +3.0 +4.0 +5.0

SBO

FMKIN

DTS

FI

IP

RLD

BMCSBC

VP

LTS

MFP

VMI


GRA

SIPTSIPT



coaching


Standard Score Comparison

Assessment Dates

VMI 2006-07

2007-08

TVPS-R 2006-07

2007-08

Lower Scores Group Change Percent

76.6 89.3 12.7 16.5%

85.1 93.7 8.6 10.1%

87 100 13 15%

80 92 12 15%

Higher Scores Group Change Percent

90.8 100.6 9.8 11%

98 105.1 7.1 7.2%

100 109 9 9%

111 120 9 8%

Study shows that children with Lower Scores improved more than children with Higher Scores. Lower Score children improved by approximately 15% in 1 year

Children with High Scores still improved by approximately 10% in neuro-physiology ability in 1 year.

Lower Scores Group Change Percent

76.6 89.3 12.7 16.5%

85.1 93.7 8.6 10.1%

87 100 13 15%

80 92 12 15%

Assessment Dates

VMI 2006-07

2007-08

TVPS-R 2006-07

2007-08

ConclusionConclusion

By testing the effectiveness of sensory integration By testing the effectiveness of sensory integration therapy as a neuro-physiological development therapy as a neuro-physiological development technique, the results of the study show that the technique, the results of the study show that the sensory integration therapy programme was sensory integration therapy programme was distinctly effective.distinctly effective.

ImplicationsImplications

As a child’s neuro-physiology is improved As a child’s neuro-physiology is improved there will there will be:be:

An increase in learning abilityAn increase in learning ability An increase in literacy An increase in literacy An increase in general academic abilityAn increase in general academic ability An increase in iAn increase in intelligence scoresntelligence scores General increase in desire to learn and enjoy General increase in desire to learn and enjoy

schooling schooling

The Effectiveness of Sensory Integration Therapy on Neuro ...

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