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Presentation 5: What are sensory integration (SI) and Disfunction of SI? M. Windsor, ScD, OTR/L

How DSI affects child and family life activities

In my experience as an occupational therapist, one of my greatest concerns is the possible disruption in family life because of the responses of children with DSI. Two early, important things a parent expects to do are to comfort and to feed the baby/child. DSI often interferes with these activities: a child may be very fussy, unable to self-regulate, and reject the loving touch of the mother and father. Sensitivity to food textures may make feeding (milk drinking and/or later solids) unpleasant and unsuccessful. A child with vestibular insufficiencies may find lying on his or her stomach "too much work" (the vestibular system is believed to help muscles move against gravity) and cry when placed in this position (the head is really heavy to hold up!). If the child has modulation issues and is fussy, the parents will often avoid "tummy time" for positioning and play. Stomach lying is essential for development of head control (an important contributor to developing eye musculature); taking weight on the elbows and pushing up on the hands/arms (at 3 to 5 months of age) are crucial sensory motor experiences that set the shoulder girdle for stability (the shoulder must be unmoving or stable in order for refined hand-eye skills to develop) and stimulate movement of the thumb out of the palm (the precursor to thumb finger movements in grasp). When the sensory information from these experiences is processed, the body scheme and a perceptual sense of self become more refined. I believe this supports the child's awareness of self as the point of reference for his or her world and is crucial for developing an internal locus of control (as opposed to seeing forces other than oneself as responsible for actions and events). We must also be aware that post-institutionalized children may be deprived of many of these experiences AND may have had to learn atypical responses (motor and social emotional) in order to survive. The good news is that human beings are amazingly resilient, especially children, and respond well to intervention.

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