What is the therapist looking at during a sensory -motor evaluation?

When children are referred to us at DPK we go through an evaluation process utilizing a variety of tests: Standardized Motor Scales, A Sensory Profile, the Sensory Processing Measure, Clinical Observations of Sensory Integration.

Many parents ask us, “What are you looking at and how can you determine what is causing the problem?”

This is a very good question and requires a comprehensive answer!

In general, we are looking at how your child’s brain is spontaneously responding to sensory input (tactile, visual, auditory, vestibular, proprioceptive, multi-sensory). We look at responses (called adaptive responses) and output behaviors to determine sensory processing ability.

All skills and functions that occur happen as a result of the Central Nervous System (CNS) processing and responding.

All behaviors and skills are a reflection of the state of the CNS.

The level of organization or disorganization of the CNS is reflected in behavior.

There are 4 categories of OUTPUTS of the CNS:

  1. Motor Behavior
  2. Fine motor
  3. Gross Motor
  4. Visual Motor
  5. Oral Motor
  • Language Behavior
  • Receptive Language
  • Expressive Language
  • Pragmatic Language
  • Cognition/Academic Behavior
  • Academics
  • IQ scores
  • Psychosocial-Emotional Behavior
    *** This area is the primary area affected by self-regulation dysfunction
  • Ability to Focus, Attend, Interact and Engage
  • Self-Awareness
  • Ability to Relate to Others
  • Ability to Relate to Objects/Things
  • Self-Esteem and Self Control

The referral source to a therapist are children expressing behavioral dysfunction in one of the 4 areas outlined above. During a sensory Integration based evaluation for Sensory Processing Disorder (SPD) we are looking at the output behaviors of the Central Nervous System to determine how the information is being processed and where in the brain the breakdown occurs.

When the CNS is organized, a person is able to respond to the environment with appropriate motor or emotional “behaviors”.

When the CNS is disorganized, the responses be it motor or emotional are also disorganized. A child’s poor behaviors may be a reflection of a disorganized CNS.

An adaptive response is defined as a spontaneous response to sensory input.

A functional or successful adaptive response is one that results in efficient and effective use of the body in the environment as a result of intact processing of sensory information through the CNS.

A dysfunctional or maladaptive response is one where there are poor responses or inconsistent responses in one or more of the output areas (Motor, Language, Cognition, Psycho-Social).

Different types of processing disorders are related to different areas in the brain where the breakdown occurs – NOT to a specific sensory system itself.

Once we have completed all ofour testing, we can determine where the breakdown occurs and begin to develop atreatment plan based in a sensory integration approach which is targeted tochange the specific part of the brain that is not processing effectively.

Rebecca Berry, MS, PT, Clinic Director
Becky has been an active pediatric physical therapist on the mid-peninsula since 1985, most recently as cofounder of Developmental Pathways for Kids in 1997. She received her Master’s Degree in Physical Therapy from the University of Southern California. For over thirty years, she has provided physical therapy evaluation and treatment for infants and children with mild to severe developmental delays. In addition to direct patient services, Becky has served as coordinator of a multidisciplinary pediatric team at Mills-Peninsula Hospitals and provided consultative services to schools throughout the Bay Area. Her expertise and areas of interest include Autism Spectrum and Sensory Processing Disorders as they relate to peer socialization and play. She has completed research on the DPK Model Combining Sensory Integration and Integrated Playgroups and is a conference presenter throughout the United States.

In her practice, she combines advanced training in NDT and Sensory Integration Theory and Practice as well as expertise in Integrated Playgroups, the ALERT Program, DIR/Floortime® and The Listening Program®. She has co-authored the book, Pathways to Play! Combining Sensory Integration and Integrated Playgroups and is the author of Hearts and Hands Together a story of inclusion.

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