Sensory deprivation

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Sensory deprivation

  1. 1. SEMINAR ON SENSORY DEPRIVATION SUBMITTED SUBMITTED BY MRS.PARMESS LECTURER TO MR. ATUL LAWRENCE M.Sc NURSING (1 st YEAR) RATTAN EDUCATIONAL COLLEGE COLLEGE OF NURSING RATTAN EDUCATIONAL OF NURSING MOHALI MOHALI
  2. 2. SUBMITTED ON COURSE : M.Sc NURSING (1st YEAR) SUBJECT : ADVANCED NURSING PRACTICE UNIT : UNIT-V, BIO-PSYCHO SOCIAL PATHOLOGY TOPIC : SENSORY DEPRIVATION VENUE : M.Sc NURSING CLASSROOM (1) AV-AIDS : POWER POINT PRESENTATION NAME OF THE STUDENT : Mr. ATUL LAWRENCE NAME OF THE EVALUATOR : Ms. Ratinder DATE AND TIME : OBJECTIVE OF THE SEMINAR: At the end of the seminar, students will be able to gain knowledge regarding concept of sensory deprivation and will effectively apply it during the theoretical and clinical aspects of the nursing profession.
  3. 3. • INTRODUCTION  NATURE OF SENSORY STIMULATION  NORMAL SENSORY PERCEPTION ♣ RETICULAR ACTIVATING SYSTEM (RAS) ♣ INPUT SENSES  CHARACTERISTICS OF NORMAL SENSORY PERCEPTION  NORMAL SENSORY PATTERN ♣ SENSOR STASIS ♣ ADAPTATION  SENSORY ALTERATIONS ♣ SENSORY OVERLOAD ♣ SENSORY DEPRIVATION  FACTORS AFFECTING SENSORY DEPRIVATION ♦ ENVIRONMENT ♦ PREVIOUS EXPERIENCE ♦ CULTURE ♦ PERSONALITY, LIFESTYLE AND HABITS ♦ ILLNESS ♦ MEDICATIONS ♦ VARIATIONS IN STIMULATION
  4. 4.  SENSORY DEPRIVATION IN HOSPITAL SETTING  EFFECTS OF SENSORY DEPRIVATION ♦ PERCEPTUAL RESPONSES ♦ COGNITIVE RESPONSES ♦ EMOTIONAL RESPONSES  CLINICAL SIGNS OF SENSORY PERCEPTION ♦ PHYSICAL BEHAVIOURS ♦ EMOTIONAL BEHAVIOURS ♦ CHANGES IN PERCEPTION BEHAVIOUR ♦ CHANGES IN COGNITIVE BEHAVIOUR  IMPACT OF ACTIVITIES ON DAILY LIVING  RELAXATION TECHNIQUE ♦ CHAMBER TEST ♦ FLOATATION TEST ♦ BENEFITS OF THE THERAPY ♦ SIDE EFFECTS OF THE THERAPY  ROLE OF THE NURSE ♦ NURSE-CLIENT INTERACTION • THEORY APPLICATION • JOURNAL ABSTRACT • SUMMARY
  5. 5. • CONCLUSION • BIBLIOGRAPHY INTRODUCTION Sensory stimulation is a subject of interest to both biological and social scientist. From conception to death, the human being uses sensory organs to learn about the environment in which he lives. Stimulation of the sensory organs also promotes development of these organs and contributes to the overall well being of the individual. Sensory stimulation programs are one of the most common types of activities found in long-term care facilities. Simply stated, sensory stimulation is a technique that provides meaningful and common smells, movements, feels, sights, sounds, and tastes through the stimulation of all six senses. There are many benefits to providing sensory stimulation such as increased communication, environmental awareness, relaxation, cognitive stimulation, opportunity to build a rapport, enjoyment of a leisure experience, increased quality of life and much more. NATURE OF SENSORY STIMULATION
  6. 6.  Sensory impulse: Phenomenon of polarization and depolarization through which the abnormal activity of a fibre spreads through a nerve.  Sensory neuron: Nerve cord carrying sensory stimuli to the brain.  Dendrite: Cytoplasmic extension of a nerve cell.  Cell body: Part of the nerve cell between the axon and the dendrite.  Axon: Extension of a neuron.  Motor neuron: Nerve that produces muscular activity.  Motor end plate: Muscular organ that becomes active in response to stimuli.  Myelin sheath: Envelope of phosphorated fats.  Receptor (free nerve ending): Receiver of nervous stimuli. For a person to receive data, FOUR conditions must be met. They are:• A STIMULUS: An agent, act or other influence capable of initiating a response by the neurons by the nervous system must be present. • A RECEPTOR OR SENSE ORGAN must receive the stimulus and convert it to a nerve impulse. • THE NERVE IMPULSE must be conducted along a nervous pathway from the receptor or sense organ to the brain. • A PARTICULAR AREA in the brain must receive the impulse into a sensation. The study of stimulation begins with nerve cells, NEURON. The cell has a projection or process called DENDRITE or DENDRON, that carries an impulse to neuron. It also has an AXON which carries an impulse to CNS. Sensory nerves carry some impulses to areas of the brain where the individual becomes aware of the stimulus ↓ Perception then occurs with awareness ↓ When impulse reaches consciousness, the individual becomes aware of outside world (e.g.: Optic nerves carry messages from the eye, Olfactory nerves carry from the nose and so on) ↓ The structure that receives stimuli is called a RECEPTOR (e.g.: Eye is the receptor of light waves, and Muscle is the receptor of skeletal muscles) NORMAL SENSORY PERCEPTION
  7. 7. Sensory Perception involves the conscious organization and translation of the data or stimuli into meaningful information. Sensory perception depends on the sensory receptors, reticular activating system (RAS), and functioning nervous pathways to the brain. The RAS influences awareness of stimuli, which are received through the five senses: sight, hearing, touch, smell, and taste. Kinaesthetic and visceral senses are stimulated internally. RETICULAR ACTIVATING SYSTEM (RAS) It is responsible for bringing together information from the cerebellum and other parts of the brain with the sense organs. The RAS is highly selective. For example, a parent may be awakened in the middle of the night at the slightest murmur of an infant in a bedroom down the hall but may sleep through the loud traffic noises outside the bedroom window. Destruction of the RAS produces coma and an electroencephalograph pattern characteristic of sleep. INPUT OF SENSES Sensory function begins with reception of stimuli by the senses.  Externally, the senses receiving stimuli are Vision, hearing, smell, taste, and touch  Receptor organs are the eyes, ears, olfactory receptors in the nose, taste buds of the tongue, and nerve endings in the skin. Internally, the kinaesthetic and visceral senses receive stimuli. These receptors are nerve endings in the skin and body tissues. The kinaesthetic sense influences awareness of the placement and action of body parts. The visceral sense receives stimuli that affect awareness related to the body's large interior organs. Vision, hearing, smell, and taste are termed, special senses. Touch, kinesthetic sensation, and visceral sensation are termed somatic senses. After stimuli are received, they are perceived with the help of the RAS. Sensory perception is a consociates process of selecting, organizing, and interpreting sensory stimuli requiring intact and functioning sense organs, nervous pathways, and the brain. CHARACTERISTICS OF NORMAL SENSORY PERCEPTION These are the normal measures in quality and quantity of the special and somatic senses. ♣ NORMAL VISION is associated with visual acuity at or near 20/20, full field of vision, and tricolour vision (red, green, blue).
  8. 8. ♣ NORMAL HEARING is associated with auditory acuity of sounds at an intensity of 0 to 25 dB, at frequencies of 125 to 8,000 cycles per second. ♣ NORMAL TASTE involves the ability to discriminate sour, salty, sweet, and bitter. ♣ NORMAL SMELL involves the discrimination of primary odours, such as cainphoraceotrs, musky, floral, peppermint, ethereal, pungent, and ptitrid. ♣ SOMATIC SENSES include discrimination of touch, pressure, vibration, position, tickling, temperature, and pain. NORMAL SENSORY PATTERN  SENSOR STASIS Each person has his or her own comfort zone. This comfort zone varies from person to person and is the range at which a person performs at his or her peak. Sensor stasis is a state of optimum arousal-not too much and not too little. The RAS is viewed by some theorists as a monitor for sensor static balance.  ADAPTATION Beyond the point of sensor stasis, sensory adaptation occurs. Sensory receptors adapt to repeated stimulation by responding less and less. Lead time and after burn are two necessary time periods crucial to helping a person deal with new stimuli. – Lead time is the time each person needs to prepare for an event emotionally and physically. – After burn is the time needed to think about, evaluate, and come to terms with the activity after it happens. The necessary amount of lead time and after burn is different for each person. Lead time and after burn helps person process stimuli so he or she can respond appropriately without becoming overwhelmed. SENSORY ALTERATIONS A change in environment can lead to MORE or LESS normal stimuli. When stimuli is different from what one is used to it leads to sensory alterations. Hospitalized patients will experience sensory alterations due to different stimuli loads.
  9. 9. Sensory alterations can result in either sensory overload or sensory deprivation. SENSORY OVERLOAD It occurs when a person is unable to process or manage the intensity or quantity of incoming sensory stimuli. The person feels out of control and overwhelmed by the excessive input from the environment. Routine activity in the health setting can contribute to sensory overload in clients. These activities fall into three main categories: – – Information, and – • Internal factors, Environment Internal Factors: such as thinking about surgery or the meaning of a medical diagnosis, can contribute to anxiety and cognitive overload so that the person cannot process additional stimuli. Pain, medication, lack of sleep, worry, and brain injury also can contribute to a person's vulnerability to sensory overload. • Information: It is Imparting information to a client may lead to sensory overload. Some examples include teaching a client about a procedure, informing a client about a diagnosis, making requests of a client, or helping the client solve a problem. Anxiety related to medical diagnosis, prognosis, and treatment can contribute to sensory overload. Lights and frequent activity may cause sensory overload in a premature newborn in the neonatal intensive care unit. • Environment: The environment of the healthcare agency provides a higher than usual amount of sensory stimulation. A client newly admitted to the hospital, for example, may have to cope with adjusting to a new roommate, having the television on more than usual, bright lights, paging systems, meeting many staff members, having the bed move up and down at someone else's bidding, waiting for someone to answer the call light, uncontrolled pain, and having strangers touch and not respect private body areas. Clients in intensive care units often exhibit symptoms of sensory overload because of the high degree of light, noise, and activity around the clock. SENSORY DEPRIVATION Although sensory deprivation can be thought of as the opposite of sensory overload, they share many elements. Sensory deprivation generally means a lessening or lack of meaningful sensory stimuli, monotonous sensory input, or an interference with the processing of information. Sensory deprivation or perceptual isolation is the deliberate reduction or removal of stimuli from one or more of the senses. Simple devices such as blindfolds or hoods and earmuffs can cut off sight and hearing
  10. 10. respectively, while more complex devices can also cut off the sense of smell, touch, taste, thermoception (heatsense), and 'gravity'. Sensory deprivation has been used in various alternative medicines and in psychological experiments (e.g. isolation tank). Short-term sessions of sensory deprivation are described as relaxing and conducive to meditation; however, extended or forced sensory deprivation can result in extreme anxiety, hallucinations, bizarre thoughts, and depression. FACTORS AFFECTING SENSORY DEPRIVATION  Environment Sensory stimuli in the environment affect sensory perception. For example, a teacher may not notice the noise in a consistently noisy environment, such as the school cafeteria. But the same teacher may perceive a loud television set very differently in his or her own home, which is usually quiet.  Previous Experience It affects sensory perception in that people become more alert to stimuli that evoke a strong response. For example, a person may drive to work by the same route each day, noticing little along the way. A person may listen to the radio inattentively until a favourite song is played, then listen to every word. A new experience, such as hospitalization, may cause a client to perceive a barrage of threatening new stimuli.  Culture – An individual’s culture often determines the amount of stimulation that a person considers usual or normal. (E.g. A child reared in big-city neighbourhood, where extended families share responsibilities for all the children may be accustomed to more stimulation, than a child reared in sub-urban of scattered single family. – In some culture’s touching is comforting and in some it’s offensive. – Some patients find cultural symbols or religious symbols re-assuring and their absence, a source of anxiety. – A sudden change in cultural surroundings experienced by immigrants to a new country- language, dress, behaviour, it could result in cultural shock.  Personality, Lifestyle and Habits
  11. 11. It affects sensory perception. One person may enjoy a lifestyle surrounded by many people, frequent changes, bright lights, and noise. Another person may prefer less contact with crowds, less noise, and a slow-paced routine. People with different lifestyles perceive stimuli differently. Cigarette smoking causes atrophy of taste buds, decreasing sensory perception of taste. Chronic alcohol abuse may lead to peripheral neuropathy, a functional disorder of the peripheral nervous system those results in sensory impairment.  Illness Certain illnesses affect sensory perception. Diabetes and hypertension cause changes in blood vessels and nerves, leading to visual deficits and decreased sensation of touch in the extremities. Cerebrovascular disorders impair blood flow to the brain, possibly blocking sensory perception. Pain, fatigue, and stress caused by illness also affect perception of stimuli.  Medications Some antibiotics, including streptomycin and gentamicin, can damage the auditory nerve, impairing hearing. Central nervous system (CNS) depressants, such as narcotic analgesics, decrease awareness and impair perception of stimuli.  Variations in stimulation If a person experiences more sensory stimulation than he or she is used to, then distress and sensory overload may occur. On the other hand, if a person experiences less than the usual stimulation, that person is below his or her optimum state of arousal and may be at risk for sensory deprivation. Reactions to sensory overload or sensory deprivation are special challenges that nurses frequently encounter in themselves and clients. Sensory overload and deprivation can lead to perceptual, cognitive, and decisional problems. When the RAS is overwhelmed with input, a person may experience sensory overload and feel confused, anxious, and unable to taken constructive action. When the RAS fails to recognize a stimulus because it is below the threshold level or lacks relevant meaning to the person, sensory deprivation may occur, and the person experiences depression, restlessness, and hallucinations. SENSORY DEPRIVATION IN HOSPITAL SETTINGS In the hospital such occurrences fall into two general categories: – altered sensory reception
  12. 12. – deprived environments ≈ Altered sensory reception Occurs in such conditions as spinal cord injury, brain damage, changes in receptor organs, sleep deprivation, and chronic illness. The person does not receive adequate sensory input because of an interference with the nervous system's ability to receive and process stimuli. ≈ Deprived environments It can have negative effects on a person's sensor stasis. A person who is immobilized or isolated for any reason is deprived of the usual amount of stimulation and may show manifestations of sensory deprivation. RISK FACTORS FOR SENSORY DEPRIVATION IN THE HEALTHCARE ENVIRONMENT • Private room • Eyes bandaged • Bed rest • Sensory aid not available (hearing aid, glasses) • Isolation precautions • Few visitors EFFECTS OF SENSORY DEPRIVATION  PERCEPTUAL RESPONSES • Inaccurate perception of sights, sounds, tastes, smell and body position co-ordination and equilibrium • Mild to gross distortions ranging from day dreams to hallucinations  COGNITIVE RESPONSE • Inability to control the direction of thought content • Decreased attention span and ability to concentrate • Difficulty with memory, problem solving and task performance  EMOTIONAL RESPONSES
  13. 13. • Inappropriate emotional responses including apathy, anxiety, fear, anger, panic or depression and rapid mood changes CLINICAL SIGNS OF SENSORY DEPRIVATION  PHYSICAL BEHAVIOURS ∼ Drowsiness ∼ Excessive yawning  ESCAPE BEHAVIOURS ∼ Eating ∼ Exercising ∼ Sleeping ∼ Running away to escape the deprived environment  CHANGES IN PERCEPTION BEHAVIOUR ∼ Unusual body sensations ∼ Pre-occupation with somatic complaints (Dry mouth, palpitations, difficulty breathing, nausea) and changes in body image, illusions and hallucinations  CHANGES IN COGNITIVE BEHAVIOUR ∼ Decreased attention span ∼ Inability to concentrate ∼ Decreased problem solving and task performance IMPACT ON ACTIVITIES OF DAILY LIVING • Sensory perception dysfunction may have effects on activities of daily living (ADLs). Visual deficits cause problems with self-care activities as basic as dressing, toileting, and preparing meals. Hearing deficits may restrict people from watching television, listening to the radio, and answering the telephone. Safety hazards also exist for who are hearing impaired. • People with taste and smell deficits may lose interest in eating. • Those with sensory deficits involving touch are at risk for burns and injuries to the extremities. Moving around outside the home may be impossible without special aids or help. • Many jobs are prohibited for people with sensory deficits, and driving may not be allowed.
  14. 14. • This further restricts the environments in which they may move about safely, making them dependent on others. If the affected person is the major wage earner, a reduction in or loss of income may occur. • People with cognitive dysfunction from sensory overload or deprivation may exhibit poor judgment and problem solving during everyday activities, increasing the necessity for family members to monitor activities and decisions. All these concerns place more stress on the family to cope with sensory dysfunctions. RELAXATION TECHNIQUE RESTRICTED ENVIRONMENTAL STIMULATION THERAPY (REST) Sensory deprivation, or Restricted Environmental Stimulation Therapy (REST), is a technique by which sensory input (sound, light, smell, etc.) is minimized. This practice encourages an extremely deep level of relaxation. There are two basic methods of restricted environmental stimulation therapy (REST):Chamber REST and Flotation REST  CHAMBER REST In chamber REST, subjects lie on a bed in a completely dark and sound reducing (on average, 80 dB) room for up to 24 hours. Their movement is restricted by the experimental instructions, but not by any mechanical restraints. Food, drink and toilet facilities are provided in the room and are at the discretion of the tester. Subjects are allowed to leave the room before the 24 hours are complete, however fewer than 10% actually do.  FLOTATION REST Modern float tanks are large enough in size and shape to allow a full-sized adult to easily enter, exit, and lie comfortably. The bottom of the light-proof and sound-insulated chamber is filled with 30% Epsom salt solution. The density of this solution provides the floater with complete buoyancy and weightlessness. Indeed, the solution's density makes it impossible for the user to sink. A float session begins when the tank's door is closed. Light is completely eliminated and sound is reduced to near zero through the combination of the tank's insulation and submersion of the floater's ears. Earplugs can further block outside noises. The air and water within the tank are maintained at a constant skin temperature. This neutral temperature prevents the physical and mental distractions caused by cold and heat. The silky nature of the solution further reduces the separation between the floater's skin and its surroundings, so that the body seems to gradually disappear. The combined elements of the tank, therefore, virtually eliminate all external stimulation for the floater Without environmental stimuli to process, the central nervous system's level of activity drops dramatically sending the floater into a state of deep relaxation. The body undergoes positive physiological changes that work toward achieving homeostasis - the state of physical equilibrium. Muscular tension is released and proper blood
  15. 15. flow is enhanced. Additionally, the body begins to balance any neurochemical imbalances caused by tension and stress. There is increased production of endorphins and T-cells, which provide pain relief and increased immunity, respectively. In essence, relieved of outward stimuli, the floater's central nervous system can concentrate most of its energies inward for the restoration of physical and mental health. During a float session, the brain also enters the theta state, usually accessible only in the brief moments before falling asleep. This level of consciousness provides access to the right hemisphere of brain, which is associated with concentration, creativity, and learning. The brain can more easily retain information while in the theta state. A typical float session lasts an hour, although longer sessions are available. After the floater rinses off the salt solution in a shower, most float centers provide a rest area to recuperate and reflect on the float session. This downtime with other floaters and staff enhances the relaxation process. In total, the entire session lasts one-andone-half to two hours. Repeated weekly sessions are suggested to achieve the full benefits of Floatation REST.  BENEFITS OF THE THERAPY These therapies have many physical and mental benefits. ♦ It provides an unparalleled level of relaxation ♦ Old wounds and injuries are allowed to heal faster ♦ Strengthens the immune system ♦ Vasodilatory effect (the body's circulation is increased while the blood pressure and heart rate are reduced) ♦ Muscles and joints release tension ♦ Reducing pain and fatigue ♦ Increase vitality and further reduce levels of stress and tension ♦ Stress-related health problems as migraine headache, hypertension, and insomnia are similarly reduced ♦ Can help with eliminating compulsive behaviors such as alcoholism and smoking ♦ People with psychological and emotional problems as anxiety and depression can also benefit from this therapy ♦ Added benefit stems from the Epsom salts which provides buoyancy (Epsom salt "draws toxins from the body, sedates the nervous system, reduces swelling, relaxes muscles, and is a natural emollient
  16. 16. (and exfoliative)." Also, because the solution does not leach salt from the skin, the floater's skin will not wrinkle during the treatment)  SIDE EFFECTS OF THE THERAPY Prolonged exposure to the Epsom salt solution may cause diarrhoea and dry skin. Otherwise, this therapy has no known negative side effects. ROLE OF NURSE Nurse-Client Interaction The nurse-client interaction promotes sensory health function. The nurse must compensate for the patient’s absent sensations to prevent sensory deprivation. This is done by stimulating the patient above the level of injury. Clients at risk for sensory deprivation may need frequent interaction initiated by the nurse. In any case, provide appropriate stimuli, such as addressing the client by name, explaining all activities, and when leaving, acknowledging the client that the nurse will return. Length, tendency, and content of interactions should be based on individual needs. Talking to the client, showing the client equipment or articles used in care, encouraging the client to smell and taste food that is served, and touching the client are appropriate stimuli during interactions. Conversation, music, strong aromas and interesting flavours should be a part of the nursing care plan. Every effort should be made to prevent the patient from withdrawing from the environment. NURSING INTERACTIONS • Providing meaningful external stimuli can help a client overcome sensor' deprivation or sensory deficit as; playing the television or the radio occasionally playing tennis, • Encouraging use of a clock and calendar, • Encouraging the client to dress or the day's activities, putting till pictures, • Encouraging visitors, opening the drapes, and turning on lights, • Plan: the bed or chair so the client can see or hear activities in the area.
  17. 17. THEORY APPLICATION LYDIA HALL’S CORE, CARE, CURE THEORY CORE CARE CURE
  18. 18. JOURNAL ABSTRACT SENSORY DEPRIVATION: A Review PHILIP SOLOMON; P. HERBERT LEIDERMAN; JACK MENDELSON; DONALD WEXLER The American Journal of Psychiatry, October 21st, 2011 VOL-114, NO.4, 114:357-363 Abstract Sensory deprivation has been produced experimentally by reducing the absolute intensity of stimuli, by reducing the patterning of stimuli, and by imposing a structuring of stimuli. Explorers have experienced it voluntarily and prisoners have had it thrust upon them. While there are many separate factors operating in these various situations, it is clear that the stability of man's mental state is dependent on adequate perceptual contact with the outside world. Observations have shown the following common features in cases of sensory deprivation: intense desire for extrinsic sensory stimuli and bodily motion, increased suggestibility, impairment of organized thinking, oppression and depression, and, in extreme cases, hallucinations, delusions, and confusion. Though the basic concepts regarding perceptual and sensory deprivation are not new, their recent importance in experimental and real life situations has made them increasingly interesting. Future studies in this area may well
  19. 19. contribute to our knowledge of the psychological and behavioral patterns of man under conditions of normality and stress. SUMMARY Sensory deprivation a condition in which an individual receives less than normal sensory input. It can be caused by physiological, motor, or environmental disruptions. Sensory deprivation facilitates the production of an altered state of consciousness through the reduction of extroceptive stimulation and/or motor activity. Sensory deprivation functions in a similar manner as meditation; both reduce the perception of external stimulus. Effects include boredom, irritability, and difficulty in concentrating, confusion, and inaccurate perception of sensory stimuli. Auditory and visual hallucinations and disorientation in time and place indicate perceptual distortions due to sensory deprivation. Symptoms can be produced by solitary confinement, loss of sight or hearing, paralysis, and even by ordinary hospital bed rest. There are many opportunities throughout the day to provide opportunities for stimulation. There are still many ways to provide stimulation for people who are no longer able to participate in daily activities of living or leisure pursuits. What is most important is to find ways to stimulate, otherwise without stimulation, a human being will decline. CONCLUSION Today we have dealt in detail about sensory deprivation- the normal sensory perception and the normal sensory stimuli, how sensory deprivation occurs, the factors causing sensory deprivation, the effects of sensory deprivation, its impact on daily activities, relaxation technique and the role of nurse in sensory deprivation.
  20. 20. BIBLIOGRAPHY BOOKS  LEWIS, BUCHER (2008) “MEDICAL-SURGICAL NURSING- ASSESSMENT AND MANAGEMENT OF CLINICAL PROBLEMS”, ELSEVIER PUBLICATIONS, 7th EDITION, PAGE NO-1603  SUZZANE & BRENDA (),”MEDICAL SURGICAL NURSING”, LIPPINCOTT PUBLICATIONS, 10th EDITION, PAGE NO: 1099 JOURNAL  The American Journal of Psychiatry, October 1st, 2009, VOL-114, NO.4, 114:357-363 NET REFERENCES  http://www.google.com/ sensory deprivation  http://www.wikipedia.org/ sensory perception

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