Sensory Integration, Occupational Therapy, Speech, Language and Communication are discussed. Sensory Integration involves organizing sensory information from the body and environment for daily life use. Occupational Therapy focuses on developing motor, self-care, and cognitive skills through purposeful activities. Speech and Language issues can cause delays in communication development. Therapists assess deficits and set SMART goals to improve integration of senses, motor skills, communication, and independence through therapy techniques.

1. Sensory Integration
Occupational Therapy
Speech ,Language and Communication
M.Sc. Child Development

2. Topics
• Sensory Integration
• Occupational Therapy
• Speech ,Language and Communication
• Setting therapy goals

3. Sensory Integration(SI)
• “The organization of sensory information for use”(Ayres,1972).
• It is the process of organizing information we get from our bodies
and the world around us for use in the daily life.
• identifies ways in which early sensory experiences are important
in normal development.
• Dr. Jean Ayres developed the applications of sensory integration
theory through evaluation and intervention methods.
• SI helps to receive, modulate ,integrate and process the sensory
information.
• Brain- ‘Sensory Processing machine’.

4. Senses
Most Commonly Known Senses
 Vision
 Hearing
 Smell
 Taste
 Touch
Other senses
 Proprioception
 Vestibular

5. Sense of touch
• Skin receptors send information about light, temperature,
pain, and pressure to the brain.
• Tactile sensation-helps to feel shape, size, location of
things
• Recognize physical properties of objects without vision.
• Academic learning often requires hands-on manipulation
• Touching and being touched impacts social skills.

6. Proprioception
• Gives awareness about Body positions.
• Unconscious awareness of sensations received through
proprioceptors of joints, muscles, ligaments, and tendons.
• Tells the brain when and how the muscles are contracting
and stretching and how joints are bending, extending,
being pulled, or compressed.
• How to develop sense of body position?
– Deep pressure and gentle “pull” to the joints,Swaddling,Hugs,
tumble play.

7. Vestibular Sense
• Inner ear detect movement and changes in the position of
head
• Supports “extensor” tone-holding body up against gravity
• Helps us know up/down; right/left
• How to develop sense of movement and balance?
– Help parents to understand importance of movement
– Dance with baby with rhythmic movements

8. Sensory Integration Dysfunction
• Inability to process the information received through
senses.
• Affects learning, development, and behaviour
• The muscles and nerves may work well, but the brain has a
difficult time organizing or integrating the information.
• Shows difficulty in organizing themselves, in school/play
activities
• Less involvement in positive social experiences.

9. Tactile Dysfunctions
Hypersensitivity or Tactile Defensiveness
– React negatively and emotionally to light touch, exhibiting
anxiety, hostility, or aggression
– Overreact to physically painful experiences over a minor
scrape or splinter
– Avoidance of new or certain textures of clothing/food.
Hyposensitivity or Under-Responsiveness
-Tend to repeatedly touch those surfaces that provide
soothing and comforting tactile experiences
-Rub or bite own skin
-Prefer certain foods such as extra spicy or extra sweet foods

10. Vestibular Dysfunctions
• Hypersensitivity or movement intolerance
– Dislike activities such as swinging, spinning, or sliding
– Show discomfort being held in some positions, especially
with head tilted back
– slow moving and sedentary
• Inefficient vestibular processing
– Need to keep moving or have trouble sitting still
– Repeatedly shake head back and forth, rock back and forth,
and jump up and down
– Crave intense movement experiences such as bouncing on
furniture or seeking fast and scary rides at amusement
parks

11. Proprioceptive Deficits
• Show poor body awareness, such as poor position in sitting
or using toys
• Seek sensation to the joints as in pushing head into corner
of crib or leaning into others

12. Other signs and symptoms
• Problems in motor planning(Inability to conceive,organize,
sequence and carry out complex movements in meaningful
way-climbing stairs, clapping out rhythms)
• Poor eye-hand coordination(illegible handwriting ,untidy
eating)
• Delays in speech, language ,motor skills, or academic
achievement.
• Poor self concept
• Social and emotional problems

13. • Associated problems
Auditory language problems
Vision problems
Eating, digestion and
elimination problems
Problems in sleep regulation
allergies

14. SI Therapy
Who do this?
Occupational Therapist, Physical Therapist, Speech and Language
Pathologist with post-graduate training in sensory integration theory,
assessment and intervention
Assessment of Sensory Integration Deficits can be done by
• Standardized tests such as the Sensory Integration and Praxis Tests
(SIPT)(Ayres,1989)
• Sensory Profile(SP)(Dunn,1999)
• Parent and Teacher questionnaires
• Observations of the child in various settings
• Ongoing assessments and re-evaluations

16. • SP and SIPT may assess the child in
following areas
– Visual perception
– Somatosensory processing(touch and
proprioception)
– Vestibular processing
– Eye hand coordination
– Motor planning

17. Occupational therapy(OT)
• Assessment and treatment of physical and psychiatric
conditions, using specific purposeful activity to prevent
disability and promote independent function in all aspect of daily
life.
• OT originally refers to ‘treatment of adults with
difficulties/disabilities,who because of injury or deformity were
unable to participate in activities of daily life.’
• Pediatric occupational therapy is skilled treatment aimed to
enable the child to be as physically psychologically and socially
independent as possible

18. Occupational Therapists work with…
Children Adolescents
Adults Seniors

19. Occupational therapists work at…
• Hospitals
• Schools
• Mental Health clinics
• Home Care
• Personal Care Homes
• Private Clinics
• Rehabilitation Centers
• Community Health Centers
• Nursing homes

21. 1.GROSS MOTOR SKILLS:
OT focuses on Movement of the large muscles in the arms,
and legs.
Abilities like
 Rolling
 Crawling
 Walking
 Running
 Jumping
 Hopping
 Skipping

22. 2.FINE MOTOR SKILLS:
Movement and dexterity of the small muscles in
the hand and fingers. Abilities like
 In-hand manipulation
 Reaching
 Carrying
 Shifting small objects

23. 3.VISUAL MOTOR SKILLS:
Perception of visual information
Abilities like copying
MOTOR PLANNING SKILLS:
Ability to
• Plan
• Implement
• Sequence motor tasks.

24. 4.ORAL MOTOR SKILLS:
Movement of muscles in the
 Mouth
 Lips
 Tongue
 Jaw,
by giving activities for
 Sucking
 Biting
 Chewing
 Blowing
 Licking
Lip closureChewing

25. 5.SELF HELP SKILLS:
Self – care skills
 Dressing
 Feeding
 Bathing
 Grooming
 Toilet tasks

26. 6.ENVIRONMENT MANIPULATION
Like handling
 Switches
 Door knobs
 Phones
 TV remote

27. COGNITIVE PERCEPTUAL
SKILLS:
Abilities like
Attention
Concentration
Memory
Thinking
Reasoning
Problem solving
Concept of shape
Size and color

28. Speech, Language and
Communication
• Speech-
 Sounds that children use to build up words, saying sounds clearly at
the correct place.
 Important to speak fluently ,with expression and in a clear voice using
pitch, volume, and intonation to support meaning.
• Language
 ‘talking and ‘understanding’
 Having words to describe objects, actions, and attributes
 Using these words to build sentences, conversations and narratives by
following the rules of grammar,so that things make sense..
• Communication-The way in which language is used in a speech to
interact with others.

29. Cont..
Message
Speech
C o m m u n i c a t i o n
Language

30. Cont…
• Children often show ‘Delayed Language skills’
• Such children may show long term difficulties
• 2 groups
– Speech, Language, Communication needs(SLCN):
• Arise from a primary and specific language
impairment
• No other learning difficulty
– SCLN due to other learning difficulties or autistic
spectrum disorders.

31. cont…
 Difficulties in accessing all areas of curriculum
 Problem in Literacy skills(reading, writing,spelling)
 Difficulty to listen, understand and follow teacher’s instructions.
Eg: The child may know how to make a rocket with paper,
but may not be able to follow verbal instruction given by the teacher.
 SCLN group of children
 difficulty in reasoning and predicting .
 They can demonstrate what will happen next in a experiment but their
language doesn’t allow them to verbalize it.
 They need more time to process language.
 Social interaction-get impaired; withdrawal /behavioral difficulties.
What happens if language doesn’t develop?

32.  May have other disorders like autism , cerebral
palsy/other learning disabilities.
 Medical reasons-Hearing loss/physical loss.eg: Cleft
palate
 No obvious reason.
Severity of child’s difficulties can vary
 Some may have for a period of time and then catch up
with other children of the same age
 Persistent difficulty that has long term impact.
 Difficulties can be lifelong
Causes for SLCN
Cont….

33. What is Speech Impairment?
 Speech Impairment is abnormal speech that is
unintelligible, is unpleasant, or interferes with
communication

34. Communication Disorder
(American Speech Language and Hearing Association)
 A communication disorder is an impairment in
the ability to receive, send, process and
comprehend concepts of verbal, nonverbal and
graphic symbol systems. A communication
disorder maybe evident in the process of
hearing, language, and or speech.

35. What is Language Impairment?
 A Language Impairment is the difficulty or
inability to master the various systems of rules in
language, which then interferes with
communication.

36. Types of SLCN
1.Speech and language delay
• The term delay is often used when a child has problems with speech or
language, but
• skills are developing in the normal developmental sequence.
• This means that the pattern of development is as you would expect, but
developing at a slower rate.
2. Speech and language disorder
• learn to speak in a way that is different from the normal pattern of
development;
• They sound unusual.

37. Cont…
3.Specific language impairment (SLI)
 Difficulties with learning and using language;
 difficulties are not associated with general learning difficulties, or other
conditions;
 The difficulties are only related to speech and language, hence the use of the
term ‘specific’.
4. Comprehension (or receptive language) difficulty
 Difficulty in understanding words, sentences or instructions.
 often hard for families to identify - children can be very good at using the clues
around them, and this hides their difficulties.

38. 5.Expressive language difficulty
 A child may have good understanding of words, but find it difficult to use
language to express their own ideas, needs or feelings.
 They might be slow to build up the number and type of words they use.
 They may know certain words, but be unable to think of them when needed.
 They may have particular difficulty building up sentences and using correct
grammar.
6. Speech difficulties
 Difficulty in saying words clearly with the correct sounds.
 It may be due to a 'phonology' difficulty - i.e. the sound system is confused or
an articulation difficulty -
 The child's speech may be difficult to understand even by familiar adults.
 Phonology refers to the speech sounds used in a particular language.
 A child may struggle to learn to say all the sounds they need, and so their
speech is difficult to understand.
Cont…

39. 6.Social interaction difficulties /pragmatic difficulties
•Difficulty in following the rules of communication and interact socially
with others.
• Difficulty in turn-taking in conversations, eye contact, listening to Others and
changes the way they talk according to who they are talking to.
7..Selective mutism
•Some children are able to talk comfortably in some situations (with close family
members at home) but are persistently silent in others (outside their homes and
with less familiar people).
•It is linked to an anxiety around talking. Children may be able to join in activities that
do not require speech, and some may be able to speak a little to their friends if they are
not overheard.
•In other situations they can’t talk at all.

40. 8.Verbal dyspraxia
 Verbal Dyspraxia is a condition where children have difficulty making and
coordinating the precise movements that their mouths need to make
to produce clear speech.
 They find it hard to produce individual speech sounds and to put sounds
together in the right order in words.
 As a result, their speech is often hard to understand even to family
members.
9. Stammering /stuttering/ dysfluency / non-fluency
The child may repeat words or parts of words, hesitate for long periods
between words or totally get stuck on words.

41. Some causes of Speech Impairments:
• Brain damage
• Autism
• Malfunction of the respiratory or speech
mechanisms
• Malformation of the articulators
• Physical or organic problem (cleft palate, cleft
lip)
• Stuttering
• Voice problems (abuse, arthritis)

42. Warning signs
In young children
• does not respond to sound
• regressing with development
• little interest in communication
• talks more slowly than other children of the same age
• has difficulty understanding simple instructions or requests
• speech or language sounds that are unusual, compared with other
children of the same age
• struggling with reading, spelling or maths
• difficulty being understood - even by members of your family
• difficulty paying attention to things that adults point to and talk about
• difficulty making and keeping friends, and joining in games

43. In older children and young people
• they might be slow to answer or to follow an instruction
• you might need to repeat an instruction several times and make it much
simpler before they respond
• they might ‘switch off’ when someone is talking to them so you can tell
they are not listening
• their language can sound muddled and they have difficulty organizing
their thoughts into words
• they may struggle with written work or telling you about something that
has happened. What they manage might be very basic.
• they don’t understand jokes, or language that is complicated like double
meanings or idioms
• they may find it hard to join in or keep up with conversations

44. Getting a diagnosis
 Who can help?
 Health visitor, early years practitioner, school teacher, speech
and language therapists
 Speech and language therapists
• assess speech, language and communication development
• identify whether there are any difficulties
• make a diagnosis and clarify the nature of any difficulty
• develop a treatment plan and work with you to implement that plan
• judge when treatment is complete and when a child should be
discharged

45.  Speech-Language Therapy(SLT)
 “Speech Therapy is a rehabilitative procedure undertaken in
order to help the people having any kind of Communication
Disorders or Problems and some swallowing problems”
 Depending on problem, SLT is given in small group/individual
training.
 In Yong children,
 Language stimulation activities
 Sound imitation training
 Babbbling etc.
 In older children,
 Articulation training-to produce clearer sound.
 In children with hearing impairment, SLT- hearing training and
development of communication system using sounds, symbols, and
hand signals.
 Speech language therapist may share concern with occupational
therapist about function of face, mouth and throat muscles.

46. Goal Setting
S.M.A.R.T theory
Specific - Set a specific goal for oneself.
Measurable - Goals should include a quantity.
Achievable - Goals Challenging but achievable.
Realistic - Match to the reality.
Time Related- Establishment of a clear amount of time and
prioritize the task.

47. References