occupational therapy

1. Bangladesh Health Professions Institute
Department of Occupational Therapy
Masters of Science in Occupational Therapy
Occupational Therapy in Adult Neurology
The Affolter approach, also known as the Affolter sensory integration approach, is a therapeutic method
developed by Rosemary White-Hoare and Dr Andreé-Emilie Affolter. This approach is used in occupational
therapy and aims to facilitate the sensory-motor and cognitive development of individuals with
neurological conditions or developmental challenges, particularly those with sensory processing
disorders.
The Affolter approach, also known as the Affolter sensory integration approach, is a therapeutic method
that aims to facilitate sensory-motor and cognitive development in individuals with neurological
conditions or developmental challenges, particularly those with sensory processing disorders. The
treatment components of the Affolter approach involve specific strategies and techniques to promote
sensory integration and functional abilities.
KEY ASSUMPTIONS OF THE AFFOLTER APPROACH
1. Sensory Processing: The approach assumes that sensory processing is a fundamental aspect of human
development and plays a crucial role in cognitive, motor, and emotional functioning. Sensory inputs from
the environment are processed by the brain to form a coherent perception of oneself and the world.
2. Neuroplasticity: The Affolter approach assumes that the brain has a remarkable ability to adapt and
reorganize its neural connections in response to sensory experiences and learning. This neuroplasticity is
believed to underpin the potential for sensory integration and functional improvement.
3. Self-Initiated Movements: The approach values the importance of self-initiated movements in
promoting sensory-motor development. Active engagement in purposeful movements is thought to
facilitate the brain's ability to integrate sensory information effectively.
4. Sensory-Enriched Environment: The Affolter approach assumes that creating a sensory-enriched
environment is essential for promoting sensory exploration and stimulating sensory integration. A rich
sensory environment can encourage engagement and active participation in therapeutic activities.
5. Individual Differences: The approach acknowledges that individuals have unique sensory processing
challenges, motor abilities, and cognitive strengths and weaknesses. Therapy is tailored to address the
specific needs and goals of each individual.
6. Task-Oriented Activities: Meaningful and purposeful task-oriented activities are assumed to facilitate
functional improvements and promote the transfer of skills to daily life.
7. Sensory Handling Techniques: The Affolter approach assumes that specific sensory handling techniques
can guide and facilitate movements, promoting sensory integration and improved motor skills.

2. 8. Therapist as Facilitator: Therapists adopting the Affolter approach are seen as facilitators rather than
instructors. They create a supportive and motivating environment to encourage the individual's active
participation in therapy.
9. Incremental Challenges: The approach assumes that gradual progression and increasing challenges in
sensory integration activities can support the development of sensory processing abilities.
10. Holistic Approach: The Affolter approach takes a holistic view of the individual, considering the
interplay between sensory, motor, cognitive, and emotional aspects of functioning. Addressing these
aspects collectively is thought to lead to more comprehensive improvements.
KEY TREATMENT COMPONENTS OF THE AFFOLTER APPROACH
1. Sensory Environment: Creating a rich and stimulating sensory environment is a fundamental aspect of
the Affolter approach. The therapist designs the treatment space to provide a variety of sensory stimuli,
such as tactile, proprioceptive, vestibular, visual, and auditory inputs. The individual is encouraged to
explore and interact with the environment actively.
2. Self-Initiated Movements: The therapist promotes self-initiated movements to stimulate the brain's
sensory-motor pathways and enhance sensory integration. The individual is encouraged to initiate
purposeful movements, explore different body positions, and engage in activities that challenge their
motor skills.
3. Sensory Handling Techniques: The therapist uses specific sensory handling techniques to guide and
support the individual's movements. Gentle touch, movement facilitation, and body positioning are
employed to help the individual organize and integrate sensory information effectively.
4. Task-Oriented Activities: Therapy sessions in the Affolter approach focus on task-oriented activities that
are meaningful and purposeful to the individual. These activities are designed to improve functional
abilities and promote independence in daily life tasks.
5. Observation and Documentation: The therapist closely observes the individual's responses to sensory
inputs and movements during therapy sessions. Documentation of progress and changes in sensory
integration and functional abilities is an essential part of the treatment process.
6. Environmental Adaptations: The therapist may suggest environmental adaptations or modifications to
support the individual's sensory integration and functional performance. These adaptations may include
changes to lighting, sound, or the arrangement of objects in the environment.
7. Sensory Integration Activities: Specific sensory integration activities are incorporated into the therapy
sessions to challenge and enhance the individual's sensory processing abilities. These activities may
involve swinging, bouncing on therapy balls, using sensory toys, and engaging in activities that require
different sensory inputs.
8. Gradual Progression: The Affolter approach emphasizes a gradual progression of challenges to support
the individual's sensory integration development. Therapists carefully adjust the level of complexity and
sensory input based on the person's responses and progress.

3. 9. Individualized Approach: Like all sensory integration-based therapies, the Affolter approach is highly
individualized. The treatment plan is tailored to address the unique sensory processing challenges, motor
abilities, and cognitive strengths and weaknesses of each individual.
The Affolter approach is implemented by trained occupational therapists or other healthcare
professionals with expertise in sensory integration. It is commonly used for individuals with
developmental delays, cerebral palsy, autism spectrum disorders, and other neurological conditions
affecting sensory processing and motor function. The goal of the Affolter approach is to improve sensory
integration, motor skills, communication, and overall participation in daily activities.
EXAMPLES OF TREATMENT TECHNIQUES WITHIN THE AFFOLTER APPROACH
Examples of treatment techniques within the Affolter approach might include:
1. Sensory Exploration: Creating a sensory-rich environment with various textures, colours, and sensory
toys to encourage the individual to explore and interact with different stimuli.
2. Swinging Activities: Utilizing swinging movements to provide vestibular stimulation and help the
individual develop a sense of balance and body awareness.
3. Tactile Play: Engaging in tactile activities, such as finger painting, playing with sand, or manipulating
different textures, to promote sensory processing and integration of touch sensations.
4. Body Movement Games: Encouraging the individual to engage in body movement games that require
active exploration, such as crawling through tunnels or crawling over textured surfaces.
5. Body Positioning: Using specific body positioning techniques during activities to support the individual's
motor control and enhance sensory processing.
6. Guided Movements: Providing gentle sensory handling techniques to guide the individual's movements
and facilitate the integration of sensory information.
7. Purposeful Activities: Engaging the individual in purposeful and meaningful activities that challenge
their sensory processing and motor skills, such as stacking blocks, threading beads, or pouring water.
8. Gradual Progression: Gradually increasing the complexity and challenges of activities based on the
individual's responses and progress in sensory integration.