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INTRODUCTION

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LEARNING OBJECTIVES

  1. Understand the purpose(s) of performing a sensory examination.

  2. Understand the relationship between preliminary mental status screening and tests for sensory function.

  3. Describe the classification and function of the receptor mechanisms involved in the perception of sensation.

  4. Identify the spinal pathways that mediate sensation.

  5. Understand the guidelines for administering an examination of sensory function.

  6. Describe the testing protocol for each sensory modality.

  7. Using the case study example, apply clinical decision-making skills to application of sensory examination data.

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SENSORY INTEGRATION

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If all of the sensory stimuli which enter the central nervous system were allowed to bombard the higher centers of the brain, the individual would be rendered utterly ineffective. It is the brain's task to filter, organize, and integrate a mass of sensory information so that it can be used for the development and execution of the brain's functions.1, p. 25—A. Jean Ayers, PhD

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The human system is continually inundated with sensory information from a variety of environmental inputs as well as from movement, touch, awareness of the body in space, sight, sound, and smell. "In all higher order motor behaviors, the brain must correlate sensory inputs with motor outputs to accurately assess and control the body's interaction with the environment."2, p.32 Sensory integration is the ability of the brain to organize, interpret, and use sensory information. This integration provides an internal representation of the environment that informs and guides motor responses.2 These sensory representations provide the foundation on which motor programs for purposeful movements are planned, coordinated, and implemented.3 Ayers defined sensory integration as "the neurological process that organizes sensation from one's own body and from the environment and makes it possible to use the body effectively within the environment."4, p. 11 In an intact system, sensory integration occurs automatically without conscious effort.

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Sensory integration is a theory developed by A. Jean Ayers (1920–1989), an occupational therapist whose work focused on examining the manner in which sensory integration develops, identifying patterns of dysfunction in children with learning disorders, and developing intervention strategies to improve processing of sensory information. The theory purports that disordered sensory integration directly affects both motor and cognitive learning and that interventions designed to enhance sensory integration will improve learning.1 Bundy and Murray5 suggest the value of the theory lies in its usefulness in (1) explaining behaviors of individuals with impaired sensory integration functions, (2) establishing a plan of care (POC) to address specific impairments, and (3) predicting expected outcomes of the selected interventions.

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SENSATION AND MOVEMENT

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Motor learning and motor performance are inextricably linked to sensation. As a motor task is practiced, the individual learns to anticipate and correct or modify movements based on sensory input organized and integrated by the central nervous system (CNS). The CNS uses this information to influence movement by both feedback ...

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