The Sensory Integration (SI) frame of reference focuses on how the interaction between the sensory systems including auditory, vestibular, proprioceptive, tactile, and visual systems, provides integrated information that contributes to a child’s learning and adaptive behaviors. The key consideration is that children have the abilities to make adaptive responses to constantly changing sensory environments. The sensory integrative abilities include sensory modulation, sensory discrimination, postural-ocular control, praxis, bilateral integration, and sequencing. In SI frame of reference, the outcomes of sensory integrative process consist of:
The ability to modulate, discriminate, and integrate sensory information from the body and from the environment,
Self-regulation to regulate and maintain his/her arousal level to focus on task,
Maintenance of postural control, ocular control, bilateral coordination, and laterality,
Praxis and organizing behavior for tasks and activities, and
Development of self-esteem and self-efficacy.
These outcomes eventually lead to successful participation in daily occupations. Interventions using the SI frame of reference include use of therapeutic equipment to provide children with various sensory opportunities, with at least two of these three sensations (tactile, vestibular, and proprioceptive). Sensations are provided in a structured environment, graded to a greater or lesser intensity depending on the needs of each child. The outcome of successful sensory integration is the participation in daily life activities and will enhance fulfillment of the children’s roles, like being a student in the classrooms that include constantly changing sensory information.
Frame of reference
Sensory processing disorder
Domain of occupation
A dynamic, process-oriented intervention
Schaaf, R. C., Schoen, S. A., Roley, S. S., Lane, S. J., Koomar, J., & May-Benson, T. A. (2010). A frame of reference for sensory integration. In P. Kramer & J. Hinojosa (Eds.), Frames of reference for pediatric occupational therapy (3rd ed., pp. 99-186). Philadelphia: Lippincott Williams & Wilkins.
Sensory Integration Theory aims to explain behaviors, plan intervention, and predict behavioral change through intervention, and provide specific intervention strategies to remediate the underlying sensory issues that affect functional performance. It purposes therapeutic interventions that incorporate sensation to affect multi-sensory perception to influence learning and behavior, as the central nervous system does not process sensory information in isolation.
This model simplifies the complex information on praxis and aims to guide clinical reasoning of practitioners who adapt sensory integrative approach. It lists three levels of theoretical considerations and specifies the neural processes, systems, and outcome functions associated.
The occupational adaptation frame of reference (FOR) focuses on the adaptation process when a person encounters occupational challenges. Three basic elements of this FOR are the person (including sensorimotor, cognitive, psychosocial system), the occupational environment (including work, play and leisure, and self-maintenance) and the interaction between these two elements. Each of the elements is consistently influenced by a constant, respectively.
The developmental frame of reference (FOR) suggests that development is sequential, and behaviors are primarily influenced by the extent to which an individual has mastered and integrated the previous stages. This FOR views people as dynamic, developing, and people’s lives go through stages of growth and decline, which require necessitate adaptation by the individual. People develop at different rate, but each stage of development can only proceed normally if the preceding stages have been completed successfully.
The psychoanalytic frame of reference (FOR) emphasizes on the unconscious aspect of what is done and said, and it is embedded in an occupational therapy relationship model of practice - the Vivaio model (MOVI). The central element of the MOVI is the recognition of constant emotions that exist in the interdependent relationship between the three elements of patient, therapist and ‘doing’.