High Country Early Intervention

Sensory Observation Guide

Sensory Integration is the process by which a child learns to use information from all of the senses for learning and maturation. These senses include body position, how the body moves, his/her relationship to gravity, and, of course sight, hearing, touch, taste, and smell. The senses weave together to develop a child's sense of him/herself, as well as the world all around. Receiving and interpreting this information is the first step in ALL learning. Our specially trained pediatric occupational, physical and speech therapists provide Sensory Integration treatment to assist children with their development. Families are trained in these techniques.

The following list contains concerns that MAY indicate a need for Sensory Integration therapy. All children display these behaviors occasionally. Also, children may display these traits for reasons other than sensory integrative needs. However, if several of these concerns are noted over a period of time an evaluation may be warranted. A pediatric therapist can assist parents in deciding whether an evaluation is needed.

Birth to 12 Months
Good Sensory Integration: The baby...   Concerns: The baby...
After six weeks of age has fairly well-established sleep cycles. Sleeps all night by six months.   Has not developed predictable sleep/waking cycles; is frequently difficult to calm or get to sleep.
Likes to be held and molds her body to that of the adult holding her.   Arches or attempts to pull away when being held.
Is comfortable when being moved.   Becomes irritable when moved or position is changed.
Easily moves from one position to another.   Prefers to stay in one position.
Has favorite songs or movement games, and anticipates these special interactions.   Avoids novel play situations or interaction with others.
Explores toys by putting them in his mouth.   Avoids mouthing toys.
After six months accepts solid and textured foods when introduced.   Has difficulty with solid or textured foods, "picky" eater.
Can attend to more than one stimulus at a time. For instance, can look at a book while listening to a story.   "Tunes out" if more than one stimulus is presented.
Has favorite sensory stimuli, such as certain music, finger games, flavors, etc.   Caregivers have difficulty determining baby's preferences.
Plays with the two hands in the middle. Transfers toys hand-to-hand.   Uses just one hand at a time (after 8 months).
         
  12 to 18 Months      
  Good Sensory Integration: The toddler...     Concerns: The toddler...
Enjoys touching textures; plays with food, textured toys, sand, play-doh, etc.   Avoids finger feeding, touching textured toys, messy hands.
Enjoys bath time and accepts touch from washcloth. Accepts clothing moving against skin during diapering and dressing.   Is excessively upset by dressing and diaper changes or by bathing.
Plays in imaginative and unique ways.   Is "stuck" in play, continues to mouth, bang or throw toys repeatedly.
Spends time exploring the various features of toys (the sights, sounds, texture, etc.)   Has short attention to new toys, does not independently explore toys' properties.
Understands simple directions without gestures, listens and looks when spoken to.   Has poor eye contact: Makes inconsistent responses (actions) when spoken to.
Accepts various clothing textures. Accepts clothing that is appropriate to the weather.   Is fussy about clothing textures. Avoids wearing shoes, OR insists on wearing shoes on all textured surfaces such as carpeting or grass. Insists on heavy clothing during hot weather, OR avoids clothing, even in cold weather.
Is not excessively frightened by loud or sudden noises.   Noises such as thunder, sirens, vacuum cleaners are frightening.
         
  18 months to 3 years      
  Good Sensory Integration: The toddler/child...     Concerns: The toddler/child...
Adjusts play to the situation, active play outdoor lay vs. structured, quiet play inside.   Has an intense need for constant movement such as jumping, rocking, swinging; Can't sit still. OR avoids movement.
Explores new play equipment, with good balance and body control   Has difficulty getting on and off play equipment, or is clumsy. Avoids new movement play situations. Does not want feet off the ground.
Can remain focused on a task despite a moderate level of activity in the room   Is easily distracted by sights and sounds.
Is able to participate in simple group activities: Understands the sequence of changes in group activities. Is able to understand turn taking.   Seems to get lost in group activities. Is unable to take turns, even with adult assistance.
Is comfortable with trying new things, or changes in routines.   Becomes upset if routines and plans are changed.
Is able to tolerate moderately loud noises, and unusual environmental stimuli.   Is upset by loud noises. Can hear distant sounds that others do not hear. Has unusual responses to light, smells, or other sensory experiences.
Accepts tooth brushing, bathing, and grooming, unless distracted by play.   Has poor tolerance of grooming such as hair combing or shampooing, tooth brushing.
         
Adapted from D. Jirgal, OTR, and Kathy Bouma, OTR, HOPE Infant Program, San Diego, CA.


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