Icdl socal inst postural m delahooke

Southern California Regional DIR速 Institute Postural Control November 20, 2009

DIR Basics  When we look at supporting relationships, one aspect

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to consider is how well the child’s sensory and motor patterns connect to his emotions.

The sensory system informs the motor system (with input from the limbic system) on what actions to take.

A developmental task is for the sensory system to hook up with the motor system, and emotions are the link.

“Affect is Action”…Lois Gold Engaging Autism, 2006, Chapter 11,

Postural Control for Functions  Can sequence purposeful gestures and

actions, to obtain desires,  1.Simple physical actions to indicate desires  2.Physically mirror gestures  3.Physically imitate gesture  4.Imitate physical actions with purpose  5. Obtain desires  6.Problem solve steps with body to move in space to interact with people & objects

 for exploration  for function & purposeful use of toys  for self help  for back and forth interactions with family and

peers  (# ___steps) recorded

 The body is the body ego…Freud  Your body is the first tool you learn how to use…Gil

Foley, 2006  Body—Tripod and Visual System -–Camera  Your body dictates how well the “picture” is taken…. (and visa versa!)  The input into the visual system from a shaky tripod (body) will not be robust, the child will likely have a restricted range in one or more areas of praxis. (ideation, planning, sequencing, execution, adaptation) Adapted from Lois Gold, OTR/L

Examples  A hypersensitive baby who turns away from the

source of sound (including mother’s voice). A hyperaroused system creates an adaptation of turning away.  An under reactive baby who may not interpret the sound of the voice as salient enough to “tell” the motor system to turn towards the caregiver.  A child with POSTURAL DELAY might adequately process the sounds coming from the caregiver, but not be able to support her motor actions, properly organizing her response. Chapter 11

DMIC Reference for following slides  Behavioral Indicators of Sensory

Discrimination Challenges by sensory systems  Visual, Auditory, Tactile, Proprioceptive and Vestibular  Pages 91 and 92 DMIC

Contributions to Motor Challenges  Postural Challenges  Difficulty stabilizing the body during

movement to meet the demands of the environment.  Can include poor stability in the trunk, poor righting and equilibrium reactions, poor trunk rotation or poor ocular control. (eye tracking)  Difficulty maintaining a good standing or sitting position, or maintaining posture to perform a task.

 Postural control patterns:  Tendency to avoid moving around and dislike

of unexpected movements  Tendency to be physically active but lacking control and safety awareness  Behavioral Indicators: ICDL DMIC page 93  Postural challenges can occur with or without a motor planning disorder, often observed with dyspraxia…bilateral riding a bike, or rhythm.. clapping to a beat.

Clinical Example  4 y.o. child with advanced language

capacities and isolated herself socially  Awkward, peer skills underdeveloped and looked like an ASD child  Poor postural control/ central vision led to isolation from peers, odd behaviors  Were the peer skills deficient or underdeveloped?  This is the underpinning of constrictions in milestones 2,3 and 4.

 This child had weakness in her body, (very

poor upper body postural control) always preferred solitary activities sitting down and never experienced power in her body.  Power (range) in body = power (emotional range) Power Rangers!  PT and OT important part of tx