Acknowledgements. The Sensory Integration and Praxis Tests (SIPT) APPROPRIATE POPULATIONS. Purpose of the SIPT. Clinical Tool. Age Groups 14/5/2015
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1 Acknowledgements The Sensory Integration and Praxis Tests (SIPT) Current and Future Uses Original by Susanne Smith Roley OTD, OTR/L, FAOTA and Susan Spitzer Ph.D., OTR/L; revised 2011, 2013 A. Jean Ayres, The Sensory Integration and Praxis Tests, Los Angeles: Western Psychological Services. Occupational Therapy Practice Framework: Domain and Process. (2002) Bethesda, MD: American Occupational Therapy Association. Purpose of the SIPT APPROPRIATE POPULATIONS Most comprehensive assessment of Sensory Integration The gold standard for evaluating sensory integration and praxis issues 17 standardized, computer scored tests Used widely with children with learning and behavior problems Used selectively with other populations such as high functioning autism, Fragile X syndrome, or cerebral palsy Age Groups Clinical Tool Standardized data available on children ages 4 years-8 years, 11 mo. Used selectively on children and some adults, older than the standardization sample May be used as a template for observations on younger children but not standardized Evaluate Sensory Integration Function and Dysfunction in Individuals. Diagnostic tool, designed to discover patterns of sensory integrative dysfunction Computerized SIPT disc scores individual tests as well as the set of 17 tests. Outcomes measure to assess function and functional change 1
2 Research Tool Defined patterns of dysfunction Psychometrically strong to support future research in SI Use Within Occupational Therapy Practice Selection of the sensory integration frame of reference or practice model Analysis of occupational profile and occupational performance determines the use of one or more frames of reference or practice models such as sensory integration Provides information re: body structure/function and activity level of performance Interpretation Links body structure/function, performance skills, and performance patterns, with engagement in activities, occupations and co-occupations, and social participation Outcomes Individual tests, especially those tests with high test/retest reliability Groups of tests to assess a domain of function such as praxis and visual motor measures. Whole test can be used for reassessment but at larger time intervals (recommended approximate 1 year between repeating SIPT) Originally: The Southern California Sensory Integration Tests (SCSIT) self-funded research developed one test at a time widely used clinical tool standardized on limited geographic sample criticized for it s standardization procedure SIPT Development Ayres expanded the praxis tests in the 1970 s and early 1980 s extensive psychometric testing strong reliability & validity normative data based on 1,997 children from US and Canada a randomized sample based on the US census norms separated by sex, handedness, at 4-6 month intervals research based on SCSIT and SIPT data provides the infrastructure for ongoing development of sensory integration theory 2
3 Populations outside of the U.S. and Canada Pilot data available for German speaking children Scores must be interpreted cautiously especially with non-english speaking children Administration Takes approximately 2 hours With proficient examiner, cooperative child, and a five minute break Additional time needed for scoring and interpretation Recommendation is to administer entire test in recommended sequence, however, any combination of tests can be administered/scored Design minimizes demands on linguistic comprehension WPS TEST REPORT Report provides standard scores and comparison using a cluster analysis technique 15 page computer analysis to assist in interpretation SUMMARY GRAPH OF SIPT RESULTS Space Visualization Figure-Ground Perc Man. Form Perception Kinesthesia Finger Identification Graphethesia Loc. Tactile Stimuli Praxis Verb. Command 0.54 Design Copying Constructional Praxis Postural Praxis 0.08 Oral Praxis Sequencing Praxis Bilateral Motor Coord Stand & Walk Balance Motor Accuracy Postrotary Nystagmus 0.00 Space Visualization Figure-Ground Perc Man. Form Perception Kinesthesia Finger Identification Graphethesia Loc. Tactile Stimuli Praxis Verb. Command Design Copying Constructional Praxis 0.44 Postural Praxis Oral Praxis Sequencing Praxis Bilateral Motor Coord Stand & Walk Balance Motor Accuracy Postrotary Nystagmus
4 Space Visualization Figure-Ground Perc Man. Form Perception Kinesthesia Finger Identification Graphethesia Loc. Tactile Stimuli Praxis Verb. Command Design Copying Constructional Praxis Postural Praxis Oral Praxis Sequencing Praxis Bilateral Motor Coord Space Visualization 0.13 Figure-Ground Perc Man. Form Perception Kinesthesia N/A Finger Identification N/A Graphethesia N/A Loc. Tactile Stimuli N/A Praxis Verb. Command 0.14 Design Copying Constructional Praxis 0.80 Postural Praxis 1.14 Oral Praxis Sequencing Praxis Bilateral Motor Coord 0.48 Stand & Walk Balance Motor Accuracy Postrotary Nystagmus Stand & Walk Balance Motor Accuracy Postrotary Nystagmus SD LOW Space Visualization Figure-Ground Perc Man. Form Perception SD LOW Space Visualization Figure-Ground Perc Man. Form Perception re-evaluation Kinesthesia 0.51 Finger Identification 0.35 Graphethesia Loc. Tactile Stimuli Praxis Verb. Command 1.00 Design Copying 1.35 Constructional Praxis 0.43 Postural Praxis Oral Praxis Sequencing Praxis 1.07 Bilateral Motor Coord Stand & Walk Balance Motor Accuracy Postrotary Nystagmus SD LOW Space Visualization Figure-Ground Perc Man. Form Perception 0.92 changing the trajectory of development Kinesthesia Finger Identification Graphethesia Loc. Tactile Stimuli Praxis Verb. Command Design Copying Constructional Praxis Postural Praxis Oral Praxis Sequencing Praxis Bilateral Motor Coord Stand & Walk Balance Motor Accuracy Postrotary Nystagmus Space Visualization Figure-Ground Perc Man. Form Perception 0.72 Kinesthesia 0.95 Finger Identification 1.33 Graphethesia Loc. Tactile Stimuli Praxis Verb. Command 1.04 Design Copying 0.47 Kinesthesia Finger Identification Graphethesia Loc. Tactile Stimuli Praxis Verb. Command Design Copying Constructional Praxis 1.18 Postural Praxis Oral Praxis Sequencing Praxis 0.80 Bilateral Motor Coord 2.20 Constructional Praxis Postural Praxis Oral Praxis Sequencing Praxis Bilateral Motor Coord Stand & Walk Balance Motor Accuracy Postrotary (c) 2014 Nystagmus USC OS 0.43OT Stand & Walk Balance (c) Motor 2014 Accuracy USC OS OT Postrotary Nystagmus 0.78 Benefits for clinical reasoning Quantifies performance on areas that are difficult to observe otherwise Provides graph of relative strengths and weakness 30 years of factor analyses and several cluster analyses provide information that relate the test information into patterns that can be used to identify and predict areas of function and dysfunction Identifies specific areas to guide targeted intervention for more efficient services Documents the hidden disabilities that are interfering with engagement in occupation and social participation Relationship to Academic Achievement Strong association of sensory integration, especially praxis to arithmetic achievement Strongest at 6-8 years of age Sensory integration was not significantly related to reading in younger ages, but was related to later reading skill 4
5 PREDICTIVE VALIDITY RELATED TO ACADEMIC ACHIEVEMENT Parham, L. D. (1998). The relationship of sensory integrative development to achievement in elementary students: Fouryear longitudinal patterns. Occupational Therapy Journal of Research, 18(3), Relationship to Occupation Provides detailed information related to client factors and skills that support performance in every day life SIPT data interpreted in conjunction with other evaluation data Clinical observations of neuromotor functions, play, sensory sensitivities, motor planning, and social interactions Parent, teacher information related to sensory responsiveness Functional performance such as fine motor, gross motor, or skills Impact of child s behavior and abilities on social and environmental context such as family impact questionnaire Predicting Occupationally- Relevant Outcomes SIPT scores alone are not intended to be used to determine whether or not a child with sensory integrative dysfunction or dyspraxia will profit from therapy. (Ayres, 1989/1991, SIPT Manual) Include documentation of the child s and the family s ability to engage in needed and wanted occupations 5
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