JJ, girl, 7 years and 2 months, first-grade primary school, full-term delivery; movement and language development is normal. You can sit alone for 6 months, coordinate with your limbs for 9 months, walk for 15 months, and speak sentences for 18 months. Mom always thinks that children are very smart and must be able to perform well in school. When the teacher said that JJ was not doing well at school, my mother was very surprised and came to consult.
JJ writes very hard, and the pencil refill is often broken. She likes to play with children younger than her, usually playing static games. Many toys in the family that require fine movements, she usually uses these toys to play the role of their own story, instead of actually operating these toys, and very imaginative, but also a lot of storytelling, that is, they will not operate. In addition, JJ's mother also told me that JJ will not go down the stairs with interactive steps without armrests, and it will not jump rope at present.
After observation, it is found that the sense of touch: JJ finger touch recognition, touch vision, hand touch recognition shape performance is poor; vestibular sense and ontology treatment: JJ muscle tension is low, limb joint stability is not good, her balance ability Not good, the head control cannot be maintained during supine flexion. Her sequential action planning ability, her ability to coordinate movements on both sides is not good, and she is lagging behind in imitating the movements of the tongue, lips, and chin (oral ability), but her ability to act according to spoken instructions is very good; This condition often occurs in children with good language skills and physical abilities. IQ: JJ's IQ is 118 points, and the language IQ is higher than the operating IQ. Therefore, I think that the ability to use physique is the main reason that affects the performance of JJ. Her ability to use dysfunction should be due to the handling of touch, vestibular sensation, and ontological problems, which affect her rough movements, fine movements and visual movements.
During the training, I designed more scenarios for JJ to explore the feelings. At first, JJ likes to squeeze herself into a small space. If I climb into a soft cylinder and hide it in the ocean pool, I will let her crawl into the sun tunnel filled with bricks to provide more tactile stimulation. Let her organize her movements; at the same time, prepare a sleeping bag at home, put some beans in it, let her move quickly in the bag, back and forth (need to put a mat on the floor). After two weeks, designing more difficult activities, putting sticks on the swings, ferrules, and throwing the ball on the trampoline, these activities need to plan and execute the sequence of actions, which is difficult for her (when designing the activity goal) Pay attention to the most appropriate challenge). When designing the event, I will let JJ try different approaches and achieve the goal every time, which means that her action planning ability can adapt to different change requirements.
I believe that with cognitive factors (such as visual guidance, focusing on the entire activity process rather than step by step, demonstrating the process of completing the activity), plus the enhancement of touch, vestibular sensation, and proprioception, it is sure to enhance the action plan and which performed. At the same time, it is very challenging to remind the training instructors to develop interventions that use dysfunction, because it also covers cognitive components.
The vestibular stimulation should be targeted to all staff engaged in sensory training.
Instant or angled head movements can stimulate the semicircular canal and cause a phase reaction (ie, fast, instantaneous):
- The head and upper torso are stable in an upright position.
- When the individual is rotated or tilted (the downward side), the limb bearing the side is straight.
- Flexion of the load-bearing limb on the opposite side (upper) side.
- Compensatory outreach and straightening of non-bearing limbs.
Instantaneous head tilt or a straight head movement stimulates the elliptical sac and produces a tonic response:
- Straightening of the lower weight-bearing member (support reaction).
- The upper part bears the flexion of the limb.
- Compensatory outreach and straightening of non-bearing limbs.
- The head and upper torso are stable in an upright position.
Therefore, in terms of functional implications, if the goal is to induce a tonic or supportive response, it is appropriate to provide an activity that stimulates the elliptic sac (ie, horizontal or vertical vestibular stimulation); if the goal is to encourage the use of more phases or An instantaneous posture response that provides activity to stimulate the semicircular canal is necessary.