Sensory Integration and Praxis Tests (SIPT)
If your child is age four or older and being evaluated by a private therapist, as opposed to a more generalized evaluation being done for special education services, the therapist will most likely administer the Sensory Integration and Praxis Tests (SIPT), a series of 17 standardized tests designed to detect a wide range of problems with receiving, interpreting, and integrating sensory information. The therapist will have been trained in both giving the tests and interpreting them.
Although the tests may look playful and nontechnical, you can't buy the official materials for giving and scoring the tests without listing your qualifications for using them. These are not informal games, but standardized tests in which your child's response will be measured against that of 2,000 children from across the United States, ages four to nine.
The results, combined with parent interviews, parent-teacher questionnaires, and observation of the child in school and at home, will help determine whether or not your child has sensory integration disorder. They will also give the therapist the information needed to set appropriate goals and choose techniques that will be most effective.
Each of the tests takes about ten minutes to administer, with the entire series of 17 taking a little more than two hours. Depending on your child's particular strengths and weaknesses, the therapist may administer only some of the tests or may split the testing into multiple sessions.
The tests fall generally into four categories: motor planning, sensory integration, touch, and visual perception.
Motor Planning Tests
These tests will determine whether your child can move blocks or body parts according to simple verbal or visual instructions. “Praxis” means the ability to plan out the movements needed for a particular activity. The tests include the following:
Constructional praxis: The therapist builds a simple structure with blocks and asks your child to build one just like it.
Design copying: The therapist draws a simple shape and asks your child to copy it.
Oral praxis: The therapist demonstrates some funny faces to make with the mouth, tongue, and lips, and asks your child to copy them.
Postural praxis: The therapist strikes some unusual poses and asks your child to copy them.
Praxis on verbal command: Your child is asked to do a simple movement activity, such as touching the top of his head.
Sequencing praxis: Your child is asked to copy arm and hand sequences performed by the therapist.
Sensory Integration Tests
These tests demonstrate how well your child's brain and body are able to use the information from the senses:
Bilateral motor coordination: Your child is asked to move her arms in ways that help the therapist assess how well the two sides of her body work together.
Motor accuracy: Your child is asked to trace a line on a piece of paper so that the therapist can evaluate her eye-hand coordination.
Postrotary nystagmus: The therapist assesses integration of the visual and vestibular systems. The therapist spins your child for 20 seconds, stops her, and then looks at her eyes. Most people have involuntary movements of the eyes (nystagmus) for a period of time after the spinning stops, but individuals whose vestibular systems are not well integrated have them for a shorter time or not at all.
Standing and walking balance: The therapist evaluates how well your child's proprioceptive and vestibular senses work together when your child stands and walks with eyes open and eyes closed.
These tests examine your child's ability to process information that comes in through the tactile sense and kinesthetic (muscle and joint) sense and his awareness of where his body is in space. They include the following:
Finger identification: The therapist touches one of your child's fingers and then asks your child which finger it was.
Graphesthesia: With one finger, the therapist traces a shape on the back of your child's hand, then asks him to trace the same shape.
Kinesthesia: The therapist moves your child's hand to a certain location and asks your child to put his finger in the same place.
Localization of tactile stimuli: The therapist makes a light mark on your child's arm with a washable pen, and your child is asked to point, without looking, at the spot.
Manual form perception: Your child is asked to identify a shape just by touching it, without being able to see it.
Visual Perception Tests
These tests seek to determine how efficiently your child can use her visual sense. They include the following:
Figure-ground perception: Your child will be asked to pick out a picture hidden among others in a busy background.
Space visualization: The therapist will see whether your child can tell just by looking which of two pieces fits into a slot on a puzzle.
Other Occupational Therapy Tests
The occupational therapist may do other tests on your child besides the one for sensory integration. Names you may hear or see in a report include these:
The Assessment of Motor and Process Skills (AMPS)
The Berry-Buktenica Developmental Test of Visual-Motor Integration (VMI)
The Bruininks-Oseretsky Test of Motor Proficiency 2 (BOT-2)
The Gardner Test of Visual-Perceptual Skills (TVPS)
The Peabody Developmental Motor Scales-2 (tests of gross motor development and fine motor development)
These tests can tell the therapist if your child is meeting various developmental milestones and can suggest areas in which occupational therapy can help with living and learning skills. The SIPT are good indicators of whether your child has difficulty with sensory integration, but there may be other ways in which occupational therapy can help your child as well.
You may not be able to watch your child during the evaluation, especially if he is easily distracted by your presence. However, some occupational therapy offices have two-way mirrors so you can observe the proceedings without your child's knowledge. You may also be able to obtain a videotape of your child's testing to review at home.