The World Federation of Occupational Therapy (WFOT) defines occupational therapy as: "A healthcare profession based on the knowledge that purposeful activity can promote health and well-being in all aspects of daily life. The aims are to promote, develop, restore, and maintain abilities needed to cope with daily activities to prevent dysfunction"

Occupational therapists view the child, the child's environment, and the interaction between the child and the environment in a holistic way. The dynamic nature of this interaction is created by the child's continual development, maturation and learning. The environment is also continually evolving and changing.

The occupational therapist is concerned with analyzing the child's ability to perform in everyday contexts. Occupational therapists hold two broad goals for the children they serve. These goals are to improve the child's functional performance and to enhance the child's ability to interact within his or her physical and social environments.

The underlying skills that an occupational therapist is concerned with are: Sensorimotor components include sensory and perceptual processing, neuromuscular abilities, and motor skills Motor components refer to gross, fine and oral motor skills Cognitive components underlie the child's ability to perceive, attend, and learn from the environment Psychosocial skills refer to the child's underlying abilities to interact with others, to cope with new or difficult situations, and to manage his or her behaviours in socially appropriate ways.

The performance areas that the occupational therapist is concerned with are: Self-care: refers to physical daily living skills. These include feeding and eating, grooming and hygiene, dressing, and functional mobility Play and leisure: refer to skills and performance of intrinsically motivating activities, spontaneous enjoyment, and self-expression School: skills in this area refer to reading, writing, math, and higher level problem solving and cognitive skills.

In 1989 sensory integration was defined as "the neurobiological process that organises sensation from one's own body and from the environment and makes it possible to use the body effectively within the environment. The spatial and temporal aspects of inputs from different sensory modalities are interpreted, associated, and unified. Sensory integration is information processing" (Ayers, 1989; p.9).

Modulation of sensory input is critical to our ability to engage in daily life activities. Filtering of sensations and attending to those that are relevant and attending attention to task requires a good level of sensory modulation (Lane, 2002). When modulation is inadequate, the child's attention may be continually diverted to ongoing changes in the environment and this may interfere with learning and play. Current research is examining the Sensory Modulation Disorder (SMD) as a valid clinical syndrome (Miller et al. 2007)

Under the light of sensory integration theory, praxis is viewed as a uniquely human skill that enables the brain to conceptualise, organise, and direct purposeful interactions with the world (Ayres, 1985). Praxis includes knowing what to do as well as how to do it and is fundamental for skills such as getting dressed, learning to write, or playing. The ability for praxis includes 3 components (Ayres, 1989) Ideation - knowing what to do Motor planning - directing and organising the movement Execution - carrying out the motor plan

For most children, sensory integration develops in the course of ordinary childhood activities. But for some children, sensory integration does not develop as efficiently as it should. When the process of sensory integration is disordered, a number of problems in learning, development, and/ or behaviour may become evident (Sensory Integration International, 1991). Sensory Processing Disorder (SPD) manifests itself in two major ways: poor praxis and poor modulation (Bundy & Murray, 2002).

Hyperactivity and distractibility Delays in speech and language Low muscle tone and coordination problems Slow development of motor skills Poor organisation of behaviour Learning difficulties at school Sensitivity to movement, touch, sights, sounds, and smells Poor organisation skills in adolescence

Clumsiness Difficulty planning and organising the sequences of movements in activities such as cutting with scissors or riding a bicycle Difficulty with daily activities such as getting dressed, using knife and fork Tendency to bump into and/ or trip over things Taking longer to learn skills such as tying shoelaces, writing letters or numbers, catching a ball Poor gross motor control when running, climbing, jumping, and going up and down stairs Doing things in inefficient ways Low self-esteem Difficulty when transitioning from one activity to another

● Aversion or struggle when picked up, hugged, or cuddled ● Aversion to certain daily life activities, including baths or showers, cutting of fingernails, haircuts, face washing and dental work ● Responding with aggression to light or unexpected touch to arms, face, legs ● Avoidance of certain styles or textures of clothing (e.g. scratchy) ● Avoidance of play activities that involve body contact ● Dislike getting hands in sand, finger-paint, paste ● Exaggerated fear of falling or heights ● Become anxious when feet leave the ground ● Seem particularly slow at movements ● Avoid jumping down from higher surfaces ● Avoid climbing, escalators, or elevators ● Seem to misunderstand what is said ● Have difficulty looking and listening at the same time ● Seem distracted if there is a lot of noise around ● Hold hands over ears ● Gag easily with food in mouth ● Picky eater ● Mouth objects ● Express discomfort with light ● Rock unconsciously ● Become overly excitable during movement activities ● Be "on the go" ● Be slower than others to respond to sensation

Sensory Processing Disorder (SPD) may exist on its own, or it may coexist with: ● Attention Deficit and Hyperactivity Disorder (ADHD) ● Asperger's Syndrome ● Fragile X Syndrome ● Autistic Spectrum Disorder (ASD) ● Pervasive Developmental Disorder (PDD) ● Cerebral Palsy (CP) ● Spina Bifida ● Nonverbal Learning Disorder (NLD)