Use of Technology to Improve Attention in Children

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1 Use of Technology to Improve Attention in Children PRESENTED BY TRACY DROEGE OTR, MS AND ELIZABETH CHASE COTA Objectives Discuss symptoms of attention deficit disorders and co-occurrence with Autism Spectrum Disorder Introduce Neurofeedback Training Using Play Attention Discuss the benefits of picture scheduling and introduce Choiceworks (an application for customizing picture schedules) Discuss the benefits of social stories and use of the application, Social Stories Creator and Library Discuss OT interventions to assist with attention ADHD The National Institute of Mental Health defines ADHD as a brain disorder marked by an ongoing pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development. 1

2 Inattention Overlook or miss details Have trouble sustaining attention in tasks or play Difficulty to follow through with instructions or finish work Difficulty organizing tasks and activity Difficulty with time management Avoid tasks that require sustained attention Lose things easily Easily distracted by unrelated thoughts/stimuli Forgetful Hyperactivity-Impulsivity Fidget or seek movement while seated Difficulty staying seated when expected Inappropriate running and climbing Avoidance of quiet play Excessive talking Difficulty taking turns in conversation with blurting out Difficulty with waiting Autism symptoms using DSM-5 Criteria Social Communication/Interaction Difficulty with social/emotional interaction to initiate or maintain conversations and difficulty to share attention, emotions, or interests with people Difficulty keeping relationships with a range of issues from decreased interest in others, difficulty with pretend play or age-appropriate social interaction, and difficulty meeting social expectations. Difficulty to use and interpret Nonverbal Communication: eye contact, posture, facial expressions, tone of voice, gestures. Restricted/Repetitive Behaviors (at least 2 of 4 must be present) Repetitive speech, movement, or object use. Inflexibility with changes in routines or ritualized patterns of verbal or nonverbal behavior Highly restricted, fixated interests that are abnormal in intensity or focus (perseveration with objects and interests). Under and Overresponsive to sensory input or unusual sensory interests(aversion to sensory inputs or sensory seeking behaviors) 2

3 Play Attention Neurofeedback: Sensors are used to detect brainwaves responsible for attention. Cognitive Training: Games target specific cognitive skills including attention stamina, short term memory, working memory, auditory processing, visual tracking. Behavior Shaping: Behaviors that interfere with attention are monitored and goals are set to improve control. Play Attention Participants should be at least 6 years of age with an IQ above 65. The program is good for anyone who wants to improve attention There are no harmful side effects Participants should have at least 2 sessions per week, minutes per session with a consistent schedule (one hour minimum play time per week) Academic Bridge can be used after 2-3 months to monitor attention during homework or other functional tasks The program is completed within hours of training The goal is to consistently demonstrate a time on task percentage 80% or higher Neurofeedback Research A randomized control study was completed by researchers from Tufts Medical School in Boston schools with 104 children with ADHD, age Neurofeedback training using Play Attention was compared to cognitive training (Captain s Log, Brain Train, North Chesterfield, VA) and a control group. Children engaged in 45 minutes of training, 3 X per week for 40 sessions within a 5 month period. Results: At 6 months follow up post intervention; Children in the neurofeedback group made the most significant gains and maintained gains at 6 month follow up on assessment using the Conners 3-Parent Assessment Report and The Behavior Rating Inventory of Executive Function (BRIEF). Over time, the neurofeedback group maintained stimulant medication dosage, while the control group and cognitive training group increased medication dosage significantly. 3

should be built into the schedule for motivation Picture Schedule Application Create custom schedules using their

4 Picture Schedules Help kids know what is coming next and what is expected of them Decrease challenging behaviors caused with unexpected demands or being asked to stop an enjoyable activity Helps to learn a routine Fun activities should be built into the schedule for motivation Picture Schedule Application Create custom schedules using their image library, photos or video Timers can be used within the schedule Create board to help kids with waiting and emotions 4

5 Social Stories A training tool originally developed for kids with Autism but useful for kids with attention issues as well. Consider the audience and environment Carol Gray invented social stories and created guidelines. The learning experience is descriptive, meaningful, and physically, socially, and emotionally safe for the child, adolescent or adult with Autism. ( Involve the child in writing the story if possible Social Story Application Allows you to create custom social stories using photos Audio is recorded so that kids can listen to the story while using the application A PDF copy can be given to the family or you can share stories with other app users Parking Lot Safety Story 5

6 Some Reasons for Inattention inability to organize sensory needs impulsivity overwhelming sensory input trouble staying on task trouble identifying priorities anxiety rigidity motor insecurity low frustration tolerance to difficult tasks Strategies that can be used during therapy sessions to decrease behaviors prepare child for what s ahead use visual schedule use checklists use social story use positive reinforcement Therapy programs that address sensory difficulties to help kids focus The ALERT program aka How Does Your Engine Run - compare brains to engines and help with self awareness and regulation to identify whether the engine is running fast, just right or slow Sensory Diets - these are incorporated into everyday activities to help with attention. It may include movement activities such as jumping on trampoline, carrying heavy objects or sensory activities such as squeezing putty, wearing weighted vests, using scooter boards. Brain Gym- improve communication between the left and right side of brain using whole body movements and crossing midline. 6

7 Visual attention strategies use bold, bright, and colorful materials play on a bright surface highlight or draw attention to details visual cues such as sticker charts, schedules or checklists visual learning activities such as word search, hidden pictures, color by number, word scrabbles visual discrimination tasks such as sorting or matching using a light table visual sensory breaks Using inclined surface Visual attention activities Spot it game Hidden pictures Scratch art Connect the dots Mazes Mosaic art work Movement attention strategies frequent changes in position offering different seating options movement breaks during transitions vestibular activities such as swinging, rolling, balancing, or rocking proprioceptive heavy work activities 7

8 Using sensory movement for attention Materials - physioball sit on ball and bounce sit on ball near wall and pick up feet using wall to stabilize lay prone and roll side to side/front to back lay prone and bounce squash the ball against the wall with chest/back stand on the ball using wall for support (requires close therapist supervision and stabilization of ball) Tactile attention strategies using hands on manipulatives and materials (legos, stringing beads, cut and paste) use tactile bins (dried beans, dried rice, sand) vibrating writing tools trace over puffy paint, dried glue, sandpaper deep pressure sensory breaks (bear hugs, crash pads, large pillows or beanbag chairs) tactile sensory breaks such as play dough, putty, shaving cream using fidget toys Fidget toys to help with attention Tangle jr Play dough/putty The desk buddy Pencil top fidgets Vibrating pen Fidget rings 8

9 Auditory attention strategies make up songs/rhymes to bring attention to a task have the child repeat instructions or important info sensory breaks using musical toys exposure to games and apps to teach music and sound use your body to build sound into learning (clapping, stomping, snapping) Oral sensory attention strategies Olfactory strategies for attention chewing tools (chew tubes, chew jewelry) chewable pencil toppers chewy snacks (bagels, gum, fruit leather) sucking (thick liquid through a straw, sports bottle) crunchy snacks sour snacks using essential oils (be aware of allergies and safe use) scented doughs scented sensory bins References Attention Activities for Kids. (n.d.). Retrieved from OT tool box: Attention Deficit Hyperactivity Disorder. (2017, 9). Retrieved from The National Institute of Mental Health: Eckersley, S. (2011, August 1). ADHD. Retrieved from Occupational Therapy for Children blog: Gray, C. (2017). What is a social story? Retrieved from Heffron, C. (2017, 9 14). Paying Attention: 30 Sensory Strategies. Retrieved from The Inspired Tree House: Play Attention. (2017). Retrieved from Steiner N, F. E. (2014, March). In-School Neurofeedback Traning for ADHD: Sustained Improvements From a Randomized Control Trial. Retrieved from Pediatrics: Susan L. Hyman, M. (2013, June). New DSM-5 includes changes to autism criteria. Retrieved from Aapnews (The American Academy of Pediatrics): Wise, R. (2017, August 20). How to Use Schedules to Improve Children's Behavior. Retrieved from educationandbehavior.com: behavior.com/using-visual-schedules-2 9

Neurobehavioral disorder Spectrum disorder Prevalence Causes Treatment

Neurobehavioral disorder Spectrum disorder Prevalence Causes Treatment Persistent deficits in social communication and social interaction across multiple contexts Restrictive, repetitive patterns of behavior,