Sensory Processing Disorder

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Disorder 101 Ingrid M. Kanics Kanics Inclusive Design Services, LLC imkanics@mindspring.com Sensory Integration Sensory Regulation Disorder Background: A.

1 Disorder 101 Ingrid M. Kanics Kanics Inclusive Design Services, LLC Sensory Integration Sensory Regulation Disorder Background: A. Jean Ayres, Occupational Therapist Neuroscience Better explains the relationship between behavior and neural functioning. Organization of sensory information for daily use. Ingrid M. Kanics, OTR/L, 1

feedback Three Overarching Postulants: 1. Typical Development 2.

2 : Sensory Input Throughput Where input is organized and reorganized. Behavioral Motor Output Normal sensory input becomes organized to produce normal motor/behavioral output with accurate feedback Three Overarching Postulants: 1. Typical Development 2. Dysfunction of Sensory Integration (Sensory Processing Disorder) 3. Guide to intervention and treatment Typical Development Assumptions: 1. Neural Plasticity the brain physically changes as we learn Ingrid M. Kanics, OTR/L, 2

Development Body Scheme Postural Security Reflex Maturity Awareness of two sides of body Ability to Screen Input Motor Planning Sensory Motor Development Smell Visual

3 Typical Development Assumptions: 2. Sensory development follows a sequence. Typical Development Assumptions: 3. Nervous system hierarchy Learning ADL Behavior Cognition Intellect ALS VSP ACF Eye-hand Ocular Motor Postural coordination Control Adjustment Perceptual Motor Development Body Scheme Postural Security Reflex Maturity Awareness of two sides of body Ability to Screen Input Motor Planning Sensory Motor Development Smell Visual Auditory Taste Tactile Proprioceptive Vestibular Sensory Systems Central Nervous System Typical Development Assumptions: 4. Adaptive behavior is the result of registration of sensory input. Ingrid M. Kanics, OTR/L, imkanics@mindspring.com 3

Background Theory: Sensory Regulation Development of Self Regulation First Order

Cortex LIMBIC SYSTEM Sensory Regulation First Order: Brainstem - Reticular Formation

4 Typical Development Assumptions: 5. Input to one sensory system can be used to support another. Background Theory: Sensory Regulation Development of Self Regulation First Order Reticular Formation (Brain stem) Second Order Limbic System Third Order Cerebral Cortex LIMBIC SYSTEM Sensory Regulation First Order: Brainstem - Reticular Formation Monitor survival Autonomic functions Temperature Respiration Heart rate Sleep/wake cycles Muscle tone LIMBIC SYSTEM Ingrid M. Kanics, OTR/L, imkanics@mindspring.com 4

Second Order: Limbic System next to brainstem Sensory Regulation Fight, Flight, Freeze when brainstem sense danger LIMBIC SYSTEM Emotion Learning

Learning Speech Cognition LIMBIC SYSTEM Sensory Regulation Perceived Threat: brainstem tells brain to pay attention Top down using thought to

5 Second Order: Limbic System next to brainstem Sensory Regulation Fight, Flight, Freeze when brainstem sense danger LIMBIC SYSTEM Emotion Learning Memory Third Order: Cerebral Cortex gray matter Corpus Callosum bridge of the brain Sensory Regulation Sensation Perception Voluntary Movement Learning Speech Cognition LIMBIC SYSTEM Sensory Regulation Perceived Threat: brainstem tells brain to pay attention Top down using thought to overcome feeling of a threat LIMBIC SYSTEM Bottom up approach Stimulation of Cerebellum with heavy work Ingrid M. Kanics, OTR/L, imkanics@mindspring.com 5

Self esteem Types: Sensory Modulation Disorder Sensory Over-responsive Sensory Under-responsive Sensory Craving Sensory-based

6 Definition: Difficulty with processing sensory input Ineffective interactions Significant difficulties in daily routines and tasks Impact of SPD: 1. Social Participation 2. Self regulation 3. Self esteem Types: Sensory Modulation Disorder Sensory Over-responsive Sensory Under-responsive Sensory Craving Sensory-based Motor Disorder Postural Disorder Dyspraxia Sensory Discrimination Disorder One or more sensory systems Sensational Kids, Lucy Jane Miller, 2006 Ingrid M. Kanics, OTR/L, 6

7 Sensory Modulation Disorder: Sensory Over-responsive Responds too much, too frequently, or for too long to sensory stimuli Aggressive or impulsive when overwhelmed by sensory stimulation Irritable, fussy, moody Unsociable; avoids group activities and has trouble forming relationships Excessively cautious and afraid to try new things Upset by transitions and unexpected changes Often labeled a fussy baby, difficult, or out of control Sensory Modulation Disorder: Sensory Under-responsive Poor inner drive, uninterested in exploring games or objects or world around him/her Passive, quiet, withdrawn Difficult to engage in conversation or other social interactions Easily lost in his own fantasy world Apathetic and easily exhausted Excessively slow to respond to directions or complete assignments Often labeled loner or lame Sensory Modulation Disorder: Sensory Craving Constantly wants control over every situation Does not wait turn, interrupts constantly, gets wound up Angry or even explosive when required to sit still or stop what he is doing intense Creates situations others perceive as dangerous or disruptive Excessively affectionate physically Discharged from schools due to behavior; often labeled bad boy or bad girl or needs better discipline Ingrid M. Kanics, OTR/L, imkanics@mindspring.com 7

Sensory-based Motor Disorder: Postural Disorder Appears weak and limp Tires easily / appears tired most of the time Gives up when challenged physically (and often cognitively) Difficulty with

8 Sensory-based Motor Disorder: Postural Disorder Appears weak and limp Tires easily / appears tired most of the time Gives up when challenged physically (and often cognitively) Difficulty with physical endurance especially in competitive games Often labeled lazy, unmotivated or indifferent Does not consistently use a dominant hand Sensory-based Motor Disorder: Dyspraxia Ideation The process of generating new ideas prior to acting Planning and sequencing The order of actions in time and space Used to organize occupation of daily life routines and activities (getting dressed, doing homework, budgeting time, punctuality etc.) Execution of planned idea Precise, efficient movements of the body Sensory-based Motor Disorder: Dyspraxia Prefers fantasy games and talking to doing Prefers sedentary activities, not active play Messy or sloppy eating and disheveled appearance Frustrated when unable to complete tasks due to poor motor skills Can be extremely smart Often labeled clutzy Ingrid M. Kanics, OTR/L, imkanics@mindspring.com 8

Sensory Discrimination Disorder: One or more sense Difficulty following directions Gets lost easily Aversion to playing with puzzles or other visually detailed games Needs directions repeated Needs

9 Sensory Discrimination Disorder: One or more sense Difficulty following directions Gets lost easily Aversion to playing with puzzles or other visually detailed games Needs directions repeated Needs more time than other children to perform many tasks Often labeled slow learner General Support Principles: Principle 1: Awareness of arousal levels and choose activities to modify as needed Principle 2: Work on relationships and engagement while engaging the sensory systems Principle 3: Incorporate function and social participation Principle 4: Build self-esteem through repeated success and emphasizing activities the child is good at. Principle 5: Most children with SPD can benefit from a sensory backpack where sensory tools are easily available. Supports for Sensory Modulation Disorder: Sensory Over-responsive Principle 1: Start with self-application of sensory stimuli. Principle 2: Gradually introduce new sensations. Principle 3: Build trust and use predictability. Principle 4: Anxiety and intensity of responses can be mediated through motivation, attention and cognition. Principle 5: Engage the parasympathetic NS to counter balance the sympathetic NS. Principle 6: Structure environment and tasks to minimize over reaction Ingrid M. Kanics, OTR/L, imkanics@mindspring.com 9

Supports for Sensory Modulation Disorder: Sensory Under-responsive Principle 1: Use stimulating sensations Principle 2: Engage in activities that enhance tactile, proprioception and vestibular

Principle 5: Address body awareness and postural components if under respective in proprioception and vestibular senses Supports for Sensory Modulation Disorder: Sensory Craving Principle 1: Create

10 Supports for Sensory Modulation Disorder: Sensory Under-responsive Principle 1: Use stimulating sensations Principle 2: Engage in activities that enhance tactile, proprioception and vestibular stimulation. Principle 3: Find sensory activities that are motivating. Principle 4: Use facial expressions and affect to entice child to participate. Principle 5: Address body awareness and postural components if under respective in proprioception and vestibular senses Supports for Sensory Modulation Disorder: Sensory Craving Principle 1: Create organized movement experiences that have a goal and purpose. Principle 2: Environment changes can increase attention. Principle 3: Use sensory and self-regulation programs that use heavy work. Principle 4: Combine movement with proprioceptive, get head out of upright position. Principle 5: Use start and stop activities Principle 6: Use Sensory backpacks Supports for Sensory-based Motor Disorder: Postural Disorder Principle 1: Strengthen core muscles of trunk. Principle 2: Work on co-activation of stabilizing muscles. Principle 3: Use weight bearing, weight shifting and rotation. Principle 4: Work on shoulder, forearm and wrist stability. Principle 5: Make sure sitting posture is stable to maximize arm and hand function. Principle 6: Address strength and endurance. Principle 7: Work on static and dynamic balance. Ingrid M. Kanics, OTR/L, imkanics@mindspring.com 10

Supports for Sensory-based Motor Disorder: Dyspraxia Principle 1: Sensory feedback enhances motor performance.

Principle 3: Choose activities that require sequencing of body movements Principle 4: Practice Ideation (all the time) Principle 5: Help child develop body maps and spatial maps.

sense Principle 1: Use fun activities that address properties of the object. Principle 2: Encourage the child to use visualization and verbalize what they can t see.

11 Supports for Sensory-based Motor Disorder: Dyspraxia Principle 1: Sensory feedback enhances motor performance. Principle 2: Use activities the require timing and spatial organization. Principle 3: Choose activities that require sequencing of body movements Principle 4: Practice Ideation (all the time) Principle 5: Help child develop body maps and spatial maps. Principle 6: Use words to reinforce sequence of tasks Principle 7: Have child conceptualize and plan their daily routines Supports for Sensory Discrimination Disorder: One or more sense Principle 1: Use fun activities that address properties of the object. Principle 2: Encourage the child to use visualization and verbalize what they can t see. Principle 3: Improve quantitative percepts by playing games that measure ht, wt, etc. Principle 4: Use activities that require attending to specific sounds. Principle 5: Use games that relate to specific location of the body and body movement through space Principle 6: Use games that occlude vision Final Thoughts Q & A Thank you! Ingrid M. Kanics, OTR/L, imkanics@mindspring.com 11

What is Sensory Processing Disorder (SPD)

What is Sensory Processing Disorder (SPD) Non Medicinal Techniques and Strategies that can be used in Behavioral Intervention Katie Frank, PhD, OTR/L Adult Down Syndrome Center Park Ridge, Illinois Umbrella