SCHOOL SENSORY BEHAVIORAL STRATEGIES P. 1

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1 SCHOOL SENSORY BEHAVIORAL STRATEGIES P. 1 copyright 2018 by John Pagano, Ph.D., OTR/L John Pagano, Ph.D., OTR/L JLP96007@gmail.com twitter.com/jlp96007 facebook.com/fabstrategies UCS2D8OPEx6aDzsgad0zQy0A

2 Best Clinical Resources P. 2 Brown, R. P. & Gerbarg, P. L. (2012). The healing power of breath. Boston, MA: Shambhala. Caldwell, B., Albert, C., Azeem, M. W., Beck, S., Cocoros, D., Cocoros, T., Montes, R., Reddy, B. (2014). Successful seclusion and restraint prevention efforts in child and adolescent programs. Journal of Adolescent Nursing and Mental Health Services, 52(11), Field, T. Touch Research Institute <www6.miami.edu/touch-research> Flook, L., Smalley, S., Kitil, M., Galla, B., Kaiser-Greenland, S., Locke, J., Ishijima, E., Kasari, C. (2010). Effects of mindful awareness practices on executive functions in elementary school children. Journal of Applied School Psychology, 26(1), Frank, J. L., Bose, B., & Schrobenhauser-Clonan, A. (2014). Effectiveness of a school-based yoga program on adolescent mental health, stress coping strategies, and attitudes toward violence: Findings from a high-risk sample. Journal of Applied School Psychology, 30, Greenland, S.K. (2010). The Mindful Child. New York, NY: Free Press. < Kazdin, A.E. (2008). The Kazdin Method for parenting the defiant child. NY, NY: Mariner Books. Koester, C. (2012) Movement Based Learning. Braingym for special education. < Laugeson, E. A. (2014). The PEERS curriculum. Murray-Slutsky, C. & Paris, B.A. (2005). Is it sensory or is it behavior? Behavior problem identification, assessment, and intervention. San Antonio: Psych Corp. Schaaf, R. C. & Mailloux, Z. (2015). Clinician's guide for implementing Ayres Sensory Integration: promoting participation for children with autism. Bethesda, MD: AOTA Press. Schaaf, R. C., Benevides, T., Mailloux, Z., Faller, P., Hunt, J., van Hooydonk, E., & Sendecki, J. (2014). An intervention for sensory difficulties in children with Autism: A randomized trial. Journal of autism and developmental disorders, 44(7), Silva et al. (2009). QST program Sensory Massage.< Singh, N. N., Lancioni, G. E., Singh, A. D., Winton, A. S., Singh, A. N., & Singh, J. (2011). Adolescents with Asperger syndrome can use a mindfulness-based strategy to control their aggressive behavior. Research in Autism Spectrum Disorders, 5(3),

4 ZIP, TOUCH, NOSE BREATHE & BIRD P. 4 Copyright 2013 by John Pagano, Ph.D., OTR/L SITTING UPRIGHT IN SEAT DO 3 REPETITIONS Zip FRONT & BACK OF, NOT TOUCHING BODY ZIPPING YOUR TRUNK UPRIGHT AND YOUR LIPS SIGN LANGUAGE CHEER DO SIGN LANGUAGE CHEER BOTH HANDS TOUCH HEAD, SHOULDERS, STOMACH (OR SUBSTITUTE) NOSE BREATHE: TAKE 3 DEEP BREATHS IN STOMACH GOES OUT, FINGERS OPEN WIDE, OUT STOMACH GOES IN FIST THUMB, DOUBLY SLOW BREATH BIRD-TAKE 3 DEEP BREATHS WINGS UP BREATHE IN WINGS DOWN BREATHE OUT

5 MINDFUL CLOCK SITTING/STANDING, BODY AWARE P. 5 Copyright 2015 by John Pagano, Ph.D., OTR/L (Greenland, 2010; Koester, 2012) MINDFUL CLOCK SITTING TIC SWAY FORWARD TOC SWAY BACK LIKE A SWAY FORWARD CLOCK SWAY BACK TILL WE SWAY FORWARD FIND OUR SWAY BACK CENTER MOVE CENTER TIC SWAY LEFT do a righting reaction (head and trunk flex uphill) TOC SWAY RIGHT do a righting reaction (head and trunk flex uphill) LIKE A (Sway Left) do a righting reaction (head and trunk flex uphill) CLOCK (Sway Right) do a righting reaction (head and trunk flex uphill) Till WE (Sway Left) do a righting reaction (head and trunk flex uphill) FIND OUR (Sway Right) do a righting reaction (head and trunk flex uphill) CENTER (Move Center) MINDFUL CLOCK STANDING TIC SWAY FORWARD TOC SWAY BACK LIKE A SWAY FORWARD CLOCK SWAY BACK TIL WE SWAY FORWARD FIND OUR SWAY BACK CENTER MOVE CENTER TIC-SQUAT DOWN TOC-STAND ON TOES LIKE A-SQUAT DOWN CLOCK-STAND ON TOES Till WE-SQUAT DOWN FIND OUR-STAND ON TOES CENTER MOVE CENTER SENSORY: Front-Back-Top-Bottom-

6 FLEX & EXTEND SHOULDER & ANKLE P. 7 & Breathing Copyright 2015 by John Pagano, Ph.D., OTR/L!! Flex & Extend Shoulder & Ankle: Same side: Right shoulder-ankle simultaneously Opposite-Right shoulder left ankle simultaneously Same half-right shoulder, left ankle, and left shoulder half way up and down, by joining right shoulder Breathing: 4 seconds BREATHS IN 4 seconds HOLD BREATH 6 seconds BREATHE OUT 2 seconds HOLD BREATH (Brown & Gerbarg, 2012)!

7 Mindfulness & Coping Strategies P. 8 copyright 2017 by John Pagano, Ph.D., OTR/L Mindfulness is paying attention to what you are currently doing, which is important for all functional occupations and new learning. It can also be a valuable daily or crisis coping strategy. In OT think about client preferences and developmental levels to choose among mindfulness options: Weight lifting, Isometrics, Cardio exercise Crafts & Fine Motor Hobbies Movement/Dance/Stretching Yoga, Brain Gym, Bal-A-Vis-X Progressive Relaxation Mindfulness/Meditation Self-Massage, Therapyball, Sensory Activities Massage

8 SBI (Sensory-Based Interventions) P. 9 Copyright 2017 by John Pagano, Ph.D., OTR/L!! SBIs are the guided use of specific sensory strategies to improve behavior by addressing sensory modulation and sensory discrimination challenges (Watling et al., 2011) SBIs used in proven school PBIS, Greenspan Floortime Approach for ASD, Collaborative Problem Solving for ODD, DBT (Dialectic Behavior Therapy) for chronic self-cutting & SMART approach for PTSD SBI environmental adaptations can help reduce student s Aggression & Self-stimulation behaviors (Murray et al., 2009) ASD & Over-responsivity Tx teaching developmentally appropriate coping strategies (e.g., energy modulate, social skills, increased salience prompts, environmental adaptations) reducing noise, tactile & visual distractions (Green et al., 2015) Massage (15 minutes twice weekly for 2 months minimum) is the strongest evidence-based SBI for improving student behavior & learning (Wan Yanus et al., 2015)

9 1. SENSORY MODULATION DISORDERS P. 10 Copyright 2017 by John Pagano, Ph.D., OTR/L Difficulty regulating sensory registration to respond to respond to functionally important environmental information and screen out functionally irrelevant input. Assessed by Sensory Profile abd Sebsirt Processing Measure a. Sensory Overresponsivity- Sensory Sensitive/Hyperreactivity) react more to sensory. More than half of youth with Autism Spectrum Disorders showed auditory and tactile overresponsivity related to decreased amygdala & sensory cortex habituation(green et al., 2015) b. Sensory Underresponsivity- (Low Registration/Hyporeactivity) do not notice sensory input, habituate quickly c. Sensory Seeking- actively seek out sensory input d. Sensory Avoiding- actively avoid sensory input (Watling et al., 2011; Schaaf & Mailloux, 2015)

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14 SENSORY DISCRIMINATION DISORDERS P. 13! Copyright 2016 by John Pagano, Ph.D., OTR/L! 2. Sensory Discrimination Disorders-difficulty distinguishing, interpreting, and organizing sensory information for functional use, contributing to disorganization and school difficulties. Sensory Discrimination Disorders can be for tactile, proprioceptive, vestibular and interoception sensory input e.g., hunger Tx-Light touch, deep pressure touch, Awareness of front-back, topbottom of body through movement, obstacle courses, touch. Core input. Tap-Press self: Ear to palm Tap-Press self: Head to feet

15 BACK X & SPINE CRAWL P. 14 X MARKS THE SPOT X on entire back WITH A DOT DOT DOT 3 dots with your fist AND A LINE LINE LINE 3 horizontal lines AND A QUESTION MARK? on entire back CRACK AN EGG ON YOUR HEAD fist egg LET THE YOKE RUN DOWN finger yoke (2 X) CREEPY CRAWLIES UP YOUR SPINE spine crawl with knuckles both sides spine CREEPY CRAWLIES DOWN palms down both sides spine

16 HOT CROSS BUNS ACTIVITY P. 15! (Meta-cognition: Sensory Discrimination, Sensory Based Motor)! BODILY-KINESTHETIC, INTERPERSONAL, AUDITORY, VISUAL & MUSICAL INTELLIGENCE! Copyright 2014 by John Pagano, Ph.D., OTR/L!! HOT (HIGH NOTE HIGH FIVE) CROSS (LOW NOTE LOW FIVE) BUNS (MEDIUM, HORIZONTAL FIST) ONE A PENNY TWO A PENNY (NO RESPONSE) HOT (HIGH NOTE HIGH FIVE) CROSS (LOW NOTE LOW FIVE) BUNS (MEDIUM, HORIZONTAL FIST)

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Sensory Processing Toolkit

Sensory Processing Toolkit Liz Koss, MOT, OTR/L Grace Reifenberg, [BA??], S/OT Laura Simon, BA Kelly Tanner, PhD, OTR/L PURPOSE To provide teachers and parents with information on evidence-based strategies