Presented by: Victoria Blackington, OTR Susan Holler, M.S., CCC-SLP Erika Peiser, PTA West Texas Rehabilitation Center

Transcription

1 SENSORY PROCESSING AS IT RELATES TO THE SCHOOL-AGED CHILD Presented by: Victoria Blackington, OTR Susan Holler, M.S., CCC-SLP Erika Peiser, PTA West Texas Rehabilitation Center

2 Objectives for the day Provide audience with information about Sensory Processing Disorder Use multi-sensory approach to stop or redirect tantrums Improve attention and engagement in classroom activities through multi-sensory approaches Classroom seating, fidget tools, movement breaks, etc Discuss progression and safety protocols that apply to sensory tools/strategies Guidelines for using sensory/gross motor courses (organization, set expectations,) Provide teachers with hands on experiences as well as items that are ready to be used in the classroom Showing how using sensory techniques effectively can help to improve academics

3 What is sensory Processing?

4 Sensory Processing Definition: Sensory Processing refers to the way your nervous system first receives sensory information or messages from the senses and then forms an appropriate motor or behavioral response.

5 Senses and their levels Interception inside the body Vestibular Proprioception Exteroception outside the body Hearing Vision Smell Touch Taste

6 Terms: Adaptive Response and Neuroplasticity Sensory info is necessary for the brain to function Too little or too much will cause problems Adaptive Response successful response to environmental challenge Deprivation or over stimulation Child is active participant, appropriate supportive environment can encourage it, create changes in the brain (new neural pathways) Neural Plasticity ability of brain to make changes Made through increased synapses and pruning of connections for refinement Most prominent in childhood (new vs. old play dough)

7 Sensory Registration 1st detection of stimuli Sensory processing how information gets into our system system ** Sensory Modulation volume control, intensity, frequency, duration, complexity, novelty Sensory Discrimination what is it? (color, how far away, tall/short), perception of of stimuli (how loud, soft, hard, bright, etc) object/event, multi discrimination within a system (tactile system) and between systems (tactile, vestibular, visual systems, etc)

8 Sensory Modulation Sensory Modulation volume control, intensity, frequency, duration, complexity, novelty of stimuli (how loud, soft, hard, bright, etc) Allows us to focus on what is important Sensitization, habituation, other facilitatory/inhibitory process Well Modulated Person Able to notice relevant stimuli and filter out unimportant stimuli Emotions and behavior reflect appropriate responses to situation rather than environment

9 Sensory processing disorder (SPD) Formal Definition: SPD is a neurophysiologic condition in which sensory input either from the environment or from one s body is poorly detected, modulated, or interpreted and/or to which atypical responses are observed. -Star Institute for of Sensory Processing

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11 Sensory modulation Disorder Over- or under- responding to sensory input, usually with atypical affective responses (Cranks the volume or mutes the program) Over-responsivity (sensory defensive) Under-responsivity Sensory seekers and passive under-responders Brain has difficulty determining what is important LD, ADHD, AU, PDD, Fragile X, DD have some sort of modulation disorder

12 Response threshold to sensory input Under-Responder (Two types) Typical Over-Responder (sensory defensive)

13 Passive under-responders (not getting enough stim- bump on a log) Under-Responsivity Over-responders (getting too much stim- sensory defensive) Sensory seeking under-responders (not getting enough stim- running, crashing, jumping)

14 Over-Responders sensory defensive Over-responsiveness of the protective responses of the nervous system Generalized or specific to particular sensory system Avoiders- avoid sensory stimuli to attempt to calm their nervous system Primarily need CALMING activities

15 Passive Under-Responder Under-active response of nervous system to incoming stimuli Passive or oblivious to stimuli bump on a log Needers but helpless to meet needs effectively Primarily need ALERTING/STIMULATING activities

16 Sensory Seeking Under-Responders Due to under-responsivity they seek MORE input to reach higher sensory threshold Constant motion or thrill seeker Needers and behaviors are attempts to reach high threshold level for sensory registration Primarily need ALERTING/STIMULATING activities (even though instinct may be to calm them down), will hopefully calm when enough alerting/stimulating input is given to reach threshold

17 Mixed Response Some with modulation disorders have extremes of over-responsiveness in some sensory systems and under-responsiveness in others. Common with AU over-responsive to: visual, auditory, olfactory, gustatory, and tactile input. Under responsive to vestibular and proprioceptive input.

18 Goals for SI dysfunction Increase functional movement as related to: Self-regulation Emotional stability Motor skills Attention Cognition Social participation

19 Assessments for therapist use: SIPT- Sensory Integration Praxis Test The Sensory Profile Sensory Processing Measure Test of Sensory Functions in Infants DeGangi-Berk Test of SI Sensory Integration Inventory Revised for Individuals with DD Sensory Processing Checklists (many available) Sensational Brain sensationalbrain.com Clinical Observation Observation Worksheet Observing Sensory Integration in Play

20 Pyramid of Learning

21 Sensational brain sensory systems checklist School version

22 So now what???

23 Have you heard of?? Heavy Work Motor course/obstacle course Weighted blankets/vests Fidgets Sensory breaks/movements breaks Adaptive seating Visual timers Sensory bins The Engine program Sensory Diet

24 Heavy Work! Heavy work is essentially putting the proprioceptive system to work! Activating the small receptors within our joints (effort, force, movement) Lifting, pulling, jumping, climbing, crawling. Any resistance task.

25 Motor course/ obstacle course Often incorporates heavy work tasks, specific gross motor/fine motor tasks, turn taking with peers, body awareness, spatial awareness, crossing midline, endurance, and digital/core/upper body/lower body strengthening. Simple vs complex Make it academic based! Putting math, spelling words/ sight words in between each motor movement Use structure. This is NOT a time for a free-for-all! Have an end goal

26 Weighted blankets/vests What is it: Organizes Nervous System to potentially: A blanket or vest with additional weight Weight is usually poly-pellets, glass beads, steal shot beads, rice, small weights that fit into internal pockets of vests Increase sleep/naps Decrease and calm tantrums Improve focus on seated work Many different kinds Weight and no compression Compression and no weight

27 Proceed with caution! Vest or blanket should NOT exceed 10% of child s body weight! Recommended for 15 minutes or for the duration of a specific activity/center. The goal is to calm child and improve focus. If left on for longer than recommended time (and the vest/blanket does not exceed 10% of body weight) no harm will be done. The body will modulate to the input however, and the effects may not be as strong. Not EVERY child needs a vest/blanket

28 Fidgets

29 The Truth about Fidgets Fidgets are not toys, they are a tool to aid in focusing Not every child needs a fidget They should NOT be used as a reward Give them to entire class, the children who need it will continue to use it after the novelty has worn off Think of your morning cup of coffee Types of fidgets:

30 A Need vs a Reward What tools do you utilize to enhance your performance throughout the day? All of us become distracted when something changes in our environment, so you have to give the class time to overcome the newness of a change before deciding if it will work Sensory tools should not be contingent on behavior, and our job is to teach student to recognize when to use them Be specific about what the child or class should look like using their sensory tools Treat the student as a team member in finding the best learning conditions for themselves Natural consequences can be employed with the goal of best learning conditions as the focus

31 Sensory breaks/movements breaks

32 Sensory Breaks/Movement Breaks Giving student a job (ie; Bella, would you please go bring this paper up to Mrs.Smith s room?) Various animal walks Short desk/table top stretch Longer guided dance video Fun but also structured Taking away recess is not recommended

33 Using Sensory Breaks for Transitions animal walks, airplanes, songs, etc. Engine runs songs. Transitions cards Give them something to carry

34 Using Sensory Breaks for Transitions Teach boundaries of personal space and self regulation Give warning that transition is coming Provide detailed description of expectations (your body is jumping. Your mouth is closed with no sound coming out.)

35 Adaptive Seating Controlled not chaotic The students who need it will use it. Ground rules/ safety rules A need not a reward

36 Visual timer Time Tracker Time Timer Choice Works

37 Sensory/Tactile bins Multi-sensory approach to learning Add preferred toys/ academic media (numbers/letters/ sight words) Important: Not all bins are created equal. There is a progression in which bins should be presented. Monitor child s reaction to the bin. If there are tears, avoidance, finger splaying, etc do not continue to with that bin. Instead, refer to handout of Steps to Negotiating Textures and move back to a better tolerated step or texture. - Conrad & Kurtz 8/02-Updated Toomey, 2010

38 Steps to Negotiating Textures 1. Tolerate medium in same room 2. Child tolerates medium on the table before him/herself 3. Child can use a long tool such as a paintbrush, stick, or pencil to touch medium. Child can roll over the medium using a rolling pin 4. Child can dab medium on tabe, window, mirror or paper using a tool 5. Child can interact with medium using a shorter tool such as a bubble wand, spoon, spool or clothes pin 6. Child can drive a toy car/train or roll a ball through medium.

39 Steps to Negotiating Textures Cont. 7. Child can get a spot of medium on fingers or hand and request immediate wiping. Activity ends per child s request 8. Child can tolerate medium on fingers and hand and request immediate wiping, but continue play. (Repeat wiping as needed) 9. Child can tolerate dabbing tip of finger in medium to paint/draw. Wiping expected. Child continues to play for several more attempts. This is called index probing 10. Child can paint/draw with several fingers; wiping expected. Child continues to play

40 Steps to Negotiating Textures Cont. 11. Child works up to palm contact to full hand contact (front and backs of hands) to smear and squeeze; frequent hand wiping/washing expected. May continue to play. 12. No hesitation- Child begins play with both hands, using several fingers or full hand contact. PRAISE PRAISE PRAISE for any level of activity that the child engages in. - Copyright, Kay A. Toomey, PH.D.

41 The alert Program How Does Your Engine Run? Fun and interactive therapy approach that assists child in understanding, maintaining and changing their level of arousal (Level of alertness). Uses multi-sensory approach. Gives a visual/model of student s current level of arousal Too high, too low, just right Offer sensory strategies to alter state of arousal to promote the just right state of arousal. Uses engine metaphor, however can be adjusted using child s preferred characters. Examples?

42 Examples of your engine level High Just Right Low 8AM 10AM 12PM 2PM 4PM 6PM 8PM 10PM

43 The alert program

44 Sensory- Motor Preference Checklist (For Adults)

45 Sensory Diet Similar to a healthy eating diet, and healthy/balanced sensory diet can be implemented to improve attention, participation, self regulation and arousal. It is a series of physical activities and accommodations to meet the student s sensory needs. Refer to handout for specific ideas, however, it is important to tailor each diet to the specific child. It is also beneficial to speak with your occupational therapist before and during implementation of sensory diets. There is not a one size fits all sensory diet There is a plan and structure to the diet

46 But we don t have to do that Remember that WE includes the therapist and other professionals- Go to your team!! It is important to know why a student has an accommodation or sensory tool What are some common accommodations? How do you know if the accommodation is helping or interfering with learning? Movement breaks benefit everyone- including the teacher! What academic goals could you incorporate into movement activities? (group activity)

47 Information from The sensory integrative Perspective, Course I of Comprehensive Program in Sensory Integration Offered by: The University of Southern California Department of Occupational Therapy and Western Psychological Services Presenter: Susanne Smith Roley M.S. OTR/L, FAOTA Creating and Implementing Effective Sensory Diets for Children and Teens Presenter: Gwen Wild, MOT, OTR Williams, M.S., & Shellenberger, S. (1992). An introduction to How Does Your Engine Run? The Alert Program for self-regulation [Booklet]. Albuquerque, NM: TherapyWorks, Inc. Star Institute for sensory processing disorder