Heavy Work Activities List -- Useful for Designing a Sensory Diet for Children

Transcription

1 Heavy Work Activities List -- Useful for Designing a Sensory Diet for Children Functional heavy work in the home and classroom environments can also provide both deep pressure and movement input which will assist with regulation. These activities can be a meaningful way to incorporate sensory input into children s day. These types of activities tend to be concrete, with an obvious start and finish and tend to be easier to engage a variety of children in. Naturally Occurring Heavy Work Activities Within the Home Environment Carry heavy items (baskets with cardboard blocks, groceries for Mom, etc.). Allow child to chew gum, eat chewy or crunchy foods, or sip water from a water bottle with a straw while doing homework. Push or pull boxes with toys or a few books in it (more resistance is provided if boxes are pushed/pulled across a carpeted floor). Fill a pillowcase with a few stuffed animals in it for weight. Child can then push or pull the pillowcase up a ramp, incline or stairs. Take the cushions off sofas, vacuum under them, then put them back. Can also climb on them or jump and "crash" into them. Pull other children around on a sheet or blanket. Roller skate/rollerblade uphill. Pull a heavy trash can. Perform household chores, such as: Vacuum, Sweep, Mop, Dust, Carry the laundry basket, Wipe off the table after dinner, Carry buckets of water to clean with or to water flowers/plants/trees, Clean windows or the front of appliances using a spray bottle, Scrub rough surfaces with a brush, Help change the sheets on the bed (then toss the linens down the stairs). Perform yard work, such as: Mow the lawn, Rake the grass/leaves, Push the wheelbarrow, Shovel sand into a wheelbarrow, push the wheelbarrow to a spot, dump out sand and use a rake to level it out (functional for filling in low spots in backyard), Dig dirt to help plant flowers, Pull a friend or heavy items in a wagon, Push a friend in a wheelbarrow. Drink thick liquids (as in milkshake, applesause, or slurpy) through a straw. The thickness of the straw and the thickness of the liquid can be varied to change the degree of heavy work (sucking) required. Carry heavy cushions. Play in sandbox with damp heavy sand. Have the child "help" by pushing chairs into table after a meal. Push a child's cart filled with cans and then put the cans away on a low shelf so that the child has to be on hands and knees (a weight bearing position) to put the cans away. Heavy Work Activities for Sensory Input 1

2 Participate in activities such as gymnastics, horseback riding, wrestling, karate, swimming (can also have child dive after weighted sticks thrown in pool). Wash the car. Fill up a child's suitcase with heavy items (such as books) and push/pull the suitcase across the room. When traveling, let child pull own small suitcase on wheels. Go "shopping" with a child s shopping cart filled with items, or have child push shopping cart when you go shopping. Go "camping" with a heavy blanket pulled across a few chairs. Child can help set up and take down the blanket. Have child put large toys and equipment away. Participate in climbing activities (such as playground equipment). Push against a wall. Fill up big toy trucks with heavy blocks, push with both hands to knock things down. Participate in sports activities involving running and jumping. Have the child color a "rainbow" with large paper on the floor or with sidewalk chalk outside while child is on hands and knees. Naturally Occurring Activities Within the School Environment (used to design a sensory diet with the school team): Place chairs on desks at end of day or take down at beginning of day. Erase the chalkboard/dry erase board. Wash desks and/or chalkboard/dry erase board. Help rearrange desks in the classroom. Help the janitor with emptying wastebaskets, mopping the floor, etc. Fill milk crates (small ones that students can carry) with books to take to other classrooms. Teachers could ask students to move these crates back and forth as needed. Help the gym teacher move mats, hang them up, etc. Take chewy candy breaks -- such as licorice, fruit roll-ups, Starburst or Tootsie Rolls. Take crunchy food breaks -- such as dry cereal, vegetables, pretzels or popcorn. Sharpen pencils with a manual sharpener. Cut out items for display from oak tag. Have students carry heavy notebooks to the office or from class to class. Carry books with both hands hugging the book to the chest. Push the lunch cart or carry lunch bin to the cafeteria. Staple paper onto bulletin boards. Have student move several packs at a time of Xerox paper from the storage area to the school copy center. Use the Ellison cut-out machine. Students can collect orders from teachers (who provide the paper and use these cut-outs for bulletin boards, etc.) and then press out Heavy Work Activities for Sensory Input 2

3 the number of pieces required under the supervision of an adult. This very heavy work is a great strategy for organizing behavior. Climb on playground equipment. Swing from the trapeze bar. Perform sports activities that involve running and jumping. Run around the track at school. Have students push against a wall. For younger students, you can use the idea that the room feels small this morning -- can everyone help me push the walls out to make the room bigger. Have the student color a "rainbow" with large paper on the floor while on hands and knees. Play "cars" under a table in the classroom where the student pushes the car with one hand while creeping and weight bearing on the other hand. Open doors for people. Use squeeze toys that can be squeezed quietly on the student s lap under the desk so that the student does not disturb the class. Do chair push-ups. Do animal walks (crab walk, bear walk, army crawl). Jump on a mini trampoline. Stack chairs. An appropriate movement break includes the following components: Lots of movement and jumping to begin. Activities like jumping jacks, pretend downhill skiing, frog jumps, etc are excellent choices. Use movement activities until students are beginning to breath harder. Next move to some heavy muscle work. Activities like plank, push-ups, sit-ups, wall squat, etc are all safe and easy ways to add heavy work. This is a very important step in the body break. If students seem to be having a hard time settling after a body break, it is likely they are not performing enough heavy work. Finish with 5 10 repetitions of deep breathing. If the class is having difficulty remaining quiet during inhalations or exhalations, it may be of benefit to have the class whisper the same 3 6 syllable word upon exhalation. This ensures exhalations are lengthened Heavy Work Activities for Sensory Input 3

4 Understanding & Working with Traumatized and Maltreated Children Barb Afseth, MSW RSW Clinical Social Worker & Christina Tarko Children s Mental Health Services Saskatoon Health Region 2017 Faculty/Presenter Disclosure Presenters: Barb Afseth and Christina Tarko Relationships with commercial interests: None This presentation Is based on the work of Dr Bruce Perry and the ChildTrauma Academy. We will define and discuss; 1) The impact of early adverse experiences and poor relational health on brain development in children 2) The key principles of brain development 3) How early adverse experiences can impact a child s functioning and behavior 4) How to support children with this kind of history in their functioning and development 1

5 TRAUMA & NEGLECT; HOW DOES IT AFFECT US What is Trauma? Based on the Diagnostic and Statistical Manual (DSM-5), trauma is the result of extraordinarily stressful events that shatter your sense of security, making you feel helpless and vulnerable in a dangerous world. Can involve a threat to life or safety, but any situation that leaves you feeling overwhelmed and alone can be traumatic, even if it doesn t involve physical harm. What is Trauma? (continued) It is your subjective emotional experience of the event that causes trauma. The more frightened and helpless you feel, the more likely you are to be traumatized. It can be caused by single-blow, one-time event or from ongoing uncontrollable events which cause heightened prolonged stress. 2

6 Adult Symptoms Associated with Trauma The DSM 5 categorizes symptoms into 4 clusters Intrusive thoughts Avoidance Negative Changes in Thinking and Mood Changes in Emotional Reactions and Arousal Child Symptoms Associated with Trauma Sensory under- and over-reactivity Difficulties with emotion regulation. Poor sleeping, eating, eliminating. Hypervigilance. Habitual or reactive self-harm. Dissociation. Negative view of self, others, and the world. Dr. Bruce D. Perry and The Child Trauma Academy Joy Osofsky Young Children and Trauma Trauma Academy Child Symptoms Associated with Trauma (Continued) Parentified behavior. Reactive physical or verbal aggression. Inappropriate boundaries in intimacy (physical or emotional). Lack of empathy. Dr. Bruce D. Perry and The Child Trauma Academy Joy Osofsky Young Children and Trauma 3

7 Child Symptoms Associated with Trauma (Continued) Delays in other areas of development (communication skills, fine motor/gross motor, and self-care skills) Called the great Imposter as it can look like many other DSM-5 diagnosis Dr. Bruce D. Perry and The Child Trauma Academy Joy Osofsky Young Children and Trauma A Neurodevelopmental Definition of Neglect Lack of a specific pattern of experience during development results in abnormal development of a core brain function The abnormal development happens in those brain systems which sense, perceive, process, interpret, and act on information related to that specific experience or input Use-Dependent Development The more a neural system is activated, the more that system changes to reflect that pattern of activation This is the basis for development, memory and learning 4

8 Multiple Forms of Neglect DOMAINS Emotional Social Cognitive Motor PATTERN Episodic Chaotic Total global The current organization of society challenges our ability to provide children what they need for healthy development KEY POINTS OF BRAIN DEVELOPMENT 5

9 The Amazing Human Brain The brain is an amazing and incredibly complex organ that acts as the command centre. Experience can change the mature brain-but during critical periods of early childhood, experience shapes brain systems! Key Points of Brain Development 1) The brain develops in a predictable fashion * from the most primitive to the most complex * from the bottom up and the inside out Key Points of Brain Development 2) There are sensitive periods of exponential growth; these sensitive periods are also windows of vulnerability. During these sensitive periods, the specific part of the brain developing is most sensitive to environmental input- including traumatic experience. 6

10 Key Points of Brain Development 3) Optimal development of more complex systems of the brain (cortex) requires healthy development of less complex areas (brainstem and midbrain). If the brainstem and midbrain (state-regulating parts of the brain) develop in less than optimal fashion (e.g. following excessive traumatic experience), this will impact development of all other regions of the brain. Key Point in Brain Development 4) The brain remains sensitive (plastic) to experience throughout life- but different parts of the brain are more plastic (cortex) and others are relatively less plastic (brainstem). HOW MEMORY DEVELOPS 7

11 Memory and how it develops is important in understanding the impact of our early experience influences our understanding of the world and our behavior First Memories In utero the most dominant repetitive sensory experience is the ever-present maternal heart beat, and the related opening/closing of valves. This powerful rhythmic pattern becomes associated with warmth, comfort, quiet, satiety and safety. The Primary Organizing Rhythm (POR) of the developing Brain is 60-80/bpm and multiples thereof. Creating Memory When incoming sensory signals (sights, sounds, smells, taste) are familiar. the brain is not altered. When an experience is unique (intense or frequent) the brain is altered - creating and storing new templates of memory 8

12 Memory & Templates The brain matches all incoming sensory signals against previously-stored patterns. This matching process takes place at all levels of the brain Patterns of neural activity that are familiar are categorized Patterns that are novel cause arousal and focus attention -sometimes even alarm Associations The brain makes associations between patterns of neural signals co-occurring in any given moment in time This capacity allows humans to learn, create images of the future and survive. This capacity can also make humans vulnerable to false associations e.g., creating fears of nonthreatening objects. Association is at the heart of understanding attachment, good and bad, as well as traumarelated symptoms Specific to General The brain takes associations from a single or specific event and generalizes to other situations. The brain can generalize from the single abusive father to all adult males. This process, generalization, can literally alter the way future experiences are sensed, perceived and processed. A key to acute trauma response treatment is to minimize the capacity of this generalization process. This often involves quickly re-exposure to the setting, context and other neutral settings cues associated with the trauma. 9

13 IMPORTANCE OF ATTACHMENT Early Attachment Relationships are very important in the development of our relationship with others as we grow older because of the development of memory templates The neural systems which mediate social interaction, communication, empathy and the capacity to bond with others are all shaped by the nature, quantity and timing of early life relationships. 10

14 ANTECEDENTS OF HEALTHY ATTACHMENT Optimal Caregiving in the First Year of Life Positive, Harmonious, Responsive, and Predictable FEAR RESPONSE SYSTEM Fear/Stress Response System Also known as the fight/flight/freeze response This gets activated when we experience something new or when it triggers a memory or association with something that was traumatizing It is a continuum of emotional states from calm to terror. We will call this the Arousal Continuum 11

15 Which symptoms will a child develop? Genetic vulnerabilities and gifts Age at which trauma occurred Nature of the trauma Pattern of the trauma Style of adaptation Relational supports Therapeutic experiences INTERVENTION & SUPPORT Key elements of healthy developmental and therapeutic experiences Relational Relevant (developmentally appropriate) Repetitive Rewarding Rhythmic Respectful 12

16 Relational Providing a calm, responsive and caring presence Being present, available and interested When dealing with unwanted behaviors such as temper tantrums first try strategies for calming by supporting sensory needs If system is too escalated, stay calm,be present and disengaged Relevant Appropriate for developmental age (not chronological age). Remember that children that have not had opportunities or experiences necessary to develop typically in certain areas will be behind Developmental capabilities may vary. For example a child may have excellent gross motor skills but extreme difficulty calming themselves during an emotional reaction Repetitive Provide structured, predictable and nurturing environment where expectation are understood Provide sensory activities frequently to help systems calm interwoven into daily routine 13

17 Rewarding The child enjoys the activity Pay attention to the activities the child is drawn to or try activities you think they might like Activities like swinging, dancing, yoga moves, biking, walking, playing with sand, coloring can all be calming to for the system. Rhythmic Activities that are rhythmic are very organizing for our brain. The mother s heartbeat in utero is very soothing for the developing fetus Respectful Models relational respect where they feel there experience and opinion matters even if they don t get there way all the time! 14

18 When Dealing with Difficult Behavior Think of this pattern of interaction REGULATE- both you and them RELATE- try to understand and help them understand what lead to the behavior REASON- implement consequence- natural or logical- developmentally appropriate Questions or Comments 15

19 Examples of activities can be used to support the regulation in the lower brain Patterned repetitive rhythmic Walking Running Jumping Skipping Swinging Clapping games Interacting with sensory material such as playdoe, sand Massage Moving to music Balavisx (watch video on youtube)