YOUTH OPPORTUNITIES UPHELD, INC. MISSION: To provide youth and families with opportunities to fulfill their potential and build a brighter future COMPONENTS: Outpatient, Community-Based and In- Home, Education and Transition, Out of Home Care ROLE OF OCCUPATIONAL THERAPIST Training Consultation Practitioner Group Facilitation
SCOPE OF OT AT YOU INC. Goal of Occupational Therapy Services: Youth will acquire skills to maximize independence in daily tasks Focus on consultation and training for staff who work with youth on a daily basis The following are methods in which occupational therapy is utilized to enhance service delivery: Environmental adaptations Weekly groups and activities Assessment
SENSORY INPUT FOR SELF-REGULATION The integration and interpretations of sensory stimulation from the environment by the brain Taps into all sensory systems Power senses Tactile Vestibular Proprioceptive Environmental senses Auditory Visual Tactile Gustatory Olfactory
TACTILE Input received through the skin Anterolateral (AL) pathway Light touch, pain, temperature Dorsal Column Medial Lemniscus (DCML) system Deep Touch Alerting Cold Temperature Light Touch Pain Calming Hands-on tasks Warm Temperature Deep Touch
VESTIBULAR Input received through change in head position (fluid in inner ear) Considers the effect of gravity on the body Typically alerting, but can be calming, based on speed, regularity, directionality Alerting Irregular, Fast, Up and Down, Side to Side, Rotary Calming Regular, Slow Front to Back
PROPRIOCEPTION, HEAVY WORK Contraction and relaxation of muscles and joints through active engagement Regulates the body Provides information about where body is in space Examples Exercise Chewing Chores Obstacle Course
ENVIRONMENTAL FACTORS Alerting Sound loud, high-pitched, erratic, unexpected Sight bright colors, clutter, bright lighting, fast moving objects Smell unexpected, unpleasant, citrus, mint Taste unique, sour, bitter, spicy Calming Sound quiet, rhythmic, lowpitched, familiar Sight pastel/pale colors, neat and tidy, low lighting, slow moving objects Smell familiar, pleasant, floral, vanilla Taste familiar, sweet, salty
RESPONSE TO SENSORY STIMULATION Reprint Permission: May-Benson, 2007 Modified from Koomar, Szklut, Raredon, Trecker and OTA staff, 1996
SENSORY MODULATION The ability to assess and identify relevance of sensory information to maintain homeostasis EXAMPLE I am in the classroom and the teacher is speaking and writing notes on the board. I am sitting in a chair and the fluorescent lights are humming and wind is blowing through the window. Overresponsive reaction I am too distracted by the fluorescent lights and humming and light touch that is stimulating my skin, to completely attend to my classwork. Expected reaction I am able to complete attend to my school work because my brain can successfully filter out sensory input that is not important.
SENSORY MODULATION Signs of Poor Modulation Could present as Defensive, Distractible, or Sensitive Is a picky eater Dislikes tags in clothes or wearing clothing made of certain materials Suffers from motion sickness Covers ears Hums or frequently makes noises Dislikes bright lights Has a poor frustration tolerance Presents with fight, flight, freeze response Is easily distracted
SENSORY DISCRIMINATION The ability to detect salient qualities of a specific sensory input EXAMPLE Movement How fast am I moving? What direction am I going? Touch What is touching me? What am I holding? Is it cold, is it smooth, is it heavy? Muscle Where am I? Can I fit in a certain space? Can I move in a room without bumping into something?
SENSORY DISCRIMINATION Signs of Poor Discrimination Could present as Sensory Seeking or Under Responsive Has poor fine motor skills Has poor body awareness/safety awareness Seeks movement opportunities jumping, moving in seat Touches everything Leans on people, furniture, walls Has poor motor planning or movement appears awkward or clumsy Has poor trunk stability or posture
SELF REGULATION Maintaining an optimal level of alertness/arousal to successfully participate in daily tasks Body must take in the appropriate amount of stimulation to feel calm, organized, and grounded Based on individual s threshold and tolerance Sensory Break regulating the sensory system once client displays initial signs of overstimulation by using strategies as a coping skill Sensory Diet incorporating regular sensory input into daily routine to prevent overstimulation
EVALUATION Sensory Processing Questionnaire simple tool to introduce sensory preferences Mostly A s Sensitive Mostly B s Seeker Mostly C s Defensive Mostly D s Under-responsive
EVALUATION Coping Skill Inventory
EVALUATION Collaborative Safety Assessment
SENSORY TOOLS Move movement tools Focus tools to keep hands and minds busy Soothe deep pressure and heavy work tools for self-soothing Relax environmental modifications General Considerations Defensive- Focus Soothe Sensitive - Relax Under Responsive - Move Seeker - Move Soothe
SENSORY TOOLS Go To Tools! Ankle weights Beanbag chair Bungee chair Body sock Crash pad Exercise/yoga cards Foam roller Neck wrap Noise-block headphones Oil/water timer Scooter board Search bins Sensory brush Stress balls/fidgets Theraband Theraputty Timer Weighted ball Weighted blanket Weighted stuffed animal Wiggle cushion
SENSORY TOOLS DIY! Our Top 10 1. Gel Pack 2. Glitter Bottle 3. Stress Ball 4. Sugar Scrub 5. Soft Playdough 6. Putty Slime 7. Sensory Bins 8. Neck Wrap 9. Search Bottle 10. Chew Necklace
SENSORY SPACES Move! Get Active! Use My Muscles! Swings
SENSORY SPACES Move! Get Active! Use My Muscles! Exercise Equipment
SENSORY SPACES Relax! Squishy Spot! Reflection Room! Deep Pressure
SENSORY SPACES Activity Area! Maker Space!
GROUP DEVELOPMENT Group Protocol TITLE OF GROUP OBJECTIVE THERAPEUTIC BENEFITS MATERIALS PREPARATION DIRECTIONS ALTERNATIVES
HOW DOES YOUR ENGINE RUN? Teaching the skills of self regulation 1. Identifying Engine Speeds HIGH, LOW, JUST RIGHT 2. Changing Engine Speeds Trying out Self Regulation Strategies 3. Regulating Engine Speeds Identifying what the body needs and actively seeking the input Williams, M., Shellenberger, S. (1996). How Does Your Engine Run? A Leader s Guide to The Alert Program for Self-Regulation. Alburquerque, NM: TherapyWorks, Inc.
ZONES OF REGULATION Teaching the skills of self regulation 1. Identifying Zones Red out of control Yellow heightened state of arousal still some control Green optimal learning Blue low state of arousal 2. Changing Zones Trying out Self Regulation Strategies 3. Achieving Optimal Learning Identifying what the body needs and actively seeking the input Kuypers, L. (2011). The Zones of Regulation: A Curriculum Designed to Foster Self-Regulation and Emotional Control. Minneapolis, MS: Kuypers Consulting, Inc.
OT STATIONS Objective: To introduce youth to various sensory regulation strategies that may help in different situations Station 1: Workout Station 3: Concentration Station 2: Relaxation Station 4: Activity
SENSES GROUP Objective: To teach about the various senses and how they can be used to regulate the body Skills supported: self-regulation, self-awareness, coping skill development, attention One sense is taught per week Group Format Warm Up Discussion Self-assessment Activity Wrap-up
GOALS GROUP Objective: to empower youth in treatment to select and set their own goal and treatment objectives Examples I will find strategies and activities that I enjoy that can help me to cope I will learn more about myself and what causes my stress I will be respectful to myself, adults, and my peers I will learn about negative thought patterns and improve my ability to use positive thinking I will learn how to communicate my ideas and feeling effectively I will handle my anger constructively I will feel comfortable in my own skin I will learn to identify different feelings I will learn how to be a good friend UNABLE TO FIND A GOAL THAT WORKS FOR YOU, Make it your Goal to learn how to SET A GOAL
PET THERAPY Objective: To provide nurturing and emotional support through interaction with a therapy dog Skills supported: self-regulation, self-esteem, attention, social skills, verbal interaction, fine motor and visual perceptual skills Group Format: Introductions and rules Demonstration Turn-taking Question and answer Drawing Close
CONSULTATION Changing Agency Culture 1. Support from all levels 2. Evidence and proof 3. Team building 4. Budget
OT TASK FORCE Inventory needs Youth needs Quarterly goal Hands-on activity Giving kids hope With tools to cope
PROGRAM EXPECTATIONS Weekly Group Sensory Tools/Space Annual Training Monthly OT Task Force Meetings Annual Team Participation in OT Day!
HANDS ON LEARNING AND HANDS ON FUN!