Sensory processing and ASD The role of the Paediatric Occupational Therapist

1. Sensory processing and ASDThe role of the Paediatric Occupational Therapist ASD Team: Rachael-Anne Scott Alanna Reid Denise Gough Lisa Wallace Sharron Kane 1st September 2014

2. Role of paediatric OT with ASD • Activities of Daily Living (ADL) • Fine Motor • Gross Motor • Visual Perception • Planning and Organisation • Sensory Processing

3. Sensory Processing Studies indicating prevalence of sensory processing difficulties within ASD National study with sample group of 44: Adamson O Hare and Graham (2006) 70% (modulation difficulties) Larger sample group of 208 (age group 20 to 54 mths) :Klintwall et al (2011) 78% (sensory differences)

4. What is Sensory Processing? Our interpretation of the information which we receive from our environment.

5. How is the information received? • Sight • Sound • Touch • Taste • Smell • Vestibular • Proprioception

6. Common difficulties Sight • Sensitivity to light • Hyper-attention to detail (Hyper-systemising) Sound • Hypersensitive to noise • Difficulty responding when addressed • Easily distracted with different noises • Difficulty filtering relevant sounds

7. Common difficulties Touch • Impact on ADL • Sensitivity to clothing textures • Reduced tolerance of touch • Difficulty with hair washing/ hair cutting • Difficulty tolerating showers • Dislike of teeth brushing

8. Common difficulties Taste Hypersensitive • Sensitive to texture • Gagging or vomiting Hyposensitive • Likes spicy food • Eats/mouths non food objects Is it specifically sensory? (other points to consider) • Systemising/ child attempting to be in control • Emotional response

9. Common difficulties Smell Hypersensitive (impact on ADL) • Vomiting with smell of certain food types and/or household smells • Issues with toileting • Avoidance of places or people Hyposensitive (impact on ADL) • Smearing of faeces • Smelling objects and people inappropriately

10. Common difficulties Vestibular (Impact on ADL) • Hyper responsive to movement • Reluctance to engage in playground activities • Difficulty leaning back to have hair washed etc • Sitting posture may be poor • Hypo responsive to movement • Sensory seeking (i.e. Spinning) • Sitting posture may be poor

11. Common difficulties Proprioception (Impact on ADL) • Difficulties with force control i.e. Excessively hugging, heavy footed, applying excessive pressure through pencil. • Difficulties dressing due to poor awareness of body position. • Enjoys firm pressure i.e. Firm hair brushing or firm drying with a towel

12. Referral process • Who can refer? • Health referrals • Request for assistance from education • When to refer? • If there are motor and/or a cluster of sensory difficulties impacting on the childs functional abilities.

13. Assessment • Clinic appointment if appropriate • Discussion with parents (completion of questionnaires as relevant) • Standardised assessments (i.e. Movement ABC, Sensory Profile, sensory processing measure) • Observation at home and/or school as appropriate • Liaison with school staff and other members of the MDT

14. OT Intervention May involve combination of the following: • Evaluation of assessments • Individualised programmes i.e. Stick kids • Strategies to assist with sensitivities toward self care tasks • Predominantly advisory in consultative role • Depending on the needs of the child, treatment blocks may be recommended • Visual stories

16. Resources • Sensory processing pack: Advice and strategies for home and school • Top tips for sensitivity • A Practical Approach at home for parents and carers: Autism spectrum Disorder: Falkirk Council. • A Practical Approach at home for parents and carers:. Making sense of sensory behaviour: Falkirk Council • Building bridges through sensory integration: Yack et al (2002) • A Buffet of sensory Interventions: Culp S (2011) • Aspergers Syndrome and sensory Issues Myles et al (2000)

17. Any Questions?