Sensory Processing Meredith Pait / Kristy Davis Occupational Therapist

1. Sensory ProcessingMeredith Pait / Kristy DavisOccupational Therapist

2. Overview of Senses • In order to understand sensory dysfunction we need to understand the purpose of our senses. • Our senses allow us to experience and respond to our environment.

3. Overview of Senses • Five senses most are familiar with: • Vision-visual perception • Hearing-auditory perception • Touch-tactile perception • Smell-olfactory perception • Taste-oral perception • Two senses some may not be familiar with are: • Vestibular-sensory info we receive from our middle ear that relates to movement and balance. For example, as a child did you ever spin yourself in circles and remember this feeling? • Proprioceptive-sensory info we receive from our muscles, joints and body parts. Close your eyes and raise your hand in the air. You know where your hand is even though you are not looking at it because of the muscles and joints in your hand and arm are sending info to the brain telling it the position.

4. Overview of Senses • The seven senses work together to help us understand and maneuver within our environment. For example • To open a door • We look at it (visual perception) • We place our hand on the doorknob (visual and tactile) • We squeeze the doorknob with the proper pressure and turn it (tactile and proprioceptive) • We pull the door open with the right strength (vestibular, proprioceptive, visual and tactile) • We walk through the doorway, stepping over the door jam (visual, vestibular, and proprioceptive) • If our brains receive inaccurate sensory information we may: • Bump into the door • Slam the door • Get hit with the door • Trip or bang into the doorway as we walk through • Be unable to open the door

5. What are Sensory Processing Difficulties?? • Unusual reactions to the way things smell, taste, look, feel or sound. • Low or high thresholds and appear to over or under react to stimuli • Children/people who over-react to sensory stimulation may respond to certain harmless sensations as if they are dangerous or painful (avoiding touch, becoming agitated by a peer accidentally bumping them, screaming during hair washing, covering ears during a fire drill). This is a low threshold. • Children/people who are under-reactive to sensory information need higher levels of stimulation in order to respond to the environment. This meaning they have a high threshold. They may seek out sensations or shy away (not aware of danger or pain, seem to tire easily, fall out of their chairs, avoid situations, bump into things). • *It is important to remember that processing of this sensory information can be extremely inconsistent: One day a child may under react to one sensation and over reactive to another. • Decreased ability to sustain focused attention • Senses are not working together properly and cause difficulty responding effectively within their environment

6. Strategy : Accommodate their Sensory Preferences • Try to observe when melt downs and distress occur for “no apparent reason” • Change the sensory environment to see if this helps prevent similar meltdowns in the future. • Noise reducing headphones • Use of carpets or plants to absorb classroom noises • Warning the child before noisy fire/tornado drills • Use of dim or natural lighting • “Sensory corners” or “relaxation stations” • Sensory bins/tubs (contains fidgets, etc.) • Allow students to transition a few minutes earlier than others to avoid sensory overloading during transitions such as changing classes.

7. Strategy : Accommodate their Sensory Preferences • Calming activities can be scheduled throughout the day: Some examples include: • deep pressure (weighted lap pads, firm hugs, massage, chewing), • rhythmic vestibular stimulation (swinging, rocking in a rocking chair, jumping, bouncing, vibration), • proprioceptive stimulation (movement breaks, fidget toys, “heavy work” breaks), and use of a “quiet space/area” • relaxation techniques (such as “take a deep breath and count to ten”).6 • Sometimes you may see a person with autism rocking their body back and forth or waving their arms and hands, or wringing their fingers. • Encourage the child to select and request an alternative sensory strategy e.g. twisting a paperclip may replace the finger ringing, and achieve the same sensory input in a less disruptive and distracting way.

8. Strategy: Use Visual Structure • Provide a consistent, predictable environment with minimal transitions. 11 • Use a visual schedule to provide the child with info regarding their day, and to prepare them for any changes which may occur in their daily routine. Auditory information alone can be too overwhelming for children with Autism and they may not understand the directions. • Use written directions for some children. • Modify assignments (fewer problems per sheet; larger visual space for responding; boxes next to each question) so that the child can complete them within specific amount of time, prior to transitioning to the next activity. • Use a “finish later” folder or box. • Use “1,2,3, finished” work system.

9. Problem Solving Strategies for Sensory Processing Dysfunction • If you see a child with Autism react in a way which does NOT match the situation… think to yourself… “could the reaction be due to a sensory processing difference?” • If so…. Think “What can I… • Take out • Put in • Teach…. the child?”

10. What can I take out, put in and/or teach? • Children with Autism can be overly sensitivity to sound, touch, taste, odors OR seeking movement…..So ask yourself…… • What can I take out? • Ask parents to remove tags from clothing • Reduce unexpected touch (e.g. Place child at back of line) • Reduce background noise • What can I put in? • Muffler on intercom, plants in room • Indirect lighting • Tennis balls on chair feet • Wet wipe/cloth beside the child during messy/sticky activities • Offer noise reducing headphones • Allow the child to transition ahead of class • “Can I take a break?” card • What can I teach the child to do? • Warn child before fire/tornado drill • Ask adult/teacher for noise reducing headphones, wipe, etc.

11. What can I take out, put in and/or teach the child? • Again ask yourself… • What can I take out? • Long sessions of seated work • What can I put in? • Visual boundaries of space (e.g. Tape on floor) • Movement breaks / errands • Air cushion / fidget toy (e.g. paperclip) • What can I teach the child? • To request a movement break or fidget tool (perhaps using a card on desk) • To use fidget tools appropriately without distracting others.

12. STRATEGY: Accommodate Sensory Preferences • We can provide students with a safe, inviting, visually appealing area, which offers a variety of multi-sensory experiences, so that students can retreat from the everyday distractions and sensory demands of the regular classroom, and “regroup” or “reorganize” themselves when in or near the point of “sensory overload”. This helps to relieve agitation, and promote relaxation and a sense of wellbeing. • Research has shown that students demonstrate increased alertness, task persistence, calmness and a sense of control when in such sensory environments.

13. Summary of sensory needs and strategies… • When you see a behavior/reaction that does not match the situation…. Think to yourself… “Could it be due to sensory processing differences?” (increased sensitivity to sound, touch, taste, odors OR seeking movement) • If so… “What can I… • Put in, • Take out • Teach the child to help keep the child in an alert, “ready to learn” state, while decreasing disruptive and distracting behavior”.

14. References and Additional Reading • Arnwine, B. (2005). Starting sensory integration therapy. Las Vegas, NV: Sensory Resources. • Attwood, T. (1998). Asperger’s syndrome: A guide for parents and professionals. London: Jessica Kingsley. • Claudia Wallis (2006). Inside the Autistic Mind. Time, May 15, 2006. • Carolyn Murray-Slutsky (2004). An OT Approach to Asperger Syndrome. • Gray, C. (1994) Comic strip conversations. Arlington, TX: Future Horizons. • Kluger (2007). The new map of the brain. Time, January 29, 2007. • Murray-Slutsky and Paris (2000). Exploring the Spectrum of Autism and Pervasive Developmental Delays: Intervention Strategies. • Myles, Cook, Miller, Rinner, Robbins (2000). Asperger Syndrome and Sensory Issues: Practical Solutions for Making Sense of the World • Nash (2007). The gift of Mimicry. Time, January 29, 2007 • www.specialed.us/autism/asper/asper12.html • www.autismspeaks.com • www.autismsociety-nc.org