How does our sensory system work? Sensory integration

How does your Engine Run?The Alert Programme for Self regulationby Mary Williams and Sherry Shellenbergerpresentation by Lois AddySpecialist Lead for SpLD

How does our sensory system work? Sensory integration

Typical Sensory Processing Under responsive Just right Over responsive

Self-Regulation • Imagine yourself driving in the car from Northallerton to Cornwall, mainly on the motorway. You have set off early to avoid heavy traffic. You have been on the road for 3 hours and you start falling asleep... • What would you do to stay awake?

Self-Regulation • Imagine yourself drifting off at the most boring lecture at the world’s most boring conference... • What would you do to stay awake?

Self-Regulation • Imagine yourself listening to a talk on self-regulation and sensory processing • It is the most fascinating material you have ever heard! • What do you do to keep this optimal state of arousal?

Self-Regulation • Imagine you are at the cinema • The sound system seems too loud • Behind you, the woman is wearing perfume • The teenagers behind you are crunching loudly on popcorn and slurping loudly • What would you do?

Various metaphors to describe concept of balance... • Yin yang • How does your engine run?™ • How are you feeling? Thermometer analogy

Sensory modulation:1.Proprioceptive input Proprioception — from Latin ‘proprius’, meaning "one's own," and perception. Proprioception is the sense of the orientation of one's limbs in space. Without proprioception, we'd need to consciously watch our feet to make sure that we stay upright while walking.

Hyposensitivity- Low proprioceptive feedback In order to gain some feedback regarding touch and sound, they will crash around bumping into things. • ham-fisted • heavy-footed. • headbanging • Over zealous when hugging or patting • Squash in between people • Tip toe walking

Poor proprioceptive feedback results in motor coordination difficulties His most blatant failure was in writing.... this motorically clumsy child had atrocious handwriting... The pen did not obey him, it stuck and sputtered; he corrected without concern for appearance and would simply write new letters on top of old ones.’ Ref: Asperger, H. (1944) Autistic Psychopathy in Children. Translated in U Frith (1991) Autism and Asperger Syndrome, Cambridge: Cambridge University Press.

2. Vestibular Disturbancea) Gravitational insecurity A tendency to react negatively and fearfully to movement experiences, particularly those involving a change in head position and movement backward or upward through space)

2. Vestibular Disturbance b) Craving Vestibular Stimulation Child spins and rocks

3. Sensory Input Difficulty modulating • Touch • Taste (gustatory) • Smells (olfactory) • Visual focus • Noises

3a. Touch Hypersensitivity Touch can be painful and uncomfortable and they will often withdraw from aspects of touch, which can have a grave effect on their relationships with others dislike of having anything on hands or feet difficulties in brushing and washing hair, and hair cutting only likes certain types of clothing or textures.

3b. Oral defensiveness (hypersensitivity) • dislikes having teeth brushed and/or face washed • has a limited food repertoire and/or may avoid certain food textures - especially mixed textures • will take their food off the fork or spoon using only their teeth, keeping their lips retracted • will gag easily when eating and may only get food down by taking a drink with it

3c.Auditory hypersensitivity Children and Young People with sensory modulation problems suffer unbearable pain because of they have multiple sensitivities. Many are hypersensitive to sounds. The intensity of their pain can be excruciating. Some indicators of that hypersensitivity are: • covering their ears with their handsto protect themselves from the incoming sounds • bursting into huge temper tantrums due to the frustration of having to deal with the constantly incoming sounds • repeating the same words, phrases or sentences perhaps as a way to soothe or stabilize themselves in the face of the barrage of intense and confusing sounds

Visual and auditory sensitivity • Hearing all sounds (no filter) • Seeing all detail (limited focus) • Experiencing all textures (tactile defensiveness) • Smelling all odours (olfactory)

Sensory Overload • Children and young people with sensory overload can often see everything and hear everything.. Results: • Paranoia/persecutory misinterpretation • Acute anxiety • Exhaustion/fatigue • System shut down/catatonia • Melt down

Sensory under-sensitivity • Craves touch • Chews anything in sight • Makes loud noises • Licks and chews inappropriate objects • Sniffs, craves unusual scents

Sensory Modulation Children and young people can modulate between hypersensitivity, hyposensitivity and gravitational insecurity

Why? Causes of Sensory Processing Difficulties • Genetic predisposition • Prenatal, e.g. parent alcohol or drug use, pregnancy complications, maternal illness • Prematurity • Birth trauma, e.g. emergency cesarean section, lack of oxygen • Post-natal, e.g. environmental pollutants, lengthy hospitalisation or institutionalisation • Lack of normal sensory experiences that may interfere neurological development ie. poor early parenting

Ecological Assessment Sensory Diet • Physical environment • Antecedent-Behaviour-Consequent(ABC) conditions • Social environment • Temporal analysis: when does the behaviour occur?

Sensory Activities That Are Calming • Fidget Toys (TACTILE)

Sensory Activities That Are Alerting • Light touch, light tickles with a feather, back scratch, koosh ball. • Fast, irregular movement, bouncing on a therapy ball, playing tag and jumping. • Crunchy foods: pretzels, crackers, popcorn or raw vegetable sticks. • Sour candy

Sensory Activities That Are Organizing (both alerting and calming) Proprioceptive activities • Pushing and pulling activities: • pushing a loaded cart, moving furniture • Hiking, climbing, tug-of-war. • Carrying and passing out books. • Chewy foods • gum, bagels, fruit bars, dried fruit, etc

Sample Sensory Diet Morning: • Wake to calming music • Wilbarger brushing to calm and decrease tactile sensitivity • Crunchy cereal • Earphones to wear on the bus to school.

Sample Sensory Diet (continued) At School • Use of a move ‘n’ sit cushion • Availability of a privacy board • Proprioceptive activities between classes, eg. Assist in the putting out PE apparatus Lunch: Thick shake, chewy sandwich, crunchy snacks

Sample Sensory Diet (continued) Afternoon • Hard sour candies to maintain arousal and calm • ‘Body breaks’ every hour • Swimming practice • Headphones to assist with transition home • Dinner Evening • Homework done sitting on a vestibular ball. • Soothing motion on rocking chair to unwind, or soothing music, or smells (e.g.Scentstories)

How does our sensory system work? Sensory integration