Understanding Sensory Processing Disorders

1. Understanding Sensory Processing Disorders Developed by Connie Ortman, OTR Presented by Kim Denny-Newkirk, OTR Outreach Services of Indiana http://www.in.gov/fssa/disability/services/seoutreach/index.html

2. Course Objectives Understand that all people process information differently and have individual preferences Recognize symptoms of sensory processing disorders Identify where to go to for evaluation and treatment Be informed about the types of services available and strategies to help individuals with sensory processing disorders. My goal is that by the end of this inservice you will be able to:My goal is that by the end of this inservice you will be able to:

3. How does this apply to me? If you know the behavior has a sensory basis, you are less likely to take it personally and more likely to be empathetic. If you understand the underlying problem it may help to identify solutions and take action. Everyone�s nervous system is plastic, it can be changed throughout their lifetime, both positively and negatively. Why do I needed to know more about sensory processing? May of you are working with individuals who possibly may have sensory processing issues. #1 One of my biggest pet peeves is when I hear someone complain about a behavior �well he�s doing that on purpose.� Well yes he is�. but it might not be just to get your goat, it might be that whatever they are doing helps them cope better. I want you to understand and appreciate the complexity of what right now you take for granted. #2 Knowledge is power! #3 There has been a huge increase in Autism and other developmental disorders, some theorists believe there are both a genetic and environmental factors that contribute to this. We can�t change the genetics but we do have the ability to change the environment! I can�t emphasize enough, all of us need to remember, either use it or loose it!Why do I needed to know more about sensory processing? May of you are working with individuals who possibly may have sensory processing issues. #1 One of my biggest pet peeves is when I hear someone complain about a behavior �well he�s doing that on purpose.� Well yes he is�. but it might not be just to get your goat, it might be that whatever they are doing helps them cope better. I want you to understand and appreciate the complexity of what right now you take for granted. #2 Knowledge is power! #3 There has been a huge increase in Autism and other developmental disorders, some theorists believe there are both a genetic and environmental factors that contribute to this. We can�t change the genetics but we do have the ability to change the environment! I can�t emphasize enough, all of us need to remember, either use it or loose it!

4. What is Sensory Processing? Definition: Sensory processing is the method the nervous system uses to recognize, organize and make sense of incoming sensory input. It includes both information coming from the external environment and input from the body in order to create an �adaptive response�. Simply put �how your body deals with the sensations it receives�. We can tell by the actions we see through observing your �behavior� When I talk about �behavior� during this presentation, I am talking about observable actions. Simply put �how your body deals with the sensations it receives�. We can tell by the actions we see through observing your �behavior� When I talk about �behavior� during this presentation, I am talking about observable actions.

5. Neurology 101 Take notes there is going to be a test on this later. Just kidding, I tried to make this as easy as possible, but if you don�t understand something, please interrupt and ask questions. The first part of sensory processing is sensory refers to your senses.Take notes there is going to be a test on this later. Just kidding, I tried to make this as easy as possible, but if you don�t understand something, please interrupt and ask questions. The first part of sensory processing is sensory refers to your senses.

6. External Senses Hearing (Auditory) Vision (Ocular) Smell (Olfactory) Touch (Tactile) Taste (Gustatory) These are the ones you learned in school.These are the ones you learned in school.

7. Internal Sensations Vestibular System detects movement Tells us we are moving, surrounded by something that is moving or on something moving Receptors located in inner ear Tells up from down Influences concept of outside space Proprioceptive System body awareness Tells us where the body parts are without having to look at them Receptors are located in muscles, tendons, and ligament around joints Provides sense of the contents of the body You have two more you may not have learned about. I need a volunteer. Have the person sit on the ground and close their eyes, then ask them to lay in different positions (stomach, right side, back, left) and then point to up in each. How do you know which way is up? What sense are you using (vestibular system)? This system detects movement. I need another volunteer. Stand with your eyes closed and your arms extended to your side. Raise your right arm above your head. Now place your left arm behind your back. Which sense told you how to do this? (proprioceptive) OK, now lets go back to the original definition. You have two more you may not have learned about. I need a volunteer. Have the person sit on the ground and close their eyes, then ask them to lay in different positions (stomach, right side, back, left) and then point to up in each. How do you know which way is up? What sense are you using (vestibular system)? This system detects movement. I need another volunteer. Stand with your eyes closed and your arms extended to your side. Raise your right arm above your head. Now place your left arm behind your back. Which sense told you how to do this? (proprioceptive) OK, now lets go back to the original definition.

8. What is Sensory Processing? Definition: Sensory processing is the method the nervous system uses to recognize, organize and make sense of incoming sensory input. It includes both information coming from the external environment and input from the body in order to create an �adaptive response�. So now we know what sense tell us information from the external environment and from within the body. All this information goes to the brain where it is PROCESSED, hence the term sensory processing you may also hear it called sensory integration. The brain sorts it out and then decides what it should do with it. We can tell if the brain is processing information well by the observable behavior or �adaptive response�.So now we know what sense tell us information from the external environment and from within the body. All this information goes to the brain where it is PROCESSED, hence the term sensory processing you may also hear it called sensory integration. The brain sorts it out and then decides what it should do with it. We can tell if the brain is processing information well by the observable behavior or �adaptive response�.

9. An adaptive response .�. is an appropriate action taken from the synthesis of incoming sensory information received through the central nervous system. can be conscious or unconscious but it is not a reflex. is a result of adequate sensory integration and assists in improving sensory integration. Most of us have well developed nervous systems that can handle the incoming sensory information adequately to tolerate, analyze and act on it. However, each of us has our own unique way of responding to our environment. This is a result or our sensory preferences, experience and level of integration. How I respond to a given situation may be very different than how you respond, but both may be considered an adaptive response, and therefore considered a result of normal sensory processing. Ex. Driving home Most of us have well developed nervous systems that can handle the incoming sensory information adequately to tolerate, analyze and act on it. However, each of us has our own unique way of responding to our environment. This is a result or our sensory preferences, experience and level of integration. How I respond to a given situation may be very different than how you respond, but both may be considered an adaptive response, and therefore considered a result of normal sensory processing. Ex. Driving home

10. Conscious vs. Unconscious Sensory Processing Let�s use driving home to evaluate how much of your sensations are you aware of, how much was automatic? Of all of the sensory information that comes in for processing, the brain can only attend to 5%. So, is your 5% listening and storing the information I am giving you, or is it planning what your having for dinner?Let�s use driving home to evaluate how much of your sensations are you aware of, how much was automatic? Of all of the sensory information that comes in for processing, the brain can only attend to 5%. So, is your 5% listening and storing the information I am giving you, or is it planning what your having for dinner?

11. Normal sensory processing includes: Receiving input from the sensory receptors. Relaying information to the brain. Identifying what information is important. Blocking information that is not important. Comparing information with past experience or other types of sensory experience to form a plan of action if needed. Developing a plan Sending the message to the parts of the body needed to execute the plan. Carrying out movements as planned. (adaptive response). Think about the first time you learned to drive a manual transmission car. Over time we no longer have to think about it and can drive and listen to music, then drive- listen to music- and eat. Then drive, listen to music, eat and talk on a cell phone�..but then what happens when we hear a siren? Now we return our conscious focus again to how we are driving. If just one piece of the puzzle is missing, it can have a huge effect on a person�s ability to function. Think about the first time you learned to drive a manual transmission car. Over time we no longer have to think about it and can drive and listen to music, then drive- listen to music- and eat. Then drive, listen to music, eat and talk on a cell phone�..but then what happens when we hear a siren? Now we return our conscious focus again to how we are driving. If just one piece of the puzzle is missing, it can have a huge effect on a person�s ability to function.

12. Lets review the steps using a more simple concept. Receiving input from the sensory receptors. Relaying information to the brain. Identifying what information is important. Inhibiting information that is not important. Comparing information with past experience or other types of sensory experience to form a plan of action if needed. Developing a plan Sending the message to the parts of the body needed to execute the plan. Carrying out movements as planned (adaptive response). Lets review the steps using a more simple concept. Receiving input from the sensory receptors. Relaying information to the brain. Identifying what information is important. Inhibiting information that is not important. Comparing information with past experience or other types of sensory experience to form a plan of action if needed. Developing a plan Sending the message to the parts of the body needed to execute the plan. Carrying out movements as planned (adaptive response).

13. Sometimes an individual�s brain does not process the incoming information from the senses (vision, hearing, taste, smell, touch or movement) normally. These individuals are said to have a Sensory Processing Disorder (SPD) or in some literature Sensory Integrative Dysfunction (SID). Problems with the receptors such as blindness or deafness, lack of awareness to touch from cerebral palsy or spinal cord injury are not true sensory processing disorders, but these conditions will also result in similar symptoms to those who have sensory processing dysfunction. Problems with the receptors such as blindness or deafness, lack of awareness to touch from cerebral palsy or spinal cord injury are not true sensory processing disorders, but these conditions will also result in similar symptoms to those who have sensory processing dysfunction.

14. SPD are caused by Problems getting the impulse to the brain Problem within the brain stem (filter) Communication between centers of the brain Problems getting the information to the brain for processing. Problems with the filter. Trouble sorting out what information is important enough to pay attention to or the brain being overloaded by too much information. 3. Trouble with communication between centers of the brain. Problems getting the information to the brain for processing. Problems with the filter. Trouble sorting out what information is important enough to pay attention to or the brain being overloaded by too much information. 3. Trouble with communication between centers of the brain.

15. Types of Sensory Processing Disorders Unfortunately, different theorists have used the same terms to describe different concepts. Therefore, when you read literature on Sensory processing or integration, try to focus on the concept rather than the terminology. Each group has its own set of symptoms. Let�s look at the different types by asking the following questions.Unfortunately, different theorists have used the same terms to describe different concepts. Therefore, when you read literature on Sensory processing or integration, try to focus on the concept rather than the terminology. Each group has its own set of symptoms. Let�s look at the different types by asking the following questions.

16. Do they respond normally to sensory input?  Symptoms of hypersentivity, defensiveness or sensory avoiding Has a narrow or limited interests Fear of movement and heights, or get sick from exposure to movement or heights Be very cautious and unwilling to take risks or try new things Respond to being touched with aggression or withdrawal Responds negatively to certain sounds Be very picky eaters and/or overly sensitive to food smells Will only wear certain kinds of clothes, sensitive to tags. Can be one or more senses. It is not uncommon to have a person who is both sensitive to touch and sound. In more severe cases you may observe self injurious behavior such as head banging or biting What does this person do with their 5%?Can be one or more senses. It is not uncommon to have a person who is both sensitive to touch and sound. In more severe cases you may observe self injurious behavior such as head banging or biting What does this person do with their 5%?

17. What are they thinking about? Self protection, the nervous system is under stress. Operating fight or flight. If you experience for long periods of time the stress has a damaging effect on the body. Self protection, the nervous system is under stress. Operating fight or flight. If you experience for long periods of time the stress has a damaging effect on the body.

18. The terms of regulation or modulation are often used to describe level of arousal of the nervous system. Think of the colors on this chart as different levels of arousal. Which level or you in��I hope alert. The terms of regulation or modulation are often used to describe level of arousal of the nervous system. Think of the colors on this chart as different levels of arousal. Which level or you in��I hope alert.

19. Think of your typical day. It probably looks something like this. The average person is able to concentrate for 15-20 minutes. What do you do help maintain your attention or modulate your level of arousal based on the current environmental demands (i.e. stretch, click a pen, chew gum, take a drink, change position, tap your foot) You can not separate the mind from the body. Motivation, stress and physical fatigue are factors that affect our ability to maintain attention. Can you give me one example of how these factors affect the levels on the graph?Think of your typical day. It probably looks something like this. The average person is able to concentrate for 15-20 minutes. What do you do help maintain your attention or modulate your level of arousal based on the current environmental demands (i.e. stretch, click a pen, chew gum, take a drink, change position, tap your foot) You can not separate the mind from the body. Motivation, stress and physical fatigue are factors that affect our ability to maintain attention. Can you give me one example of how these factors affect the levels on the graph?

20. "Everyone has some sensory integration problems now and then, because no one is well regulated all the time. All kinds of stimuli can temporarily disrupt normal functioning of the brain, either by overloading it with, or by depriving it of, sensory stimulation." Carol Stock Kranowitz "The Out-Of-Sync Child" (1995) from http://www.sensory-processing-disorder.com/sensory-processing-disorder-checklist.html Are you afraid you may have a sensory processing disorder?Are you afraid you may have a sensory processing disorder?

21. We aren�t born with the ability to regulate our level of arousal. Think about a newborn�s nervous system is immature. They have spend a great deal of time sleeping, drifting between awake and asleep. They begin spending more time awake but often go from one extreme to another asleep to wake to upset then to sleep. At this time in their life they don�t have the ability to self regulate, and are reliant on parents to make sure they are awake enough to eat and help calm them when they are upset. Over time their nervous system is better prepared both by past experience and maturation so the child becomes able to calm themselves and keep themselves awake through movement in order to learn. The more time they spend in green, the more learning and integration occurs, which in turn promotes more learning and integration. The human mind is hard wired to seek stimulation and therefore learning. If stimulation is not available the body will seek create its own, although these may be maladaptive. Studies of babies left alone in orphanages��We aren�t born with the ability to regulate our level of arousal. Think about a newborn�s nervous system is immature. They have spend a great deal of time sleeping, drifting between awake and asleep. They begin spending more time awake but often go from one extreme to another asleep to wake to upset then to sleep. At this time in their life they don�t have the ability to self regulate, and are reliant on parents to make sure they are awake enough to eat and help calm them when they are upset. Over time their nervous system is better prepared both by past experience and maturation so the child becomes able to calm themselves and keep themselves awake through movement in order to learn. The more time they spend in green, the more learning and integration occurs, which in turn promotes more learning and integration. The human mind is hard wired to seek stimulation and therefore learning. If stimulation is not available the body will seek create its own, although these may be maladaptive. Studies of babies left alone in orphanages��

22. You can see this person spends little time being able to focus on task. What do you think this person is focusing on in their 5%?You can see this person spends little time being able to focus on task. What do you think this person is focusing on in their 5%?

23. Symptoms of poor modulation/ regulation Difficulty tolerating or adjusting to even minor changes in routine Disregard or impaired ability to interact with others Disrupted sleep and wake cycles Attention problems: either easily distracted, or fixated on one activity with difficulty shifting focus Feel uncomfortable in busy environments, such as sports events, malls

24. What are they thinking about? Maybe lots of different things one right after the other. Maybe they are so overwhelmed by the incoming information all they can do is hide or cover their face. If they have trouble sorting what is important, it is better to pick one thing and fixate on it as a means to block out the other input.Maybe lots of different things one right after the other. Maybe they are so overwhelmed by the incoming information all they can do is hide or cover their face. If they have trouble sorting what is important, it is better to pick one thing and fixate on it as a means to block out the other input.

25. Can they use their body effectively?Good Integration of �Power Sensations� (internal sensations) is essential for later growth and development Going back to Neuro 101. When a child is developing the primarily use these senses to explore the world and learn about themselves.Going back to Neuro 101. When a child is developing the primarily use these senses to explore the world and learn about themselves.

26. Hyposensitivity (under registration) Handles people or objects roughly Under-awareness of touch or pain, or touching others too often or too hard (which may seem like aggressive behavior) Taking part in unsafe activities, such as climbing too high Fatigues easily and appears unmotivated In some literature this may be call under registration. Again this can be isolated to one of the senses, including movement or body awareness. In some literature this may be call under registration. Again this can be isolated to one of the senses, including movement or body awareness.

27. The senses are the building blocks for future learning. If you don�t have a stable base the incoming sensory information is not effectively process. So it is not uncommon for individuals to who have difficulty with body awareness to be able to use the information coming in from different sources at the same time. This is sometimes called poor integration or discrimination. Which affects higher level functions such as cognition or thinking.If you don�t have a stable base the incoming sensory information is not effectively process. So it is not uncommon for individuals to who have difficulty with body awareness to be able to use the information coming in from different sources at the same time. This is sometimes called poor integration or discrimination. Which affects higher level functions such as cognition or thinking.

28. Poor Integration or discrimination Has difficulty with fine motor tasks such as handwriting, cutting, tooth brushing, clothing fasteners, or assembly tasks Trouble maintaining balance or coordinating movements for activities such as kicking, throwing, dressing, in/out of showers or tubs, negotiating stairs

29. For more detailed symptom checklists go to: http://www.kidfoundation.org/spdchecklist/ or http://www.sensory-processing-disorder.com/sensory-processing-disorder-checklist.html If you would like identify more specific symptoms and types of sensory processing disorders, here are some good resources. If you would like identify more specific symptoms and types of sensory processing disorders, here are some good resources.

30. Checklists can be helpful, but .... Ask yourself: How much does this interfere with the quality of life or ability to function? OK Now how many of you out there think I might have a Sensory Processing Disorder? There is not a specific number of symptoms to indicate they have a sensory processing disorder. Often it is the number in one specific area, or the severity of symptoms that is more indicative of SPD. OK Now how many of you out there think I might have a Sensory Processing Disorder? There is not a specific number of symptoms to indicate they have a sensory processing disorder. Often it is the number in one specific area, or the severity of symptoms that is more indicative of SPD.

31. Sensory processing dysfunction can be classified as MILD Individual can generally hold it all together while at work or school but tend to loose it when they get home or when under stress They are generally unhappy, feel different but are unable to pin point why. May tend to be compulsive and maintain strict routines May appear to be tightly wound Have a narrow range of interests/activities These individuals are likely to be experiencing SPD and may benefit from further investigation to determine if there are specific strategies that will improve function.These individuals are likely to be experiencing SPD and may benefit from further investigation to determine if there are specific strategies that will improve function.

32. It is recommended this person be evaluated, the will likely benefit from environmental adaptations, and in some cases may need treatment. It is recommended this person be evaluated, the will likely benefit from environmental adaptations, and in some cases may need treatment.

33. Sensory processing dysfunction can be classified as SEVERE This person needs the help of others to participate or complete basic self-care needs They are obviously uncomfortable for a significant portion of the day They may engage in stereotypic, aggressive or self injurious behavior. It is strongly recommended these individuals be evaluated for SPD and are more likely to require therapy along with a variety of other strategies and intervention which will be discussed later.It is strongly recommended these individuals be evaluated for SPD and are more likely to require therapy along with a variety of other strategies and intervention which will be discussed later.

34. What can you do? Report your concerns and the symptoms you observe to your personal care physician or case manager. Obtain a referral for an occupational therapy evaluation from a practitioner who has experience evaluating sensory processing disorders. 1. It is not unusual for the physician to be unaware of sensory processing disorders. It may be helpful for you to come prepared with information from a checklist and the knowledge that �Regulatory Sensory Processing Disorders� are outlined in the Diagnostic Manual of the Interdisciplinary Council on Developmental and Learning Disorders (ICDL). 2. Not all therapists have the training or experience to treat SPD. Some may specialize in infant/toddler, children or adolescent/adults and have little experience with other age groups. 3. Some questions to ask the OT prior to making the appointment for the evaluation: A) Do you accept Indiana Medicaid? B) Do you accept I/DD clients? C) Are you comfortable treating large adults with DD issues? 1. It is not unusual for the physician to be unaware of sensory processing disorders. It may be helpful for you to come prepared with information from a checklist and the knowledge that �Regulatory Sensory Processing Disorders� are outlined in the Diagnostic Manual of the Interdisciplinary Council on Developmental and Learning Disorders (ICDL). 2. Not all therapists have the training or experience to treat SPD. Some may specialize in infant/toddler, children or adolescent/adults and have little experience with other age groups. 3. Some questions to ask the OT prior to making the appointment for the evaluation: A) Do you accept Indiana Medicaid? B) Do you accept I/DD clients? C) Are you comfortable treating large adults with DD issues?

35. Diagnostic Manual for the Interdisciplinary Council on Developmental and Learning Disorders (ICDL) "Regulatory Sensory Processing Disorder" (code #200) www.icdl.com Although SPD is not in the current Diagnostic and Statistical Manual of Mental Disorders (DSM), inclusion in ICDL's diagnostic manual may help to have it recognized by more professionals. Although SPD is not in the current Diagnostic and Statistical Manual of Mental Disorders (DSM), inclusion in ICDL's diagnostic manual may help to have it recognized by more professionals.

36. Sensory Processing Evaluation should include: Interview of individual if possible, parents and/or caregivers. Observation of individual, if possible in natural setting. Informal or standardized testing of the individuals response to a variety of sensory input.

37. Be informed Review evaluation results and ask questions of therapist if you do not understand information presented. If sensory processing problems are identified and treatment is recommended�ask what things will they be doing, will you be able to observe therapy. Request suggestions that can be done at home to support therapy such as a �sensory diet.� Share information with other care providers and across settings ie. home, school, or workshop

38. What is Sensory Integration Therapy? Active Participation �Just Right Challenge� �Adaptive Response� Self Directed Because there are different types of disorders, Sensory Integrative Therapy may focus on different types of activities based on the individuals needs. Since the nervous system is struggling, therapy generally centers on the sense or senses that are having the most difficulty. It generally includes movement (vestibular) and resistive activities (proprioceptive) sometimes called �heavy work� activities. These help build those foundation for the other senses to build on. Swings, ball pits, mini trampoline, vibrators, therapy balls are commonly used. Activities that include pushing, pulling, lifting and carrying provide �heavy work�. If the individual is defensive specific treatment involving therapy brushes and joint compression may be incorporated in treatment and taught to care providers to use at home The Theory of Sensory Integration has four main components. 1.Active Participation: in the most severe cases this may mean just watching or not leaving the area or �shutdown�. 2.�Just Right Challenge�: not too hard or too easy. 3.�Adaptive Response�: responding appropriately to the activity that is present, may include some trial and error in order to get there 4. Self Directed: the individual's preferences are taken into consideration when planning treatment This last component may not be present initially but is always the goal. Realistically this takes time for the therapist to identify preference. In some cases, especially with severe cases the only sign of self direction is the person not leaving the area or shutting down.Because there are different types of disorders, Sensory Integrative Therapy may focus on different types of activities based on the individuals needs. Since the nervous system is struggling, therapy generally centers on the sense or senses that are having the most difficulty. It generally includes movement (vestibular) and resistive activities (proprioceptive) sometimes called �heavy work� activities. These help build those foundation for the other senses to build on. Swings, ball pits, mini trampoline, vibrators, therapy balls are commonly used. Activities that include pushing, pulling, lifting and carrying provide �heavy work�. If the individual is defensive specific treatment involving therapy brushes and joint compression may be incorporated in treatment and taught to care providers to use at home The Theory of Sensory Integration has four main components. 1.Active Participation: in the most severe cases this may mean just watching or not leaving the area or �shutdown�. 2.�Just Right Challenge�: not too hard or too easy. 3.�Adaptive Response�: responding appropriately to the activity that is present, may include some trial and error in order to get there 4. Self Directed: the individual's preferences are taken into consideration when planning treatment This last component may not be present initially but is always the goal. Realistically this takes time for the therapist to identify preference. In some cases, especially with severe cases the only sign of self direction is the person not leaving the area or shutting down.

39. Goals and Outcomes of Sensory Integration Therapy Improve attention to task, participation and learning Increase independence in self care tasks Decrease fear and anxiety Improve communication Improve ability to adapt to change/flexibility Increase socialization Increase self confidence Improve ability to explore choices in their environment, community integration Goals will be identified as part of the treatment plan. They are individualized but are related to the specific processing problem. For example if the person is hypersensitive to movement the goal may be to improve tolerance of different head positions. The outcome may be that they are able to tip their head back when having their hair washed or bend over to pick up their books off the floor without having an negative response to these activities. Goals will be identified as part of the treatment plan. They are individualized but are related to the specific processing problem. For example if the person is hypersensitive to movement the goal may be to improve tolerance of different head positions. The outcome may be that they are able to tip their head back when having their hair washed or bend over to pick up their books off the floor without having an negative response to these activities.

40. Consultation Services Strategies Sensory Diet Home Program In milder cases of SPD the individual may only need to incorporate specific strategies to improve their ability to function within their environment. Some examples may be to use a highlighter to increase recognition of important information, incorporating movement breaks within their day, playing background music to reduce distractions from noise while studying/working. With increased awareness to sensory preferences and practice using specific strategies to facilitate improved function, the individual generally will move these strategies from conscious to automatic� freeing up the 5% for more complex tasks. Some individuals may need specific �doses of the needed input� to maintain their ability to function. This is called a �sensory diet�.In milder cases of SPD the individual may only need to incorporate specific strategies to improve their ability to function within their environment. Some examples may be to use a highlighter to increase recognition of important information, incorporating movement breaks within their day, playing background music to reduce distractions from noise while studying/working. With increased awareness to sensory preferences and practice using specific strategies to facilitate improved function, the individual generally will move these strategies from conscious to automatic� freeing up the 5% for more complex tasks. Some individuals may need specific �doses of the needed input� to maintain their ability to function. This is called a �sensory diet�.

41. Sensory Diet vs. Sensory Stimulation For more information or examples of a sensory diet you can go to: http://www.sensorysmarts.com/diet.html http://www.sensorysmarts.com/diet.html#Sample Have any of you heard of a sensory diet? Can you give me examples? Because every nervous system is different something that may be calming for one person may be stimulating for another. Therefore a sensory diet should be individualized. It provides the type of input needed at the right times throughout the day. It will generally include the power sensations of movement and deep pressure input (proprioception), but may also have different activities well. Often there is a variety of equipment such as swings, mini tramps, balls, weighted equipment, textured items. Have any of you heard of a sensory diet? Can you give me examples? Because every nervous system is different something that may be calming for one person may be stimulating for another. Therefore a sensory diet should be individualized. It provides the type of input needed at the right times throughout the day. It will generally include the power sensations of movement and deep pressure input (proprioception), but may also have different activities well. Often there is a variety of equipment such as swings, mini tramps, balls, weighted equipment, textured items.

42. Resource for Sensory Equipment http://www.southpawenterprises.com http://www.flaghouse.com www.abilitations.com www.sensorycomfort.com The therapist may suggest other types of equipment to be used at home other than previous mentioned such as pressure vest, weighted blankets, activities to explore tactile sensation. These are good sources for these types of equipment. The therapist may suggest other types of equipment to be used at home other than previous mentioned such as pressure vest, weighted blankets, activities to explore tactile sensation. These are good sources for these types of equipment.

43. Ideas for modifying environment If easily overwhelmed by change, reduce stress by setting up structured daily routines. Involve speech therapy to help improve communication strategies. Provide a calming space when over stimulated. Establish realistic expectations and adhere to consistent guidelines for intervention. (Behavioral clinician, case manager, social worker or psychologist are good recourses). Discuss with your occupational therapist which strategies may be most helpful to the individual. Discuss with your occupational therapist which strategies may be most helpful to the individual.

44. How to modify environment for Hypersensitivity Increasing your awareness of environmental stimuli which may cause distress i.e. toilet flushing, vacuum cleaner, dishwasher, fans, bright sunlight, fluorescent lighting. Reduce the frequency or intensity of problematic stimuli. Work to develop trust by only providing interaction/input as tolerated. Again the occupational therapist may give you specific ideas but here are some general ideas.Again the occupational therapist may give you specific ideas but here are some general ideas.

45. Where can I go to learn more? American Occupational Therapy Association Sensory Integration International Websites, associations or support groups for Autism or Pervasive Development Disorders Fact sheet for this presentation Since sensory processing disorders are common with individuals who have Autism or Spectrum disorder, therefore information on SPD is often available. Since sensory processing disorders are common with individuals who have Autism or Spectrum disorder, therefore information on SPD is often available.

46. Alternate Views SPD often coexist with other conditions. It is possible for SPD to be misdiagnosed. Precautions should be taken so that any other conditions will not be overlooked. Remember you can not separate mind and body. The effects of stress on the body of a normal nervous system can present similar symptoms of SPD. Sensory Integrative Therapy often works better in combination with other supports such as speech and behavioral approaches. Although sensory integration research has been published in peer-reviewed (mostly occupational therapy) journals, most are case studies or have a small sample size. Other professionals have questioned the research design and conclusions/results of these studies. Clearly more research is needed. Cautions and disclaimer: Food intolerances, physical conditions such as cerebral palsy or genetic and behavioral disorders may have similar symptoms as those evidenced by SPD. An Interdisplinary approach can minimize the possibility of misdiagnosis. Including Parents/ Care Providers, Physicians, Educators, Speech, Physical and Occupational Case Managers, Psychologist/Social Workers and most of all THE INDIVIDUAL!Cautions and disclaimer: Food intolerances, physical conditions such as cerebral palsy or genetic and behavioral disorders may have similar symptoms as those evidenced by SPD. An Interdisplinary approach can minimize the possibility of misdiagnosis. Including Parents/ Care Providers, Physicians, Educators, Speech, Physical and Occupational Case Managers, Psychologist/Social Workers and most of all THE INDIVIDUAL!