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Sensory Processing 101 Implications of Sensory Challenges in ASD. Chris Filler Transition Coordinator Ohio Center for Autism and Low Incidence. Sensory Processing challenges can influence how students respond to: Environment People
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Sensory Processing 101 Implications of Sensory Challenges in ASD Chris Filler Transition Coordinator Ohio Center for Autism and Low Incidence
Sensory Processing challenges can influence how students respond to: • Environment • People • Instruction/Tasks/Activities • Understanding these influences leads to the selection of effective interventions
What is Your Response to…… • Cold shower • Wool clothing • Panty hose • Sweatpants • The feel of Jell-O in your mouth • The sound of birds • Bright colored walls in the bedroom • The smell of perfume • Elevators • Roller Coasters
Sensory Processes Sensory Processes include: • Sound/Auditory • Sight/Vision • Smell/Olfactory • Taste/Gustatory The Power Senses • Touch/Tactile • Vestibular • Proprioception
Research suggests that the following areas of the brain are affected in Autism which can cause change in sensory processing: • Cerebellum • Purkinje Cells • Limbic System • Hippocampus • Amygdala • Frontal Lobes • Gray and White Matter • Occipital Lobes
What is Sensory Processing? A Process by which we: 1. Take in Information 2. Interpret the Information 3. Develop a Response or Action 1
“Breakdowns” • Breakdown may occur at any point • Challenges to the “intake system” are more easily recognized • Faulty operation of the “interpretation and integration” of information may be seen as a behavioral issue • Negative consequences may only make the situation worse
Struggles to stay alert or awake Overly alert, unable to attend Delays in processing and shifting attention Cannot stay focused … attention shifts continually Sensory Processing Gone Astray OR... OR...
Sensory Processing Gone Astray Unable to touch many items, picky eaters OR... Explores the environment by touching everything
Luke, a 13 year old with AS had wandered away from his family at the beach. In attempt to find Luke, his parents paged him overhead. Luke writes….. “Coastguards, police, a pack of Brownies and every available person were all shouting my name over a loudspeaker. I didn’t hear a thing! I have a strange kind of hearing and can only concentrate on listening to things I know I am meant to. Distinguishing between background and foreground noise has always been a problem, so however loud they shouted I would have presumed that it was a background noise.” From “Freaks, Geeks, and Asperger Syndrome
Review of challenges/characteristics….. • Slow Processing - Difficulty shifting attention • Inattentive, Difficult to arouse • Does not like change or transitions - Rigid – Demands routine
Difficulty with, or seeks out, certain types of foods/textures • Smells all food before eating - smells objects • Unable to sit with anyone behind them in class • Difficulty attending from the back of the room • Explosive emotions or lack of emotions or incongruent emotional responses
Aggression to self or others • Compulsive Behaviors • Difficulty with clothing, type of clothing, and change of clothing
Perseveration on topic or activity - Fixation on sensory stimuli • Clumsy, awkward, difficulty in sports • Over or Under-reaction to pain • Unsure of group situations, cautious, or a loner 2
UNDER-RESPONDER Poor Awareness & Low Sensitivity to Stimulation. Misses Environmental Cues Slow Processing (Acts as if does not hear, misses gestures and cues, sedentary) SEEKER Heightened Awareness with Low Sensitivity to Stimulation Will Seek Out Input (Frequently and Intensively Moving, Jumping, Spinning, Touching) Summary of Processing Challenges ACTIVE AVOIDER High Awareness, with High Sensitivity and Active Responses. Will actively avoid (Searching out Escape Areas, Covering ears/eyes, Aggression to “Protect” self) OVERWHELMED Heightened awareness, High Sensitivity but lacks active response, Can become easily overwhelmed. ( Complains of things “bothering” Frequently anxious/upset, overreacts to small changes in the environment)
Seeker and Active Avoider can appear similar • Both may move frequently • Seekers are looking for the stimulation • Avoiders are attempting to escape the stimulation SEEKER Heightened Awareness with Low Sensitivity to Stimulation Will Seek Out Input (Frequently and Intensively Moving, Jumping, Spinning, Touching) ACTIVE AVOIDER High Awareness, with High Sensitivity and Active Responses. Will actively avoid (Searching out Escape Areas, Covering ears/eyes, Aggression to “Protect” self)
UNDER-RESPONDER Poor Awareness & Low Sensitivity to Stimulation. Misses Environmental Cues Slow Processing (Acts as if does not hear, misses gestures and cues, sedentary) • Under-Responder and Overwhelmed can also have some similarities • May not appear as “sensory needy” as the seeker/avoider • Overwhelmed are vigilant and will have anxiety to the environment and will resist change • Under-responders also may not respond to environmental cues, however due to lack of awareness and not vigilance OVERWHELMED Heightened awareness, High Sensitivity but lacks active response, Can become easily overwhelmed. ( Complains of things “bothering” Frequently anxious/upset, overreacts to small changes in the environment)
UNDER-RESPONDER Poor Awareness & Low Sensitivity to Stimulation. Misses Environmental Cues Slow Processing (Acts as if does not hear, misses gestures and cues, sedentary) SEEKER Heightened Awareness with Low Sensitivity to Stimulation Will Seek Out Input (Frequently and Intensively Moving, Jumping, Spinning, Touching) Summary of Processing Challenges ACTIVE AVOIDER High Awareness, with High Sensitivity and Active Responses. Will actively avoid (Searching out Escape Areas, Covering ears/eyes, Aggression to “Protect” self) OVERWHELMED Heightened awareness, High Sensitivity but lacks active response, Can become easily overwhelmed. ( Complains of things “bothering” Frequently anxious/upset, overreacts to small changes in the environment)
The "Sensory Diet" So What Can We Do?
The “Sensory Diet” includes…. • PROVIDING SENSORY EXPERIENCES • A combination of sensory experiences needed by a person to adaptively interact with the environment (“make it through the day”). • MAKING ENVIRONMENTAL MODIFICATIONS • Modification and organization of the environment in order to decrease stress on a fragile sensory system.
Those with sensory processing challenges • May not be able to filter and focus • May attempt to adjust in a maladaptive way (Ex: Escalation of Mood, Shutting Down) • Will require a “sensory diet” enriched with unique sensations and experiences
Creating The Sensory D.I.E.T. D …..Do an Informal Assessment I …..Individualize E …..Environmental Supports T …..The Power Senses
Do an Informal Assessment Assess the Environment and the Individual’s response to a variety of sensory experiences • Seeker? • Active Avoider? • Under-Responder? • Overwhelmed
Individualize the Sensory Diet What has worked for one person may not work at all for someone else!
UNDER-RESPONDER Increase the use of visual supports and routines. Structure the environment. Time to respond Careful encouragement to try new experiences • SEEKER • Provide sensory • experiences frequently & • proactively • May need to limit • excitatory experiences Considerations for the Sensory Diet • ACTIVE AVOIDER • Modify the environment • to reduce the need • to escape • Gentle introduction to • new experiences OVERWHELMED Control the environment Limit stimulation Limit change but prepare for changes when they need to occur.
EnvironmentalSupports • Other People • Organization • Predictable, Structured, Consistent Environment • Task or Curriculum • Visual Supports • Escape Environments
The Power Senses • Vestibular • Movement • Proprioception • Input through joints and muscles • Tactile • Deep Pressure Touch
Why Focus on The Power Senses?
To“fill the sensory bucket” quickly use the Power Senses • Three Power Senses will provide: • more input • more quickly • to make changes that are more rapid Sensory Bucket Based on Work of Bonnie Hanshu www.sensoryprocessing.com
Proactively Schedule Sensory Activities • Use the Power Sensesthroughout the day in order to help a person alert, attend, act, and react • Activities should be non-contingent on behavior! • At times, additional activities or input may be needed based on the behaviors observed
Proprioceptive System Vestibular System The Power Senses Tactile System
The Power Senses Tactile System
Two Tactile Systems Protective Discriminative
Tactile System • Pertains to the sense of touch • Alerts to danger • Gives body boundaries • Helps provide a basis for body image
Protective System • Activates “Fight, Fright, or Flight” • Born with this system- “Primal” • Stimulated by light touch, pain, temperature • Processed through the emotional, excitatory portion of the limbic system • NOT a cognitive response
DiscriminativePressure Touch • Deep touch/pressure, and vibration • Activates Parasympathetic System • Calms and organizes • Allows for more cognitive response • Helps us learn and think
Dysfunction of the Tactile System • Distractibility • Hyperactivity • Over/Under Sensitivity • Hyper-vigilant • Inappropriate pain sensation • Avoids getting hands dirty • Difficulties with clothing/textures • Avoids whole hand • Disorganized when touched • Intolerant of wearing glasses/hearing aide • Difficulty with Social Space
Tactile Defensiveness is when… - Sensitive to light touch • Touch causes difficulty organizing behavior and concentration • Touch causes negative emotional responses • Can become aggressive, if feeling threatened or stressed
Interventions for Tactile Defensiveness • Brushing Protocols • Wilbarger Protocol • PRR Brushing over arms, legs, back with a soft brush , followed by joint compressions • Caution • A brushing protocol should only be implemented after an assessment and training by a qualified professional
Environmental Supports • Access to an escape/private area • Caution with placement. Student may want to sit where no one is behind him • Some feel secure with boundaries that keep others at a distance….. • Others need space in order to make a “quick escape”
Other Tactile Supports Heavy Blankets, Pillows, Lap Pads Pencil Grips Fidget Items
Choose carefully….. Seeker may want this..... ....but need this to avoid getting too "high"... Avoider Overwhelmed Under-Responsive Or Some can alert and excite (light touch) instead of cognitive calming responses
Other Tactile Supports • Consider the type of clothing and the way it fits • Tight? • Loose? • Fabric? • Swimming/Water Play • Body Sock Remove tags from clothing