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Sensory Processing, Sensory Integration, Regulatory Disorder

Sensory Processing, Sensory Integration, Regulatory Disorder. What are these and why do we care?. Toby Long, PhD, PT, FAPTA Georgetown University Center for Child and Human Development October 19, 2012. Todays Workshop.

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Sensory Processing, Sensory Integration, Regulatory Disorder

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  1. Sensory Processing, Sensory Integration, Regulatory Disorder What are these and why do we care? Toby Long, PhD, PT, FAPTA Georgetown University Center for Child and Human Development October 19, 2012

  2. Todays Workshop Today evening we will discuss the concept of sensory processing and how children (and adults) perceive, process, and use sensory input during everyday interactions. We will also discuss some of the consequences when children’s interpretation of sensory input leads to undesirable behavior. Strategies that are easy to incorporate into everyday activities and classroom routines will also be discussed.

  3. Speaker Toby Long, PhD, PT, FAPTA is an Associate Professor in the Department of Pediatrics, Georgetown University and the Training Director of the Center for Child and Human Development, University Center for Excellence in Developmental Disabilities. Dr. Long is the Director of the Graduate Certificate Program in Early Intervention offered by Georgetown University and teaches Children with Disabilities, within the undergraduate Minor in Education, Inquiry and Justice. Dr. Long is also the Director of the Comprehensive System of Personnel Development for the District of Columbia’s early intervention program, Strong Start. She is a Professor of Physical Therapy at the Krannert Graduate School of Physical Therapy at the University of Indianapolis, and Rocky Mountain University of Health Professions. Dr. Long is an internationally known speaker and consultant on service delivery to children with disabilities and special health care needs. She is the author of multiple publications including The Handbook of Pediatric Physical Therapy, Second Edition. The recipient of a variety of awards, Dr. Long is a Catherine Worthingham Fellow of the American Physical Therapy Association. She can be reached at longt@georgetown.edu

  4. Agenda • Differentiate sensory processing, sensory integration, and regulation • Discuss relationship between sensory processing/regulation and development • Discuss tools used to identify sensory processing challenges in your children • Discuss strategies that promote functional sensory processing and regulation

  5. For Now and Forever What are your hopes and dreams for the young children in your life? They have friends They are successful They are happy

  6. How do we become happy & successful with good friends ? • Opportunities to participate in community based activities • Use developmental strengths functionally • Social and emotional • Cognition • Language • Motor • Use compensations, modifications, accommodations as needed

  7. What may prevent us from becoming happy & successful?

  8. Sensory Processing, Sensory Integration, and Regulatory Disorder • Learning and healthy behavior is influenced by • How we experience sensory input from the environment • How we interpret that input • How we organize it • How we use it • How we PROCESS, INTEGRATE, REGULATE and USE sensation

  9. Processing, Integrating, Regulating allows us • Explore and play • Complete every day activities • Be available for learning • Maintain focus and attention • Manage our emotions

  10. Apply this to your life?

  11. Sensory Processing The ability of the central nervous system to receive sensory information, interpret that information, and make a behavioral response that is consistent with the sensory information • Effective Sensory Processing • leads to a response that is appropriate or well matched to the situation! • Ineffective Sensory Processing • leads to a response that is not appropriate. http://www.youtube.com/watch?v=6O6Cm0WxEZA

  12. What does recent research tells us • 2004: 1 in 20 children were affected by SPD (Ahn, Miller, Milberger, McIntosh) • 2007: Children with ASD scored significantly poorer on all aspects of Short Sensory Profile (Tomchek& Dunn, 2007) • 2009: 1 in 6 children have sensory challenges sufficient to disrupt academic, social, &/or emotional development (Ben-Sasson, Carter, Briggs-Gowen) • 2011: 2 Subtypes of SPD/SMD identified: • sensory seeking, hyperactive, impulsive, aggressive • movement sensitivity, emotionally withdrawal, and low energy/weak behavior (James, Miller, Schaaf, Nielsen, Schoen) • 2011: Sensory over responsiveness correlates with negative temperament and fear in 2 y.o.(Keuler, Schmidt, Van Hulle, Lemery-Chalfant, Goldsmith)

  13. Sensory Processing Profiles • Sensory Seeker • Sensory Avoider • Sensory Sensor • Sensory Bystander

  14. So what profile are you??? Long, 2009

  15. Ryder (Pathways Awareness Foundation) http://pathways.org/top/pathways-videos/sensory-integration-processing/

  16. So what do we know about kids and SP

  17. What do we know about kids with certain disabilities and SP?

  18. How we can we tell?

  19. IT 3: Infant Toddler Temperament Tool • Temperament: 9 common traits (handout) • Goodness of Fit: Compatibility between adult and child • Adults expectations and caregiving strategies match child’s personal style (temperament) http://www.ecmhc.org/temperament/IT3.php?infant “Participation Period”

  20. What will we learn? • IT 3 : Goodness of Fit concerns • Checklists: Child may have sensitivity to certain sense • Movement • Proprioception • Touch • Auditory • Taste • Smell • Visual • Sensory Profile: Intensity of response to sensation: under  over • How the sensitivity impacts every day expectations

  21. So what do we do??? Long, 2009

  22. Well-maybe not that • Sensory diets • By Profile • By Sense • Sensory friendly environments • Accommodations • Modifications • Routines • Especially helpful for infants and toddlers

  23. What does current research tell us • 2002: Little evidence to effectiveness of sensory-motor intervention for children with ASD (Baraneck) • 2009: Behavioral strategies more effective than SI in reducing self-injurious behavior in 9 y.o. children (Devlin, Leader, Healy) • 2010: No differences in preschool teacher assessment of estimated percentages of time on-task with SI (Bonggat, Hall) • 2011: Social responsiveness, sensory processing, functional motor skills, social emotional factors improved more in 6-12 yo children with ASD receiving SI than the fine motor only group although both groups improved (Pfeiffer, Koenig, Kinnealey, Sheppard, Henderson)

  24. Sooooooo

  25. Sensory Diets By Sense By Profile

  26. Sensory Friendly Environments De-clutter  Maintain arrangement of furniture • Unambiguous definition of spaces • Keep noise level down: radio with gentle music rather than TV or rock music • Do NOT watch TV during meals or when you want to interact • White noise can be calming  Natural lighting as much as possible  Maintain temperature between 68-72o  Greens/blues are calming; reds/pinks alerting • Keep an activity schedule posted and refer to it on a regular basis

  27. Direct Sensory-Motor Activities Incorporated into Day • Infant Position: http://www.youtube.com/watch?v=M7J3w7opdUE • Infant Massage http://www.youtube.com/watch?v=-clV2Ekn55c&feature=relmfu • Infant Interaction/Bundling http://www.youtube.com/watch?v=pA7vFgKuQdA&feature=relmfu • Preschoolers: Carol Kranowitz, The Out-of-Sync-Child

  28. Incorporating sensory input into daily activities and routines • Bath time: Scrub with washcloth or bath brush, try a variety of soaps and lotions, play on the wall with shaving cream or bathing foam, rub body with lotion after bath time (deep massage), sprinkle powder onto body and brush or rub into skin. • Meal preparation or baking: Let your child mix ingredients, especially the thick ones that will really work those muscles. Let child mix and roll dough and push flat. Allow child to help you carry pots and pans, bowls of water or ingredients (with supervision, of course). Let your child tenderize meat with the meat mallet. • Grocery shopping: Have your child push the small cart. Let your child help carry heavy groceries and help put them away. • Mealtime: Encourage eating of chewy foods and drinking out of a straw. Try having your child sit on an air cushion to allow some movement. A weighted lap blanket may be helpful as well. NO TV

  29. Some more routines… • Household chores: Allow child to help with the vacuuming or moving the furniture; help carry the laundry basket or the detergent; help digging for gardening or landscaping. • Play time:  • Reading books in a rocking chair or bean-bag chair may be calming. • Make obstacle course in the house/ yard using crawling, jumping, hopping, skipping, rolling, etc. • Incorporate sensory activities into play • Swimming, horseback riding, bowling, mini or full-size trampolines, sandboxes or big containers of beans or popcorn kernels: add small cars, shovels, cups, etc. • Errands and appointments: Before visiting dentist/hairdresser try deep massage to the head or scalp or try having your child wear a weighted hat. Try chewy foods or vibration to mouth with an electric toothbrush. Let your child wear a heavy backpack or weighted vest. • Give ample warning before any changes in routine or any unscheduled trips or errands.

  30. And more…. • Be consistent with rules and consequences • Create specific routines for troublesome times of day (bedtime or getting ready for school). • Discuss upcoming anticipated changes in routine at a point in time that is beneficial for your child. You will have to experiment with how early the child "needs to know." • Indirectly use sensory preferences for fun rewards. • For example, having your child work towards an extra trip to go bowling or horseback riding may be helpful. • Try not to restrict movement activities or sensory preferences as punishments. Your child may need that movement time, and by removing it, his or her behavior may actually become more difficult later.

  31. Caregiver Strategies You are an Important Person in the Life of an Infant or Toddler

  32. Connect With Families • Families have the most continuous and emotionally charged relationship with the child. Infants and toddlers learn what people expect of them and what they can expect of other people through early experiences with parents and other caregivers. (Day & Parlakian, 2004) • Learn about a families culture, traditions, beliefs and dreams for their child. • Share positive experiences • Affirm parents, use reflective listening

  33. “A good example has twice the value of good advice” - author unknown

  34. Provide Activities and Routines • Use routines as a time to connect with children • Maintain a predictable schedule • Plan routines around each child’s needs and abilities • Ensure time for quiet and active play • Talk, read and sing with children every day

  35. Provide Responsive Caregiving • Hold, cuddle and rock children • Respond to cues (coos, smiles, cries, etc) • Talk to infants and toddlers about their emotions • Stay close by as children interact with one another • Observe each child’s skills

  36. Provide Safe and Nurturing Learning Environments • Create a homelike environment • Have duplicates of favored toys • Display toys within reach • Allow children to have and use comfort items • Keep the room and materials safe • Make sure there are enough adults to safely care for children

  37. Application

  38. Summary • All of us perceive sensory input differently • That’s OK! • Sometimes the way we respond to sensory input get’s in the way of learning, interacting, and behaving • That’s not OK! • Strategies embedded into the daily routine are our first choice in helping kids • Some kids may need more Key Resources http://www.spdfoundation.net/whatweoffer.htm www.STARCenter.us http://out-of-sync-child.com/ www.teachingei.org www.ecmhc.org

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