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Sensory Processing Skills and Self-Regulation

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Sensory Processing Skills and Self-Regulation Sensory Processing Skills and Self-Regulation Abigail McKenzie, MOT, OTR/L [email protected] Objectives Brief overview of terminology Review and information on sensory systems Under Responsiveness vs. Over Responsiveness Sensory processing skills in relationship to self-regulation and function Sensory Systems How many sensory systems do we have? Sensory Systems – All 8 of them Touch (Tactile) Auditory Vision Taste (Gustatory) Smell (Olfactory) Proprioceptive – input received from our muscles and joints that tell us where we are in space. Vestibular – located in the inner ear and it coordinates your body’s movement and balance as well as movement of your eyes separate of your head (e.g. visual tracking, saccades, convergence/divergence). Interoception – Sensation relating to the physiological condition of the body. These receptors are located internally and provide a sense of what our internal organs are feeling. For example, a racing heart, hunger, thirst, etc. Sensory Systems are our “foundation” Sensory Processing “Sensory processing is a term that refers to the way our nervous system receives and interprets messages from our senses and turns them into appropriate motor and behavioral responses.” (“About SPD, 2017”) Sensory Integration “The ability of the nervous system to organize sensory input for meaningful adaptive responses.” (Ayres) “Typical” Sensory Integration Process Sensory input Adaptive Brain Response Information is combined Meaning is with given to the previously input stored info Sensory Integration Process with SPD Sensory input Maladaptive Brain response Information is combined Meaning is with given to the previously input stored info Sensory Processing Disorder “Sensory Processing Disorder (SPD), exists when sensory signals are either not detected or don't get organized into appropriate responses. Pioneering occupational therapist, educational psychologist, and neuroscientist A. Jean Ayres, PhD, likened SPD to a neurological "traffic jam" that prevents certain parts of the brain from receiving the information needed to interpret sensory information correctly. A person with SPD finds it difficult to process and act upon information received through the senses, which creates challenges in performing countless everyday tasks. Motor clumsiness, behavioral problems, anxiety, depression, school failure, and many other problems may impact those who do not have effective treatment.” (About SPD, 2017) Umbrella of Sensory Processing Disorder Sensory Modulation “Sensory modulation is a neurological function and is the organization of sensory information for on-going use. Efficient sensory modulation is the ability to effectively regulate the degree to which one is influenced by various sensory inputs.” (Northshore Pediatric Therapy, 2017) Think of modulation as the “dimmer switch” we can grade our reaction to sensory input. Who felt their socks this morning? Who noticed them all day long? Sensory Modulation Often over (e.g. fearful of movement) or under responsive (e.g. decreased auditory awareness or constantly moving) to sensory input. Poor modulation skills results in kids often being in fight, flight, or freeze. High levels of stress, anxiety, perfectionism, rigidity, etc. “Over-reactors” Umbrella of Sensory Processing Disorder Sensory Discrimination Sensory discrimination is the ability to interpret and make meaning of input from your different sensory. “A disorder of discrimination means that you have difficulty interpreting information (i.e., differentiating stimuli in the affected sensory systems).” For example: Auditory: Did she say cat, cap, or pack? Tactile: Is that a quarter or a nickel in my pocket? Visual: Where is the key that looks like this? Proprioceptive: How hard should I push this forward to move it, but not break the glass? Vestibular: Which way am I turning? What can SPD look like? What can SPD feel like? Occupational Therapist’s role with SPD “Provide intervention to help children respond more appropriately to information coming through the senses.” (Amy Johnson, OTD, OR/L, 2017). Sensory Systems – “Powerhouse” Senses Touch (Tactile) Auditory Vision Taste (Gustatory) Smell (Olfactory) Proprioceptive – input received from our muscles and joints that tell us where we are in space. Vestibular – located in the inner ear and it coordinates your body’s movement and balance as well as movement of your eyes separate of your head (e.g. visual tracking, saccades, convergence/divergence). Interoception – Sensation relating to the physiological condition of the body. These receptors are located internally and provide a sense of what our internal organs are feeling. For example, a racing heart, hunger, thirst, etc. Proprioception & Vestibular – “Powerhouses” Our proprioceptive and vestibular systems are considered our “powerhouse” senses because receiving input to these systems can last for hours. Proprioceptive: After engaging in a heavy work activity (proprioceptive) we may see benefits to the central nervous system (CNS) for up to 2 hours. Examples: DPPT (brushing), crashing, crawling, jumping, exercising, heavy work, etc. Vestibular: Input to this system can impact the CNS for up to 8 hours. For example, Swinging, Astronaut Training, riding roller coasters, etc. Auditory “Powerhouse Booster” Sense Auditory – Research indicates that “Therapeutic Listening in combination with a sensory diet appears effective in improving behaviors related to sensory processing in children with SPD and visual-motor impairments.” (Hall & Case-Smith, 2007) Therapeutic Listening (TL) – Changes are on a case to case basis. I’ve seen this work extremely well with some kids, moderately well with others, and have minimal to no effects with a few kids. Always consult with your child’s OT or SLP when considering TL. Real life experience says – music impacts your arousal level and as adults we use it as a tool for self-regulation. Umbrella of Sensory Processing Disorder Sensory Over vs. Under Responsiveness Under Responsiveness Over Responsiveness Input is not perceived by the CNS when “Drama” in response to sensory input as a present result of overactive CNS Needs more input to register that something is Difficulty “tuning out” non-important sensory happening input (easily distracted) Sensory Over vs. Under Responsiveness Sensory Over vs. Under Responsiveness Response to sensory input varies through the day and is different based on type of sensory input. For example, your child may be very under responsive to gustatory input (taste) so they may seek out foods that are crunchy, spicy, and full of flavor At the same time, your child may be over responsive to auditory input and is easily distracted by sounds that you may not even notice (i.e. the lights buzzing, someone talking in the hallway, others breathing, etc.) Real life examples – “Camping with friends” and “lights on all day until bedtime” Proprioception Information sent to the CNS from one’s muscles and joints. Helps determine where you are in space. Under Responsive Seeks crashing Falls into objects Excessive force used Clumsy/Accident prone Moves quickly and often Proprioception Kids with Autism and SPD are often under-responsive to proprioceptive input These kids may be scared of the dark because they are overly reliant on their visual system to move in space. Always want a night light Clumsier in low lighting Proprioceptive Considerations Under Responsive Provide input they are seeking throughout their day Allow oral motor proprioceptive input if this is organizing (i.e. use of a chewy, chewing gum, crunchy/chewy snacks, etc.) Allow opportunities for crashing and jumping to help create better awareness of body in space Vestibular Under Responsive Over Responsive Seeks movement constantly Fearful of feet leaving the ground (gravitational insecurity) Spins excessively Moves entire body rather than head to look towards the ground (doesn’t dissociate eyes from head to look down) Fearless Quick to get sick from movement Vestibular Considerations Linear movement (back and forth) is typically calming Rotational movement (spinning) is typically alerting Under Responsive Over Responsive Allow frequent movement breaks If the child is fearful of movement throughout the day introduce it very slowly and watch for signs of distress Vestibular Example Real life example: I have been working with a kid for 5-6 months now, previously, swinging for any amount of time resulted in him being immediately overstimulated (hysterical laughter, unsafe decisions, increased impulsivity) Now, swinging for 6-8 minutes (linear) is very calming and organizing to him Expanding tolerance of vestibular input: scooter board Initially was fearful of “feeling calm” and still fears it often – teach it is okay to feel calm Vestibular and Core Strength Vestibular input can elicit changes in muscle tone. Long sitting, straddling, prone, crawling, etc. For kids that have poor core strength and oculomotor control it may be a good idea to start prone in suspended equipment. This position works on strengthening the extensor musculature (muscles in the back), can improve bilateral upper extremity coordination and strength, and can improve oculomotor coordination and strength. Auditory Under Responsive Over Responsive Slow to respond or does not Easily distracted by noises that respond when name is called others may or may not notice and may cover ears frequently Poor or no orienting response to Startled by unexpected noises sounds
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