Better Responses through Sensory Strategies

How much sensory input is too much? The answer really depends on the child you are working with.

As adults, we all have our individual tolerance levels towards sensory input. Think of how some of us are bothered by loud music, certain smells, deep pressure touch etc., while others are not. Some of us don't like the feel of paint or dirt on our hands, some of us don't like certain food textures or tastes. Similarly, children with special needs can have heightened or hyper-sensitive sensory systems.

Some children seek sensory input and might now know how to seek it appropriately. These children  might be described as "constantly on the run", "cannot sit still" or "crashing into everything". Educators/caregivers can shape these behaviors into more socially acceptable behaviors. Sensory breaks work wonders. Allow the child to jump on a trampoline and swing on a swing for a few minutes, and this will lead to a calm and "ready learning stage". If the child is seeking sensory input orally (chewing pencils, shirt sleeve etc.), they can be given a chewy tube to chew on instead.

On the other hand, some children find it too difficult to manage all the sensory input they receive on a daily basis. They cannot stand bright lights, loud noises or too much visual stimulation. The everyday world seems too chaotic and disorganizing to them. These are children who stand in the middle of the school hallway and shut their ears, or cannot deal with being a part of a large crowd.

Below are some strategies for better responses while providing sensory input. A big thank-you to Lorrie Massa, a wonderful OT that I work with. She has truly amazing ideas and has transformed the lives of so many kids.

1. Brain function influences behavior, and behavior influences brain function. Abnormal behavior reinforces abnormal brain function.
2. Make interactions fun, for the person and you. Make yourself the source of pleasurable sensation.
3. Input to self is easier to accept than input through an object. Input by another person is hardest to accept.
4. Person must be calm and alert before being able to orient for the purpose of learning.
5. Input to one system affects the other systems as well.
6. Everything you do influences the neurons, neurochemistry and neural circuitry. Input should be given similarly to both sides of body.
7. Getting the person to do something active, like initiating or finishing an action, will get best results. Hand-over-hand usually does little but "walk a body part" through an action.
8. It's crucial to have the person participate in functional activity whenever the person is settled and able to generate an organized response. Functional activity is something the person needs to do or else someone else has to do it for the person.
9. Maintain your own arousal at an appropriate level.
10. Be alert to ANS responses, (change in facial color, sweating/clamminess, nausea/vomiting, increased/decreased respiration, drowsy or sleepy) especially those that signal trouble.
11. Let person be actively involved, give input to self, stay with input if it's helping. Give choices: ask "more?"
12. Frequent doses of input acquired as part of natural routine gets beat results. Give input where individual is not in isolated treatment environments.
13. Reinforce total communication, i.e., using everything: sign, pictures, symbols and line drawings, verbally stating words, pointing to written words, augmentative communication.
14. Adjust what you are doing anytime the person withdraws. You want the person’s nervous system to have only the most positive experience possible with you.
15. Giggling, being too emotional, grimacing, not "listening" to input, avoidance responses, over arousal, being too relaxed all these indicate you should adjust or try another strategy.
16. Take advantage of good days. That is the time to emphasize functional activity. And that is the time to help the person learn how to give him/herself helpful sensory input.
17. You can make some things happen on your own, but you can make a lot more happen faster when others support your effort. If you have limited time with a person with severe sensory needs you’ll get more accomplished if you help the person's care providers to better understand the needs and how to meet them.
18. When in doubt - don't.

Adapted by Lorrie Massa, OTR/L
From B. Hanschu, 1997

Repetitive Behaviors can be Sensory Seeking Behaviors

Very often children with Autism Spectrum Disorders (ASD) demonstrate repetitive behaviors. To the regular person, repetitive behaviors (such as hand flapping, chewing on shirt sleeve, toe walking, jumping, licking desks  etc.) might appear to be obsessive in nature. But my experience of co-treating with some wonderful Occupational therapists (OTs) has taught me, that many of these rote behaviors actually alleviate their difficulties with sensory regulation.

The brain processes information provided by the sensory systems: touch, kinesthetic, spatial awareness, sight, sound, smell, and the pull of gravity. Sensory integration refers to the manner in which the brain processes, organizes, and interprets information coming from the sensory system. Processing sensory information provides a critical foundation for later, more complex learning and behavior.

In most typically developing children, sensory processing develops during ordinary childhood activities; however, students with ASD often have a variety of sensory impairments. Typical sensory integration deficits include difficulty coordinating gross and fine motor movements, locating their bodies in space, and regulating the level of sensory input. Sensory processing problems negatively impact academic learning, social skills, behavior, and self-esteem.

Students with ASD may exhibit deficits in sensory processing in some or all of these areas:

• Sensitivity or insensitivity to sensory information

• Attention and focus

• Regulation of activity level

• Transitions between activities

• Control of impulses, behavior, and/or fear in dangerous situations

• Fine or gross motor skills, motor planning, or coordination

• Oral motor—may put objects in his/her mouth or may not be able to use a straw

• Recognition of personal space—respecting others’ personal space and/or escalated reaction to purposeful or accidental invasions of their personal space

Movement Activities that Promote Task Engagement and Focus

• Provide opportunities for rhythmic, sustained movement (jumping on a jogging trampoline, marching, or bouncing on a ball) to organize the nervous system.

• Suggest a 5 minute sensory task (swinging or rocking at recess) before seat work.

• Encourage students to hang by their arms on the monkey bars.

• Identify tasks that provide additional opportunities for movement—erasing the blackboard, washing desks, taking and/or retrieving messages.

• Provide a rocking chair in the classroom.

• Use timers for specific tasks to help with timely task completion.

Why Children with Autism need Visual Strategies?

Dedicated to World Autism Day: April 2, 2011! 

We support the Light It Up Blue Campaign on April 1 and 2, 2011!

It is critically important to understand the learning style of students so the most effective teaching can occur. Recognizing that students have different learning styles leads to the discovery that most students with autism spectrum disorders and many others with communication or behavior challenges are visual learners. That means they understand what they see better than what they hear. Yet we tend to communicate with them primarily with talking.

It is typical for teachers and parents to presume that students understand everything that is said to them. Frequently they do not. In fact, many of the behavior and social skill problems that these students demonstrate can be linked to a lack of understanding.

As we observe students, we discover that many of them demonstrate a strength in understanding visual information compared to their ability to respond to what they hear. Using visual strategies to support communication provides an effective way to improve both understanding and expressive communication.

For many students with communication challenges, the use of visually supported communication is more effective and efficient than just talking to them. Visual tools assist students in processing language, organizing their thinking, remembering information and many other skills necessary to participate effectively.

Consider this example:

Auditory information is fleeting. It is there and then it is gone. It is transient. That means it comes and then it disappears.

Social interaction requires lots of shifting . . . back and forth . . . from person to person. Effective communication requires the ability to rapidly establish attention and shift attention. We take in information and process it. Then we formulate responses appropriate for the situation. These steps need to happen quickly because social life moves and changes continually.

Our targeted students may experience difficulty accomplishing these skills at the speed necessary to participate effectively in communication interactions. They can have difficulty rapidly establishing or shifting attention. Auditory information may disappear before students have a chance to pay attention enough to take in what is being said. They may miss a lot of information. Students may be accurately interpreting only fragments of communication messages.

Using visual strategies helps. The visual cues help students to establish attention.  Visual information stays there long enough for the student to see it, take in the information and respond to it. It is non-transient. It doesn't fly away. Students can go back over and over if they need, to understand and remember.

Multi-sensory Learning

Children need movement and sensory breaks for the most effective teaching to occur. This ideology is becoming increasingly accepted in schools and other therapeutic and educational settings. Children learn best when teaching is combined with movement because muscle memory for children with special needs, especially children with autism, is better than just visual or verbal memory alone.

Here are some facts:

10% of the information we READ is retained

10% of the information we HEAR is retained

30% of the information we SEE is retained

50% of information we SEE and HEAR is retained

80% of information EXPERIENCED is retained

95% of information that is actively taught (SEE, HEAR, READ, MOVE, EXPERIENCE) is retained.

Conclusion- When something is taught in the classroom, unless it is reinforced in the real world, it will not be retained by students. Research shows that children need at least 10 passes to a new vocabulary word before they begin to internalize it. Children with special needs will need even more passes at new words/concepts. And they will learn best when these concepts are actively taught by hearing, seeing, reading AND experiencing the concept in the real world.  

Make things literal. Here is an example. The next time you are teaching about plants (leaves, stems, roots) take your students into the garden. I’ve had lessons where one classroom plants a vegetable garden in the summer. They begin by cleaning up flower beds, getting them ready, sowing seeds, watering everyday and watching seedlings grow over a few weeks to eventually grow vegetables. We’ve actually used these garden-grown vegetables to make salsa at our school’s therapeutic kitchen (which I LOVE!). The students get so much out of this activity each summer. They learn not only about the parts of a plant but how to take care of plants, what plants need to grow and where vegetables really come from. The last question (where vegetables come from) is an important one to answer for our kids in today’s world. Most children I work with will respond “from the grocery store”. 

Combining actions with words is critically important for learning words, especially verbs. For example, when teaching the word ‘run’, go out and run and not just in one context, but in many different situations- run in the gym, on the playground, in the park etc. We also know that children, especially children with autism, learn well with rhythm and body movement such as clapping, tapping. 

So, get moving, be creative and get your students to move and groove to your lessons. Let them ‘touch’  ‘feel’ and ‘experience’ the new concepts that are taught to them.

Grades: Measures of ability or disability?

Here is a video by a parent that I think all parents should watch. I'm sure you will hear many things that you might have questioned in our education system.

Is it fair that our kids, especially those with special needs, are measured on the same yardstick of 'grades' and 'percentages' in academic subjects, when their abilities and creativity shines in other areas?

  

Albert Einstein said it best. "Everybody is a genius. But if you judge a fish by its ability to climb a tree, it will live its whole life believing that it is stupid." (Albert Einstein 1879-1955)

http://www.youtube.com/watch?v=5GIS3Yc1uTM&feature=player_embedded

Questions

Asking and answering wh- questions (who, what, where, when, why) is so, so challenging for many children with language difficulties. This was a frequent query asked of me by many parents during my India visit. More strategies on that coming up on a later date….but this post is for the opposite reason.

Recently, I was asked by the mother of a 6 year old why her son asks questions that he already knows the answer to. This is a very common question among the families we work with, even families with typically developing children.

A few reasons your child may be asking the same questions over and over (and over):

• Because questions with known responses are very predictable and predictability is comforting. They are a sure way to engage someone with whom the child wants to interact and they provide a safe, familiar way of doing it. He already knows the answer so there are no big surprises- just a pleasant and reliable back and forth interaction. It’s regulating and may serve as kind of a warm up for further, more adventurous conversation.
• Formulating novel and expanded questions can be very challenging and anxiety provoking for some children. The familiar, more rehearsed ones are going to be easier to retrieve from memory. Think about when you feel nervous or under pressure to generate conversation. We all have some standard questions/responses that we rely on as well, even if it’s just as fillers until we come up with something better.
• The child may have difficulty processing novel information (especially when given a quick, hurried answer like we adults do when we’re being asked lots of questions). So, even if he is able to formulate a new question, it might lead to confusion when he gets the answer. If this is something that’s happened a few times, the emotional memory of the anxiety exprienced by the child may be enough to discourage him from taking any risks.
• Part of the reason may also be that he’s doing what he’s learned to do. Children are asked questions all the time by adults who know the answers to them. This is especially true for kids who might not talk as much or are slower to develop language. Think about how often we ask kids what color something is or what noise an animal makes, even when we clearly know they know the answer. The motivation is somewhat the same: we get the response we’re hoping for, have an enjoyable interaction, and feel good as a result.

Answering a couple of these familiar questions to help regulate a child may be a good way to start an exchange. I would suggest expanding on them in any way you can: offering a familiar response but adding more information, wondering out loud about something associated with the same thing (but not directly asking him another question because that can have the opposite effect and cause dysregulation/confusion). Turn it into a game if you can! Providing silly answers can lead to a nice back and forth and then the pressure that comes along with question/response will ease off  because the focus is on shared engagement and silliness instead. It might also help to have a replacement “warm up”- some kind of predictable, back and forth game or song that has lots of repetition.

*Adapted from the work of Laura Allison, SLP