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.