Transcript Sensory Integration

Sensory Integration
What is it?
Who needs help with this?
When do I intervene?
How do I use it?
Sensory Integration
• Sensory Integration is the neurological
process that organizes sensation from
one’s own body and the environment.
Then our body can react effectively in the
environment
Sensory Integration Dysfunction
(SID)
• Dysfunction occurs when a person with an
intact nervous system, is unable to
interpret sensory information appropriately.
Thereby this dysfunction or
misinterpretation of sensory information
interferes with daily activities or
development.
Normal SI
• You walk into a
home, smell
something like
cookies cooking and
you walk to the
kitchen. (Your senses
integrated information
and allowed your
body to move in the
environment)
SI Dysfunction
• You walk into a home,
smell something like
cookies cooking and
you grab the scented
candle. (Your senses
are met and remain
focused on 1 thing.
Never occurs to you
to go in the kitchen
and look for real
cookies.)
Sensory Dysfunctions
• Modulation Dysfunction
•
Inability to process sensory input
so that you can organize yourself
for a motor or cognitive activity.
Hypersensitivity
Distractible, focus on small
movement or sounds
Hyperactive, poor coping skill
Hypo sensitivity
Oblivious to certain sounds, task
Poor personal space
Lethargic, sleepy or hypoactive
• Registration Dysfunction
– Hypersensitivity
Very definite food, clothing and
play preference
Overreacts to sounds or certain
touch
Hypo sensitivity
Clumsy, careless, rough
Daredevils, Loud voice,
Puts things in mouth, ears,
touching constantly
Oblivious to hygiene
Difficulty grasping rules,
schedules
Sensory Integration
Who needs help with this?
• Types of Sensory Defensiveness
Types of Sensory Defensiveness
Auditory Defensiveness – Sound
Tactile Defensiveness - Touch
Oral Defensiveness – Taste/Smell/Tactile
Vestibular Insecurity – Balance & Movement
Auditory Defensiveness
Student may show extreme sensitivity to common
sounds (vacuum, bell, door slam)
Frequently cover their ears to block out ‘loud’
noises
Anxious or uncomfortable in noisy environment –
may refuse or delay going into an assembly
Avoids activities that most children enjoy (recess,
birthday parties)
May focus on wrong sounds and not complete task
Auditory Defensiveness
How do I help
• Staff Intervention – assist in success
– Recognize the need to intervene
– Prepare the student for bell, fire drills (desensitize)
– Provide ear plugs or headset for assemblies (to
decrease noise)- ‘white noise’
– “Buddy system” or Hand over hand assist
– Headset to focus on task
– Music therapy (consult speech therapy)
– Provide alternate environment if possible
Tactile Defensiveness - Touch
• Student may overreact to ordinary touch
experiences (touching playdoh, being
touched by others, shirt/sock tag aversion)
• They dislike the ‘feel’ and are hesitant
• Avoids daily hygiene; inappropriate clothes
• Avoids light touch but seeks out deep
touch (hugs)
• Fidgets inappropriately (rocking, clapping,
shaking hands, rubbing same spot)
Tactile Defensiveness - Touch
• Staff Intervention – assist in success
– Recognize the need to intervene
– Provide desensitization – rice/beans box
– Hand over hand to guide and touch new thing
– Fun activities – pretend play for hygiene,
demonstration, sequence, repetition, pictures
– Crafts with various textures
– Brushing, Weighted objects
– Provide fidget toys and limits
Oral Defensiveness –
Taste/Smell/Tactile
• Student may be a ‘picky’ eater
• May gag from certain textures, taste or smells
• Avoids messy meals (does not like food items to
touch – eats items separate, unable to make a
taco)
• Dislikes brushing teeth or washing face
• Aversion to food or cleaning smells, may show
agitation
• Inappropriate tasting/mouthing non food items
Oral Defensiveness –
Taste/Smell/Tactile
• Staff Intervention – assist in success
– Recognize the need to intervene
– Work with family to identify & obtain favorite
foods, hygiene items (toothpaste, soap)
– May place food items in recognizable
container
– Introduce one food item at a time
– Avoid or modify environment – smell
– Provide chew items for self stimulation
Vestibular Insecurity – Balance &
Movement
Student may have excessive fear of falling during
ordinary movement
Dislikes swinging, riding a bike, climbing, sliding
Poor endurance/tires easy/poor muscle tone
Overall weak muscles, especially pencil grip
Walk on toes or ‘stiff’ with joints “locked”
Can not sit ‘still’ in a desk; sits on feet, head down
Poor socialization, avoids groups, poor boundaries
Vestibular Insecurity – Balance &
Movement
• Staff Intervention – assist in success
– Recognize the need to intervene
– Encourage hand over hand assist during play
time to climb, slide & ride, elicit peer assist
– Adjust writing angle, size of pencil/color
– Provide stretching, movement, ‘Yoga’ type
activity
– Utilize flexible seating &/or weighted vest;
heavy work
– “Buddy system” to play or socialize, role play
Sensory Diet – Individualized
• Individualized per student – some students are
oversensitive to touch, but under responsive to
movement
• Remains flexible and changeable with environment
• Identify ‘triggers’ to inappropriate behavior/or reaction to
sensory stimuli
• Transitions – what makes it smoother
• Identify food/clothing likes/dislikes
• How is peer interaction?
• Note any gross or fine motor problems (does student fall
or bump into things, balance problems, writing,
coordination problems
Environmental Set up
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Environment
• Limit extraneous visual material; provide written
instruction/assignments/notes
• Organize class materials with labels (colors,
words & pictures)
• Use note cards or tape number/letter line on
desk
• Use tactile manipulative
• Limit auditory distractions – prepare SID student
for scheduled drills
• Define student space with visual & tactile aide
Schedules
• Flexible but structured and organized
• Pictures or color coded (ST & OT assist)
• Encourage families to share home
schedules & changes anticipated. Notify
them of school changes
• Encourage staff to recognize student need
for flexibility in schedules --- allow space
for “melt downs”
Auditory, Sight, Smell
• Quiet Space
• Headphones
• Calm music
• Alerting music
• Highlighter strip
• Calming scents
• Alerting scents
Calming, safe space
>concentration
<overload
Low volume, 60 bps, limit/no
change tempo
Medium volume,80 bps,
frequent changes
Decreases visual stimuli,
organizes
Lavender & vanilla – calm
Peppermint & lime - alerting
Sensory Diet
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Environmental
Schedule
Auditory, Sight, Smell
Tactile – touch
Oral – Motor
Vestibular – movement & balance
Proprioception – movement & resistance
Tactile - Touch
• Deep touch – ‘hug
yourself’ shoulder press
by teacher/peer
• Textures – glue on sticks
on place in box
• Dough – hide items,
make shapes, letters
• Calming, deep pressure
• Ball bath or box of
beans/rice- hide items
• Alerting, whole body
discriminative light touch
• > focus & attention
• > discriminative touch
• Calm, propioceptive
input, strengthen hands &
fingers for handwriting
Oral Motor
• Gum – mix flavors
• Chew device
• Calming
• Deep pressure to jaw
• Water bottle –add
lemon
• Wide straw less effort
• Calming
Propioceptive input
• Facilitates
convergence of eyes
• Prepares eyes for
reading/computer
work
Vestibular- Movement & Balance
• Rocking chair, glider,
ball chair, upside
down ball
• Calming, > attention, <
fidgeting, > body
awareness,> motor
planning
• Scooter board, Barrel • Alerting, facilitates back &
upper body strength &
crawl, swinging,
stability
trampoline, rolling, net
• > Head & eye control,
swing spin
Integrates visual &
vestibular systems
Proprioception – movement & resistance
Preparatory activities
• Weighted vest, blanket, lap
pad, pencil weight
• Burrito, pillow crash
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Calming, > focus >attention, >
body awareness
Use the least amount of time for
desired result
•
Calming, deep pressure, body
awareness
•
Calming, strengthens upper
extremities, prepares hands for
handwriting
•
Calming, provides organizing
input, especially after sensory
overload
• Wall & chair push ups
• Funny face– lace your fingers
together, place hands on top
head & press down, suck in
your cheeks to make fish face
Classroom Tips
• Preferential seating
• Visual cues to secure student attention
• Have student repeat instruction prior to
beginning task
• Keep tone even and moderate pace
• Provide outline & vocabulary list
• Provide notes and let student highlight
• Sequential steps for directions.
• Define specific boundaries & rules
Handwriting Tips
• Encourage strengthening by modifying surface (vertical & horizontal)
• Small pencil for tripod grasp
• Typing/keyboarding skills may be an alternate form of writing. Start
early showing the student how to type his name
• Graph paper used to align numbers, letters
• Alternate forms of paper – large lines, colored lines, raised lines
• Directional maze tracing & cutting
• Stencils for letter formation
• Tactile letter formation (playdoh, sponge, trace shaded or dots)
• Cutting cardboard, playdoh, darkened outlined objects
References
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American Occupational Therapy Association “Answers to Questions Teachers Ask
About Sensory Integration”
www.superduperinc.com
www.henryot.com
www.lati3.com