Transcript here

SENSORY PROCESSING
DISORDER IN CHILDREN
By: Meredith Adams, MOT, OTR/L
SENSORY PROCESSING:
AKA Sensory integration/ SI
 According to the Sensory Processing Foundation
(SPD) refers to the way the nervous system
receives messages from the senses and turns
them into appropriate motor and behavioral
responses.
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SENSORY PROCESSING DISORDER:
Formerly Sensory Integration Dysfunction
 A condition that exists when sensory signals
don’t get organized into appropriate responses.
 A. Jean Ayers (Pioneering OT, Neuroscientist,
PhD) described SPD as a neurological “traffic
jam” that prevents certain parts of the brain from
receiving the info needed to interpret information
correctly.
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EVER WONDER WHY YOUR CHILD DOES
THE THINGS THAT HE/SHE DOES?
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Do you wonder why they are excessive risk takers - jumping and crashing
into anything they can ?
Why they can’t do puzzles - write well - or find the coordination for riding
a bike or hitting a ball?
Why they cry or cover their ears with every loud sound - even vacuums,
toilets or hairdryers ?
Why they don’t like to be touched or can’t be touched enough?
Why they will only eat macaroni and cheese and pizza?
Why they will only wear certain clothes or need you to cut the tags out of
their shirts?
Ever wonder why you can’t seem to calm them down or get them to sleep?
Why they won’t put their hands in anything messy or use glue, Play Doh,
or play with mud?
Why they fear playground equipment or being tipped upside down?
Why crowded stores bother them so much leading to major meltdowns in
public places?
www.sensory-processing-disorder.com
PEOPLE WITH SPD:
Difficulty processing and acting upon info
received through the senses.
 Challenges performing everyday tasks
 If untreated, can cause:
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motor clumsiness
behavioral problems
anxiety
depression
school failure/issues
PREVALENCE:
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According to one study (Ahn, Miller, Milberger,
Mcintosh 2004) 1 in 20 children’s daily lives
affected by SPD.
According to another study (Ben-Sasson, Carter,
Briggs-Gowen, 2009) 1 in 6 experience sensory
symptoms significant enough to affect aspects of
everyday life functions.
SYMPTOMS OF SPD:
Ranges in severity
 Usually chronic
 Disrupts everyday life
 Can affect 1 sense (touch, sight, movement) or
multiple senses
 Over-responsiveness (clothes, physical contact,
light, sound, food, etc.)
 Under-responsiveness (little or no reaction to
stimulation even pain or hot/cold)
 Posture and motor skills affected (“floppy” babies,
clumsy children)
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SYMPTOMS OF SPD (CONT’D)
Sensory seeking (perpetual overdrive; can be
misdiagnosed with ADHD)
 Most commonly diagnosed in children
 Adults (if untreated) can lead to problems with:
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Work
Relationships
Recreation
Depression
Isolation
CAUSES:
Unknown
 Inherited/genetic
 Environmental
 Prenatal and birth complications
 Autism spectrum has higher risk
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SENSORY SYSTEMS
Tactile (touch)
 Vestibular (balance/movement/head in space)
 Proprioception (sense of joint movements/body in
space)
 Oral (chewing, etc.)
 Auditory (hearing)
 Olfactory (smell)
 Visual (seeing)
 Gustatory (taste)
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SPD AND AROUSAL SYSTEMS
Over-responsiveness/High arousal
 Sensory tools in calming manner
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linear movement on swing
ball/deep pressure
trampoline
tactile stimulation (shaving cream,
play-doh)
joint compression
heavy work/weighted vest
brushing program/ Wilbarger
SPD AND AROUSAL SYSTEMS (CONT’D)
Under-responsiveness/ Low arousal
 Sensory tools in stimulating manner
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rotary movement on swing
 ball w/ quick changes in position
 fast music
 jumping/trampoline
 vibration/vibrating toothbrush
 crunchy textures
 smells/olfactory kit (exciting smells/calming smells)
 tactile stim (shaving cream, play-doh, rice, beans,
sand)
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SPD AND AROUSAL SYSTEMS (CONT’D)
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Adaptive response following input:
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Increased eye contact
Increased talking/vocalization/interaction
Increased attention/school skills
Calmer/ better transitions
Increased functional play skills
Increased postural awareness/control
Improved motor planning
Decreased negative behaviors
Self-regulation
Importance of positive sensory experiences/low
pressure
ASSESSMENTS
Sensory Integration & Praxis Test (SIPT)(1995)
 Sensory Profile (1999)
 School Companion (2006)
 Sensory Processing Measure (SPM)(2007)
 Degangi-Berk Test of Sensory Integration (TSI)
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TREATMENT OF SPD:
Occupational therapy with SI approach
 Fun activities, challenging but successful
 Foster appropriate responses to sensation in an
active, meaningful way promoting function
 Over time, appropriate responses generalize to
the environment (home, school, community)
 Family centered/ advocacy for parent
 Teacher and other therapist’s involvement
 Listening therapy (therapeutic listening
program)
 Multi-sensory room (child-centered, low
demands, exploration of environment)
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OCCUPATIONAL THERAPY /TREATMENT
Fun, play- based intervention in a sensory-rich
environment
 Research based
 Family centered
 Addresses arousal regulation
 Increased social participation, self-regulation,
and self-esteem
 Increased postural control/motor planning using
SI strategies
 Parent identified priorities
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OCCUPATIONAL THERAPY/TREATMENT
Goal: Children with SPD to detect, regulate,
interpret and execute appropriate motor and
behavioral responses to sensations and to
perform everyday tasks in a functional manner
 Parents learn strategies for home, school, and
community
 Challenging yet successful
 Emphasis on developing automatic and
appropriate responses to sensation in active,
meaningful, and fun ways (i.e. toys, nets, ropes,
swings, shaving cream, etc.)
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SENSORY DIETS
COMBINATION THERAPY
Parent training (UMCARD, Alert program, etc.)
 Listening systems therapy
 Speech/language therapy
 DIR/floortime
 Coaching/counseling
 Social groups
 Interactive Metronome (auditory response=motor
response)
 Feeding Therapy
 ABA/Behavioral therapy
 AAC (Augmentative &Assistive Technology)
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PROPRIOCEPTIVE ACTIVITIES
Climbing, crawling, and moving such as crab
walking, wheelbarrow walking, combat crawling,
bear walking, use of tunnels
 “Heavy work”-Digging, lifting, pushing, pulling,
carrying groceries, pushing wheelbarrow
 Games with jumping, skipping, climbing, running
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(i.e. Simon says, tag, hopscotch, follow the leader, Mother
May I, jump rope, leap frog, kick ball, obstacle courses)
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Wearing a weighted vest/using weighted blanket
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Push/pull someone on scooter board/blanket or w/ ball
Trampoline activities
 “Sandwich” game/ hiding under blankets
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www.sensory-processing-disorder.com
VESTIBULAR ACTIVITIES
Two types: Calming (linear)/Excitatory (rotary)
 Swings- start with linear, can move to rotary
 Target games (bean bags) while on swings
 Pick up objects from floor while prone on swing
 Bump child with large ball while on swing
 Rocking chairs, gliders, porch swings, rocking
horse for calming input
 Balancing activities (balance beams, stand on one
foot, walk heal to toe)
 Scooter board activities
 Catch or balloon volleyball while balancing
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www.sensory-processing-disorder.com
TACTILE ACTIVITIES
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Funny foam or shaving cream
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Finding objects buried in beans or rice (uncooked)
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Fingerpainting with pudding or paint
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Towel rub down after a warm bath (firm, quick strokes).Using various
sponges, washcloths, and loofahs in the bath. Messy play in the tub where
they can immediately wash off if bothered by it
Lotion massage to extremities
Wearing spandex or lycra exercise-type clothes under regular clothes for
calming, evenly distributed deep pressure input
Vibrating toys or massagers
Sand and water tables
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Sandbox and beach sand toys
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Play-doh/ Silly Putty / Scented Play-doh
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Colored glue... sprinkle glitter on it using finger tip or shaker
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Feathers
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Brushing protocol for defensiveness
www.sensory-processing-disorder.com
SLEEP PROGRAMS/PRODUCTS
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Children and adults with sensory processing difficulties (esp.
ASD/ADHD) often have difficulty settling down for sleep and
regulating sleep/wake cycles.
New study in Pediatrics of sleep disturbances in boys with Autism
and ADHD with prolonged video-game use and TV’s/computers in
bedrooms contributes to significant sleep problems.
Products and activities to try include...
nature sound machines
white noise machines
aromatherapy machines
bubble tubes, rope lights, lava lamps etc.
relaxation cd's
weighted blankets
heavy work activities prior to bed
vibrating mattresses and vibrating pillows
unique children's sleeping bags
www.sensory-processing-disorder.com
HANDWRITING HELP
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Mazes
Handwriting Without Tears Program
Tabletop easels, chalkboards, and any upright surface
making letters with fingers on table or easel in funny
foam, shaving cream or pudding
Using raised lined paper for tactile feedback on
proper lettering heights
Puzzles, stringing beads, playing games
Using play "tweezers" or "chopsticks"
Handwriting programs to music
Pencil grips
Weighted pens and other adaptive equipment
Theraputty manipulation and games
www.sensory-processing-disorder.com
SENSORY ROOMS (HOME OR CLINIC)
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For relaxation: nature sound machines, aromatherapy
machines, and aromatherapy diffusers, soft pillows and
blankets, rope lights, bubble tubes, table fountains, and
wall fountains, bean bag chairs, massage chairs, and
massage mats, relaxing music and relaxation cd's, guided
imagery cd's, light and sound machines, lava lamps,
metronomes.
For “more”: tactile mats, tactile balls, hammocks,
suspended relax and/or swing chairs, etc. vibrating
recliners, pillows, chairs, toys and pads, interactive bubble
columns and tubes ,Fiberoptics, Liquid light projector,
bubble machines, weighted blankets,and animals, tactile
toys, whistles/blow toys, and oral motor activities/products,
mats, ball pools, cushions or chairs (vibration and music!)
suspended equipment, swings, ladders, bouncers, twirlers,
zip lines and trolley rider, rock walls, etc.
www.sensory-processing-disorder.com
CALMING ACTIVITIES FOR THE CLASSROOM FOR
AN OVERLY ACTIVE CHILD
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Use low level lighting, no fluorescent lights!
Allow the child to listen to calming music with headphones
Use a soft voice and slow down your speech and movements while talking
Allow the child to lay on the floor in a secluded area with weighted blankets, heavy pillows
or bean bag chairs on top of them during written work or reading
Push down heavily on the child's shoulders, with equal and constant pressure
Avoid rushing the child
Have the child be responsible for the heaviest work at clean up time; putting heavy books
or objects away, moving/pushing chairs in, wiping down tables etc.
Plan ahead, allow enough time between and during activities
Make the child the "teacher's assistant"; carrying books to the library, allow them extra
movement breaks with in-school errands (taking notes to the office or another teacher,
passing out papers etc.), or giving them "heavy work" chores such as sharpening pencils,
erasing and cleaning blackboards and erasers, etc.
Provide opportunities for the child to jump on a mini trampoline, bounce on a therapy ball
or sit on one instead of their chair to give them extra input
Allow the child to have quiet fidget toys, chew toys/tubing, or squish/stress balls to squeeze
while sitting and listening or during desk work
Encourage twirling, spinning, rolling and swinging during physical education or recess
Have child do "chair push ups" (raising their body off the chair with hands next to them on
their seat)
www.sensory-processing-disorder.com
ORAL MOTOR TOYS/PRODUCTS/GAMES
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Whistles
blow toys
blo pens
straws (ie. playing hockey by blowing cotton balls or
splatter painting by blowing on paint using a straw etc.)
sweet and sour candies and gum
weird and different foods
making food into toys or animals
oral massagers
textured teething rings
spoons
bubbles
chewy tubing
edible play doh
www.sensory-processing-disorder.com
SPD AND FEEDING
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Relationship between tactile and oral system
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Increased drooling/gagging with presentation of textures
Plastic food/playing in kitchen
Smells (home, therapy, olfactory kit)
Cooking with caretakers
Participation in meal times
Modeling peers/family
Visually appealing foods/ temperature preference
Lower chair if gravitationally insecure
Organizing child prior to treatment (swing/vest)
Giving choices/ ordering for self in public
Visual schedules for meal times
Food Play
Bartling, K. and Ausderau, K. (2013) To Play With Your
Food; OT Practice July 8, 2013 edition
Bartling, K. and Ausderau, K. (2013) To Play With Your
Food; OT Practice July 8, 2013 edition
RESEARCH STUDIES
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Systematic review of the research evidence examining the
effectiveness of interventions using a sensory integrative
approach for children.
AJOT.2010 May-Benson, Koomar
Twenty-seven studies systematically reviewed to identify
research literature on effectiveness of SI intervention with
SPD
Results suggest SI results in positive outcomes in
sensorimotor skills and motor planning, socialization,
attention, behavioral regulation, reading-related skills,
participation in active play, and achievement of
individualized goals.
Gross motor skills, self-esteem, and reading gains may be
sustained from 3 m.o.-2 yr.
RESOURCES
www.spdfoundation.net SPD Foundation
 www.sensory-processing-disorder.com (has a
store to buy products also)
 Autism Speaks
 AOTA
 Pathways.org
 UMCARD
 Books on SPD (The Out-of-Sync Child:
Recognizing and coping with SPD by Carol
Kranowitz)
 Parent to Parent/support groups
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References
www.spdfoundation.net
Bartling, K. and Ausderau, K. (2013) To Play With Your Food; OT
Practice July 8, 2013 edition
www.sensory-processing-disorder.com
May-Benson, TA and Koomar, JA (2010) Systematic review of the
research evidence examining the effectiveness of interventions using
a sensory integrative approach for children. American Journal of
Occupational Therapy 2010 May-June;64(3):403-14.
Questions???
Thank you!
“God created sensory processing disorder
to help offset the excessive number of
boring people on earth”
-unknown