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The Rollercoaster Question
How to Identify Sensory Integration Dysfunction in Children
Extreme Sensory Modulation Behaviors in Toddlers with Autism Spectrum Disorders
Written by Ben-Sasson, Cermack, Orsmond, Tager-Flusberg, Carter, Kadiek, and Dunn
American Journal of Occupational Therapy (AJOT)
September/October 2007, 61, 584-592
This study examined the incidence of extreme sensory modulation behaviors in toddlers with autism spectrum disorders (ASD) and investigated the consistency of sensory information across measures. Parent report of sensory behaviors in 101 toddlers with ASD was compared with 100 toddlers who were typically developing matched on chronological age and 99 additional infants or toddlers matched on mental age. Measures included the Infant/Toddler Sensory Profile, Infant Toddler Social Emotional Assessment, Autism Diagnostic Interview Revised, and Autism Diagnostic Observation Schedule Generic. Toddlers with ASD were most distinct from typically developing groups in their high frequency of underresponsiveness and avoiding behaviors and their low frequency of seeking. Within the toddlers with ASD, there were significant associations across sensory parent report measures, but parent report was not correlated with clinical observation. Findings point to the early onset of an extreme sensory profile in ASD. Occupational therapists need to assess multiple domains of sensory behaviors to accurately identify the needs of toddlers with ASD.
Click here - Nine page article to download as a PDF
Tactil fun in the sun
So, you have a child who hates to get messy. Maybe he is the one who chooses not to participate in the finger painting activity at school or the one who wipes his hands clean as soon as anything gets on them. Or does she choose not to walk on the grass or even play in the snow, or even requests to have all of the tags cut out from her clothing? If any of these descriptions fit your child or someone you may work with, the child may be labeled as "tactile defensive". Tactile defensiveness is a condition that describes a child who reacts negatively or with alarm to a tactile input which is generally considered harmless or non-irritating to a person with a typically developing sensory system.
To help children overcome tactile defensiveness suggestions are given to include various play activities to help increase a child's tolerance to tactile stimuli. Often these activities tend to be messy and goopy, and therefore many parents are left to pick and choose the ones suitable for home. This does not truly allow a child to become engulfed in the whole experience. That is why summer is a great time to bring all those tactile activities outside. Being outdoors to do these activities will provide some good quality playtime for those children who are tactile defensive.
Now is the time to bring out the shaving cream. Using a vinyl table cloth or tarp, allow your children to create an entire art masterpiece, or better yet, whip off the shoes and go 'ice skating' in summer. And once you are all done, use the hose for easy clean up.
This is also a great time of year to spruce up those flower beds or plant a vegetable garden. Allow your child to help dig up the dirt and begin planting. Begin with using gardening gloves, moving then to thin, medical gloves, and if you can get them to go bare handed. This will really let them get dirty while exploring the earth.
Take some time to just play in the grass. Take off their shoes and let them run! Feeling the grass with their hands, and allowing the blades to touch their skin is a great experience. Make your playtime in the grass fun with tossing or kicking a ball, log rolling, or having races, including running, hopping, crab walking, and bear walking.
Get creative with some full body painting using pudding. Not only with this provide a sticky, wet, soft tactile input to the skin, it is also very yummy to lick your fingers clean. And then enjoy a trip through the sprinkler for a fun way to clean up.
Fill a baby pool with dry media-beans, rice, sand or pasta allowing for more of a full body experience. Hide items in the pool and give your child a treasure hunt list to find the items. Placing a tablecloth under the pool will also make clean up a breeze. If you want to get really adventurous, fill the pool with cooked spaghetti allowing your child to take a 'swim'.
Any type of water play is a great activity, especially for those children who do not enjoy the bathing ritual. Provide cups and bowls of various sizes for scooping and dumping the water out. And using any type of squeeze toy also helps with fine motor strengthening.
So, now is the time to take advantage of the summer weather and the ability to be messy outside. This will be truly beneficial for the child who is tactile defensiveness. And these activities are also great and lots of fun for any child. What child doesn't love to make a mess?
Behavioral Indexes of the Efficacy of Sensory Integration Therapy
Roberts, J. E., King-Thomas, L., & Boccia, M. L. (2007). Behavioral indexes of the efficacy of sensory integration therapy. American Journal of Occupational Therapy, 61, 555-562.
CONCLUSION. Classical sensory integration therapy may be associated with improved self-regulatory behaviors.
Click here - Eight page article to download as a PDF
Validating the Diagnosis of Sensory Processing Disorders Using EEG Technology
Davies, P. L., & Gavin, W. J. (2007). Validating the diagnosis of sensory processing disorders using EEG technology. American Journal of Occupational Therapy, 61, 176-189.
CONCLUSION. These results present empirical evidence that children with SPD display unique brain processing mechanisms compared to children who are typically developing and provide external validity for the diagnosis of SPD.
Click here - Fourteen page article to download as a PDF
Collecting Data for the Sensory Processing Measure (SPM)
By Diana A. Henry, MS, OTR/L
Administrators in U.S. public school systems are increasingly requiring evidence-based interventions, based on the No Child Left Behind Act of 2001, as well as the 2004 re-authorization of the Individuals with Disabilities Education Act (IDEA). Generating and using evidence is also an essential component of the American Occupational Therapy Association's (AOTA's) Centennial Vision.
As a pediatric occupational therapy practitioner in the "trenches" in a school or a clinic, you are probably excited about contributing to and participating in research through active data collection. Although data collection is extremely rewarding, it does have some challenges. In this article I present issues to ponder so you can be successful, and contribute to evidence-based practice (EBP).
Click here - Six page article to download as a PDF
Not Too Old For Sensory Integration
By Diana A. Henry, MS, OTR/L
In 1972, when Dr. A. Jean Ayres first defined the sensory integration (SI) process as "the ability to organize sensory information for use", her research focused on identifying specific subtypes or patterns of dysfunction among children. Unfortunately, the emphasis placed on the plasticity of the young brain has been incorrectly interpreted by some to mean that individuals older than age 7 can no longer benefit fromsensory integrative intervention. As clinicians, we can now turn to a scholarly and newly published textbook, Sensory Integration. Theory and Practice (1991), and find the following:
Click here- Two page article to download as a PDF
Sensory Integration: It's Not Just For Children
"...We believe that the sensory integration framework can be a useful lens for interpreting behaviors and a guide for implementing strategies to enhance occupational performance in clients across the lifespan... This article makes a case that because humans are sensory beings and sensation is inherent in all occupations, the sensory integration framework is relevant to occupational therapy practice beyond pediatric..."
Authors: Renee Watling, PhD, OTR/L, Stefanie Bodison, MA, OTR/L, Diana A. Henry, MS, OTR/L, CWT, and Heather Miller-Kuhaneck, MS, OTR/L, BCP
Published: 12/2006 in the AOTA SI SIS Quarterly
Click here - Four page article available to download as a PDF
1. Mahoney, S. (2004).What was he thinking? Don't blame hormones. New research shows what really causes your teen's weird behavior and what to do about it. Prevention Magazine, 56, 3, 159-165 &199.
2. Butler, K. (2006). Drinking may take big toll on teen brains. Deseretnews.com.
3. Ebbeck, V., & Gibbons, S. L. (1998). The effect of a team building program on the self-conceptions of grade 6 and 7 physical education students. Journal of Sport and Exercise Physiology, 20, 300-310.
4. Pfeiffer, B., Kinnealey,M., M.,Reed, C., & Herzerberg, G. (2005). Sensory modulation and affective disorders in children and adolescents with Asperger's disorders. American Journal of Occupational Therapy, 59, 335-345.
5. Puliti, B. (2006). Standing Room Only: Children learn without chairs in the 'classroom of the future.' Advance for Physical Therapists and PT Assistants 30-31, June 5, 2006
Classroom Seating for Children With Attention Deficit Hyperactivity Disorder:
Therapy Balls Versus Chairs
Denise Lynn Schilling, Kathleen Washington,
Felix F. Billingsley, Jean Deitz
Students at a Halifax school have traded in their plastic desk chairs.
Staff have come up with a unique solution to a common classroom problem: fidgety, distracted and inattentive kids. They've traded in the plastic desk chairs for something that might surprise you -- rubber balls. View Article
From a child's point of view....
Zac attending "Tool Kit TM" presentation in
the "nest" he created for himself. April 1, 2000.
I always end up hitting people if they stand too close to me. I’m a disaster area! I can’t see them so I don’t know they’re there. I might put my elbow up and out to the side by my ear, maybe I’m scratching or I might hit them in the chin when I’m stretching.
The last time this happened, the teacher in room 11 stood at the back of my chair. I guess she was watching for mistakes or something. I didn’t have a clue she was there (hey, maybe she was spying on me. She’d made a good spy if the enemy was sitting in a chair working on a social studies paper.) Anyway, I lifted by head up to rest and PHISH– I hit her, somewhere near the stomach, a soft hit. She said "Say excuse me! but I said "Sorry". I think you should say "sorry" when you hit someone. Excuse me is just a nice way of saying "MOVE OUT OF THE WAY NOW!!" But I’m sorry is the short way of saying "I didn’t mean to hit you" and stuff like that.
In general, I’m very clumsy. I hate being clumsy– it’s annoying. Sometimes I accidently hit people I like. Or I fall on them. Sometimes I drop plates – Oh my GOSH is that every embarrassing!!" Once, when I was borrowing my dad’s sleeping bag for a camping trip at my summer camp, I was walking around in it pretending to be a big blue slug while I made trench toast with my mom. I had batter in my hands one minute – you know that batter is made out of eggs – and then I dropped it, bowl and all. The bowl broke. Batter went all over me! I dripped all over my knees and feet and splashed up my stomach. The real problem was I had Dad’s sleeping bag on my feet and knees and stomach!! I needed to leave for the camping trip in 1 hour. There wasn’t time to wash the sleeping bag so we had to run out and buy a new sleeping bag at Target, the only store that was opened that early on a Sunday.
The morale of the story is – while they say three feet is a good space to keep between normal people, five feet is more like it for us clumsy kids. You’d think people would remember I’d done all those clumsy things and stay back but they don’t. Maybe I’ll wear a shirt that says "Go away! I’m gonna blow and I don’t mean in anger I mean in energy! My body will fly all over the place and eventually hit someone and that someone could be YOU!" or maybe, instead of "E=MC2" I could write on my shirts, "E-ME2 – so WATCH OUT!"
It gets pretty funny at my house. One night my mom was putting me to bed and she said "Goodnight" and bent down to give me a goodnight kiss.
I stuck my hand up to hug her back but I accidentally punched her in the head. I reached out to say I was sorry and I poked her in the eye. We were laughing so hard and would you believe it that I head butted her in the nose! We laughed really hard then. I sometimes think there should be an announcer that follows me around saying "Embarrassing Funny Moments will be Right Back After a word from our Sponsors."
Another time I dropped a bowl of berries all over the kitchen floor within minutes of my mom finishing mopping it. If you look in our family’s photo album, you’ll see me standing there looking at a floor covered with berries and berry juice. I’m standing in the pictures with my hands on my head, my mouth dropped open properly screaming and looking down at the mess. I have the look on my face like food aliens have invaded my house. I know that at some people’s houses the mom screams "GO TO YOUR ROOM YOU LITTLE BRAT" but in my house the mom goes and gets the camera – just taking a record of my childhood.
Three pages before my pictures of the Berry Alien Invasion are some pictures of my dad, my dad who had put a little bit too much of the wrong kind of soap into the dishwasher and OOPS! it bubbled like heck. I wish we had made a video of it. I wouldn’t mind duplicating that and recording it this time and having our very own showing of "World’s Funniest Videos" in our living room. The bubbles were coming out of the dishwasher and down all the cabinets. Dad was standing in the bubbles, looking up innocently as if saying, "Oh Yeah? Nothing happened, don’t worry about a thing." He’s holding a sponge mop in the pictures but it won’t do him any good because the bubbles keep coming and there’s already a lot of them on the floor. He’s got a small sponge.
Usually, being a disaster isn’t always funny. At the time, it’s actually very embarrassing. But later, when I think about it, it’s hilarious and I can laugh. Hee hee hee hee Heh heh heh.
Zac Whitney is a 4th grader in California. He was diagnosed with NLD (None Verbal Learning Disabilities) when he was in kindergarten. He loves to write creative stores. To learn more about NLD go to www.nld.com.
Sensory Processing Disorders:
Through The Eyes Of Dysfunction
Have you ever wondered what children or adults with sensory processing disorders feel like, or have to deal with? I certainly have.
Now I would like to give you the opportunity to see SPD "through the eyes of dysfunction". This can, in turn, lead to acceptance, understanding, and avoidance of blame and judgment.
Please open your hearts and minds to the struggles individuals with sensory processing disorders go through on a daily basis.
We can see the behavioral signs of distress with too much input, or the energy of not enough input. But, what does the child/adult really go through while trying to take in and effectively process the bombardment of daily sensory input?
Stanley Greenspan, the author of "The Challenging Child" (1995) has an insightful analogy to help us understand what people experience when they can not effectively process, or interpret, sensory input.
He describes it this way:
"Imagine driving a car that isn't working well. When you step on the gas the car sometimes lurches forward and sometimes doesn't respond. When you blow the horn it sounds blaring. The brakes sometimes slow the car, but not always. The blinkers work occasionally, the steering is erratic, and the speedometer is inaccurate. You are engaged in a constant struggle to keep the car on the road, and it is difficult to concentrate on anything else."
It's no wonder children with sensory processing disorders feel out of control, exhibit a whole host of behaviors, and have difficulty concentrating and focusing at school!
Now, also imagine being a parent of one of these children. Many parents have expressed how exhausted, rejected, lost, incompetent and alone they feel in trying to live with, and understand, their child.
I challenge you to remember this beautifully painful quote the next time you encounter a child with sensory processing disorders and begin the process of awareness, understanding, and treatment to help them take control of their bodies, minds and self-esteem.
It is so very difficult for them. Let's acknowledge that and do our best to understand and help them!
Let me put this another way for you, from an adult perspective.
I once did a presentation in a conference room full of adults that worked in day care and preschool settings. I wanted them to relate to and understand the children they saw in their classrooms that struggled with sensory processing disorders.
I explained it to them this way...
· You could see obstacles in your way, but you could not make your body move the direction you wanted it to to avoid them.
· You felt like someone had given you a shot of Novocain in your backside so you couldn't feel if you were sitting in the middle of your chair and you fell off 3 times during this training.
· Your clothes felt like they were made of fiberglass.
· You tried to drink a cup of water from a paper cup, only you couldn't tell how hard to squeeze it to hold onto it. So, you squeezed it too hard and the water spilled all over you. The next time you didn't squeeze it hard enough and it fell right through your hands and onto the floor.
· Every time you tried to write with your pencil, it broke because you pushed too hard.
· The different smells in this room made you utterly nauseous.
· The humming of the lights sounded louder than my voice.
· You couldn't focus your eyes on me because everything and everyone in the room catches your attention and your eyes just go there instead.
· The lights are so bright you have to squint, then you get a pounding headache half way through the presentation
· Every time someone touches you, it feels like they are rubbing sandpaper on your skin.
· You could only sit here for 15 minutes and then you had to take a run around the building or do 20 jumping jacks so you could sit for another 10 minutes before your muscles felt like they were going to jump out of your skin.
· People's whispers sounded like they were yelling.
· The tag in the back of your shirt makes you feel as uncomfortable as you would if a spider was crawling on you and you couldn't get him off.
· You wanted to write something down but it took you at least 5 seconds to form each letter. You can see the letter in your head, but your hand will not go in the right direction to write it.
· You had to pull the car over 3 times on the ride here because the motion makes you sick.
These examples may sound extreme but for some with sensory processing disorders they are not.
At least as adults we have grown to understand ourselves and our bodies. We know what we can and can not tolerate, what does or does not feel good and most importantly, we have the coping skills and problem solving abilities to deal with it the best we know how. These children do not!
Unless we understand what is going on, help them understand their own bodies and minds, get them the right treatment and help them find the coping skills and insight, they will continue to suffer until adulthood.
Sensory processing disorders are best treated if caught before the age of 7 when the nervous system is still malleable.
It is imperative we identify and treat these children as early as possible so we can make a positive difference and get to them before...
· learning is too difficult
· self-esteem has suffered too much
· relationships never fully develop
· and they begin to isolate themselves into their own little safe and protective world.
The time is now!
The Out-of-Sync Child - Recognising and Coping with Sensory Dysfunction
Kranowitz MA - Perigee (ISBN 0-399-52386)
The Out-of-Sync Child
Has Fun - Activities for Kids with Sensory
Integration Dysfunction Carol Stock Kranowitz
MA - Perigee
Answers to Questions Teachers Ask about Sensory Integration:
Forms, Checklists, and Practical Tools for Teachers and Parents
Kranowitz MA - Perigee
Too Loud, Too Bright, Too Fast, Too Tight: What to Do If You Are
Sensory Defensive in an Overstimulating World
Building Bridges Through Sensory Integration -Therapy for Children with Autism and Other Pervasive Development Disorders (Spiral-bound)
Ellen Yack, Paula Aquilla, Shirley Sutton (2002)
The Gift of Dyslexia - Why Some of the Brightest People Can't Read and How They Can Learn
Ronald D. Davis, Eldon M. Braun
Development Coordination Disorder - Hints and Tips for the Activities of Daily Living
M. F Ball. Jessica Kingsley Publishers, London (2002)
Helping Children with Dyspraxia
M. Boon. Jessica Kingsley Publishers, London (2006)
Aspergers Syndrome and Sensory Issues
B. Smith Myles, K. Tapscott Cook, N. E Miller, L. Rinner, L.A Robbins. A.P.C. Kansas (2000)
The Goodenoughs Get in Sync: A Story for Kids about the Tough Day When Filibuster Grabbed Darwin's Rabbit's Foot and the Whole Family Ended Up in the Doghouse--An ... Introduction to Sensory Processing Disorder (Hardcover)
Rby Carol Stock Kranowitz (Author), T. J. Wylie (Illustrator)