A world of possibility

ASD & Sensory-based Interventions

Moira Pena, B.Sc. O.T., M.O.T, Reg. (Ont.) Occupational Therapist, Child Development Program

Holland Bloorview Kids Rehabilitation Hospital

ASD & Comorbidities

ASD & Sensory Processing Differences

The 8 Sensory Systems

oAuditoryoVisualoTasteoSmelloTouch

• Vestibular System sense of body position & movement

• Proprioceptive Systemjoint & muscle sense

• Interoception System sense of internal organs

Classification of Sensory Processing Disorders Patterns and Subtypes (Miller, L., J., et al., 2007)

Phenotypes within Sensory Modulation Differences (SMD)

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Impact of SPD on function and participation

“Smells like dogs, cats, deodorant, smoke and aftershave lotion are so strong to me I can't stand it, and perfume drives me nuts.”

“Music is nice but it can be overwhelming in some situations, especially when combined with loud voices, the temperature being too hot, and/or smells that are strong.”

“If I get sensory overload then I just shut down; I get what's known as fragmentation...it's weird, like being tuned into 40 TV channels.”

“Every time I am touched it hurts; it feels like fire running through my body.”

Sensory-based Interventions (SBIs)

• Sensory Processing & Occupational Therapy

• Ayres’ Sensory Integration (ASI) vs Sensory-based interventions (SBIs)

Bottom-Up Approach: Deep Touch Pressure (DTP) Interventions included in our study (Pena, M., Ng, Y., Ripat, J., & Anagnostou, E., 2017, in submission)

• Massage• Trampoline• Weighted lap-snake and weighted toys• Weighted backpack• Oral-motor tools• Weighted vest• Pressure vest• Joint compressions & brushing• Wrist weights• Ankle weights

Recommended DTP Sensory-based interventions versus their usage

Acceptability of DTP Sensory-based interventions

Acceptability of DTP Sensory-based interventions

Environmental Supports & Adaptations

Rocking Chair

Pea Pod

Top-Down Approach: Visual Supports

• Visual Schedules• First & Then• Timers• Visual Routines• Video Modeling• Reward Charts http://a2.mzstatic.com/us/r30/Pur

ple4/v4/30/cd/14/30cd14a1-679b-4edb-6c78-1d523904528a/screen480x480.jpeg

http://www.autismpluggedin.com/wp-content/uploads/2012/01/mzl.vxwlholk.320x480-75.jpg

Top-Down Approach: Social Stories (low-tech)

I take the bus to school everyday

My Daddy brings me to the bus and says “Have a good day”

I say hi to Ann and get on the bus

Daddy helps me put on my seat beltMy seatbelt helps me stay safe on the bus

When my seatbelt in on, Barb gives me my special bus toy.

I can ride the bus safely, keeping my hands and voice quiet

When I get to school I get a star for riding safely

An aide helps me get off the bus

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Top-Down Approach: Social Stories (high tech)

Ipad Apps:• Pictello• Kid in Story Book Maker• Stories2Learn

http://a4.mzstatic.com/us/r30/Purple5/v4/ca/1e/a8/ca1ea8d4-7966-60fe-8b1a-3e096a705573/screen920x920.jpeg

https://itunes.apple.com/us/app/social-stories/id507893514?mt=8

Top Down Approach: Self-Regulation

Regulation ScalesVolume MeterChannel Changer

www.sensorysmarts.comwww.spdcanada.org/https://www.spdstar.org/

www.toystoolsandtreasures.comwww.fdmt.cawww.pattersonmedical.ca

Informationon SPD

Sensory Tools

Resources

References• Case-Smith, J., Weaver, L. L., & Fristad, M. A. (2015). A systematic review of sensoryprocessing interventions for children with autism spectrum disorders. Autism, 19(2), 133-148.• Duerden, E.G., Oatley, H.K., Mak-Fan, K.M., McGrath, P.A., Taylor, M.J., Szatmari, P., & • Roberts, S.W. (2012). Risk factors associated with self-injurious behaviors in children• and adolescents with autism spectrum disorders. Journal of Autism and Developmental

• Disorders, 42(11), 2460-2470

• Reynolds, S., Glennon, T. J., Ausdearu, K., Bendixen, R.M., Kuhaneck, H., et al. (2017). Using a

multifaceted approach to working with children who have differences in sensory processing and

integration. American Journal of Occupational Therapy, 71.

• Reynolds, S., Lane, S. J., & Mullen, B. (2015). Effects of deep pressure stimulation onphysiological arousal. American Journal of Occupational Therapy, 69(3), • Tomchek, S. D., Huebner, R. A., & Dunn, W. (2014). Patterns of sensory processing in children with an autism spectrum disorder. Research in Autism Spectrum

Disorders, 8(9), 1214-1224. • Weeks, S., Boshoff, K., & Steward, H. (2012). Systematic review of the effectiveness of the Wilbarger protocol with children. Pediatric Health, Medicine and Therapeutics, 3, 79-89.

• http://www.child-autism-parent-cafe.com/social-story-to-school-and-to-home.html 57

THANK YOU.mpena@hollandbloorview.ca