MAKING SENSE OF SENSORY PROCESSING AND SELF-

REGULATION

October 23, 2020 – Virtual Edition

BRANDON LIFT CONFERENCE

Presented by:

Karen Gillespie BSc BMR, OT Reg. (MB)

Daydra Dietrich MOT, OT Reg. (MB)

Kahoot! App

Kahoot! App – please download

Or:

https://kahoot.it/

Objectives

◼ Learn the importance of sensory processing and self-regulation

◼ Brief overview of the sensory systems

◼ Learn to recognize children with sensory processing difficulties

◼ Learn practical strategies to support students and maximize learning opportunities

◼ Top 10 tips for Sensory Friendly classrooms

2020 Goals

Safety.

Connection.

Mental Wellness.

Physical Health.

Maintain Relationships.

Emily W. King, PH.D.

Sensory Processing During A Pandemic

◼ Dr. Jody Carrington: we are all wired for connection, be kind to yourself and others – Book (2019) Kids These Days: (Re)Connecting with Those We Teach, Lead and Love.

◼ It is through connection with other people that we are much better able to handle hard things. To persist, to be resilient, to remember our why!

Dr. Jody Carrington

◼ Connection is a universal language and disconnection is the biggest problem we face today. She talks about the science behind relationships and the connections (and disconnections) that we have with our babies, our teens, our partners, and our colleagues.

◼ WE ARE WIRED TO DO HARD THINGS

◼ You can do those hard things so much easier if you’re connected to someone who can help you make sense of it all.

Sensory Integration

◼ A neurological process that organizes sensations from our environment to enable us to learn and behave effectively

◼ Helps us to interpret and organize sensory information for our use in everyday life

◼ A theory of brain/behavior relationships developed by Jean Ayres to describe neurological dysfunction (1950’s and 60’s)

◼ Sensory Integration is the basis for all behavior: “The glue that holds it all together”

Sensory Processing

➢ Input

➢ Processing

➢ Organization

➢ Output or

Response =

ACTION

Typical Development

◼ Level 1 – primary sensory systems by 2 months

◼ Level 2 – sensory-motor foundations by age 1-2

◼ Level 3 – perceptual-motor skills by age 3

◼ Level 4 – cognition/intellect and academic readiness by age 6

The “Hot System”

◼ All humans have a “hot system” and a “cool system”

◼ The “hot system” is where the fight or flight reaction comes from. It is emotional, simples, stress induced, reflexive, fast, centered in the amygdala and draws on the limbic system.

◼ It is fundamental to survival and it develops early

The “Cool System”

◼ The “cool system” is higher order thinking, complex, connected to memory and slow. It is based in the front lobe and the hippocampus and develops later.

◼ It is crucial for self-control.

◼ Source: Walter Mischel – Stanford University

3 Roles of Sensory Processing:

PROTECTIONKeeps us safeFight, Flight, Fright (Freeze)

DISCRIMINATIONTells us “What it is?”Helps us to learn about our world

SENSORY REGULATIONProvides a “Just Right” level of arousal Essential to the development of self-regulation

PROTECTIONIn a student whose protective system is over-stimulated (i.e. overwhelmed) you may see:

◼ Verbal or physical refusal, anger, rages, tantrums (fight response)

◼ Turning eyes or body away from the task at hand, nervous, anxious, panicky, running away (flight response)

◼ Shuts down, overwhelmed, not be able to speak, or move. Crying, fear (fright/freezeresponse)

Sensory RegulationSELF-REGULATION:Is the nervous system’s ability to attain, maintain, and change levels of arousal or alertness (Williams and Shellenberger, 1994).

Provides balance of arousal• focus on the meaningful aspect of a task or interaction• develop attention to task, impulse control, frustration

control and a balance of emotional reactions

The levels change depending on the needs of specific situation and activities.

Can the Student Self-Regulate?

If students are developmentally younger than 8 years old, they will need to rely on adults to supervise their self-regulation.

(1991-2011 Therapy Works)

True “Independent” self regulation does not occur until we turn 25.

Kim Barthel, OT and Neurobiologist

Every move we make,

Every response,

Every word we say,

is dependent upon what

we take in through

our senses.

Sensory Systems Overview

◼ 5 external sources of sensory information

“Outside Senses”: sight, hearing, touch, taste and smell

◼ 3 internal sources “Inside Senses”: Movement (vestibular), Body Awareness (proprioception), Interoception (internal sense of touch)

◼ Sensory integration evolves along a continuum of development throughout our lives

◼ Birth – 7 to 10 years is an important period of sensory development, as well as adolescence

Outside Sensory Systems Overview

◼ Tactile (touch)

◼ Vestibular (balance)

◼ Proprioception (body awareness)

◼ Visual (sight)

◼ Auditory (hearing)

◼ Gustatory (taste)

◼ Olfactory (smell)

Sensory Preferences

◼ All of us have sensory preferences that help us to deal with the constant stimulation we receive from our environment everyday.

◼ Our sensory systems attempt to take in and organize this information so we can function on a daily basis.

◼ Checklist activity…..do you know what your sensory preferences/needs are?

Sensory Processing Sensitivity as a category or continuum?

◼ The literature on SPS suggests that roughly 20% of the population is assumed to be highly sensitive and 80% less sensitive (Aron et al., 2012). A popular metaphor is the Orchid-Dandelion metaphor, where Dandelions reflect the majority of the population (around 80%) who are less sensitive to the influence of either positive or negative environments, whereas Orchids (the remaining 20%) are more strongly affected by environmental adversity but also flourish more in positive environments (Boyce and Ellis, 2005).

◼ That 20% of the population is highly sensitive was first proposed by the theory on SPS as an analogy to the work on infant reactivity (or behavioural inhibition), as defined by Kagan (1994b)

◼ https://www.sciencedirect.com/science/article/pii/S0149763418306250

Tactile (touch)

◼ Touch: provides information about the environment and object qualities (touch, pressure, texture, sharp, dull, heat, cold, pain)

◼ Children may be over or under-sensitive to touch, or may have problems with tactile discrimination.

Tactile – Over-sensitive

◼ Avoids touch or contact

◼ Avoids and dislikes messy play

◼ Responds negatively to textures in foods, toys, furniture

◼ Reacts excessively to minor touch (e.g. light touch, leaf touching arm)

◼ Avoids activities such as: using clay, glue, playdough, sand, water, paint

◼ Dislikes teeth brushing, hair brushing

◼ Difficulty standing in line, sitting close to others

Tactile – Under-sensitive

◼ Touches other people and objects to get information

◼ Seeks deep touch, such as bear hugs, back rubs, rough play

◼ Wants to touch surfaces that give strong feedback, such as hot, cold, rough, sharp

◼ Frequently puts things in mouth, chews collar or clothing

◼ Seems unaware of “mess” on faces or hands

◼ Difficulty manipulating small objects

◼ Delayed reaction to touch or pain

Vestibular (balance)

◼ Vestibular: provides information about where our body is in space, and whether or not we or our surroundings are moving (speed and direction).

◼ Location: inner ear – stimulated by head movements and input from other senses, especially visual

◼ Children may be over or under-sensitive to movement, gravity or changing head position.

Vestibular – Over-sensitive

◼ Over-reacts to or avoids movement activities

◼ Walks close to walls, clings to supports such as banisters, furniture

◼ Difficulty with motor planning

◼ Difficulty with visual tracking

◼ Fear and avoidance of the playground, gym, stairs, feet leaving the ground

◼ Prefers to hold head upright; disoriented after change in head position (e.g. putting on shoes)

Vestibular – Under-sensitive

◼ Seems to need constant movement (rocks, fidgets, can’t stay still)

◼ Seek out stimulating motor activities such as merry-go-rounds, swinging, likes feeling dizzy

◼ May take excessive risks (e.g. jumping from high places)

◼ May use too much pressure to pick up or hold objects (e.g. tie laces, touch a pet)

◼ Poor sitting balance in chairs

◼ Poor balance while changing body position

Proprioception

◼ Body awareness: provides information about where a certain body part is an how it is moving

◼ Location: activated by muscle and joint movements

◼ Proprioception is the unconscious awareness of body position.

◼ Children who are under-responsive to proprioceptive input may seek out additional input to increase their knowledge of where their body is in space.

Proprioception

◼ Signs:

◼ Unable to determine the amount of force to move things.

◼ Printing is too heavy or too light.

◼ Leans into objects or people.

◼ Frequently drops objects

◼ Weak grasp.

◼ Excessive clapping, crashing, banging.

Visual (sight)

◼ Vision: provides information about objects and persons. Helps us define boundaries as we move through time and space.

◼ Not referring to visual acuity

◼ May be over or under-sensitive.

Visual – Over-sensitive

◼ Disturbed by bright light or flickering indoor light

◼ Covers eyes or squints to avoid sunlight

◼ Follows any movement in the room with eyes

◼ Block field of vision with head

◼ Avoids looking directly at people or objects

Visual – Under-sensitive

◼ Seems unaware of presence of other people

◼ Unable to locate desired objects, people

◼ Loses sight of objects when they move

◼ Can’t draw or copy what he sees

◼ Has difficulty with eye-hand coordination

◼ Has difficulty tracking

Kahoot! Quiz

◼ First quiz

Carly’s Cafe

https://www.youtube.com/watch?v=KmDGvquzn2k

http://www.carlyscafe.com/index_nf.html

Signs of Sensory OVERLOAD◼ Loss of Balance / Co-ordination◼ Skin flushes / Goes Pale◼ Child is verbalizing STOP!◼ Child refuses activities◼ Racing Heartbeat◼ Stomach distress/nausea/vomiting◼ Sweating◼ Begins repeating words◼ Stimming occurs◼ Reactions range from acting out to

shutting down

Signs of Sensory OVERLOAD

◼ Distracted, hyperactive

◼ Tactile sensitivities-avoid messy activities, tags, touches and sounds may bother the child

◼ Fearful of heights and movement

◼ Decreased response to injury

◼ Slow to respond when spoken to

◼ Emotional outbursts, hitting, yelling, Crying

◼ Becomes Angry / Agitated

◼ Wants to leave room, task avoidance

◼ Difficulty with personal space

Auditory (hearing)

◼ Hearing: provides information about sounds in the environment (loud, soft, high, low, near, far).

◼ May be Over or Under sensitive to sounds.

Auditory – Over-sensitive

◼ Easily distracted by background sounds

◼ Hold hands over ears

◼ Becomes anxious in anticipation of unpleasant sounds

◼ Has difficulty looking and listening at the same time

◼ Over-reacts to quiet, everyday sounds

Auditory – Under-sensitive

◼ Does not answer to name

◼ Does not distinguish speech from other environmental sounds

◼ Seem oblivious to sounds of surrounding activities

◼ Creates constant sounds (e.g. echoing TV, sounds)

◼ Uses voice that is too loud of too soft

Gustatory (taste)

◼ Taste: provides information about different types of taste (sweet, sour, bitter, salty, spicy).

◼ Child can by Over-reactive or under-reactive.

◼ Taste concerns addressed with parents and home support

Taste – Over-reactive

◼ Eats a limited variety of foods

◼ Gags, refuses/avoids certain food

◼ Spits out foods, medications

◼ Difficulties with oral hygiene

◼ Smell-defensive: will avoid places or people with strong odours

◼ Reacts to odours that other people don’t notice

Taste – Under-reactive

◼ Licks objects or people in the environment

◼ Chews or mouths objects inappropriately

◼ Sniffs objects or people in unusual ways

◼ Wants food constantly

◼ High threshold for bad tastes

Interoception

Interoception and the Brain

• The sensory system that gives us information regarding the internal condition of our body-Kelly Mahler, 2017

• Insula- the interoception centre of the brain

• Interoceptive Awareness- ability to notice sensations and give meaning to the sensations

Insula

• Insula gathers information and sends out messages in a conscious level

• Translates the signals into a body state or emotion state

• A good working Insula correlates with good Interoceptive Awareness

Interoception• Is considered the 8th sensory system to-

visual, tactile, auditory, gustatory, olfactory, vestibular, proprioception

• Interoception allows us to “feel” internal organs and skin

• It is connected to our feelings, each emotion feels differently in the body.

• Interoception and self-regulation• Interoception is important other areas:

• Self-awareness, Problem Solving, Perspective Taking, Flexible Thinking, Intuitive Social Skills, Overall Health and Well-Being.

Interoceptive Awareness

◼ “Interoceptive Awareness: refers to the ability to

feel the inside of our body with a high degree of clarity and purpose. Good IA involves clearly sensing the signals coming from our internal organs, skin and tissues and understanding what these signals mean” (Mahler, 2017)

◼ Some people experience differences in Interoceptive Awareness

◼ Interoceptive Awareness can be improved

TED TALKDr. Sarah Garfinkel

https://www.youtube.com/watch?v=hI_gG49sV2s

Guided Meditation

Headspace

“Feeling Overwhelmed”

Sensory “red flags”

◼ Constant meltdowns and frustration

◼ Frequent inability to handle certain forms of touch, sights or sounds

◼ Constant hiding, need to move under furniture or roll on the floor

◼ Covering ears frequently

◼ Unable to transition

◼ Bumpers & crashers, seekers

*Sensory concerns become an issue when they interfere with daily participation*

Why is this important?

◼ Top Down Approach: using words to change

behavior “sit still, stop, pay attention” = less effective

◼ Bottom Up Approach: using sensation –Movement, Heavy Work, Deep Pressure, Fidget Tools, Sounds Tools, Structure, Predictability

Finding A Balance…

◼ Too High

◼ Just Right

◼ Too Low

◼ Sensory Dysregulation Can Result In: Flight, Flight, or Fright/Freeze

Where do we start?Sensory Strategies

◼ Sensory checklist, observation, implement

◼ Sensory Diet – a planned and scheduled activity program designed to meet a child’s specific sensory needs.

◼ Sensory Diets include a combination of alerting, organizing and calming activities.

◼ Help the child to learn and recognize their own sensory preferences

SENSORY DIET• Individually planned and scheduled activity program

to meet specific sensory needs• Considerations of timing, duration, and intensity of

activities. • Consists of various planned activities for short

periods throughout the day• Carry-over effect between 90-120 minutes• Activities can be part of daily routine so normalcy

and integration are maximized• Behavioral effect• May eliminate challenging and self-stimulatory

behavior• May help change sensory processing skills

Self-regulation

◼ Self-regulation is essential to the learning process (Jarvela & Jarvenoja, 2011; Zimmerman, 2008). It can help students create better learning habits and strengthen their study skills (Wolters, 2011), apply learning strategies to enhance academic outcomes (Harris, Friedlander, Sadler, Frizzelle, & Graham, 2005), monitor their performance (Harris et al., 2005), and evaluate their academic progress (De Bruin, Thiede & Camp, 2011).

◼ Teachers thus should be familiar with the factors that influence a learner’s ability to self-regulate and the strategies they can use to identify and promote self-regulated learning (SRL) in their classrooms. In addition to self-regulation, motivation can have a pivotal impact on students’ academic outcomes (Zimmerman, 2008).

Goals of a Sensory Diet are to:◼ Provide the child with predictable sensory

information which helps organize the central nervous system.

◼ Support social engagement, self-regulation, behavior organization, perceived competence, self-esteem, and self-confidence.

◼ Inhibit and/or improve modulation of sensation within daily routines and environments.

◼ Assist the child in processing a more organized response to sensory stimuli.

Top 10 Strategies

For a Sensory Friendly/Informed Classroom:

1. Visuals – reduce visual distractions, change the environment

◼ Reducing the amount of visual distraction is key to helping them maintain attention and complete classroom tasks.

◼ Desktop or tabletop partitions, privacy boards, or “offices” are sometimes all it takes to help a student to focus on their work.

Top 10 Strategies

2. Visual Supports

◼ It’s important to look at visual supports for learning as well as for regulation assistance in a classroom.

◼ When visuals are effective, they reduce the amount of verbal direction, reminders, or prompting needed. For some sensory students, these strategies could make a huge difference in supporting positive classroom behaviors and self-regulation.

◼ Visual Timers and visual calm down bottles both offer non-verbal ways of prompting transitions and behavior supports.

Sensory PathwaysRiverview School, Brandon

As Heather Keeble OT described, "a sensory path is a colourful, creative and playful way for children to build sensory pathways or connections in the brain by participating in exercises or movement patterns such as hopping, jumping, crawling, marching and spinning. A sensory path is also a great way for children to develop motor skills such as balance, hand-eye coordination and spatial awareness. The high-energy nature of many of these exercises get a child's blood pumping, helping them to sit still and focus for longer periods of time in the classroom. A sensory pathway can be a great "brain break" throughout the school day and prepare students for learning activities."

Sensory Pathways Video

http://video.isilive.ca/brandonsd/2019-09-23%20RV%20Sensory%20Video.mp4.html

Top 10 Strategies

3. Flexible/Alternative Seating

◼ Did you know that school-aged children need 4-5 hours of movement per day to meet their developing central nervous system’s sensory needs? The easiest way to allow for movement in a classroom is to offer students active seating options.

◼ “Active seating” is seating that allows for wiggling, moving, and adjusting as an alternative to the typical classroom chair.

Raylax Chair

Zuma Rocker

Hokki Stool

Top 10 Strategies

4. Movement

◼ Student-specific movement activities for individuals and/or whole classroom activities

◼ Present on: key rings, flashcards, or classroom posters can cue kids to take movement breaks to help regulate.

◼ Movement breaks – 2-3 minutes in duration, get the blood pumping and muscles moving!

◼ Movement-minded “Classroom helper jobs” like mail carrier, materials manager/paper passer, or office runner allow for movement within natural routines. Washing tables, whiteboards, chairs, floors.

Movement in the Classroom“Physical Exercise puts the brain of the learners in the optimal

position for them to learn” John Ratey, Harvard Medical school, 2008 Education Week

◼ Book: Spark: The Revolutionary New Science of Exercise and the Brain (John Ratey)

◼ Bodies are designed to move◼ Some people think best when moving◼ To deepen understanding◼ To engage diverse types of learners: Kinesthetic learners or

Sleepy learners◼ Resources: Go Noodle, Jammin’ Minute (You Tube), Just

Dance Kids, MeMoves◼ “Cravers” need organized and structured movement breaks!

Top 10 Strategies

5. Heavy Muscle Work Activities

◼ Heavy Work = actions or movements that require the muscles to work hard. Using our muscles/joints strenuously, leads to a feeling of relaxation, calm and increases body awareness.

◼ Heavy work activities are designed to provide proprioceptive input that has a calming, organizing effect on all students.

◼ Daily classroom “jobs” that incorporate heavy work activities: chair stacker, library book returner, white-board eraser, recess equipment carrier, door holder.

◼ Using body weight: walk up stairs, wall sits, chair push-ups, wall push-ups, animal walks, jumping, yoga/balance poses, resistance bands

Top 10 Strategies6. Manipulatives/Fidget tools

◼ For kinesthetic learners, or students who learn best when actively touching, moving, and manipulating materials.

◼ Tactile tools are used as fidgets to help some kids to focus. Sensory-informed classrooms can incorporate tactile manipulatives and fidgets to support a multitude of students.

◼ Consider distraction-free fidgets like pencil top fidgets, bouncy bands on chairs and desks, and set expectations with fidget rules.

◼ Examples: wrists bands, bracelets, tangles, squeeze balls, k’nex, thinking putty

https://www.google.com/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=2ahUKEwii6YDH0YLZAhUTwGMKHfzfDAUQjRx6BAgAEAY&url=https://www.teacherspayteachers.com/Product/Fidget-Rules-3444260&psig=AOvVaw07fcmzLiUrjX-Uu6F1xLBa&ust=1517502820547335

Top 10 Strategies7. Deep Pressure

◼ Weighted materials like weighted vests, weighted lap pad offer deep pressure input that has a calming and organizing effect.

◼ Weighted objects and weighted lap pads can be used for seated tabletop tasks and carpet times.

◼ Pressure from another person: bear hugs, squeezes.

◼ An object: “mat sandwich”, squished/lying on floor, beanbag chair, chill-out chair, heavy blankets, snug vest, weighted vest, etc.

◼ Lycra swings – deep pressure and rhythmical movement

Temple Grandin – Deep Pressure

https://www.youtube.com/watch?v=ZnU1uqZVqwo

Kim Barthel, OT

https://www.youtube.com/watch?v=_MbXvvIG9DQ

Top 10 Strategies

8. Oral Input

◼ Offering liquids to suck through a thick straw (i.e. water bottle with thick straw) will also require the use of mouth muscles

◼ Chewy, crunchy foods will offer proprioceptive input to the mouth/jaw

◼ For kids who need more oral input in school, alternative oral-motor/chewing tools, examples:

Calming Oral Sensory Input

◼ Chewing can provide calming oral sensory and proprioceptive input.

◼ Chewy snacks like bagels and fruit leather or even gum.

◼ Chewy pendants, bracelets, or other items to provide this calming input.

◼ Sucking against resistance (e.g. sucking a thick smoothie through a straw)

◼ Blowing (e.g. blowing a feather or pompom across a table).

Top 10 Strategies

9. Calming area

◼ Because a classroom can be a noisy, visually overwhelming, overstimulating place for a sensory student, it’s important to have a designated “quiet corner”.

◼ Could be as simple as the reading nook in the corner of the class or as complex as a teepee with a beanbag chair and headphones.

◼ Having an identified sensory deprivation area will allow your child to initiate taking a break when needed, proactively de-escalating when he feels overstimulated.

◼ Or encourage natural breaks, like: washroom break, go get a drink of water (change of environment).

A Quiet Space. . .

A quiet space can be as simple as a corner with a bean bag chair and some

pillows, a small tent or canopy made from a sheet, or even a desk with a

partition for some privacy.

A quiet space is a great way to limit auditory, visual, and other input so a

child can regroup and calm.

Top 10 Strategies

10. Auditory

◼ We’ve talked about reducing sensory stimulation with a quiet corner in the classroom, but there are times when auditory information can help sensory students identify transitions and learn new information.

◼ Familiar songs, rhymes, and music can prompt students through the routine expectations of the classroom.

◼ Predictable musical prompts, whether they are a song or an instrument like a chime, can ease transitions from preferred to non-preferred activities.

Calming Auditory Input

One of the quickest way to help kids who are overstimulated and overwhelmed is to quiet things down.

◼ Using a quiet voice to address kids and get their attention rather than raising your voice over the noise

◼ Noise Meter - to monitor sound in the classroom

Calming Auditory Input

◼ White Noise

◼ Quiet, soft calm music

◼ Noise Reducing Headphones

Strategies To Remember◼ Be a Sensory Detective

◼ Change the environment

◼ Use of meaningful visuals

◼ Reduce sensory overload (calming strategies)

◼ Plan movement breaks (alerting-body wake up activities) during transitions

Edutopia (Sensory Room)

https://www.edutopia.org/article/sensory-room-101-betty-ray

https://www.edutopia.org/video/sensory-room-helping-students-autism-focus-and-learn

Temple Grandin – learning differently

https://www.youtube.com/watch?v=YeWks6cgJ-k

SUMMARY

◼ Recognize child’s sensory preferences. Strong preferences do not automatically mean a child has a “sensory issue”.

◼ Choose one strategy and try it to see it works, before trying something else

◼ Sensory checklist

◼ Explore whole classroom sensory activities

◼ Changes to the environment can produce significant results

◼ Consult with OT

References & Resources

◼ Sensorimotor Processing Activity Plans: Constance Sheda & Patricia Ralston (1997)

◼ The Out-of-Sync Child: Carol S. Kranowitz(1998)

◼ The Out-of-Sync Child has Fun: Carol S. Kranowitz (2003)

◼ The Sensory Connection: Nancy Kashman & Janet Mora (2005)

◼ http://kimbarthel.ca/

◼ www.mahlerautism.com

References & Resources

◼ Building Bridges through Sensory Integration, 1998. Authors: Ellen Yack, Shirley Sutton & Paula Aquilla.

◼ The Sensory Profile: Authors: Julie Ermer and Winnie Dunn

◼ Sensory Integration and the child, 1979. Author: Jean Ayres.

◼ Website: www.otworks.ca

◼ Movie: The Temple Grandin Movie

◼ http://carlysvoice.com/carlyscafe/

References and Resources

• Dr. Jody Carrington, kids these days: a game plan for (re)connecting with those we teach, lead and love, 2019

QUESTIONS