sensory processing disorder - pbis...

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Addressing Misguided Behavior Through Sensory

StrategiesGerry Morgan, M.S.

Early Childhood PBIS Consultant

Sensory Processing Disorder


n Affects 5-10% of typically-developing children.

n Affects 40-80% of children with another diagnosed disability

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Acknowledgements

n Early Childhood CARES Sensory Groupn Lane County NMT Study Group n Dr. Bruce Perry

& the Child Trauma Academy

Training Objectives

n To understand how the brain processes sensory information

n To discuss how sensory elements impact behavior

n To provide an overview of sensory systems and strategies

Why are we doing this?

n Sensory systems impact a child�s world:n Developmentn Focus and Learningn Emotional Regulationn Behavior

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Reflection

Think-Pair-Share:n A sensory element that evokes discomfortn A sensory element that evokes comfort

The Neurosequential Model of Therapeutics (NMT):

a model of brain processing

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Brain Development

Cortex

Limbic

MidbrainCerebellum

Brainstem

Abstract thought

Concrete Thought

Affiliation

"Attachment"

Sexual Behavior

Emotional Reactivity

"Arousal"

Appetite/Satiety

Blood Pressure

Heart Rate

Body Temperature

Sleep

Motor Regulation

Bruce D. Perry, MD, Ph.D.© www.ChildTraumaAcademy.org

Brain Processing

n Our senses filter everything we process

n Our sensory experiences create templates which guide our experiences

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Cortex

Limbic

MidbrainCerebellum

Brainstem

Cognitive

Relational

SelfRegulation

SensoryIntegration

Bruce D. Perry, MD, Ph.D.©ChristineDobson,Ph.D.,LMSW©

Impacting the Brain

Patterned, Repetitive, Sensory-Motor Activities

n Stimulate the brainn Affect foundational systemsn Create change and new templates

Cognitive/Instructive

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Neocortex

Limbic

Diencephalon

Brainstem


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Music and Movement

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Neocortex

Limbic

Diencephalon

Brainstem


Therapeutic Massage

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Neocortex

Limbic

Diencephalon

Brainstem


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ChildTrauma Web Sitewww.ChildTrauma.org

Online Education and Training Materialswww.ChildTraumaAcademy.com

www.ChildTraumaAcademy.org

Integrating Sensory & Cognitive

Impact on Children�s Behavior

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Universal / Primary Prevention:

Program-/Classroom-Wide Systems for

All Children, Families,& Staff

Targeted / Secondary Prevention:

Specialized GroupSystems for Children with At-Risk Behavior

Intensive / Tertiary Prevention:Specialized

IndividualizedSystems for Children

with High-Risk Behavior

~80% of Students

~15%

~5%

PROGRAM-WIDE POSITIVE BEHAVIOR

SUPPORT

Pyramid Model

n Nurturing and Responsive Relationshipsn High Quality Supportive Environmentsn Social Emotional Teaching Strategiesn Intensive Individualized Interventions

Function of Behavior

n To obtainn To avoidn To express emotionn Response to sensory elements

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Cortex

Limbic

MidbrainCerebellum

Brainstem

Cognitive

Relational

SelfRegulation

SensoryIntegration

Bruce D. Perry, MD, Ph.D.©ChristineDobson,Ph.D.,LMSW©

Foundation for Learning

When the child�s sensory systems are in balance, the nervous system is in an optimal state for alertness, attention and learning.

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Over-aroused State

n Active to hyper (jumpy/over excited)n Tense, on edge in appearancen Loud, excited vocalizationsn Misguided physical behaviorsn Fidgety, difficulty keeping stilln Meltdowns

Hypersensitive Child

n Tactile Defensivenessn Difficulty with touch

n Auditory Defensiven Difficulty tolerating noisy environments,

unexpected sounds, loud noisesn Movement Sensitivities

n Uncomfortable with movement, feet off the ground, posture and balance

Under-aroused State

n Overly relaxed/sleepyn Fatigued appearancen Boredom/withdrawnn Quiet, overly calmn Difficult to engage

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Just Right State

n Alert, rested, ready to learnn Not too calm or excitedn Functional tone and speed of speechn Interacts effectively with othersn Body position conducive to activity

Sensory Processing

A Childs View of Sensory Processing: Overview

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n Affects 5-10% of typically-developing children.

n Affects 40-80% of children with another diagnosed disability

Sensory Strategies

Sensory Dietn We all require a certain amount of sensory input

and movement to function.n By providing a person with correct amount and type

of input, prepares to be alert, active and ready to learn.

n Sensory diet is individualized.n Specific to the environment, activity and one�s

temperament.n Part of a normal routine.n Includes scheduled activities with child including:

n Changes in environmentn Calming strategiesn Alerting strategies

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Vision

Vision

n Function - interprets what we see, alertingn Receptors - in the eyes, retinan Visual processing includes

n Motor control, eye movements, what we visually perceive.

n Vision is used forn Alerting & orienting, finding and tracking, scanning

the environment, sustained eye contact, shifting focus, eye hand coordination, depth perception, figure ground

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Sound

Auditory

n Function - interprets what we hearn Receptors in ears, middle/inner earn Auditory processing includes the

perception of and the ability to understand sound

n Audition is used for - Sound discrimination, localization, orientation, decoding, remembering what is heard

Intervention Strategies:Calming strategies for the Over-aroused Child

n Visual - Auditoryn Soft lights, dim lights, no lightsn Minimize cluttern Block distractionsn Play soft classical music or nature soundsn Sing and speak softly

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Sensory Diet

n +: list a sound or auditory element that evokes discomfort

n -: list a sound or auditory element that evokes comfort

Taste & Smell

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Taste & Smell

n Function of gustatory/olfactory systems is for taste & smell of environment

n Receptors in tongue and nosen Used for tastes of food, smell of

foods/environmentn Smell has a powerful effect on our emotions

and evokes powerful memories


n Oral Motor Strategiesn Chewingn Suckingn Blowingn Vibration

Smell: Lavender, vanilla, sweet smells

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Intervention Strategies: Alerting Activities for the Under-aroused Child

n Oral Motor Strategiesn Crunchy snacksn Salty, sour, smoky, tart, tangyn Cold- ice, popsicles, ice watern Blowing whistles, bubbles

Smell: Citrus, savory smell

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Sensory Diet

n +: list a taste that evokes discomfortn -: list a taste that evokes comfort

Touch

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Tactile

n Function – Information gathering from objectsn Skin receptors, tactile receptors in mouthn Tactile is used for:

n Protective– �fight or flight�n pain, pressure, temperature

n Discriminative – info re: shape, size, texture n Light touch, 2 point discrimination, temperaturen Essential for coordinated manipulation

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Sensory Diet

n +: list a tactile sensory element that evokes discomfort

n -: list a tactile sensory element that evokes comfort

Proprioceptive

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Proprioception

n Function – Awareness of body and limb position in space

n Receptor – joints, ligaments & muscles/tendons

n Proprioception is used for determiningn Joint anglesn Muscle tension and amount of pressuren Rate of movement

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Touch Pressure n Hugsn Lap pad, pillow, weighted blanketn Cozy cube, box, break arean Warmthn Heavy/weighted clothingn Heavy/weight blanket, comforter, sleeping

bagn Rhythmic patting on child�s back/leg

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Sensory Diet

n +: list a proprioceptive sensory element that evokes discomfort

n -: list a proprioceptive sensory element that evokes comfort

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Vestibular

Vestibularn Function – awareness of body movement

through spacen Receptors- inner earn Vestibular is used for determining:

n Where head/body is in relation to earthn Whether body or other objects are moving or

standing stilln Helping to maintain a stable base of support

n Balancen Coordination of both sides of body

µ Input primes the entire nervous system

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n Movementn Slow, rhythmic swinging/rockingn �Heavy work�n Weight bearing activitiesn Movement opportunities throughout the day

Sensory Diet

n +: list a vestibular sensory element that evokes discomfort

n -: list a vestibular sensory element that evokes comfort

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Interaction Between Sensory Systems

n Vestibular, proprioceptive, visual & tactile inputs work together

n Interact to develop:n Body awarenessn Motor control and planningn Grading of movementn Postural stability/Balancen Emotional security

Yoga

n physical movementn holding posesn breathingn body awareness

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n Environmental Strategiesn Quiet area

n Large box with pillowsn Decreased clutter

n Be aware of the effects of screen time on behaviorn Visuals for communicationn Consistency and Structured Routines

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Messy Activities

n Coach parents about the importance of sensory activities n Send letter home explainingn Ask parents to dress children accordingly

n Set up the activity strategicallyn Reasonable expectations, explicitly taughtn Adequate supervision

n Set-up and clean-up as part of the activity

Plan for Sensory Opportunities

n Include sensory activities in the child�s educational plan

n Embed sensory elements in the everyday activities and routines

n Provide parents and other caregivers with a rationale for sensory strategies

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When Attitudes Interferen Sensory needs perceived as �misbehavior�

n Reframe the behavior as meeting a needn Teach the parent and the childn Try sensory strategies first, then re-assess

n Sensory strategies perceived as playn �Everyone�s working on something different�n Erika needs glasses to see. Trey needs a lap

pad to sit at the table

Increasing Engagement Through Choices

Visual Tools for Choices

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Help Me Get What I Need:

go for a walk turtle

stuffed animal sit on lap and be held

Increasing Engagement Through Choices

Visual Tools for Choices

Choice Wheels in MV• Provide children choices to get their needs met• Are tailored to meet the specific needs of each

child• Use pictures of each child doing the activity to

provide visual supports and make it personal to them

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Evaluation

n History – Developmental & Sensoryn Standardized tests based on parent and/or

teacher report (Sensory Profile)n Observation of child�s behavior/activity

Sensory History

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The Out-of-Synch Child

Resources

SensoryLanesensorylane.wordpress.org

Gerry’s Kidsgerryskids.com

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Contact InformationGerry Morgan541-912-9586

[email protected]

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