sensory strategies in the classroom · theory of mind sk© theory of mind. what are communication...

Occupational Therapy (OT)

Practical Strategies

Presented By:

Mairéad Twohig (Occupational Therapist) and

Donna Ross (Occupational Therapist)

November 2019

Overview of Talk

Recap - What is an Autism Spectrum Disorder?

What is Occupational Therapy?

Sensory Processing & Practical Strategies

Sensory Regulation

Motor Coordination and Planning

Practical strategies that you can carry out at home.

Some information …

Autism is a lifelong

developmental difficulty

that affects how a person

communicates with, and

relates to, other people. It

also affects how they make

sense of the world around

them.

Assessment: Areas of need must be apparent in each of the three regions

SticKids © visuals used with permission. See www.stickids.com for further details regarding the program and additional resources

What are social interaction

difficulties?

Making friends

Turn taking

Eye contact

Sharing

Understanding “hidden rules”- e.g. personal space

Understanding what others are thinking and feeling –

Theory of Mind

SK©

Theory of Mind

What are communication difficulties?

Language Difficulties

Tone of voice

Volume

Body language – including gestures

Eye contact

Facial expressions

Conversation skills- e.g. starting, staying on topic,

asking and commenting on what you said, finishing the

conversation

Flexibility of thought and behaviours

Black and white thinking

Perseverance to complete a task

Focussed attention

Very interested in topic

Perfectionistic

Routines and transitions

Change

Repetitive behaviours

Repetitive play

SticKids © visuals used with permission. See www.stickids.com for further details regarding the program and additional resources

SK©

What is Occupational Therapy?

Occupational Therapy supports people in performing tasks they need to do everyday (e.g. dressing, playing, personal hygiene, using cutlery, writing, paying attention) in their different environments (Home, School, Community)

Depending on the type of challenges your child is having there are different approaches to intervention:

◦ You might pick up some OT strategies to make these tasks less

challenging for your child.

◦ Parent Training

◦ School Training/Consultation

◦ Direct Intervention

Let’s look at Sensory Processing

SK©

What are our senses?

SticKids © visuals used with permission. See www.stickids.com for further details regarding the program and additional resources.

EXERCISE: VESTIBULAR AND

PROPRIOCEPTIVE SYSTEMS IN ACTION Finger to nose eyes closed

Sequential finger touching

Balance on one leg eyes open and closed

Our Senses

touch

taste

sound

vision

smell

Balance/Movement/vestibular

Body awareness/proprioception

Interoception

What is Sensory Processing?

What is Sensory Processing?

Continuous flow of information through sensory

systems.

Informs our brain about our bodies and about our

environment.

Brain must sort, prioritise and emphasise to

understand and decide what to do.

What problems can arise with

Sensory Processing?

For some children sensory processing does not occur as it should.

The brain cannot sort out, filter, organise or integrate sensory messages.

This does not mean that the brain is damaged, but that the information from the senses is not flowing and integrating efficiently.

It is important to note that we all process information differently, some of us are

more sensitive to certain type of sensory input and some of us crave certain type

of sensory input. This is normal!!

It is only a problem if it prevents us or impairs our ability to take part in activities we need to do every day!!

Sensory Sensitivities

Some sensory systems may need lots of sensory input.

Some sensory systems can only tolerate a

small amount of sensory input.

How can you help?

SticKids © visuals used with permission. See www.stickids.com for further details regarding the program and additional resources.

SK©

Sensory Processing

What

do we

see?

Need to move in

seat

Too bright or visually distracting

Overwhelme

d by smells or seeking out smells

Sensitive to touch or seeking touch

Poor postural control

Reduced attention and concentration

Too much noise or slow to register sound

Strategies you can try for the child who is sensitive

to touch

• Allow the child to use gloves, utensils to avoid directly touching messy materials

• Allow the child to see you before you touch them.

• Consider tags and different types of clothing

• Consider queuing

• Consider shower vs. bathing

• Consider toilet

• Never force the child to participate

• Allow the child to use wipes or wash hands if they need to

• Use visual borders on the desk to highlight children’s space

• Use firm rather than light touch

• Deep pressure

Strategies to try with the child who seeks a lot of touch

•Schedule sensory breaks where the child gets touch input: rice play,

shaving foam sensory walk etc.

•Use fidgets (where, when and how?)

•Materials/objects with extra texture (spiky ball)

Sensory Processing

What

do we

see?

Need to move in

seat

Too bright or visually distracting

Overwhelme

d by smells or seeking out smells

Sensitive to touch or seeking touch

Poor postural control

Reduced attention and concentration

Too much noise or slow to register sound

Strategies you can try for the child who is sensitive to noise

or slow to register sounds

• Reduce the noise if possible

• Allow the child a breaks out of the noisy environment

• Watch your own tone and pitch when communicating with your child

• Use reduced language, give the child time to process what has been said

before repeating using the exact same language.

• Use of visuals instead

• In some cases headphones may be necessary • Use the child’s name

when addressing them

• Make sure the child sees you.

• Use deep pressure to help the child be calm

Sensory Processing

What

do we

see?

Need to move in

seat

Too bright or visually distracting

Overwhelme

d by smells or seeking out smells

Sensitive to touch or seeking touch

Poor postural control

Reduced attention and concentration

Too much noise or slow to register sound

SK© SticKids © visuals used with permission. See www.stickids.com for further details regarding the program and additional resources.

Strategies you can try for the child who is

overloaded by visual stimuli

Consider homework – how much does the child SEE that they have to do –

can you reduce this?

Reduced ‘pictures/posters’ on the walls

Use blinds if light is too bright

Highlight the important visuals for communication

Sun glasses

Sensory Processing

What

do we

see?

Need to move in

seat

Too bright or visually distracting

Overwhelmed by smells or seeking out

smells

Sensitive to touch or seeking touch

Poor postural control

Reduced attention and concentration

Too much noise or slow to register sound

Strategies you can try for the child who

appears to seek out smells constantly

• Schedule sensory breaks where the child gets smell input: make a smell bank

air fresheners, scented hand cream, scented candles etc.

• Create opportunities to get extra smell input in everyday activities: art,

cooking, make an orange air freshener, make scented playdough etc. – add

essential oils.

• Use visuals (‘rules’) to explain what is appropriate and not appropriate to

smell.

Strategies you can try for the child who is

overloaded by olfactory (smell) input

• Reduce smells in the classroom: no strong

perfumes please!

• Eat separately to other children

• Find out which smells they don’t like.

Sensory Processing

What

do we

see?

Need to move in

seat

Too bright or visually distracting

Overwhelme

d by smells or seeking out smells

Sensitive to touch or seeking touch

Poor postural control

Reduced attention and concentration

Too much noise or slow to register sound

Children who have poor postural control

(this can impact writing – consider the following in particular for

homework)

Ensure the chair is the correct size and the child can put their feet flat on the floor

Armrest? Cushion? Footrest? Slant board?

Visual cues as reminder to adjust position in chair

Sit beside wall for extra stability

Practice sitting balance on the gym ball

Sensory Processing

What do we

see?

Need to move in

seat

Too bright or visually distracting

Overwhelme

d by smells or seeking out smells

Sensitive to touch or seeking touch

Poor postural control

Reduced attention and concentration

Too much noise or slow to register sound

Scheduled or unscheduled movement breaks: gym

ball, walk, heavy muscle work (crawling, rolling,

animal walks etc)

Jobs for group

Move-n-sit or disc-o-sit cushions

Sit on gym ball for activities

Children who need to move

Additional sensory/movement break suggestions

Bounce on peanut ball, roll over ball

Weight-bearing activities: animal walks, wall push ups, chair push ups Trampoline

Deep pressure: self squeeze, hand massage, push 5’s

In school you could suggest that your child’s teacher gets him/her to hand out lunches, copies, opening windows, going to the office etc.

Movement input for teenagers

Mini trampoline

Running on the spot

Blue-tac for fidgeting

Chewing gum

Self squeeze for deep pressure

Hair bobbles, bracelets

Activities that provide enhanced proprioception

Theraband

Animal walks

Playground equipment: e.g. climbing apparatus, monkey bars

Tug of War

Household chores Gardening

Gym activities

Swimming

Cycling

Jogging

Martial Arts

Sensory Processing

What do we

see?

Need to move in

seat

Too bright or visually distracting

Overwhelme

d by smells or seeking out smells

Sensitive to touch or seeking touch

Poor postural control

Reduced attention and concentration

Too much noise or slow to register sound

Children who are distractible or have reduced concentration and attention

Look at all other possible causes: (break it down)

Is there a schedule – visual supports in place?

Has the child sufficient sensory breaks, before and during homework etc.

Anxiety around certain tasks

Poor motor planning and coordination

Dyslexia, Dyscalculia, Dysgraphia

Regulation

• Sensory-regulation is the ability to adjust or regulate the level of alertness depending on the time of the day and the stimuli presented.

•Emotional regulation is similar – but is how we regulate our emotions in response to events etc. - the psychologists will be talking a little more about this.

•Co-regulation – helping others in regulation. How do we do this?

Sensory regulation changes throughout the day … WHY?

Effects of Sensory Processing on

Children

Teaching children about their own and others

regulation

Zones of Regulation

Sensory Break Symbol

SticKids © visuals used with permission. See www.stickids.com for further details regarding the program and additional resources.

SK© SK©

SticKids sensory break activities

Independence and ADL Skills

Development of skills in dressing, showering, organisation, using cutlery, playing and leisure etc are all dependent on motor coordination and motor planning.

Many people with Autism Spectrum Disorders present with praxis difficulties, i.e. difficulties with planning and carrying out new movement tasks. Praxis comprises of three different steps:

◦ Ideation – coming up with an idea of what you want to do.

◦ Motor Planning – Figuring out how you are going to do it.

◦ Execution – Carrying out what you want to do

At your service!

Role of Parent Parents play the biggest role in a child’s life

Parent’s own knowledge

Your knowledge of your child’s needs

Sensory Passport

◦ Are all people who work with your child aware of their sensory needs?

Think about your daily routine

Practical Strategies

Mind maps – problem solving

Visuals – break task down – help with sequencing

and planning.

Language – your child’s understanding – consider

the literal child

Social stories

Backward/Forward chaining

Just Right Challenge

Visuals

Breaking down tasks

BACKWARD CHAINING AND TASK ANALYSIS

Video Example:

https://www.youtube.com/watch?v=LbBj4Tzi9CQ

Free Dressing Workbook on Backward Chaining:

http://www.sense-ability.co.za/article04.pdf

EXAMPLE OF FORWARD CHAINING

THE JUST RIGHT CHALLENGE

A just-right challenge is an activity that is just slightly above what a person is currently able to easily do.

A balance between the challenge of the task and the skills of the person.

If the challenge of a task is too high and the skills of a person are too low, frustration is usually the result.

If the challenge of a task is too low and the skills of the person are too high, boredom is usually the result.

If the challenge of the task is equal to the skills of the person, he or she will experience a state of "flow" which is a motivating, engaging, and positive experience.

General Strategies for teaching new tasks

• One goal at a time

•Child’s Goal Vs Parent goal

•Motivation – Intrinsic Vs External motivators.

•Teach skills at non-stressful times (i.e. not before school).

•When demonstrating a tasks – exaggerate – Make it obvious! Ask the

child what am I doing?

•Coach don’t do (Sit on your hands)

•Ask don’t tell

•Allow child to make mistakes

•Smart Practice

•Consider the child’s regulation level

Additional Resources

Useful companies for purchasing resources

www.thinkingtoys.ie

www.sensationalkids.ie

www.disabilityaids.ie

www.amazon.co.uk Tiger

(Mahon Point & Town)

Useful Books

Building Bridges through Sensory Integration, Second Edition [Ellen Yack,

Paula Aquilla, Shirley Sutton]

The Out-of-Sync Child [Carol Kranowitz, Lucy Jane Miller]

‘The Zones of Regulation: A Curriculum Designed to Foster Selfregulation

and Emotional Control’ by Leah M. Kuypers.

Sensational Kids: Hope and Help for Children With Sensory Processing Disorder (SPD) by Lucy Jane Miller

Can't Eat, Won't Eat: Dietary Difficulties and Autistic Spectrum Disorders by Brenda Legge

Books can be purchased online at ‘Amazon’ or at the ‘Book Depository’

Useful websites

• www.southleeasd.wordpress.com

• http://www.spdfoundation.net

• See tips on supporting children who are picky eaters here

http://www.sensory-processing-disorder.com/

• http://www.sensoryintegration.org.uk/parents-corner

• www.ncse.ie

Facebook Pages

• The Sensory Integration Network

•Sensory Play Ideas for Children