sensory processing handouts

3/26/2009

1

Winnie Dunn, PhD, OTR, FAOTA

Professor and Chair

Department of Occupational Therapy Education

University of Kansas

Copyright © 2009 by Winnie Dunn, PhD, OTR, FAOTA. Used with permission.

LEARNING OBJECTIVES Delineate the core concepts of sensory

processing to others

Recognize how sensory processing concepts can be applied in everyday life situations

Recognize the occupational therapist’s role as information broker in the therapeutic process

Select appropriate evidence to support practice decisions

Recognize how to integrate sensory processing insights into school and home environments

2


Lessons in This Program

Core Concepts of Sensory Processing

Explaining Sensory Processing Concepts to

Others

Assessment and Interpretation of Sensory

Processing Patterns

Evidence-Based Intervention Planning

Applications to School Practice

Directions for the Future

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I am the author or coauthor of the Sensory Profile measures

discussed in this lesson; they are published by Pearson, Inc.

I am the author of the book Living Sensationally: Understanding Your

Senses, which is referenced in this lesson; it is published by Jessica

Kingsley Publishers.


• Dunn’s (1997) Model of Sensory Processing guides our thinking.

• Sensory processing reflects nervous system activity.

• Sensory processing patterns apply to everyone.

• Sensory processing concepts can be situated with other approaches.

5


Dunn’s (1997) Model of Sensory

Processing

Responsiveness/

Self-Regulation Strategies

Thresholds/

Reactivity

Passive Active

High

Registration Seeking

Low

Sensitivity Avoiding6

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3


Dunn’s Model of Sensory

Processing

Responsiveness/


Thresholds/

Reactivity

Passive Active

High


Low



Dunn’s Model of Sensory

Processing

Responsiveness/


Thresholds/

Reactivity

Passive Active

High


Low



Sensory processing reflects

nervous system activity.(Brown, Tollefson, Dunn, Cromwell, & Filion, 2001)

Responsivity/ habituation

Sensitivity: high/high

Avoiding: high/low

Registration: low/low

Seeking: low/high

0

5

10

15

20

25

Sen

sit

ivit

y

Avo

id

Reg

iste

r

Seek

Respond

Habituate

9

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4


Sensory processing reflects

nervous system activity. McIntosh, Miller, Shyu, & Dunn, 1999)

00.5

11.5

22.5

33.5

44.5

5

Tac s

ens

Taste

/sm

Mvm

t sen

s

Under

/see

k

Aud fi

lt

Low e

nergy

Vis

/aud s

ens

SHORT SENSORY PROFILE

Normal EDR

Abnormal EDR

10


MEG Brain Imaging Data18-year-old with

Asperger syndrome

Definite difference:

Sensory sensitivity

Sensation avoiding

Dunn, Popescu, & Gustafson, Study currently underway at University

of Kansas Hoglund Brain Imaging Center

11


Seeking High ability to

generate ideas and responses

Notices and enjoys all the activity in the environment

May be fidgety, excitable, continuously engaging

Responsiveness/


Thresholds/

Reactivity

Passive Active

High


Low

Sensitivity Avoiding

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Avoiding

High ability to

design and

implement structure

Enjoys routines

May be reliant on

rituals, rigid

Responsiveness/


Thresholds/

Reactivity

Passive Active

High


Low


13


SensitivityHigh ability to

notice, vigilant

Particular about task completion

May seem like a “complainer,” distractible

Responsiveness/


Thresholds/

ReactivityPassive Active

High


Low


14


Registration High ability to focus

on something

Easygoing

Unaffected by varying environments

May seem uninterested, apathetic, self-absorbed

Responsiveness/


Thresholds/

ReactivityPassive Active

High


Low


15

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6

Sensory processing patterns

are not unitary constructs.

Sensory processing patterns apply to

everyone, not just people with

disabilities.

Everyone has some amount of each

sensory pattern.

Contexts and activities provide unique

sensory experiences.

Copyright © 2009 by Winnie Dunn, PhD, OTR, FAOTA. Used with permission. 16


Example of Sensory PatternAVOIDER for

sounds in

hallway

SEEKER for food

tastes, spices,

variety

BYSTANDER who doesn’t notice

disarray in home

SENSOR for clothing textures

and weight of items

DECORATING

YOUR HOME

WORKING

SELECTING

YOUR

WARDROBE

DINING

17

What sensory processing pattern for dressing do these people have?

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How do sensory approaches

compare with each other?

19


Emphasis

for Sensory

Integration

Activity Demands

Context and Environment

Performance Patterns

Performance Skills

Client Factors

Areas of Occupation

Emphasis

for Sensory

Processing

Occupational

Therapy Practice

Framework

(American

Occupational

Therapy Association

[AOTA], 2008)

20


Occupational Therapy Practice Framework (AOTA,

2008)

Occupational Therapy Intervention Approaches

Create/ Promote

Establish/ Restore

Maintain Modify Prevent

Emphasis for

Sensory Integration

Emphasis for

Sensory Processing

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• Using common ―sense‖

• Using clear language

• Linking to everyday life

• Coaching: Talking to family, teachers, friends, and

individuals

• Creating friendly documentation: Useful written

communication

22


Common “Sense” Key Points

Use regular words, no jargon.

Use clients’ own words to link everyday life

to sensory processing knowledge.

Listen—really listen—to what they need.

Learn how to coach them toward finding

solutions.

23


Use clear, understandable,

and precise language.

Unclear/jargon filled:

Your child has

difficulty with

somatosensory

processing.

Clear/jargon free:

You said your child

hits and screams;

it may happen

when people and

objects touch his

skin.JARGON

ALERT!

Being

unclear

Regular

words

Being

precise

24

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Linking to Everyday Life

The general way:

―He would have trouble in crowds, like at a concert or sporting event.‖

(The child does not encounter these experiences.)

The everyday life way: ―…that’s why he has

trouble standing in line with the other children; they will bump into him.‖

(The teacher has told you that line behavior is a challenge.)

Shows you are really listening to

what concerns them.

25


Coaching invites involvement.

“Yes” “Well, it seems to be when we

get home from school. . . .”

Traditional way:

Are there times

when he has

outbursts for no

apparent reason?

Coaching way:

What do you know

about the times

that he has

outbursts for no

apparent reason?

Keeps you in

charge

Invites

participation26


COACHING: Reflective QuestioningAWARENESS

What do you know about. . . ?

What have you tried?

What happened when you. . . ?

What supports were most helpful?

ANALYSIS

How does that compare with what you

did before?

What do you think will happen if you. . .

?

How is that consistent with your goals?

ALTERNATIVES

What else could you have done?

What would it take for you to be able

to. . . ?

What might make it work better next

time?

ACTION

What do you plan to do?

What supports do you need to take that

step?

Where will you get the resources you

need?(Rush & Shelden, 2005a, 2005b)

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Creating Friendly Documentation

Summary Report for Daniel

Daniel is an 8-year-old third

grader. His parents and

teacher are concerned that he

picks fights with other children

for no apparent reason. . . .

Our testing included

completing questionnaires

(School Companion: teacher

and Sensory Profile: parents);

interviewing the teacher and

parents; and observing Daniel

in several environments,

including. . . .

Summary Report for Daniel

. . . our results show that Daniel is just like

other children in his responses to what he

sees and hears. These are great

advantages for Daniel, because school

emphasizes using information from eyes and

ears to follow directions, complete work

sheets. . . .

. . . our results show he reacts differently

from his peers when he is touched; in the

normal course of lining up, getting on the

bus, and playing, children bump into each

other. Daniel may be picking fights with other

children because his nervous system is

overreacting to these experiences. . . .

Use many

sources.

Say what is

great!

Link to

participation.

State

concern in

life.

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Creating Friendly Reports

Keep participation in the FOREFRONT.

Link sensory patterns with participation.

Do NOT write about every score!!!Report on patterns.

Emphasize links to participation:○ Findings that support participation

○ Findings that seem to interfere with participation.

29


Ongoing Assessment and Setting

GoalsDO Focus on the priorities

of the child, family,

and teacher regarding

participation.

Measure progress on

the basis of the child’s

effectiveness in life.

―Abe will get on the

bus independently.‖

DON’T Retest underlying factors

that contribute to or

interfere with participation.

Measure progress on the

basis of changes in

underlying factors.

―Abe will demonstrate

better one-foot balance.‖

30

Comprehensive assessment (every 3 years) can include a wider range of

areas for testing.

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• Identifying participation challenges

• Gathering data from standardized measures

• Designing strategic interpretation strategies

• Applying strategies to children’s everyday experiences

31


Identifying Participation

ChallengesReview the referral concern and record.

Interview the client, family, and teacher.

Conduct skilled observations:

Participation is successful.

Participation is challenging.

Complete formal assessments:

Performance-based testing

Informant questionnaires.

32


(Brown & Dunn, 2002; Dunn, 1999, 2002,

2006a, 2006b)

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CollaboratorsDebby Daniels, PhD, CCC

Pat Pohl, PhD, PT

Donna Bennett, MS, OTR

Tana Brown, PhD, OTR, FAOTA

Jessica Clark, MS, OTRSunday Dove, PhD, OTR

Julie Ermer, MS, OTRMary Kientz, MS, OTR

Lucy Miller, PhD, OTR, FAOTA

Kay Westman , MS, OTR

Brenda Myles, PhD

PT

Teacher

Speech

OTOTOT34


Bell CurveTypical

Performance

Much More

Than Others

Much Less

Than Others

More Than

Others

Less Than

Others

68% of

Population

14%14%

2%2%

For more info: http://classes.kumc.edu/sah/resources/sensoryprocessing/35

Comparison across groups

Infant Toddler Sensory Profile

0.00

10.00

20.00

30.00

40.00

50.00

60.00

typical autism DD

Avoid

0.00

10.00

20.00

30.00

40.00

50.00

60.00

typical autism DD

Registration

mean

-1SD

+1SD

Typical

range

Dunn, 2002

Bell Curve

on its side

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Comparisons With the Sensory

Profile

0.00

10.00

20.00

30.00

40.00

50.00

60.00

70.00

80.00

Registration

0.00

20.00

40.00

60.00

80.00

100.00

120.00

140.00

Seek

0.00

20.00

40.00

60.00

80.00

100.00

120.00

Sensitivity

0.00

20.00

40.00

60.00

80.00

100.00

120.00

140.00

160.00

Avoiding

(Dunn, 1999, 2006a,

2006b)

Note. ADHD = attention

deficit–hyperactivity

disorder.

37


Sensory Processing Across Groups (Rogers, Hepburn, & Wehner, 2003)

Short Sensory

Profile (McIntosh, Miller, Sh

yu, & Dunn, 1999)

Autism

(n = 26)

Fragile X

(n = 20)

DD

(n = 32)

Typical

(n = 24)

Tactile

sensitivity

Signif. more

than others

Signif. more

than others

Same as others Same as others

Taste–smell

sensitivity

Signif. more

than others

Same as others Same as others Same as others

Low energy/

weak

Same as others Signif. more

than others


Auditory

filtering

Signif. more

than others

Signif. more

than others


Under/seek Same as others Signif. more

than others


Differences NOT accounted for by DEVELOPMENTAL LEVEL or IQ

38

Note. DD = developmentally delayed.


Interpretation Strategies

Keep participation in the FOREFRONT.

Link sensory patterns with participation.

Report about supports to participation.

Look for patterns in data. Concepts from Dunn’s Model of Sensory Processing.

Consider which sensory systems support or interfere.

How do interviews and observations link with test data?

Prioritize findings within the person’s life.

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Look for patterns in data.

REGISTRATION SEEKING Both high thresholds: may

miss cues when tired or

stressed

[Reg + Seek]

SENSITIVITY AVOIDING Both low thresholds: may

be rigid in situations

[Sens + Avoid]

Both passive self-

regulation: May find

themselves

overwhelmed in

situations [Reg + Sens]

Both active self-

regulation: Need and

want some control over

situations [Seek + Avoid]

For example, when two patterns are both “different from others”:

Expect these

behavior

patterns.

40


THOMAS: Elementary School

Student

Struggles with changes in routines and with transitions

Uses emotional outbursts when things don’t go his way

Withdraws or gets angry when in trouble

Shoves and pushes peers

Doesn’t understand “personal space”

Poor sense of his body

Never recognizes dirt on his face

Mouths objects, loves to chew

Poor articulation: When others don’t understand him, he gets angry

When getting dressed, doesn’t know what to do next

Hates tags on his clothing

Hates socks

Loves being naked

Loves the shower, but doesn’t use soap or cloth

Ok academically

Handwriting poor

41


THOMAS: Elementary school

student

Struggles with changes in routines and with transitions











Hates socks

Loves being naked


Ok academically

Handwriting poor

1. Thomas is a good student

who might be at risk because of

difficulty with self-management.

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student Struggles with changes in

routines and with transitions











Hates socks

Loves being naked


Ok academically

Handwriting poor

2. Thomas may have oral–sensory difficulties.

43



student Struggles with changes in

routines and with transitions











Hates socks

Loves being naked


Ok academically

Handwriting poor

3. Thomas may have poor body

awareness due to difficulty

interpreting touch input.

44



student

Struggles with changes in routines

and with transitions

Uses emotional outbursts when

things don’t go his way

Withdraws or gets angry when in

trouble


Doesn’t understand “personal

space”




Poor articulation: when others don’t

understand him, he gets angry

When getting

dressed, doesn’t know what

to do next


Hates socks

Loves being naked

Loves the shower, but

doesn’t use soap or cloth

Ok academically

Handwriting poor

4. Thomas may have poor body awareness

due to difficulty interpreting movement

[Vestib] and body position [Proprio] input

45

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Thomas Case Study: SP

DataMuch

Less Less

Same as

Others More

Much

More

SEEK X

AVOID X

SENS X

REG X

AUD X

VIS X

VEST X

TAC X

MULTI X

ORAL X

What do you see?

Notices just like

others [Reg]

Seek + Avoid =

need for control

Vestib and Oral

same as others!

Tactile much more

than others [2%]

Aud and Vis: some

concerns

46

Note. SP = Sensory Profile.


Thomas Case Study: SP Data

(cont.)Much

Less Less

Same as

Others More

Much

More

TONE X

POS/MVMT X

ACTIVE X

SENSORY/

EMOT

X

MULTI X

EMOT/

SOC

X

BEH X

THRESH X

What do you see?

Proprioception/tone

is ok.

It may be harder for

Thomas when

stimuli are combined

(modulation sections

are “more”).

Difficulty with

managing self is

verified [Emot/soc and

Beh scores].

Mo

du

lati

on

Secti

on

47


Decision Hypotheses Findings

Hypothesis

supported1. Thomas is a good student

who might be at risk

because of difficulty with

self-management.

+ Skilled observations

+ Parent and teacher report

+ Emot/soc score; Beh score SP

+ Seek, Avoid, and Sens scores SP

+ Tactile score SP

+ Modulation scores SP

+ Aud and Vis scores SP

Hypothesis

rejected2. Thomas may have oral–

sensory difficulties.


ok Oral score SP is typical.

Hypothesis

supported3. Thomas may have poor

body awareness due to

difficulty interpreting touch

input.



+ Tactile score SP

Hypothesis

rejected4. Thomas may have poor

body awareness due to

difficulty interpreting

movement [Vestib] and body

position [Proprio] input.



ok Vestibular score SP is typical.

ok ―Tone‖ score SP is typical.

48

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• Reviewing evidence on traditional interventions

• Framing decision making with interdisciplinary evidence

• Using evidence to create a participation focus

• Implementing an evidence-based sensory processing approach within daily life

49


Summary Review of Sensory–Motor Interventions in Autism

Design educational programs that accommodate unique sensory

processing patterns.

Make task and environmental modifications.

Use systematic data collection to chart progress.

Consider that traditional sensory integrative (SI) therapy is

beneficial ANECTODALLY, but evidence does not substantiate

effects.

Increase generalization with functional activities in daily routines

within natural contexts.

(as reported in Baranek, 2002)50


Evidence Brief on

Sensory Integration

Refer to Evidence Brief: Keeping Current in Sensory

Integration (Pollock, 2006; www.canchild.ca/Default.aspx?tabid=1237).

Some studies report positive changes in behavior; treatment efficacy is still unknown because of limitations in designs.

Better designed studies do not show a difference in SI therapy.

SI therapy (classical) should be considered a trial.

51

http://www.canchild.ca/Default.aspx?tabid=1237

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18


So . . . Now What?

There is a difference between knowledge

and the application of knowledge.

Neuroscientists and others have provided

evidence about how the brain works.

Applied scientists make use of knowledge in

particular ways.

52


Evidence About the

Structure of Services

Teachers are 4 times more likely to

implement practices learned through

partnerships than to implement practices

learned in traditional in-service training.

Implementation of strategies rates:

From traditional in-services: 10%

From partnership approach: 85%

53

(Knight, 2004, 2008; Showers & Joyce, 1996)


Evidence About Using

Children’s Routines as Context

for Intervention Using children’s routines provides more varied

opportunities for practice.

Using everyday activities has a positive impact on

children’s development.

Parent-facilitated child learning is equally or more

effective than therapist-implemented interventions.

Must be active, intentional, purposeful, and contextual

Must be interest-based, responsive interactions.

54

(Dunst, 2001; 2006; Dunst, Bruder, et al., 2001; Dunst, Trivette, & Hamby, 2006;

Gibbard, Coglan, & MacDonald, 2004; Kellegrew, 1998; Law et al., 1998;

Law, Garret, & Nye, 2004; McLean & Cripe, 1997; Roper & Dunst, 2003;

Trivette, Dunst, & Hamby, 2004)

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Evidence About Capacity

Building Family-, person-, and school-centered care has a

capacity-building effect.

Build capacity by teaching care providers how to

interact with children within natural learning

opportunities.

Capacity building:

Therapists support strengths and abilities.

Care providers recognize, learn, and use their abilities.

Therapists and care providers assume responsibility for

working toward desired outcomes.

55

(Davies, 1995; Dempsey & Dunst, 2004; Dunst, Trivette, & Snyder, 2005; Law et

al., 1998, 2004; Shelton & Stepanek, 1994; Trivette et al., 2004)


Evidence Related to

Natural Environment Interventions

Providing theoretically sound interventions during daily life routines improves PARTICIPATION.

Skill development develops isolated skills.

(Dunst, Bruder, Trivette, & Hamby, 2006; Dunst, Bruder, et al., 2001; Dunst, Hamby, Trivette, & Raab, 2002; Dunst, Hamby, et al., 2000; Dunst, Herter, & Shields, 2000; Dunst, Humphries, & Trivette, 2002;

Dunst, Trivette, & Cross, 2002; Dunst, Trivette, Humphries, Raab, & Roper, 2001)

Sensory processing interventions need to be part of the natural context to support generalization.

(Baranek 2002; Hanft & Pilkington, 2000)

@ winnie dunn 2009 56


Summary: Key Tips for Practice

Here’s What to Do Here’s Why

Create partnerships with

care providers.

To increase implementation fidelity and

achieve better child outcomes

Provide person-centered

care.

To increase capacity of care providers

and achieve children’s developmental

outcomes

Embed your expertise

within children’s daily

routines and natural

contexts.

To provide more practice and foster

generalization

Provide theoretically sound

interventions.

To provide a structure for data collection

and decision making

57

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20


Impact of

Caregiver-Implemented Routines Multiple-baseline

design with 4 toddlers

with developmental

delays

Train parents during

indoor play

Test for generalization

in outdoor play and

caregiving routines

Positive parent and

child outcomes

Multiple-baseline

design with 5

children with autism

Train parents during

certain daily routines

Test for

generalization in

other daily routines

Positive parent and

child outcomes(Kashinath, Woods, & Goldstein, 2006;

Woods, Kashinath, & Goldstein, 2004)

58


Comparison of Traditional and

Functional Physical Therapy (Ketelaar, Vermeer, Hart, Beek, & Helders, 2001)

55 children with cerebral palsy

Compared functional physical therapy (PT) to

normalization of movement

Measured quality of movement, skill

development, and movement in daily routines

BOTH groups improved gross and fine motor

skills.

Functional PT group did better in daily

routines (Pediatric Evaluation of Disability Inventory;

Haley, Coster, Ludlow, Haltiwanger, & Andrellos, 1992).

59


Use of Touch Pressure and

Proprioception to Support Participation

VandenBerg (2001)

4 students with ADHD

Wore vests for 15 min (put on

5 min before observation)

5% of the child’s weight

Outcome

On-task behavior improved

18% to 25%.

Students asked to use the

vest again.

One student noticed

difference in weight.

60

Fertel-Daly, Bedell, & Hinojosa (2001) 5 preschoolers with

pervasive developmental disorder

Wore vests for 2 hr (data collected at 1.5-hr mark)

1 lb of weight

Outcome Improvements in behavioral

repertoire included– < Self-stimulation,– < Distractibility, and– > Focused attention.

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Use of Postural and Vestibular

Activation to Support Participation

Schilling, Washington, Billing

sley, & Deitz (2003)

Used ball chairs in fourth-grade

classrooms to study in-seat

behavior and legible word

productivity

ABAB design (3-wk alternating

chair and ball)

Significant increase in in-seat

behavior and legible writing

61

Schilling & Schwartz (2004)

4 preschool boys with autism

Used ball chairs with molded

feet in preschool classrooms to

study in-seat behavior and

engagement

Teacher chose time of day

ABAB design (2-wk alternating

chair and bench seat)

Significant increase in in-seat

behavior and engagement


Sensory Processing Patterns of

Teachers Related to Their

Students

seeker

avoider

Pers

on

al–

So

cia

l

(Teachable Pupil Inventory

[Kornblau, 1982]; this study by Johnson-

Coffelt, 2001)

PERSONAL–SOCIAL

• Happy

• Cheerful

• Honest

• Sense of humor

• Sincere

• Confident

62

High Seeking

High Avoiding

(Mische-Lawson & Dunn, 2008)

Miniature pretend toys

vehicles

Creative art

Building materials

no toy preference

No body position changes

Varied body positions


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• Gaining insights about the teachers’ points of view

• Understanding the special context of school

• Learning about the data available from school context

• Practicing how to meet the demands of learning and

interacting at school

64

Providing insights about the teacher’s point of view

(Dunn, 2006a)


Understanding the special context of school…

What are the benefits and risks?

What are the benefits?

Sensory Profile (SP) is

not appropriate for

teachers.

We need context-specific

data.

School is a major life

context for children.

What are the risks?

We might compare

teachers and parents to

see who is RIGHT.

We might abandon parent

information because

teachers are more

convenient.

We might get

overwhelmed with

complexity of data.

66

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23


Data Available From the

Sensory Profile School Companion

Comparable Info to SP

Quadrant Scores

SEEK

AVOID

SENSITIVITY

REGISTRATION

System Scores

Auditory

Visual

Touch

Movement

Behavior

New Info Available

School Factor Scores

School Factor 1

School Factor 2

School Factor 3

School Factor 4

67


School Factor 1

School

Factor 1


Degree to which a child

needs someone else to

manage or influence the

actions

Teacher interacts to change

the course of events with the

child

External influences affect

behavior

Combination of SEEK and

REG [Registration]High

Thresholds

68


School Factor 1 Examples

REGISTRATION

Misses oral directions

in class more than

other students

Has trouble keeping

materials and

supplies organized for

use during the day

SEEKING

Hums, whistles, sings, or

makes other noises

throughout the day

Gets up and moves

around more than other

students

69

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24


School Factor 2

School

Factor 2

Seeking Sensitivity

Level of child’s attention and

awareness of self and

environment

Busy, engaged, alert, resp

onsive, detail oriented

Combination of SEEK and

SENS

70



SEEKING

Adds more details to

drawing and coloring

than other students

Seems more curious

than other students

SENSITIVITY

Comments on small

details in objects or

pictures that others

haven’t noticed

Is bossy with

classmates and

peers

71


School Factor 3

School

Factor 3


Range of tolerance for

what is going on in the

environment

Hyperawareness, rigidit

y, bothered, defiant

Combination of SENS

and AVOID

Low

Thresholds

72

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SENSITIVITY

Is easily upset by minor injuries (e.g., bumps, scrapes, cuts)

Becomes distressed during assemblies, lunch, or other large gatherings

AVOIDING

Withdraws when changes in the environment or routine occur

Flinches when people get in close proximity to or touch his or her body

73


School Factor 4

School

Factor 4

Registration Avoiding

Level of availability for

learning

Removed, stoic, distant, disengaged, inactive

Combination of AVOID and REG

74



REGISTRATION

Shows little emotion regardless of the situation

Seems oblivious within an active environment (i.e., is unaware of activity)

AVOIDING

Stands or sits at the side of the playground during recess

Withdraws from active environments or situations (e.g., retreats to a quiet area in the classroom)

75

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26


Zachary’s Participation

Zachary is a 6-year-old first grader.

SCHOOL

Zachary is doing fine at

school.

He has more challenges in

group situations

(e.g., lunch, hall, group

projects).

Zachary fiddles with small

toys at his desk but won’t use

glue during art.

HOME

Zachary doesn’t respond to his

parents’ calls.

He is particular about

situations, including getting

dressed.

Zachary’s parents want him to

be successful at school.

76


Zachary’s Sensory Profile and School

Companion Quadrant ScoresMuch

Less Less Same More

Much

More

SP home

SEEK Seek

SENS Sens

AVOID Avoid

REG Reg

SP school

SEEK Seek

SENS Sens

AVOID Avoid

REG Reg

What do you see?

Seeking scores are

Same.

Both parents and

teacher see Zach as

having low thresholds

[Sens and Avoid scores

More Than others on

both].

Parents see Zach as

failing to

notice, whereas teacher

sees Zach as noticing

just like everyone else

[Reg scores].77


Hypotheses About Registration for

Zachary

He has enough models at school to see

what to do if he misses directions; if he

misses directions at home, he is lost.

The teacher has seen many more 6-

year-olds and thus has a different idea

about ―missing cues.‖

The family and teacher see Zach in

different situations that might bring out

his noticing or missing information.

78

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27


Zachary’s Sensory Profile

School Companion ScoresMuch

Less Less Same More

Much

More

SP school

Visual X

Auditory X

Touch X

Movement X

Behavior X

School Factor 1 X

School Factor 2 X

School Factor 3 X

School Factor 4 X

What do you see?

Zach is just like

other students in

the amount of

guidance he needs

from the teacher

[Factor 1],

and

he is just as available

for learning as

other students

[Factor 4].

He is more sensitive

to touch and sound.

He is more busy and

less tolerant

[Factors 2 and 3].

79


Victoria’s Participation Victoria is an 11-year-old middle

school student.

Teachers agree that she is bright;

grades are lower because she doesn’t

turn in homework.

Parents report that she does homework

every night.

Some teachers are resistant to ―taking

over Victoria’s responsibilities for her.‖

80


Victoria’s Scores

Much

Less Less Same More

Much

More

AASP*

SEEK Seek

SENS Sens

AVOID Avoid

REG Reg

SP school

SEEK Seek

SENS Sens

AVOID Avoid

REG Reg

*Victoria completed the Adolescent/Adult Sensory Profile because she is 11 years old.

What do you see?

Victoria completed

the AASP on herself.

The teacher and

Victoria agree about

her patterns of

sensory processing.

Victoria sees herself

as more avoiding

than does the

teacher.

81

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28


Victoria’s Scores (cont.)

Much

Less Less Same More

Much

More

SP school

Visual X

Auditory X

Touch X

Movement X

Behavior X

School Factor 1 X

School Factor 2 X

School Factor 3 X

School Factor 4 X

What do you see?

Visual and Movement

sensation scores are

“More Than Others.”

School Factors 1 and

4 both involve

Registration.

82


Maria’s Participation

Maria is a 4-year-old attending

the neighborhood preschool

program. Maria does great during free play at

preschool.

Maria does great during teacher

directed activities.

Maria is out of control during snack

time.

Mom and Dad say Maria is fine at

mealtime at home.

83


Maria’s Sensory Profile and School

Companion Quadrant ScoresMuch

Less Less Same More

Much

More

SP home

SEEK Seek

SENS Sens

AVOID Avoid

REG Reg

SP school

SEEK Seek

SENS Sens

AVOID Avoid

REG Reg

What do you see?

Maria has some

sensitivity at home and

at school.

Maria is mostly like other

children at preschool

[Same scores on School

Companion].

Maria’s reactions at

home are mostly more

intense and frequent

than would be expected

of children her age

[scores More and Much

More than others on

Sensory Profile].84

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29


Maria’s Sensory Profile School

Companion scores (cont.)

Much

Less Less Same More

Muc

h

More

SP school

Visual X

Auditory X

Touch X

Movement X

Behavior X

School Factor 1 X

School Factor 2 X

School Factor 3 X

School Factor 4 XNOTE: on the SP, scores more than others on

auditory, touch, multisensory and oral processing

What do you see?

Maria needs the

same amount of

support as others

[Factor 1].

Maria is just as

available for learning

as others [Factor 4].

Maria reacts more

than others to sound

and touch stimuli.

Maria is more active

and needs more

structure in the

school environment

than others [Factors

2 and 3]. 85


• What is on the horizon to invite us to higher ground?

86


Consider Other Points of

View

Is normalcy . . .

Overrated?

Underrated?

An artificial parameter?

Are too many people being

labeled with illnesses?87

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30


Consider Other Points of

View Is our perspective about disability . . .

Too negative?

Too narrow?

Does our perspective about intervention . . .

Need to be more universally focused?

Need to be reconsidered?

88


Returning to Sensory Processing

Seeker:

Creates excitement and

change

Bystander:

Easygoing and can maintain

focus

Avoider:

Creates routines to manage day

Sensor:

Notices details and has precise

ideas

89

Dunn, W. (2008) Living sensationally:

Understanding your senses.

London: Jessica Kingsley Publishershttp://livingsensationally.blogspot.com/

Acknowledgments

Images of the Sensory Profile assessments are reproduced with the permission

of NCS Pearson, Inc., as follows:

Sensory Profile. Copyright © 1999 by NCS Pearson, Inc. Reproduced with

permission. All rights reserved.

Infant/Toddler Sensory Profile. Copyright © 2002 by NCS Pearson, Inc.

Reproduced with permission. All rights reserved.

Adolescent/Adult Sensory Profile. Copyright © 2002 by NCS Pearson, Inc.


Sensory Profile School Companion. Copyright © 2006 by NCS Pearson, Inc.


Sensory Profile Supplement. Copyright © 2006 by NCS Pearson, Inc.


―Sensory Profile‖ is a trademark in the United States and other countries of

Pearson Education, Inc., or its affiliate(s).


http://livingsensationally.blogspot.com/

3/26/2009

31

Acknowledgments (cont.)

The image on the cover of Living

Sensationally: Understanding Your

Senses, by W. Dunn, is reproduced with

the permission of Jessica Kingsley

Publishers.


References

For course references and bibliography, go

to the References tab on the main menu.

A course bibliography is included in the

course resources.


sensory processing handouts

Documents