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