Showing posts with label sensory processing. Show all posts
Showing posts with label sensory processing. Show all posts

Saturday, 4 June 2016

DIY Sensory Feel & Find Me Box

                               
                                         


                               (Developmental Age: 5 years onwards)

We all are very much in love with different sensory activities as they are engaging, fascinating and nurturing,keeping us calm, alert and organised in our day to day accomplishments. Besides activating (alerting sensory activities) or relaxing (calming sensory activities) different sense organs, these tasks improve self-regulation, fine motor coordination, eye-hand coordination, laterality and dexterity.

At the same time, sensory fun can rescue our ASD, ADHD and SPD children from meltdowns, anxieties or sensory overloads due to their nature and character. 

Saturday, 7 May 2016

Strategies for Tactile Defensiveness!

                                                     



Touch is the first sensation that starts developing in the womb at five weeks. Some children react adversely, negatively or display  escape-like behaviour on being touched, hugged or kissed since they have difficulties in processing sensory information due to the poor tactile system. This behaviour is referred as Tactile Defensiveness.

Due to the inaccurate functioning of touch mechanism and neural system, these children are often in the state of 'red alert'. They may react by clinging or complaining (fright) to someone, or lashing out (fight) and running away (flight).

Often children displaying tactile defensiveness may also have self-stimulating behaviour. Repeated movements such as hand flapping, body rocking, hand gazing, spinning have been found prevalent in children with developmental disabilities and Autism.

Research done by Feig et al (2012), concludes that there is a significant relationship between Tactile defensiveness and Self-stimulatory behaviours.They both are problematic as they appear and interfere in child's day-to-day activities. For example, a child who engages in hand flapping may not be able to do any other activity such as washing herself or eating on her own. Likewise, due to tactile defensiveness doing teeth-brushing or other self-care activities will be difficult.


Here are some of the suggestions for tactile defensiveness which may or may not be helpful, as each child is different, however making appropriate changes within child’s environment or strategies according to his needs and priorities can support him to live better and stay calmer.



A) Understand your child: (Address child's issues seriously= Trustworthy relationship + better behaved child)

Most importantly, it is parent’s responsibility to understand their child and her problems. Giving labels such as she has "bad behaviour" or "poor "attitude will not solve the issue. 
If she says “something always hurts me” or gets irritated due to scratching herself all the time, do not think she is pretending to gain empathy or purposefully trying to seek attention. 
There must be something unusual happening causing her to behave in this manner. 
Developing trust and developing an understanding of child's difficulties are essential parts of combating any problem. 
It will be great if parent and child both stay on the same team as good team players to resolve the issue rather than opponents where parents label the child for being anti-social frequently, and child reacts impulsively and aggressively on hearing those words over and again. 

B) Deep Pressure: (Leads to release of Dopamine or "happy neurotransmitter"= Calm brain & relaxed body)

Firm massage or deep pressure with pillows, cushions or rolling in a weighted blanket is very calming. Parents should understand signals when these strategies are needed. Children having sensitivities are overloaded with touch or noise in crowded places or parties. Parents should be aware of these situations and intervention should be provided before emotional or anger outbursts happens.Children get sleep disturbances caused due to sensory issues.Using techniques like Wilbarger Brushing Protocol  has been found to be an effective way of calming child for better sleep.
This should be under the supervision of Occupational Therapist or consult child's OT before trying Brushing Technique.


C) Weighted Items: (Stimulates body joints & muscles = Improves self-regulation,modulation,stress and anxiety)

Wearing weighted blankets, vests, backpacks or hats can have the calming effect in the classroom as well as at home. Great range of weighted items is available on Amazon such as ankle weights, lap weights shoulder and neck weights. They help to calm down a child in the classroom as well as any other environment leading her to focus on the task and reduce distraction. Weighted blankets are very helpful in calming the child’s distractibility, emotional liability, and hyper activeness. Another very good resource is TFH, South Paw. 
T-Jackets have been found to be a good resource of calming down a child. They have been scientifically customised for providing deep pressure and calming effects. 


D) Safety: (Prevention is better than cure so TAKE-CARE of child!)

Children who are hypo-responsive or sensory seeking towards touch are unaware of bruises and injuries. They do not get pain sensation messages from brain centers due to which they are prone to injuries. They may display self-stimulating or self-injurious behaviours along with tactile defensiveness.The stereotyped behaviours are common among Autistic children. Most common form is motor patterns are hand flapping, body gazing or object manipulation. Temple (1992) in her study Calming Effects of Deep Touch Pressure in Patients with Autistic Disorder, College Students, and Animals has suggested that Tactile Defensiveness co-exists with Stereotypical behaviour in Autism .Sensory Modulation and regulation is an important function which does not work well in both hyper and hyposensitivity of touch.It is important to follow some hands-on strategies such as:

  • Use of sensory experiences :Such as trampoline jumping,obstacle course, running
  • Follow Routines and maintain structure: e.g., planning a week ahead
  • Communication: Understanding child's behaviour in anticipation, environment, emotional liability.
  • Visual Support: Emotion's chart, use of PECS.
  • Talk to GP about Medication.
  • Use Barriers such as using cushions or pillows if the child does head banging,or tie the cloth on his hand to reduce self-biting.
  • Use soft furniture.
  • Keep rooms safe, the child should not be able to lock himself in a room, windows should not be wide-open.
  • Keep sharp objects like knife, fork, scissors, razors out of reach of the child.



F) Fabrics: (Removal of unpleasant sensory input = Relief & physical comfort)

Pay attention to the different fabrics. Following tips may be helpful related to fabrics:-
  • Give preference to child's fabric or texture.Some children like to wear cotton and avoid woolens, synthetics or any other texture that might irritate them. 
  • Wearing skin fit clothing is preferable than loose clothing. 
  • Stick to seamless clothing. 
  • Liners and tags are always irritable making child impulsive and distracted easily. Removing or cutting tags is the simple solution for this. 
  • As far as footwear is concerned, it should be comfortable and slip on type. Fasteners are also the good option if he finds tying laces complicated.
  • Long sleeves are preferable than short arm sleeves. 
  • Do not force him to wear belts, waistbands if he doesn’t feel good about it.

H) Active Involvement: (Child knows himself better than anyone else)

Self-directed tactile experiences are more calming then done by anyone else. Therefore, encourage the child to perform activities himself rather than done passively, by anyone else for him, however, assistance or supervision may be needed for completing tasks. After bath let him rub himself or put lotion independently since he can judge well how much deep firm pressure will be calming for self. Make your own Play-Doh at home.

I) Classroom Strategies: (Favourable IEP = Better provisions = Better behaved child + raised self-esteem)
Let the child stand last in a row in school. Let him
sit alone if he gets distracted by other pupil’s touch. Talk to teachers and school management to create awareness about your child’s difficulties. Teachers should know what child is going through and why is he distracted multiple times or scratches himself during the lessons. They should allow the child to do wall pushes or chair pushes if he feels calming during break times. The child should also get movement breaks if the teacher allows.  This should be included in his IEP. http://www.additudemag.com/adhd/article/5894.html


J) Inform before touching: (Respect child's integrity)

Hugs, kisses or any other type of touch should be done with consent. Ask or inform him before touching the child. This reduces anxiety levels and arousal too.Touching without consent can create disruptive behaviour. To know more about cause and neuroscience of tactile defensiveness click here.

K) Heavy Work Activities (Proprioceptive Input): (Tactile + proprioceptive input = calming effects,reduced anxiety,disruptive behaviour)

Pushing and pulling heavy objects such as barrels, carts, large bean bags,
the pile of chairs or pushing another child on the swing. All this 
gives proprioceptive input!

These activities provide deep pressure to muscles, joints, ligaments and key points of the body (Shoulders, Pelvis, Hips) to a tactile defensive child. 
Moreover, giving movement breaks will support a child to concentrate better in studies, such as sending him to an office to handover papers or asking him to distribute assignments in the classroom. See Classroom strategies for more information.



Friday, 29 April 2016

Deep Pressure: Magic of Weighted Blanket!



                                                     
                                                  


John diagnosed Autistic at age of 6 years got admission in special needs school for progressive future. His parents did not inform school staff much about his maladaptive behaviours except being picky eater, impulsive and having tactile defensiveness. On first day to his school, he was introduced to classmates and support assistant (Ms. Johnson) by his class teacher (Ms. Winslet). As the day progressed, John seemed calm and settling within the classroom surrounded by some new friends.

During the lunch-time, Ms. Winslet told him about rules of eating in classroom and ensured that he is doing fine.  John without making any eye contact heard everything and absorbed all in (taking in too much information from new environment,resulting in sensory overloading) while eating his sandwich and nodded head.
All of a sudden, after fraction of seconds, everyone heard John shouting, being physically aggressive on child sitting next to him and crying without listening to anyone. He also bitten the support assistant who tried to stop him from hitting. Due to extreme kicking, hitting, pushing and biting behaviour (physical violence) he was restrained by two male staff members.

School OT intervened and he was taken to therapy room where she wrapped John in a weighted blanket (deep firm pressure) and rolled on floor until he calmed down.

Later, this little man mentioned that he got angry because child sitting next to him was eating crisps and making noise, that John didn’t like!!

Phew!! so, now we know why John behaved in such a manner.

Well, but what happened when he was wrapped in a weighted blanket? How so much angry young man (who needed male staff for restraining) calmed down so easily? Why didn’t he resist to weighted blanket?

This happened due to MAGIC of DEEP PRESSURE!!

Thursday, 17 March 2016

Proprioception:The Position Sense


Apart from five basic senses (vision, auditory, touch, olfactory and gustatory), we have three more hidden senses called as Proprioception, Interoception (recently discovered) and Vestibular Sense. 
The following discussion is about our proprioceptive sense and how it works in typical and atypical children.Awareness about one’s own body position happens due to this sixth sense is known as proprioception.

Proprioception is also called as “position sense” since it tells us, where we are we sitting, standing, lying or walking in relation to any object or surrounding. The word Proprioception comes from Latin word, “proprius” meaning “one’s own”. This sense supports a child to regulate their responsiveness to sensations. 


This sensation occurs when our muscles move or work.Consequences of poor proprioceptive functioning are the poor academic achievement, lack of self-care skills, difficulties in self-regulating emotions, attention and stress.

To know more about proprioception, let’s consider a simple example.

Suppose, you are blindfolded and asked to ascend and descend stairs you have never seen. Now your eyes do not have any experience or measurement of these stairs.The depth of every stair is unknown that can actually help your body to go up and down without falling or tripping. It is obvious that your balance will lose while doing this activity.

So what role does body play to protect you?

To be careful and protect you from falling, your hands will try to search and hold railing or any other external support. 
Your dominant foot will step forward slowly and attempt to judge how much is the height of the first stair so that you can climb the second step easily, with a swift movement. 
As you will climb further, your body will be confident enough to take steps confidently and instantaneously with controlled balance. 
Moreover, descending stairs will be easier for you now since the body can easily judge and feet can measure the steepness of staircase.

So how does this all happen?

This all happens because of our Proprioceptive sense! It is a hidden sense, that carries sensory information telling us about our own body’s movements and positions. It allows the brain to understand body's position, posture and place in relation to surroundings and other individuals.
Whether we are standing under the tree, over the bed, in the sand or on the top of the cliff, this unconscious awareness happens due to this sense.

Being able to walk in the dark room without losing balance control, typing without looking at the keyboard, driving a car without looking at brakes and other components, or performing ballet will not be possible without this sense.

This sense is the foundation for our body postures and actions. It makes us feel where are we sitting standing or lying in relation to our surrounding.

Consider, while sitting on the chair, how does our body know, where it has to sit? How much our knees need to bend according to chair’s height? Is chair comfortable or not?This all work is done by Proprioceptive sense.


It informs body about direction, velocity and force needed by one’s body
for doing any task. Finely graded movements, body coordination and body scheme are some of the areas that are affected due to lack of proprioception.Heavy work activities are calming for these children.


The functions of proprioception are to increase body awareness and contribute to motor control and motor planning (praxis). Children with poor proprioceptive sense have poor body awareness which causes difficulties in carrying out a gross motor and fine motor activities such as playing football, get dressed, zipping a jacket, buttoning a shirt or doing handwriting tasks.

Characteristics of poor prop (short form used by OTs) sense can be easily observed within the classroom or home setting among SPD (Sensory Processing Disorder) children such as, they would slap feet on ground while walking, or hold pencils too tightly to make a clear impression, or that the points break, there can be erasure holes on sheet producing messy work.

Unlike typical children, atypically developing children are not able to judge space around themselves. They might bump into other people or objects.  They may enter into other person’s intra-personal space which is considered weird and uncomfortable by most of the people. Such a child might be considered strange however reason behind this action is not his intentional bad behaviour but the lack of body awareness. 


Credit
People's strange reactions cause anger,depression and emotional liability in the child since he is not doing all this deliberately or intentionally but indirectly trapped by his own body.

The perception of judging ordinary tasks such as the weight of a coffee mug, holding a pencil efficiently in order to write, poor balance while standing, tripping while walking, difficulties in planning actions are some of the examples of poor proprioception. 

Moreover, children with poor proprioception usually slip from their chairs while sitting in classrooms or other settings. These children have affected body positions and difficulties in organising their sensations therefore falling is usual. Providing Wobble cushion or wobble wedge provides combined tactile-proprioceptive input helping the child to sit appropriately. Moreover, it helps in preventing slouch and increases attention on the task. These resources can be purchased from different websites such as Amazon  at cheaper prices.

Other weighted items such as weighted vests or weighted lap pad provide calming effect on the child. They support child to stay in place and focus well
credit
on given task.

Other classroom activities to can be Brain Gym and yoga exercises to improve child’s focus in academics. Mediation has very calming and long lasting effect.

Sensory Diet designed by Occupational Therapist is essential to be incorporated in child’s schedule specifically to meet the needs of the individual's own nervous system.  Its purpose is to help the person become more focused, adaptable and skilful.  It is the combination of alerting and calming activities that helps in organising child’s behaviour and needs.

Home activities can include jumping on a trampoline, riding scooter or bicycle, participation in running, jumping, hopping activities, obstacle courses, sand play, hopscotch play, gymnastics, horse riding.

                                                                   
Credit
                                                             

Monday, 29 February 2016

Normal Development of Tactile System

                                                               
 
Tactile system starts developing since 5th week of pregnancy, supports child to influence recognise different types of touch sensations as he grows. It has very important on newborn for the rest of his life. Functionally, this system supports in two important aspects, sucking and establishing emotional security.


Sucking: Touch sensations comforts baby in sucking, chewing and swallowing food. Children who have difficulties in sucking, may face challenges in eating different textures of food later in their lives. In other words, they might have oral hypersensitiveness (oral defensiveness). 

It is being often mentioned by mothers of special needs children, “Oh my son is picky eater” or “he doesn’t eat very well”. Signs of oral defensiveness include disliking for tooth brushing, face washing or avoidance of mixed textured food.

Emotional Security: It has major role every newborn’s life since it establishes
expressive protection, trust and acquaintance with mother or caregiver. After delivery, child’s first bodily contact with his mother or caretaker has great influence on child’s body system for rest of his life. 


After contact, the brain should interpret ate the sensations correctly and appropriately in order to form first emotional attachment. Sometimes, it is also called as mother-infant bond. This bond is very essential for physical and mental development of baby. This bonding later helps in developing body image and body awareness. It also provides sense of himself as physical body.