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Learning Challenges in Sensory Processing Disorder

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Drs. Brock and Fernette Eide's presentation at the Seattle SPD Foundation International Symposium. The Eides discuss how SPD may affect reading, writing, math, and attention and certain types of ...

Drs. Brock and Fernette Eide's presentation at the Seattle SPD Foundation International Symposium. The Eides discuss how SPD may affect reading, writing, math, and attention and certain types of memory.

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  • So helpful! I have a bright child who has been diagnosed with SPD. I only recently found out about the academic connections with SPD. This presentation describes her perfectly and will be easy for her father to understand.
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    Learning Challenges in Sensory Processing Disorder Learning Challenges in Sensory Processing Disorder Presentation Transcript

    • Common Learning Challenges in Sensory Processing Disorder Brock Eide M.D. M.A. and Fernette Eide M.D. Neurolearning.com Facebook.com/SensoryProcessing This presentation will be posted on Slideshare.net/drseide Flickr.com/mrhayata
    • Ways to Think About Sensory Processing Disorder Dr. Jean Ayres defined the clinical syndrome of Sensory Integration Dysfunction functionally: as an impairment in the ability to organize sensation for use. Dr. Lucy Jane Miller: “Sensory Processing Disorder exists when sensory signals don’t get organized into appropriate responses and a child’s daily routines and activities are disrupted as a result.” Both descriptions emphasize information processing in the current moment.
    • We can also view SPD from the Perspective of Learning. What kinds of learning and cognitive issues do we see in children with SPD? What is Learning? We can think of learning as: Information that has been encoded in memory in a form that can be used.
    • What Kinds Of Memory Do We Have? Memory Long-Term Memory: Information Working Memory: Information you you can use later. can use now. Mental Desk Space, or keyboard memory. (Also considered part of Attention)
    • What Kinds Of Information Does Long-Term Memory Retain? Declarative Memory: Facts about Procedural Memory: How to do things. the world. Rules and Procedures, Rote Facts, Things that become automatic through practice so you can do them without conscious effort.
    • Most Basic Academic Skills are Procedural • Most language skills are rule-based, including: discriminating word-sounds; correctly articulating and pronouncing words; segmenting words into sounds; phonics (decoding and spelling); s; grammar and syntax; style and pragmatics. • Many other academic skills are also rule-based, like: rote (or automatic) memory (e.g., math facts, dates, titles, terms, or place names); procedures like long division, carrying over, borrowing, or dealing with fractions in math; sequences, like the alphabet, days of the week, months of the year, etc.; writing conventions like punctuation and capitalization; and motor rules for forming letters the same way every time when writing by hand, and spacing evenly between words. • Classroom schedules, rules, and procedures/organization
    • The Link Between SPD and Procedural Learning: Same List of Cognitive and Learning Challenges • Development of Automatic Skills; • Mastery of Procedures (versus simple facts); • Rote Memory; • Working Memory Overload and Attention Challenges; • Understanding of time, space, quantity, sequence; • Language Retrieval, organization, prosody, pragmatics; • Social Fluency (versus comprehension);
    • Neurologically, What Links SPD and Procedural Learning? Answer: Cerebellar Dysfunction Senses Motor Spatial Interoceptive (Organs) Limbic / Emotional Language Automaticity When the cerebellum’s working hard, you don’t have to... Cerebellar Cognitive Affective Disorder: “Dysmetria of Thought” Dr. Jeremy Schmamman, Harvard
    • Risk Factors for for Cerebellar Dysfunction and SPD essentially the Same • Preterm birth • Birth injury • Down Syndrome, Fetal Alcohol Syndrome • Deprivation, Child Abuse • ADHD: the most consistent brain abnormality • Autism / Aspergers: the most brain consistent abnormality... • Dyslexia: the most commonly identified brain abnormality • Developmental Motor Coordination Disorder • Pediatric Bipolar The Cerebellum is Particularly Vulnerable to Hypoxia / Ischemia and is the Most Commonly Affected Area in a Wide Variety of Conditions Associated with Learning Challenges
    • Cognitive/Learning Issues Besides Basic Skills: 1. Attention and Working Memory • Failure to automatize functions leads to the need for conscious compensation or oversight. • When too many tasks require conscious attention, overloading • of working memory is the inevitable result.
    • Sustaining Attention Is Also Harder for Children With Cerebellar Dysfunction and Procedural Learning Challenges • Children with procedural learning difficulties must focus more intently to perform the same tasks as other children, and this is tiring. • Think of the difference in attention required to drive the same stretch of twisty mountain road on a clear day versus a rainy night—and the difference in resulting stress and fatigue.
    • Other Attention Issues with Cerebellar Dysfunction/Procedural Learning Problems/SPD • Selective attention/distractibility (Poor automatic filtering) • Difficulty with task switching (set-shifting), dividing attention, and transitions. • Difficulty following complex instructions • Difficulty with “oversight” or executive functions due to working memory overload • Poor appreciation and understanding of time/time management.
    • 2. Social Interactions • Learning and using social and self-help rules. • Most social interactive skills are rule-based. • Real-time fluency/praxis versus comprehension. • Auditory processing (telling word sounds apart, hearing in background noise, sound sensitivity) • Speech articulation • Prosody/tone and style (“pedantic” or “mechanical”) • Bright children often misdiagnosed with autism spectrum disorders due to unusual style, prosody, or pragmatics, but generally language comprehension is flexible and fluid
    • Take Home Points about Procedural Learning in SPD • “How” or “praxis” skills: Things that become automatic through practice, like rules, procedures, rote facts • Most Basic Academic Skills are procedural in nature • Square root rule: take square root longer of number of repetitions to master • Affects implicit learning (observation and imitation) more than explicit (detailed instruction) • Poor automaticity requires conscious compensation and working memory overload • Often show up on WISC as slow processing speed, decreased comprehension score. • Alternative learning strategies based on explicit learning and declarative (factual) memory mnemonics.
    • Common Academic Labels Given to Children with Procedural Learning Challenges • Dysgraphia • Dyslexia • Dyscalculia • Dyspraxia • ADHD • Autism Spectrum
    • Sensory Processing & Learning Visual Auditory Cerebellar / Proprioceptive Sensory-Motor Sensory Input Attention Output Pattern Processing Memory & Learning
    • SPD in the Classroom Reading Math Writing
    • SPD and Reading Visual – skipped words and lines, misreading Auditory – mispronounced words, trouble sounding out, discrimination / phonics mistakes, poor word retrieval Cerebellar – Impaired reading automaticity SPD kids may have unrecognized Dyslexia http://flickr.com/Old Shoe Woman
    • Visual Demands of Reading Scholarpedia
    • Visual Functions and Reading Smooth eye movements for reading Eye saccades or jumps to switch between lines Focus adjustment near and far Visual recognition of letters and whole words Flickr.com/Josh Liba
    • Auditory Processing & Reading Distinguishing similar sounds – „hod‟ for „hot‟, „brush‟ for „blush‟ Quick speech, Sounds within Words Mishear, Mispronounce, Misspell, Misfiled - „Mushy Speech‟ Misfiled Words Harder to Retrieve Flickr.com/JKoenig
    • Interventions for Reading Multisensory learning See, hear, air write, say Auditory discrimination Auditory memory Vision and visual memory Imagery Teachers, parents, tutors, SLPs, audiologists, dev optometrists reading specialists, computers
    • SPD and Writing Automaticity of letter writing Sensory feedback Motor planning and execution Visual and kinesthetic memory Word retrieval and organization Flickr.com/pyhooya
    • Emotional Toll of Dysgraphia “His teacher would let him take his work home, but even after 3 hours, there was no way he could finish…” Depression Severe Behaviors School Withdrawal Suicidal Flickr.com/nao.k
    • Examples of Dysgraphia in Students with SPD
    • Dysgraphia and SPD
    • Impaired Motor Automaticity Control Cerebellar SPD Degeneration (Critchley) “Draw several squares on top of each other” May Avoid fingers
    • Handwriting and Working Memory Overload Sentence Copy Better than Free Writing
    • Interventions for Writing ACCOMMODATE ! Dictation, Typing, Assistive Technology THERAPY Fine motor / Upper Girdle Strengthening Kinesthetic Strategies – Air Writing / Imagery / Verbal Automaticity Practice – over-learning LANGUAGE Template prompts, imitation, writing tutor Expressive language work – SLP Assistive software Flickr.com/cowtools
    • Assistive Technology Word Prediction Software Report Writers- CoWriter 6 Spelling Prediction Speech to Text - Dragon Dictate Text to Speech Software and Browsers Ginger: Context-Sensitive Grammar Kindle, iPad, iPhone, iPod, etc. Intel Reader, Kurzweil Training and Support for Assistive Tech More Resources: DyslexicAdvantage.com Flickr.com/neuro74
    • SPD and Math Impaired Sense of Number and Quantity Number Sense Related to Spatial Perception Finger Agnosia Often Seen with Dyscalculia Rote Math Facts, Procedural Memory Normal Intelligence Counting and Quantity Sequence and Multiple Steps Money, Clocks, Time Math Facts
    • Students with SPD Often Struggle with Math Visual Crowding Impaired Number Writing Automaticity Working Memory Overload Impaired Sense of Number and Sequence
    • You do not have to be a great calculating wiz To be a great mathematician or scientist Math Problem Solving May Be Quite Strong in Dyscalculics Wikipedia
    • Interventions for Math Kinesthetic Strategies to Number, Quantity Episodic / Personal Memory for Math Facts Dysgraphia, Working Memory ,Vision Accommodations Math Reasoning ≠ Arithmetic Flickr.com/Nexus6
    • Sensory Contributions To Attention Visual Overload Tunes Out Poor Posture Visual Mistakes ‘Visual Learner’ Bodily Distractions Poor eye contact Trouble with Fidgety, Hyperactive Lazy eye Instructions Poor Hands-On Worksheet Errors Learners Lazy eye, birth, dyslexia Preemie, dyslexia, ADHD Birth, preemie, ADHD, dyslexia
    • This is hard. Visual Crowding
    • This is hard. Visual Crowding
    • This is easier. More whitespace.
    • Auditory Attention in the Classroom Fan, Projector Students Talking Distracting Noise Teacher Speaking HearingReview.com
    • Reduce Visual, Auditory, and Sensory Distractions Visual Focus, Convergence, Pursuits, Jumps Auditory Background, Discrimination, Closure Proprioceptive: Muscle Tone, Spatial Map Multi-Disciplinary / Referrals Sequential Multisensory Teaching Software, neurofeedback Flickr.com/Noel Zia Lee
    • Divided Attention Less Listening When Seeing http://www.indiana.edu/~cnilab/multiorder.pdf
    • Improving Divided Attention Incremental Challenge Mixed Sensory-Sensory and Sensory-Motor Seeing-Hearing, Seeing-Moving, Moving-Rote Home / Normal Kid Activities + Therapy http://flickr.com/silkegb
    • Sensory Learning Survey Sensory Processing Disorder and Learning © Eide Neurolearning Clinic 2010 Visual Auditory Proprioceptive / Cerebellar Attention Visual overload Tunes out with listening Fidgets / sensory seeking Careless mistakes Missed instructions Flops, poor tone Distracted by visual details Distracted by sounds Trouble multi-tasking Memory Problems learning letters, spelling Problems remembering what's Poor procedural memory mistakes been heard Trouble with graphs and other Mispronounced words, Word visual learning substitutions Reading Skipped words Phonics and rhyme problems Poor reading fluency Lose place Wild guesses with words Eyes close to page Avoids reading Misreads questions Writing / Speech Large messy handwriting, eyes Phonetic errors in writing and Irregularly formed letters close to page speech - dropped letters and (impaired automaticity), overload sounds errors Spelling mistakes Very poor spelling Visual monitoring of writing Reversals Trouble retrieving words Reversals
    • Sensory Learning Survey Sensory Processing Disorder and Learning © Eide Neurolearning Clinic 2010 Visual Auditory Proprioceptive / Cerebellar Math Problems with crowded Mistakes counting fingers, poor worksheets approximation Skipped problems Unable to do multi-stepped problems Speech / Socialization Interrupts conversation Poor back-and-forth conversation Poor back-and-forth conversation Problems hearing in background Awkward speech – self-editing noise (fluency) Mispronounced words Problems learning a foreign language Word finding problems Play / Socialization Retreat from crowded Retreat from crowded Retreat from crowded Misses visual signals in sports Trouble assemblies, gym, echoing Unexpected falls, leaning on rooms children in line Impaired depth perception Can't hear in PE or music Bad at sports – multitasking, timing
    • Join Us on Facebook Facebook/SensoryProcessing Neurolearning.com DyslexicAdvantage.com Sensory DVDs Amazon.com The Dyslexic Advantage is coming Fall 2011 Flickr.com/Inoc