2. Goals For the Presentation
• Overview of Sensory Processing / Sensory
Integration (Adaptation)
• Adapted vs. Un-Adapted
• Supportive Suggestions for Home & School
• Sensory Stepping Stones: Clinic/Therapies
3. Melissa Bianchini, LCSW; Executive
Director of Sensory Stepping Stones
NYS Licensed Clinical Social Worker (LCSW): Children & Families Specialty / Play Therapy
Masters in Social Work (MSW): Fordham University
BS in Psychology/Sociology: Fordham University
NYS Credentialed Alcohol & Substance Abuse Counselor (CASAC)
Post-Graduate studies at Arizona State University in Anatomy-Physiology; Neuroscience
Training in:
Auditory Integration Training (AIT) & Tomatis Method
Syntonic Phototherapy
Vestibular Disorders (VEDA)
NeuroFeedback
Certified Provider of SmartMind® Pro NeuroFeedback
Masters Level Clinician & Certified Provider of Interactive Metronome®
Certified Provider of Sensory LearningSM Program (AIT, Light, Vestibular Therapist Trained)
Certified Provider for The Listening Program®
Training in Assessment & Diagnosis; Certified Provider of IVA +Plus/IVA-AE® Testing
Training in Cognitive Rehabilitation; Certified Provider of Captain‟s Log®
Therapeutic Crisis Intervention System(TCI) / Nonviolent Crisis Intervention® (CPI)
Level 1 Training in American Sign Language
Training in Brain Gym®
Volunteer Red Cross Instructor
4. What is Your
Response to……
A cold shower
Wearing wool sweaters/clothing
Being in wet socks/shoes
Wearing tight jeans/pants
The feel of Jell-O in your mouth
Spicy foods
The sound of birds/traffic/background noises
The sound of a nail down a chalk board
Bright colored walls in the bedroom
The smell of perfumes, certain foods
Packed elevators/rooms
Riding on roller coasters
Music at a rock concert
Sitting in back seat of a car
5. Our Senses: The sensations that the
nervous system recognizes.
The five (5) common & two (2) “Hidden Senses” that
relate to our body position & movements
* Hearing / Auditory
* Taste / Gustatory
* Touch / Tactile
* Sight / Visual
* Smell / Olfactory
“Hidden Senses”
* Vestibular / Movement
* Proprioception / Body Position
6. Vestibular Sensory System:
Sense of Balance
This system involves balance as well as the
relationship we have to spatial orientation; which way
is up, down, left, right, horizontal or vertical
This system also tells the
individual if they are
moving or not, how fast
and in what direction –
movement, balance &
coordination
7. Proprioceptive Sensory System:
Movement & Sense of Body in Space
The way we receive information from
our muscles, joints and tendons telling
the body where it or the body part is at a
given moment = Body Awareness
Nerve Pathways travel two ways
and relay messages from the
muscles to the brain & back
Muscle Memory – Drive a car, play a sport/instrument
8. Sensory Processing / Integration:
The ability to take in, organize/process & then respond to the sensory
input in a meaningful & appropriate way
9. What Does It Look Like?
NONE of these are right or wrong!!!
We all process differently but when it is impacting
us negatively we need to address it
Hypersensitive or
Over-Responsive
Hyposensitive or
Under-Responsive
Low Sensory or
Seekers
High Sensitivity
or Active Avoider
4 Reasons of Any Sensory Overload (TAPE):
Terror
Annoyance
Pain
Exhaustion
10. Hypersensitive or Over-Responsive
Need little amount of energy or stimulation
Heightened awareness & high sensitivity but lacks active response
Can become easily overwhelmed
Complains of things “bothering” them & is frequently anxious/upset
Overreacts to small changes in the environment
Tactile: Responds negatively to light touch, including
the anticipation of touch; touch seems scary or
uncomfortable; wrestle during dressing or lifting; kick,
punch, scream when someone is too close
Visual: Reacts
strongly to contrasts,
reflections, bright
lights; may turn eyes
away or cover them;
may be disturbed by
moving objects; may
duck when ball
comes toward them
Auditory: Listen to every
sound CONSTANTLY;
easily distracted; startled or
irritated by standard
sounds; covers ears; refuses
to participate
Vestibular: Movement,
or the possibility of it,
Taste: Objects to
causes negative reaction
certain textures or
or to become
temperatures of foods;
overexcited; may get car
may gag while eating
sick, avoid riding a bike,
or in certain rooms;
sliding or swinging; may
may plug nose; may
become easily dizzy;
become upset by
may lose the ability to
certain smells or tastes
keep up with others
OPPOSITIONAL: JC-shoes, touch / TB-playground, car, foods
11. Hyposensitive or Under-Responsive
Need a lot of energy or stimulation
Poor awareness and low sensitivity to stimulation
Miss environmental cues
Slow Processing
Auditory: Seems
Tactile: Often disregards touch;
unaware of sounds;
typical injuries don‟t hurt, usually
does not respond
doesn‟t protect self well
visibly to sounds;
Visual: May not pay
may speak softly
attention to new things
Vestibular: Doesn‟t seem to
visually such as
notice movement - may
holiday decorations,
have been an “easy baby”;
Taste: Might be
rearranged furniture;
lacks inner drive to move
able to eat foods
may not respond fast
actively; doesn‟t usually
that have a lot of
enough when objects
taste, spice,
come in their direction; seek movement, but once
started, has difficulty
flavor
may stare at objects or
stopping; doesn‟t protect
people‟s faces
self well from falling
QUIET: JT-staring, low
voice, gym & balls
12. Low Sensory or Seekers
Heightened awareness with low sensitivity to stimulation
Will seek out input
Frequently and intensively moving, jumping, spinning, touching
Tactile: Needs more deep pressure & skin
Auditory: Loves crowds and
contact than most; touch & feel everything
places with noisy action; wants to
in sight, even dangerous things or things
turn the volume up; may make
uncomfortable to others; loves messy play
own noisy sounds; uses “outside
IN YOUR FACE: BP-voice,
voice” often
up close, touchy/feely
Vestibular: Seeks & enjoys
Visual:
a lot of vigorous movement,
Might always
often in unusual ways
want to be in
Taste: Might try
(upside down, “downward
front of TV,
to taste or lick
dog”, place head on the
computer,
items that are not
floor); may love to climb;
Ipad; may be
may crave rocking, swinging, edible (chalk,
attracted to
Playdough); may
spinning in circles; attention
bright lights
prefer spicy,
span may be short
flavorful foods
13. Active Avoider
High Awareness with a high sensitivity & active responses
Will actively avoid things / events - excuses
Searches out escape areas, covers ears/eyes, shows aggression to “Protect” self
Tactile: Initial response to avoid the
situation with excuses – responds negatively
to touch, especially the anticipation of
touch; avoids closeness first then will kick,
punch, scream if someone is too close
Visual: Initial response
to avoid the situation
with excuses – when
forced to attend may
turn eyes away or cover
them; may stay off on
the side or in back
OPPOSITIONAL: TSexcuses, auditory, tactile
Auditory: Initial response to avoid
the situation with excuses – is hyper
alert; easily distracted; irritated by
sounds; covers ears; refuse to
participate prior to events
Vestibular: Initial
response to avoid the
situation with excuses –
Movement, or the
possibility of it, causes
anxiety or panic; avoids
group games, playground
activities
Taste: Initial response
to avoid the situation
with excuses – Objects
to unknown textures or
temperatures of foods;
refuse to try new
things
14. 2 Challenges of the Un-Adapted
Areas Mentioned….
1. Low Sensory/Seeker & Active Avoider Can Appear Similar:
•
•
•
Both may move frequently
Low Sensory/Seekers are looking for the stimulation
Avoiders are attempting to escape the stimulation
2. Under-Responder & Overwhelmed Can Also Appear Similar:
• May not appear as “sensory needy” as the seeker/avoider
• Overwhelmed are vigilant and will have anxiety to the environment and will
resist change
• Under-responders also may not respond to environmental cues, however due to
lack of awareness and not vigilance
15. Is It Behavioral?
DEFINITION: The range of actions & mannerisms made in response to the
environment
Children & adults can learn strategies in order to respond to the
environment and adjust our behaviors
Children tend to use one or two strategies for multiple
situations and may be the ONLY way a child knows how to
behave and after repeated use (reinforcement) without
correction becomes established
HOWEVER….once established
it MAY appear willful, BUT we
must remember that a CHILD
often acts without thinking or
analyzing their behavior.
Real question is
to ask WHY are
they acting this
way???
16. Sensory VS. Behavior
Sensory processing disorders frequently
get labeled as behavioral problems,
inattention, distractibility, motor
coordination, hyper/hypo sensitivities,
anxiety/panic attacks or other emotional
problems
Addressing ONLY the Behavioral
issues does not address the whole
problem, leaving the Sensory issues
unaddressed and we then still see
issues occur
17. What Does It Really Look Like?
AUDITORY
Covers ears in loud
environments/situations
AND/OR does not respond to
being called/spoken to
TACTILE
Doesn‟t like to be
touched/touches everyone &
everything, does not like glue,
paint, marker on fingers/hands,
does not like bath, hair combed,
certain clothes/fabrics
VISUAL
Squints in bright
environments, trouble
focusing on one object or
person AND/OR eye tracking
difficulties
SMELL
Sick with strong orders
present, smells/sniffs
everything they are in
contact with
18. What Does It Really Look Like?
TASTE
Picky eater, puts
everything in their
mouth or licks things
PROPRIOCEPTIVE
Looks clumsy, accident prone,
trouble coordinating body
movements
VESTIBULAR
Difficulty with motion,
spinning, swinging OR
craves motion, spinning
swinging
19. FOR
PARENTS
What Can We (Adults) Do?
During the Distress Period / Meltdown
REMEMBER: As the adult we need to
introduce/teach them how to respond/regulate their
reactions!
Deep Breaths to stay calm
Hydration / Health / Food / Sleep
STOP TALKING!!!
Listen
LISTEN MORE
Validate his/her feelings
Collaborate with them to solve the current problem
Show them you appreciate them often
20. What Can We (Adults) Do?
FOR
PARENTS
During the Calm / Preventative
GOAL: REMAIN REGULATED! Encourages
rational thinking to process & function
• Identify past & present symptoms &/or situation
• Map out the child‟s daily routine
•
People, Time, Activities, Similar Children
• Minimize the current impact (PTA)
•
Prevent, Treat, Accommodate
• Ensure the Big Four!
•
•
•
•
•
Sleep, Stress, Nutrition, Chemical Exposure
Develop sensory replacements (Sensory Diet)
Form a team of supportive therapies / providers & include the child!
Adapt the environment
References / Resources
21. Sensory Diets
Created by Patricia Wilbarger, OT
• Just as you need food throughout the course of the day, we need
sensory input, and opportunities for getting away from stimulation,
spread out over the whole day.
• A carefully designed, personalized activity plan that provides the
sensory input a person needs to stay focused and organized throughout
the day.
• Examples: Jiggling your leg, chewing gum to stay awake, soaking in a
hot tub to unwind
• Infants, young children, teens, and adults with mild to severe sensory
issues can all benefit from a personalized sensory diet.
• Ideally, you should work with an Occupational Therapist who
specializes in sensory processing issues
22. SOME Sensory Strategies
Vestibular / Proprioceptive
Visual /
Auditory
Bounce, jump, stomp, run, walk, spin,
clap, punching bag
“Heavy Work” that requires lifting,
pushing, pulling, climbing, raking,
Dim lights, natural or
digging, sweeping, wrestling, crashing
full spectrum lighting
“Deep Pressure” : Bear hugs, steam
Turn TV / radio /
rolling, body sacks, massage,
computer off
brushing/compression
Soft Music, white noise,
(Follow OT recommendation)
fan, water/ocean waves
Weighted blankets, vests
Oral
(Follow OT recommendation)
Chew Gum
Stroking / walking a pet
Suck Applesauce, yogurt,
pudding through a straw
Blow bubbles, harmonica,
kazoo, singing, humming
23. References & Resources: Books
•
Kranowitz, C.S. (1989). The Out of Sync Child, New York, NY: The Berkley
Publishing Group
•
Murray-Slutsky, C. & Paris, B. (2005). Is It Sensory or Is It Behavior? Behavior
Problem Identification, Assessment, and Intervention, San Antonio, TX: Harcourt
Assessment Inc.
•
Beil, L. & Peske, N. (2005). Raising A Sensory Smart Child, New York, NY: Penguin
Books
•
Miller, L.J. (2006) Sensational Kids, New York, NY: G.P. Putnam‟s Sons.
•
Baker, J. (2008). No More Meltdowns, Arlington, TX: Future Horizons
•
Horwitz, L.J. & Röst, C. (2004). Helping Hyperactive Kids – A Sensory Integration
Approach, Alameda, CA: Hunter House Inc., Publishers.
•
Taylor, J. (2011). Learn To Have Fun With Your Senses, Arlington, TX: Sensory
World (Future Horizons).
24. References & Resources: Books
(Continued)
•
Taylor, J. (2006). The Survival Guide for Kids with ADD or ADHD, Minneapolis, MN:
Free Spirit Publishing
•
Zysk, V. & Notbohm, E. (2011) 1001 Great Ideas for Teaching and Raising Children
with Autism or Asperger's, Revised and Expanded 2nd (second) Edition, Arlington,
TX: Future Horizons
•
Collins, B. & Linder-Olson, J. ( 2012 ) Sensory Parenting, From Newborns to
Toddlers: Everything is Easier When Your Child's Senses are Happy! Arlington, TX:
Sensory World (Future Horizons).
•
Collins, B. & Linder- Olson, J. (2012) Sensory Parenting - The Elementary Years:
School Years Are Easier when Your Child's Senses Are Happy! Arlington, TX:
Sensory World (Future Horizons).
•
Sheedy-Kurcinka, M. (2001) Kids, Parents, and Power Struggles: Winning for a
Lifetime, New York, NY: William Morrow Paperbacks.
•
Warshowsky, J (2012) How Behavioral Optometry Can Unlock Your Child‟s Potential,
London, UK: Jessica Kingsley Publishers
25. Free Online Tools
• Sensory Checklist
From Raising a Sensory Smart Child, Biel & Peske, 2005
http://sensorysmarts.com/sensory-checklist.pdf
• SPD Support .org – Printable Resources
http://spdsupport.org/resources/print-resources.shtml
• Getting to Know My Child - Downloadable form that can help teach
the school about your child
http://parentingspecialneeds.org/attachments/19_about_me_forms.pdf
26. Sites for Apps for Children
with Special Needs
One Place for Special Needs Website:
• http://www.oneplaceforspecialneeds.com/main/library_special_needs_apps.html
• http://www.oneplaceforspecialneeds.com/main/library_ipad_picks.html
Apps for Children with Special Needs: http://a4cwsn.com/
Special Needs Apps Review (Friendship Circle): http://www.friendshipcircle.org/apps/
78 Free IPad Apps (Slideshow):
• http://www.slideshare.net/elearningindustry/78-free-ipad-apps-for-students-withspecial-needs
Smart Apps For Special Needs: http://www.smartappsforspecialneeds.com/
(Facebook Link) https://www.facebook.com/SmartAppsForSpecialNeeds
29. Sensory Stepping Stones
Developmental Rehabilitation
& Learning Center
A center dedicated to providing a variety of both
traditional & innovative treatment programs for those
having difficulties with:
Sensory Integration, Gross Motor Planning &
Coordination, Attention & Focus, Cognitive Skills,
Fine & Visual Motor Coordination, Visual Perceptual
Skills & Reading Development.
(Sensory processing skills & developmental learning abilities)
.
30. HOW?
Through Sensory Adaptation
Sensory adaptation is the reduced sensitivity to stimulation
that results from repeated presentations of that stimulation
As humans we get used to things in life including smells,
sounds, sights, games, people, situations... after a while we
get used to everything.
Examples: Rental Car (Smoker/Non-smoker)
Loud / Dark Restaurant
Sensory Adaptation occurs when sensory
receptors change their sensitivity to the
stimulus
32. Our Programs Address:
Sensory Integration
Gross Motor Planning & Coordination
Attention & Focus Stamina Training/Skills
Alternating/Selective/Divided Attention
Fine Motor Coordination & Handwriting Skill
Visual Motor Coordination & Visual Perceptual Skills (Scanning/Tracking)
Auditory Processing
Central Visual/Auditory/Mental Processing Speed & Attention
Discriminatory Processing
Cognitive Training
Listening Skills
Receptive/Expressive Language Processing
Conceptual & Spatial Memory Skills
Logical Skills
Problem Solving Skills
Working & Short Term Memory / Sequencing
Impulsivity & Aggression Control
Time on Task
Reading & Math Development & Fluency
Social Skill Building
33. Types of Assessments Offered
* Comprehensive Assessment
* Educational (Pre-School) Assessment
* Peak Performance: Athletic-Brain Assessment
Assessments May Include:
Listening profile
Visual field assessment
Interactive Metronome - Long Form Assessment
Measures neurological functioning of motor planning & sequencing
IVA Plus/IVA-AE Test – Integrated Visual & Auditory Continuous
Performance Test
Measures inattention, impulsivity & hyperactivity (associated with
ADHD)
Reading Test
Letter Recognition & Recall
Phonemic Awareness & Recall
Vowel Rhyming & Recall
Consonant Diagraph Memory
Working Memory & Recall Test - Picture / Letter / Number
Educational / Sensory-Behavioral Assessment
Assessments are
completed in 1 - 3
hours depending on
the tests, age & ability
of the individual being
tested.
Results are reviewed
with parents /
guardians at a
separate appointment
time, and are
approximately 40
minutes long.
Copies of all results
will be given at this
time.
34. The Sensory LearningSM
Program - What Is It?
3 Individualized Therapies occurring at the same time:
AIT – Auditory Integration Training
Syntonic Phototherapy – Light Therapy
Vestibular Therapy - Movement
GOAL: Improve Perception, Understanding
and the Ability to Learn
Unique Features:
Gentle / Simultaneous Multi-Sensory Experience
Minimal Motivation Needed
Input vs. Output
Non-Cognitive vs. Cognitive
41. Sensory LearningSM Program
Summary
• The Sensory Learning Program is a 30-day,
drug-free intervention
• 12 consecutive days in the office
• 18 days at-home with a portable light instrument
• Two 30 minute sessions per day for a child
(One 60 minute session per day for an adult)
• Assessment / Re-Evaluation: Post-30, Post-60,
Post-90 days & Post 6 months
Website: www.sensorylearning.com
42. Interactive Metronome® (IM) –
What Is It?
The Program:
A computer based program used to improve the processing
abilities that affect attention, motor planning, sensory
processing and sequencing through rhythmic beats that are
synchronized with exercises. Feedback is given to tell the
person how "on beat" they are, and guides them to improve
their timing and ability to plan actions.
Areas Seeing Improvements:
•
•
•
•
•
•
Attention & Focus
Initiation
Mental Stamina
Coordination
Planning & Organizing
Sequencing
•
•
•
•
•
•
Language Processing
Reading & Math Fluency
Reasoning & Abstract Thinking
Time Management
Cognitive Processing Speed
Control of Impulsivity &/or
Aggression
44. Cognitive Learning & Memory
Programs –What Are They?
Computer based programs that help individuals
with ADHD/ADD, brain injuries, psychological
disorders or LDs to improve their thinking
(cognitive) skills – AT THEIR COGNITIVE PACE!
Main Areas of Training:
Attention Skills: Attention/Visual Skills
Problem Solving & Memory Skills:
Conceptual, Logical & Numeric Skills
Working Memory Skills: Auditory &
Working Memory Skills
Mental Processing Speed
Brain Train: Captain‟s Log®
Brain Train: MindPower Builder®
Brain Train: Memory Gym®
45. Cognitive Learning & Memory
Programs (Continued)
Cognitive Training & Memory Research:
ADHD, Working Memory & Cognitive Dysfunction
Multiple Sclerosis
Schizophrenia & Chronic Psychiatric Disorders
Stroke
Traumatic Brain Injury
Parkinson‟s Disease
Alzheimer‟s and Dementia
Cerebral Malaria and HIV
Website: www.braintrain.com
46. NeuroFeedback & EduFeedback
What Are They?
NeuroFeedback:
Monitors the electrical activity in your brain (brainwaves) through the
placement of electrodes on the scalp and an electroencephalograph (EEG).
The information is displayed as a graph or video game which gives the
user feedback about their brain activity or „neuro‟ „feedback‟. This
helps to inform the person when they are focused or not paying
enough attention.
The goal is to change brainwave patterns
Facts:
Ages 4 to adult
Intake - 90 minutes
19 - 21 sites on the scalp tested
Can be combined with Cognitive Training
Games
Takes 30 to 50 sessions/visits
47. NeuroFeedback & EduFeedback
(Continued)
EduFeedback:
The integration of feedback technology with proven educational
methodologies & behavioral shaping techniques.
These help one become more organized, have better short-term memory,
ignore distractions, or even balance one‟s check book in a normal
amount of time.
Edufedback teaches these skills and insures transfer to the workplace
& classroom.
Facts:
Ages 4 to adult
Primary difficulty is paying attention.
Results seen in as little as 15 hours;
Average of 40-60 hours of training
Website: www.playattention.com/
48. Reading Fluency & Development
What Is It?
Computerized reading & memory program that
identifies precisely where the individual is having
difficulty and AT THEIR ACADEMIC PACE
combines the cognitive and reading “games” to
help individuals develop their abilities.
Test „N‟ Train Reading®
49. Reading Fluency & Development
(Continued)
The reading programs follow the
national Common Core Standards.
These Reading programs are
ideal for RTI programs and for
setting IEP goals.
Website: www.braintrain.com/
50. Other Services
Peak Performance Training
•
•
•
•
Athletic/Academic Peak
Performance Assessment
Sport Specific Peak Performance
Training
Music Specific Peak Performance
Training
General (Business) Peak
Performance Training
Counseling Therapy
•
•
•
•
•
Assessments for children, adolescents
and adults
Educational Evaluations
Sensory-Behavioral Evaluations
Parenting skills / techniques
Referrals for additional Counseling
services
Occupational Therapy
•
•
•
•
Assessments for children and
adolescents
Educational Evaluations
Sensory-Behavioral Evaluations
Referrals for additional OT services
Presentations
•
•
•
Parent Presentations
Topic Specific
Presentations
Professional Presentations