Sensory Processing - Making Sense of the Missing Piece - Melissa Bianchini


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Sensory Processing Presentation - Making Sense of the Missing Piece: Presented by: Melissa Bianchini on 2/11/14 for Ossining SEPTO

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Sensory Processing - Making Sense of the Missing Piece - Melissa Bianchini

  1. 1. Sensory Processing: Making Sense of A Missing Piece February 11th, 2014
  2. 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. 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. 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. 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. 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. 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. 8. Sensory Processing / Integration: The ability to take in, organize/process & then respond to the sensory input in a meaningful & appropriate way
  9. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 25. Free Online Tools • Sensory Checklist From Raising a Sensory Smart Child, Biel & Peske, 2005 • SPD Support .org – Printable Resources • Getting to Know My Child - Downloadable form that can help teach the school about your child
  26. 26. Sites for Apps for Children with Special Needs One Place for Special Needs Website: • • Apps for Children with Special Needs: Special Needs Apps Review (Friendship Circle): 78 Free IPad Apps (Slideshow): • Smart Apps For Special Needs: (Facebook Link)
  27. 27. Additional Resources Zuma Rocking Chair Howda Chair Disco Seat Smart Knit KIDS Portable Parenting
  28. 28. Additional Resources Fidgets & Movement: Sensory Stixx Tangle Spin Disc
  29. 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. 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
  31. 31. Sensory Stepping Stones: Theraputic Services  Sensory LearningSM Program  Interactive Metronome®  Cognitive Learning & Memory Programs  NeuroFeedback / EduFeedback  Reading Fluency & Development
  32. 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. 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. 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
  35. 35. The Sensory LearningSM Program System
  36. 36. How the Program Works
  37. 37. Visual Fields Pre and Post Sensory LearningSM Program 13 year old
  38. 38. Improvements in Visual-Spatial Perception 10 year old
  39. 39. Improvements in Fine Motor Skills 8 year old Pre Post (8 months)
  40. 40. 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:
  41. 41. 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
  42. 42. Interactive Metronome® (IM) (Continued) Neurological Conditions Seeing Improvements: • • • • • • • • • • ADHD/ADD Apraxia/Dyspraxia Autism Spectrum Disorders / Asperger’s / PDD Brain /Spinal Cord Injuries Brain Tumor (following surgery or chemotherapy) Auditory Processing Disorder Cerebral Palsy Communication Impairments / Stuttering Confidence & Self-esteem Dyslexia and Other Reading Disorders • • • • • Language & Learning Disabled Non-verbal Learning Disorder Obsessive Compulsive Disorder / Anxiety Sensory Processing Disorder Stroke / MS / Parkinson’s Website:
  43. 43. 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®
  44. 44. 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:
  45. 45. 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
  46. 46. 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:
  47. 47. 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®
  48. 48. 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:
  49. 49. 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
  50. 50. Thank You! Melissa Bianchini, LCSW Executive Director – Sensory Stepping Stones (914) 244-4101