1.
LONE RØMER JENSEN
CENTRE FOR DEAFBLINDNESS AND HEARING LOSS, DENMARK
How to act with arousal in mind

2.
ABOUT US
Centre for Deafblindness and Hearing Loss (CDH),
Aalborg, Denmark
Brochure available; https://bit.ly/2YU4kUP

3.
A NEUROPSYCOLOGICAL PROJECT
4 adults with congenital deafblindness and multiple
impairments
Self-stimulating behaviour prior to the project

4.
RESEARCH QUESTION
How does the arousal framework help us to analyze,
describe and act accordingly, in our daily work of
ensuring an appropriate level of attention and
readiness for interaction and communication?

5.
WHAT IS AROUSAL?
Regulating internal energy
The importance of interactions
Visible in unconscious bodily reactions

6.
THEORETICAL METHOD
Neuroaffective Developmental Psychology by
Susan Hart
The autonomic compass; a model of energy
management and body sensations

7.
PleasureDispleasure
Activity / Sympathetic
Passivity / Parasympathetic
Hyperactivity
Disarming smile
Brief alarm
response
Curiosity
Vitality
Engagement
Low energy
Passivity
Brief freeze
Relaxation
Rest
Urge to cuddle
Exaltation
Mania
Extreme daydreaming
Narcolepsy
Fight
Flight
Helplessness
Sustained freeze
Axis of hedonic tone
Axis of arousal regulation
Reference: Bentzen & Hart, 2015, p.47

8.
INDICATOR POINTS IN THE AUTONOMIC COMPASS
PleasureDispleasure
Passivity / Parasympathetic
Activity / Sympathetic

9.
SIMON
Case presentation
Prior to the project; general state and behaviour

10.
Activity / Sympathetic
Passivity / Parasympathetic
Displeasure Pleasure
INDICATOR POINTS FOR SIMON

11.
AROUSAL REGULATING ACTIVITIES
Creating arousal regulating activities
Activities for Simon:
Clapping/padding activity
Sensory activity board

12.
PICTURES OF SIMONS SECOND ACTIVITY
Left: Homemade sensory board, made from a kitchen cutting board with colorful items.
Right: Placed on an tablet holder on a table.

13.
RESULT AND CONCLUSION FROM THE PROJECT
Based on observations, we found that sensory
stimulating activities planned with arousal in mind:
• seem to have minimized the need for self-
stimulating behavior and
• helped to improve attention and readiness for
interaction and communication.
•Understanding communicative expressions.

14.
REFLECTIONS
• Which activities do you see useful, to influence
high arousal or low arousal?
• Share your experiences.

15.
PleasureDispleasure
Activity / Sympathetic
Passivity / Parasympathetic
Hyperactivity
Disarming smile
Brief alarm
response
Curiosity
Vitality
Engagement
Low energy
Passivity
Brief freeze
Relaxation
Rest
Urge to cuddle
Exaltation
Mania
Extreme daydreaming
Narcolepsy
Fight
Flight
Helplessness
Sustained freeze
Axis of hedonic tone
Axis of arousal regulation
Reference: Bentzen & Hart, 2015, p.47

16.
THANKS TO
My fellow colleagues in the residential home for creating
this project, developing the knowledge and experience.
Tina Bendixen and especially Tanja Møller Christiansen for
being my “partner in crime” – developing the knowledge
and keeping the arousal-project alive and spreading the
word around the world 

17.
SUPPLEMENTARY
MATERIAL

18.
ADDITIONAL ACTIVITIES
Picture: Handy-sling (walking aid for a personal lift in the ceiling) and moving disco lights, where the
resident with a visual impairment walked in a dark room, searching for the colorful light. In combination
with the physical stimulation, this activity helped to awaken her body and mind, and thereby
heightened her arousal level to the quadrant of active/pleasure from the quadrants passive or
active/displeasure.

19.
ADDITIONAL ACTIVITIES
Picture: Sensory stimulating massage ball. This ball was used in an activity where an individual with high
arousal (quadrant active/displeasure) needed help to lower his arousal. This activity was altered to
massage where hands was used, instead of this ball. Over time, this had a positive effect, where we
could help him regulate his arousal to the quadrant of passive/pleasure.

20.
ADDITIONAL ACTIVITIES
Picture: Sing-a-long book (song: Wheels on the bus go round and round). Activity where we combined
singing with physical gestures and signs. By doing this half an hour before dinnertime we could help a
female resident to regulate her arousal level from very low (quadrant passive/pleasure) to a more balanced
level (quadrant active/pleasure), in order for her to stay awake during mealtime. By doing this activity every
day for two to three years, she has slowly altered her internal energy level – basic level of arousal - from
passive to active, where she is more awake during the day.

21.
REFERENCES
Literature in English about the neuroaffective approach;
Bentzen, M. 2018. The Neuroaffective Picture Book. North Atlantic
Books.
Bentzen, M., Hart, S. 2015. Through windows of opportunity – a
neuroaffective approach to child psychotherapy”. Karnac Books
Ltd.
Hart, S. 2018. Brain, Attachment and Personality: An Introduction to
Neuroaffective Development. Taylor & Francis Ltd.

22.
lrj@rn.dk
Centre for Deafblindness and Hearing Loss, Aalborg
The North Denmark Region
LONE RØMER JENSEN
Pedagogue