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IMPLICATIONS AND TREATMENT
  OF SENSORY PROCESSING
         DISORDERS

     Sandy Droster, OTR
Objectives:
Participants Will Learn About:
   Normal Sensory Systems

   Sensory Processing Disorders (SPD)

   How To Identify SPD

   How To Interact With Individuals Who Have
    SPD
How A Normal Sensory
System Works:
   A normal sensory system takes in
    information through the senses of
    touch, movement, smell, taste, vision, a
    nd hearing and combines the resulting
    perceptions with prior
    information, memories, and knowledge
    already stored in the brain in order to
    derive coherent meaning to be able to
    effectively respond to our environment.
The Process Of Sensory
   Integration:

                        Sensory
                         Systems
                         Begin in
                         Utero
                        Fetal Life is
                         Rich in
                         Sensations
Sensory Integration In
     Infancy:
   Baby Introduced
    to Intense
    Sensory
    Experiences at
    Birth
   Depends on
    Caregivers for
    Regulation of
    Systems
Sensory Integration In Early
   Childhood:




   Begin Self Regulation
   Engage in Sensory Exploration
   Learn how to Make Things
    Happen
   Improve Body Movement
   What Happens When The
    Sensory Processing System
    Does Not Fully Mature?
Sensory Processing Disorder:
   A neurological disorder causing
    difficulties with processing information
    from the five classic senses
    (vision, auditory, touch, olfaction, and
    taste), the sense of movement
    (vestibular system), and or the
    positional sense (proprioception).
Sensory Processing Disorder:
   Sensory Information is Sensed
    Normally, but Perceived Abnormally
   May Cause Distress or Confusion
   Affect Learning, Social
    Interactions, Task
    Performance, Everyday Activities
   Can Lead to
    Motor, Emotional, Psychological, Social,
    Communication or Behavior Problems
Sensory Processing Disorders
Are Associated With:
   Mental Retardation (Severe, Profound)
   Autism
   Pervasive Developmental Disorders
   Attention Deficit Disorder
   Learning Disabilities
Causes Of Sensory Processing
   Disorders:
   Functional/Structural Abnormalities
   Trauma to/Defect in Sensory Receptors
   Brain/Head Trauma
   Biochemical Abnormalities
   Sensory Deprivation
   Genetic Disorder
   Prenatal Drug/Alcohol Abuse
   Physical/Sexual Abuse
Four Categories Of Sensory
   Processing Disorder:
                  Sensory
                   Defensiveness
                  Sensory Modulation
                   Disorder
                  Sensory Registration
                   Disorder
                  Sensory Integrative
                   Disorder
Sensory Defensiveness:
   Aversive or Defensive
    Reactions to Non-Noxious
    Stimuli Across One or
    More Sensory Modalities
   Characterized by
    Overresponding to One
    or More Sensory Systems
   Has an Overriding
    Negative Emotional
    Response
Sensory Modulation Disorder:
                 Over/Under
                  Responding or
                  Seeking Sensory
                  Stimulation
                 Characterized by
                  Fearful/Anxious
                  Response
                 Negative/Stubborn
                  Behaviors
                 Self-Absorbed
                  Behaviors
Sensory Registration Disorder:
   Process by Which
    the CNS Attends to
    Stimuli
   Characterized by
    Over, Under, or
    Inconsistent
    Response to Stimuli
   May Appear
    Lethargic
Sensory Integrative Disorder:
                  Difficulty
                   Responding as a
                   Result of Cortical
                   Organization
                  Characterized by
                   Fight, Flight, or
                   Fright
                  Impaired
                   Agility, Coordination,
                    Visual Motor
                   Skills, and
Symptoms Of Sensory
   Processing Disorder:
   Vision
   Hearing
   Touch
   Vestibular (Movement)
   Taste/Smell
Vision:

   Delayed/Inconsistent Responses, Eyes
    Dull/Out of Focus, Gaze Aversion, Avoids
    Bright/Direct Light, May Startle to Unexpected
    Approach, Excessive
    Blinking, Hypervigilance, Poor Visual-
    Perceptual Skills, Poor Visual –Motor
    Skills, Poor Visual Attention
Hearing:
Inconsistent/Unable to

Localize Sounds,

Delayed Response, Startles to Sound, Intolerant

to Certain Sounds, Vocalizes Loudly in Noisy

Environments, Upset by Loud Noises, Distracted

by Background Noise, Doesn’t Tolerate Loud

Environments, Covers Ears, Hits Side of Head
Touch:
Inconsistent Response, Stereotypical Behaviors,

Self-Abuse, Avoidance or Fixation on Oral

Stimulation, Limited Acceptance of Food

Textures, Avoids Hand Use, Allows Touch by

Certain People, Toe Walks, Strips/Completely

Covered, Brief Grasp of Objects
Vestibular (Movement):
Lacks Protective Reactions,

Fearful of Movement,

Resists Imposed Position Changes, Becomes Motion

Sick, Aggressive/Upset if Balance is Disturbed, Avoids

Change in Head Position, Avoids Playground

Equipment, Seeks Certain Movements
Taste/Smell:
            Sensitive to Many Odors

            Limited Range of Foods/Fluids
             Accepted

            May Act as if All Food Tastes
             the Same

            Strong Preference for Spicy
             Foods
Four Principles For
   Intervention
   Just Right Challenge

   Adaptive Response

   Active Engagement

   Child Directed
Just Right Challenge
The Child Must be Able to Successfully

Meet the Challenges That Are Presented

Through Playful Activities
Adaptive Response:
The Child Adapts His Behavior With New

and Useful Strategies in Response to the

Challenges Presented
Active Engagement:
The Child Will Want to Participate

Because the Activities are Fun
Child Directed:
The Child’s Preferences Are Used to

Initiate Therapeutic Experiences Within

the Session
Sensory Intervention:
   Designed to Stimulate and Challenge All
    of the Senses by Engaging the Child in
    Activities That Provide Vestibular
    (Movement), Proprioceptive (Sense of
    Position), and Tactile (Touch)
    Stimulation
Vestibular:
                 Input From Inner
                  Ear Receptors
                 Relationship to
                  Gravity
                 Can Alert or Calm
                  the Nervous System
                 Follow with Tactile
                  or Proprioceptive
                  Input
Proprioceptive:
   Input From Major
    Weight Bearing, Neck
    and Jaw
    Joints, Tendons, Muscle
    s
   Key Roll in Remediation
    of Sensory Modulation
    Problems
   Provides Sense of Body
    Contents, Mass, and
    Presence
Tactile:
              Input From Skin and
               Internal Tissues
              Provides Sense of
               Boundaries and
               Self/Non-Self
              Establishes Body
               Image in
               Conjunction With
               Proprioception
              Better Accepted
               When Self-Imposed
Hyposensitivity Vs.
   Hypersensitivity
   Hyposensitivity: Children With Lower
    Sensitivity. May Be Exposed To Strong
    Sensations.

   Hypersensitivity: Children With
    Heightened Sensitivity. May Be
    Exposed To Peaceful Activities.
Examples Of Activities For
          Hyposensitive Kids:
Land Activities: Stroking With Brush, Exercise Bikes,

Walking, Trotting/Running, Swinging, Jumping,

Resistive Pushing, Carrying Weights, Back/Shoulder

Rubs, Chores Using Large Muscles, Structured Rough

Housing, Self Applied Vibration, Resistive Sucking,

Chewing, Pressure Sandwiches, Modeling Clay

Manipulation, Finger Painting
Examples Of Activities For
   Hyposensitive Kids:
Water Activities: Riding the Magic Carpet

(Rapid/Unpredictable), Kicking, Splashing,

Jumping Into Water, Toy Manipulation

(Textured), Squirt Toys
Examples Of Activities For
         Hypersensitive Kids:
Land Activities: Scents (Natural), Things To

Squeeze or Fidget With, Music, Comfort Sounds

(Birds/Running Water), Mild Vibration, Quiet

Rooms, Soft Colored Lights, Gentle Rocking,

Cover With Blanket, Deep Pressure Activities,

Slow/Deep Breathing, Low Toned Music Bars
Examples Of Activities For
   Hypersensitive Kids:
Water Activities: Riding the Magic Carpet

(Slow/Rhythmical), Floating on Floatation

Device, Gentle Movement With Action Songs

Sung With Soft Voice, Self-Imposed Toy

Manipulation, Supported Movement Through

Water
Precautions:
   Physical

   Environmental

   Interpersonal
Physical Precautions:
           Joint Instability
           Postural Instability
           Misaligned Joints
           Painful Joints
           Fragile bones
           Poor Protective Response
           Diminished Sensation
Environmental Precautions:
   Visual Stimuli

   Auditory Stimuli

   Touch/Proprioception

   Smells
Interpersonal Precautions:
        Avoid Offending Sensory System
        Follow Client’s Lead
        Provide Sensation If It Helps
        Monitor Non-Verbal Communication
        Offer Choices
        Provide Consistency
        Individualize Proximity To Others
        Be Aware Of Unfamiliar People
        Use Appropriate Teaching Styles
        Monitor Tone & Volume Of Voice
        Be Conscious Of Body Language
        Use Appropriate Touch
        Be Predictable
        Use Eye Contact, Facial Expression
        Monitor Hair, Scent, Clothing
One Size Does Not Fit All:
   Kids With Sensory Processing Disorder
    Have Their Own Unique Set Of Sensory
    Responses

   You Must Accommodate Based On How
    They Respond
Case Study:
   Child With Sensory Registration
    Disorder
   CNS Under Responding to Sensory
    Stimulation
   Poor Body Awareness
   Difficulty Discriminating Specific
    Sensations
Activity:
   Child Asked To Draw A Picture Of Herself (A)
   One Week Later Asked To Draw Herself Again (B)
Intervention:
   Done Immediately Following Her Drawing of
    the Second Picture
   5 Minutes in Duration
   Intervention Included:
       Heavy Muscle Work and Proprioception (Pushing
        Against Staff Person)
       Deep Pressure Strokes Down
        Extremities, Back, and Head With Body Part
        Labeling
       More Pressure and Labeling Done on Left Side Due
Activity:
   Asked to Draw Herself Again Immediately After
    Intervention
Observations:
   Detailed Outline of Self (Including Head, Hair,
    Eyes, Mouth, Arms, Hand Fingers, Legs, Foot,
    and Bones)
   Colored-In Drawing Indicates Wholeness of
    Self
   More Awareness of Body Parts and Their
    Position
   Greater Detail On Side That Received Deep
    Pressure and Labeling
Conclusion:
   5 Minutes of Sensory Input
       Improved   Discrimination Between Senses
       Improved   Body Part Identification &
        Position
       Improved   Sense of Self
       Improved   Alertness
       Improved   Function & Relationships
The End:
           Questions???

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Treating Sensory Processing Disorders

  • 1. IMPLICATIONS AND TREATMENT OF SENSORY PROCESSING DISORDERS Sandy Droster, OTR
  • 2. Objectives: Participants Will Learn About:  Normal Sensory Systems  Sensory Processing Disorders (SPD)  How To Identify SPD  How To Interact With Individuals Who Have SPD
  • 3. How A Normal Sensory System Works:  A normal sensory system takes in information through the senses of touch, movement, smell, taste, vision, a nd hearing and combines the resulting perceptions with prior information, memories, and knowledge already stored in the brain in order to derive coherent meaning to be able to effectively respond to our environment.
  • 4. The Process Of Sensory Integration:  Sensory Systems Begin in Utero  Fetal Life is Rich in Sensations
  • 5. Sensory Integration In Infancy:  Baby Introduced to Intense Sensory Experiences at Birth  Depends on Caregivers for Regulation of Systems
  • 6. Sensory Integration In Early Childhood:  Begin Self Regulation  Engage in Sensory Exploration  Learn how to Make Things Happen  Improve Body Movement
  • 7. What Happens When The Sensory Processing System Does Not Fully Mature?
  • 8. Sensory Processing Disorder:  A neurological disorder causing difficulties with processing information from the five classic senses (vision, auditory, touch, olfaction, and taste), the sense of movement (vestibular system), and or the positional sense (proprioception).
  • 9. Sensory Processing Disorder:  Sensory Information is Sensed Normally, but Perceived Abnormally  May Cause Distress or Confusion  Affect Learning, Social Interactions, Task Performance, Everyday Activities  Can Lead to Motor, Emotional, Psychological, Social, Communication or Behavior Problems
  • 10. Sensory Processing Disorders Are Associated With:  Mental Retardation (Severe, Profound)  Autism  Pervasive Developmental Disorders  Attention Deficit Disorder  Learning Disabilities
  • 11. Causes Of Sensory Processing Disorders:  Functional/Structural Abnormalities  Trauma to/Defect in Sensory Receptors  Brain/Head Trauma  Biochemical Abnormalities  Sensory Deprivation  Genetic Disorder  Prenatal Drug/Alcohol Abuse  Physical/Sexual Abuse
  • 12. Four Categories Of Sensory Processing Disorder:  Sensory Defensiveness  Sensory Modulation Disorder  Sensory Registration Disorder  Sensory Integrative Disorder
  • 13. Sensory Defensiveness:  Aversive or Defensive Reactions to Non-Noxious Stimuli Across One or More Sensory Modalities  Characterized by Overresponding to One or More Sensory Systems  Has an Overriding Negative Emotional Response
  • 14. Sensory Modulation Disorder:  Over/Under Responding or Seeking Sensory Stimulation  Characterized by Fearful/Anxious Response  Negative/Stubborn Behaviors  Self-Absorbed Behaviors
  • 15. Sensory Registration Disorder:  Process by Which the CNS Attends to Stimuli  Characterized by Over, Under, or Inconsistent Response to Stimuli  May Appear Lethargic
  • 16. Sensory Integrative Disorder:  Difficulty Responding as a Result of Cortical Organization  Characterized by Fight, Flight, or Fright  Impaired Agility, Coordination, Visual Motor Skills, and
  • 17. Symptoms Of Sensory Processing Disorder:  Vision  Hearing  Touch  Vestibular (Movement)  Taste/Smell
  • 18. Vision:  Delayed/Inconsistent Responses, Eyes Dull/Out of Focus, Gaze Aversion, Avoids Bright/Direct Light, May Startle to Unexpected Approach, Excessive Blinking, Hypervigilance, Poor Visual- Perceptual Skills, Poor Visual –Motor Skills, Poor Visual Attention
  • 19. Hearing: Inconsistent/Unable to Localize Sounds, Delayed Response, Startles to Sound, Intolerant to Certain Sounds, Vocalizes Loudly in Noisy Environments, Upset by Loud Noises, Distracted by Background Noise, Doesn’t Tolerate Loud Environments, Covers Ears, Hits Side of Head
  • 20. Touch: Inconsistent Response, Stereotypical Behaviors, Self-Abuse, Avoidance or Fixation on Oral Stimulation, Limited Acceptance of Food Textures, Avoids Hand Use, Allows Touch by Certain People, Toe Walks, Strips/Completely Covered, Brief Grasp of Objects
  • 21. Vestibular (Movement): Lacks Protective Reactions, Fearful of Movement, Resists Imposed Position Changes, Becomes Motion Sick, Aggressive/Upset if Balance is Disturbed, Avoids Change in Head Position, Avoids Playground Equipment, Seeks Certain Movements
  • 22. Taste/Smell:  Sensitive to Many Odors  Limited Range of Foods/Fluids Accepted  May Act as if All Food Tastes the Same  Strong Preference for Spicy Foods
  • 23. Four Principles For Intervention  Just Right Challenge  Adaptive Response  Active Engagement  Child Directed
  • 24. Just Right Challenge The Child Must be Able to Successfully Meet the Challenges That Are Presented Through Playful Activities
  • 25. Adaptive Response: The Child Adapts His Behavior With New and Useful Strategies in Response to the Challenges Presented
  • 26. Active Engagement: The Child Will Want to Participate Because the Activities are Fun
  • 27. Child Directed: The Child’s Preferences Are Used to Initiate Therapeutic Experiences Within the Session
  • 28. Sensory Intervention:  Designed to Stimulate and Challenge All of the Senses by Engaging the Child in Activities That Provide Vestibular (Movement), Proprioceptive (Sense of Position), and Tactile (Touch) Stimulation
  • 29. Vestibular:  Input From Inner Ear Receptors  Relationship to Gravity  Can Alert or Calm the Nervous System  Follow with Tactile or Proprioceptive Input
  • 30. Proprioceptive:  Input From Major Weight Bearing, Neck and Jaw Joints, Tendons, Muscle s  Key Roll in Remediation of Sensory Modulation Problems  Provides Sense of Body Contents, Mass, and Presence
  • 31. Tactile:  Input From Skin and Internal Tissues  Provides Sense of Boundaries and Self/Non-Self  Establishes Body Image in Conjunction With Proprioception  Better Accepted When Self-Imposed
  • 32. Hyposensitivity Vs. Hypersensitivity  Hyposensitivity: Children With Lower Sensitivity. May Be Exposed To Strong Sensations.  Hypersensitivity: Children With Heightened Sensitivity. May Be Exposed To Peaceful Activities.
  • 33. Examples Of Activities For Hyposensitive Kids: Land Activities: Stroking With Brush, Exercise Bikes, Walking, Trotting/Running, Swinging, Jumping, Resistive Pushing, Carrying Weights, Back/Shoulder Rubs, Chores Using Large Muscles, Structured Rough Housing, Self Applied Vibration, Resistive Sucking, Chewing, Pressure Sandwiches, Modeling Clay Manipulation, Finger Painting
  • 34. Examples Of Activities For Hyposensitive Kids: Water Activities: Riding the Magic Carpet (Rapid/Unpredictable), Kicking, Splashing, Jumping Into Water, Toy Manipulation (Textured), Squirt Toys
  • 35.
  • 36. Examples Of Activities For Hypersensitive Kids: Land Activities: Scents (Natural), Things To Squeeze or Fidget With, Music, Comfort Sounds (Birds/Running Water), Mild Vibration, Quiet Rooms, Soft Colored Lights, Gentle Rocking, Cover With Blanket, Deep Pressure Activities, Slow/Deep Breathing, Low Toned Music Bars
  • 37. Examples Of Activities For Hypersensitive Kids: Water Activities: Riding the Magic Carpet (Slow/Rhythmical), Floating on Floatation Device, Gentle Movement With Action Songs Sung With Soft Voice, Self-Imposed Toy Manipulation, Supported Movement Through Water
  • 38.
  • 39. Precautions:  Physical  Environmental  Interpersonal
  • 40. Physical Precautions:  Joint Instability  Postural Instability  Misaligned Joints  Painful Joints  Fragile bones  Poor Protective Response  Diminished Sensation
  • 41. Environmental Precautions:  Visual Stimuli  Auditory Stimuli  Touch/Proprioception  Smells
  • 42. Interpersonal Precautions:  Avoid Offending Sensory System  Follow Client’s Lead  Provide Sensation If It Helps  Monitor Non-Verbal Communication  Offer Choices  Provide Consistency  Individualize Proximity To Others  Be Aware Of Unfamiliar People  Use Appropriate Teaching Styles  Monitor Tone & Volume Of Voice  Be Conscious Of Body Language  Use Appropriate Touch  Be Predictable  Use Eye Contact, Facial Expression  Monitor Hair, Scent, Clothing
  • 43. One Size Does Not Fit All:  Kids With Sensory Processing Disorder Have Their Own Unique Set Of Sensory Responses  You Must Accommodate Based On How They Respond
  • 44. Case Study:  Child With Sensory Registration Disorder  CNS Under Responding to Sensory Stimulation  Poor Body Awareness  Difficulty Discriminating Specific Sensations
  • 45. Activity:  Child Asked To Draw A Picture Of Herself (A)  One Week Later Asked To Draw Herself Again (B)
  • 46. Intervention:  Done Immediately Following Her Drawing of the Second Picture  5 Minutes in Duration  Intervention Included:  Heavy Muscle Work and Proprioception (Pushing Against Staff Person)  Deep Pressure Strokes Down Extremities, Back, and Head With Body Part Labeling  More Pressure and Labeling Done on Left Side Due
  • 47. Activity:  Asked to Draw Herself Again Immediately After Intervention
  • 48. Observations:  Detailed Outline of Self (Including Head, Hair, Eyes, Mouth, Arms, Hand Fingers, Legs, Foot, and Bones)  Colored-In Drawing Indicates Wholeness of Self  More Awareness of Body Parts and Their Position  Greater Detail On Side That Received Deep Pressure and Labeling
  • 49. Conclusion:  5 Minutes of Sensory Input  Improved Discrimination Between Senses  Improved Body Part Identification & Position  Improved Sense of Self  Improved Alertness  Improved Function & Relationships
  • 50. The End: Questions???