si in the home

8/9/2019 SI in the Home

1/28

Presented by:Laurie Johnson, MHS, OTR/L

Adrienne Rousseau, parent of Autistic Child

SensoryIntegration in the

Home:An overview


2/28

The neurological process that organizes sensation from ones own body andfrom the environment and makes it possible to use the body effectively

within the environment. (Ayres, 1979)


3/28

Figure 11-8 Sensory Integration Theory and Practice, 2nd ed.

Anita Bundy, Shelley Lane, Elizabeth Murray


4/28

The capacity to regulate and organize the degree, intensity, and

nature of responses to sensory input in a graded and adaptivemanner. This allows the individual to achieve and maintain an

optimal range of performance and to adapt to challenges in daily

life. (Miller & Lane, 2000)


5/28

Passive Active

High

Threshold

Poor

Registration

Sensory

Seeking

Low

Threshold

Defensive Avoiding

Dunn, W (2002). Implementing a Sensory Processing Approach In School Practice.

SCOTA Conference, Charleston, SC.


6/28

The amount and type of sensory input needed to be

most alert, adaptable, and skillful in ones

environment. With the right input, our bodies feel

calm, alert and ready to tackle daily challenges.

Negative sensory input can have a disorganizing

affect on the body.

the multisensory experiences that one normally seeks on a daily basis to satisfy ones

sensory appetite; a planned and scheduled activity program that an occupational therapist

develops to help a person become more self-regulated. (Kranowitz, 1998)


7/28

Tactile

Sensation derived from stimulation to theskin (Bundy, et al. 2002)


8/28

Tactile

AlertingLight touch

Tickling

Hot or cold food (strong temperature)

Playing in textures (rice, sand, beans,finger painting, playdoh)

Go barefoot, use textured towels/blankets/ objects

Chose crafts with touch feedback (gluing,clay molding, etc)

CalmingFirm pressure on skin, longer duration

Hold hand firmly

Avoid unnecessary touch and forewarn ofnecessary touch

Weighted vests, blankets, etc.

Wilbarger Brushing Program (under OTdirection)

Oral tactile defensiveness strategies

.

underresponsiveness/ poor registration

Defensive/ Avoiding

principles:


9/28

ProprioceptionSensations derived from movement (ie.

Speed, rate, sequencing, timing, and

force) and joint position. Derived fromstimulation to muscle and, to a lesserextent, joint receptors, esp. from

resistance to movement. (Bundy, et al. 2002)


10/28

Proprioception.

Calming/ Organizing

Heavy work, jump, crash, resistance,

push/pull

i.e. squeeze ball, carry groceries, jump ontrampoline, tug of war, weightedbookbag, pillow crashing, hanging byarms or climbing

Underresponsive/ seeking as a modulator

Defensive?? (little evidence for)

principles


11/28

VestibularSensation derived from stimulation to the

vestibular mechanism in the inner ear that

occurs through movement and position of

the head; contributes to posture and the

maintenance of a stable visual field (Bundy etal., 2002)


12/28

Vestibular

AlertingChanges in speed and direction

Change of head position

Swinging (tire swing with lots ofdirectional changes)

Sliding

SomersaultsDragging on a blanket

Bouncing on adults knee/ therapy ball

Movement activity prior or during athinking task

Movement breaks in class (accompany onerrands to office, library, etc.)

CalmingLinear, predictable, repetitive

Head moving in straight line

I.e.. Rocking chair, bouncing up anddown, gentle linear swinging

Allow child to direct

Couple with organizing inputs(proprioceptive input, deep pressure,etc.)

I.e. Swing and crash! Child swingswith feet held firmly with pulling/pushing, etc.

Underresponsiveness/ poor registration/ seeking

Defensive/ AvoidingGravitational Insecurity


13/28

By: Wiley MillerNon Sequitar


14/28

Visual

AlertingHigh intensity, contrast, or change of

stimuli

i.e. bright lights, contrasting colors

Cover blocks in foil, roll a clear ballwith moving objects inside, highlightwords, label drawers with brightcolors

Use visual input to engage the seekingchild

Calming

Low contrast, dim

i.e. low lights, unclutteredenvironments, decreased competing

stimuli with attending to a task, setup visual blinds with sheets overcluttered areas, allow visual breaksin a dark room

Underresponsive/ Seeking

Defensive/ Avoiding


15/28

Auditory

Alerting

Strong intensity or changing sounds

Music with unpredictable rhythm

I.e.. Ring bell at stimuli you want child toattend to

Calming

Repetitive, constant, quiet

Rhythmic music,

Quiet spaces for child to retreat to when overstimulated

Carry headphones with calm, rhythmic music

Warn of loud noises, use earplugs

In Class, seat away from loud speakers andtraffic


Defensive/ Avoiding


16/28

Taste/ Smell

Alerting

Strong intensity

i.e. Spicy, sour, such as warheads, sourpatch kids, BBQ sauce, sour straws)

Calming

Mild intensity, nondistinct or familiarqualities, gradually progress tastesto expand diet

i.e. Use unscented cleaning products/soaps, start with bland foods(cream of wheat, mashed potatoes)


Defensive/ Avoiding


17/28

There is no recipe that alwaysworks! Many children doconfusing things!!

Examples

A professional trained in SI should helpinterpret the childs behavior and develop an

appropriate program


18/28


19/28

Tactile Sense

What it looks like in Xander

Defensive with light touch, will

not tolerate hair-brushing,

haircuts, hair washing, etc.

Particular about type of

clothing, how it fits, tags must becut out.

Difficulty walking barefoot on

grass, and must assimilate to

sand slowly. Change in walkingsurface is tough when barefoot.

Defensive with gentle touch or

affection, prefers firm pressure

when touched.

How we treat Xander

Equipment we have: resistance

tunnel, brush, koosh balls,

cotton balls, sand, rice, beans

playdoh, vibrating tools, and

any food he will tolerate. Wilbarger brushing/joint

compression protocol.

Throughout the day we

encourage Xander to try newinput, with each success he is

rewarded.

Educate those Xander interacts

with.

Defensive


20/28

Proprioceptive Sense

What is looks like in Xander

Seeks high impact in play-

running, jumping, bumping into

people and objects often.

Runs, jumps, bounces, wiggles

nearly continuously! (Looks a lot

like hyperactivity.)

Even at rest he often rolls, kicks,

flicks his arms/legs, drags his head,

etc.

Seeks deep impact during typical

daily routine activities- rubbing

against walls as he walks, bouncing

off of or pushing on objects.

Seeker

How we treat Xander

Equipment we have: mini-

trampoline, weighted vest, bear

hug vest, weighted shoes,

pillow and blanket, ball pit,

therapy ball, vibrating tools,joint compressions (with

brushing protocol).

Allow plenty of time for

gross motor play, including lotsof rough play (wrestling,

steam roller, pillow fights).

Regular proprioceptive

activity (every 15-30 minutes).


21/28

Vestibular Sense

What is looks like in Xander

At times he strongly seeks

vestibular input by spinning,

hanging upside down from

furniture, standing on his head,

swinging, riding his bike.

Other times he avoids taking his

feet off the ground, resists

movement in the car, avoidsswings, dislikes riding in the

stroller/wagon..

Fluctuates

How we treat Xander

Equipment we have: swings

(indoor and outdoor), scooter

board, mini-trampoline, therapy

ball, during summer we go to thepool often.

During periods of seeking, we

give Xander sensory choices to

feed his need - then transition tonew activities.


22/28

Visual Sense

What it looks like in Xander

Easily overwhelmed in cluttered

environment with numerous

stimuli to accept

Easily distracted by visualstimulus in every day environment

and sometimes hides eyes

Easily distracted by school

work/ therapy/ ABA work that is

visually over stimulating; making

it difficult to complete an

assignment or task.

Sometimes repeatedly tracks for

no apparent reason

FluctuatesHow we treat Xander

During defensive times we give

him time in a dark room,

sometimes with his eyes/head

covered.

In the community we take ablanket which he will pull over

his head when over stimulated.

Hand held video games give

him something to focus on when

the surroundings are too much to

handle.

We often use visual supports/

but keep them simple and avoid

extraneous pictures/ colors


23/28


24/28

The Sensory Diet

Morning Routine

Brushing/Joint Compressions

At school: Bear Hug Vest,Weight Vest, Crash mat,

Brushing/Joint Compression

After school: Quiet Activity

(rest time)

Sensory Choice(s)

Afternoon Activities including

calming input & brushing

Evening Routine


Outside Play

Sensory Choice(s)

Dinner

Bath/Brush Teeth/Pajamas


Quiet Time (reading, tv,

massage)

It is very important that regular sensory activities are used to keep

Xander centered for optimal function throughout the day.


25/28

Other ways to handle Sensory Integration

difficulty

Social Stories

Visual Schedule

How does your engine run?(ALERTProgram)


26/28

Special Circumstances

DOCTOR

DENTIST

GROCERY STORE

LIBR

ARY

WALMART


27/28

Some of Xanders successes

Xander tolerates his hair grown out and cut ratherthan buzzed!

Xander goes to the dentist and has his teethcleaned!

Xander jumps in the pool, dives for toys, andcompletes a somersault!

Xander eats a regular meal at school!

Xander calmly says no thanks to sensory inputhe doesnt want, rather than screaming NOOO!

(all previously impossible with STRONG resistance)


28/28

si in the home

Documents