Sensory Processing 101

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Sensory Processing 101 Implications of Sensory
Challenges in ASD
Chris Filler Transition Coordinator
Ohio Center for Autism
and Low Incidence
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• Sensory Processing challenges can influence how
  students respond to
• Environment
• People
• Instruction/Tasks/Activities
• Understanding these influences leads to the
  selection of effective interventions

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• What is Your Response to
• Cold shower
• Wool clothing
• Panty hose
• Sweatpants
• The feel of Jell-O in your mouth
• The sound of birds
• Bright colored walls in the bedroom
• The smell of perfume
• Elevators
• Roller Coasters

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Sensory Processes

• Sensory Processes include
• Sound/Auditory
• Sight/Vision
• Smell/Olfactory
• Taste/Gustatory
• The Power Senses
• Touch/Tactile
• Vestibular
• Proprioception

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Research suggests that the following areas
of the brain are affected
in Autism which can cause change
in sensory processing

• Cerebellum
• Purkinje Cells
• Limbic System
• Hippocampus
• Amygdala
• Frontal Lobes
• Gray and White Matter
• Occipital Lobes

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What is Sensory Processing?

• A Process by which we

1. Take in Information
2. Interpret the Information
3. Develop a Response or Action
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Breakdowns

• Breakdown may occur at any point
• Challenges to the intake system are more easily
  recognized
• Faulty operation of the interpretation and
  integration of information may be seen as a
  behavioral issue
• Negative consequences may only make the situation
  worse

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Sensory Processing Gone Astray
OR...
OR...
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Sensory Processing Gone Astray
Unable to touch many items, picky eaters
OR...
Explores the environment by touching everything
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Luke, a 13 year old with AS had wandered away
from his family at the beach. In attempt to find
Luke, his parents paged him overhead. Luke
writes..
Coastguards, police, a pack of Brownies and
every available person were all shouting my name
over a loudspeaker. I didnt hear a thing! I have
a strange kind of hearing and can only
concentrate on listening to things I know I am
meant to. Distinguishing between background and
foreground noise has always been a problem, so
however loud they shouted I would have presumed
that it was a background noise. From Freaks,
Geeks, and Asperger Syndrome

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Review of challenges/characteristics..

• Slow Processing - Difficulty shifting attention
• Inattentive, Difficult to arouse
• Does not like change
  or transitions -
  Rigid Demands
  routine

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• Difficulty with, or seeks out, certain types of
  foods/textures
• Smells all food before eating - smells objects
• Unable to sit with anyone behind
  them in class
• Difficulty attending
  from the back of the room
• Explosive emotions
  or lack of emotions or
  incongruent
  emotional
  responses

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• Aggression to self or others
• Compulsive Behaviors
• Difficulty with clothing,
  type of clothing, and
  change of clothing

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• Perseveration on topic or activity - Fixation on
  sensory stimuli
• Clumsy, awkward, difficulty in sports
• Over or Under-reaction to pain
• Unsure of group situations, cautious, or a loner

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Summary of Processing Challenges
SEEKER Heightened Awareness with Low Sensitivity
to Stimulation Will Seek Out Input (Frequently
and Intensively Moving, Jumping, Spinning,
Touching)
UNDER-RESPONDER Poor Awareness Low
Sensitivity to Stimulation. Misses Environmental
Cues Slow Processing (Acts as if does not hear,
misses gestures and cues, sedentary)
ACTIVE AVOIDER High Awareness, with High
Sensitivity and Active Responses. Will actively
avoid (Searching out Escape Areas, Covering
ears/eyes, Aggression to Protect self)
OVERWHELMED Heightened awareness, High
Sensitivity but lacks active response, Can
become easily overwhelmed. ( Complains of things
bothering Frequently anxious/upset, overreacts
to small changes in the environment)
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SEEKER Heightened Awareness with Low Sensitivity
to Stimulation Will Seek Out Input (Frequently
and Intensively Moving, Jumping, Spinning,
Touching)

• Seeker and Active Avoider
  can appear similar
• Both may move frequently
• Seekers are looking for the stimulation
• Avoiders are attempting to escape the stimulation

ACTIVE AVOIDER High Awareness, with High
Sensitivity and Active Responses. Will actively
avoid (Searching out Escape Areas, Covering
ears/eyes, Aggression to Protect self)
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UNDER-RESPONDER Poor Awareness Low
Sensitivity to Stimulation. Misses Environmental
Cues Slow Processing (Acts as if does not hear,
misses gestures and cues, sedentary)

• Under-Responder and Overwhelmed
  can also have some similarities
• 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

OVERWHELMED Heightened awareness, High
Sensitivity but lacks active response, Can
become easily overwhelmed. ( Complains of things
bothering Frequently anxious/upset, overreacts
to small changes in the environment)
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Summary of Processing Challenges
SEEKER Heightened Awareness with Low Sensitivity
to Stimulation Will Seek Out Input (Frequently
and Intensively Moving, Jumping, Spinning,
Touching)
UNDER-RESPONDER Poor Awareness Low
Sensitivity to Stimulation. Misses Environmental
Cues Slow Processing (Acts as if does not hear,
misses gestures and cues, sedentary)
ACTIVE AVOIDER High Awareness, with High
Sensitivity and Active Responses. Will actively
avoid (Searching out Escape Areas, Covering
ears/eyes, Aggression to Protect self)
OVERWHELMED Heightened awareness, High
Sensitivity but lacks active response, Can
become easily overwhelmed. ( Complains of things
bothering Frequently anxious/upset, overreacts
to small changes in the environment)
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Work Sheet

• Which is your student/child?
• Identify the sensory type (or types) that
  you observe to be true of your
  student or child

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The "Sensory Diet"
So What Can We Do?
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The Sensory Diet includes.

• PROVIDING SENSORY EXPERIENCES
• A combination of sensory experiences needed by a
  person to adaptively interact with the
  environment (make it through the day).
• MAKING ENVIRONMENTAL MODIFICATIONS
• Modification and organization of the environment
  in order to decrease stress on a fragile sensory
  system.

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Those with sensory processing challenges

• May not be able to filter and focus
• May attempt to adjust in a
  maladaptive way
• (Ex Escalation of Mood,
  Shutting Down)
• Will require a sensory diet enriched with
  unique sensations and experiences

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Creating The Sensory D.I.E.T.

• D ..Do an Informal Assessment
• I ..Individualize
• E ..Environmental Supports
• T ..The Power Senses

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Do an Informal Assessment

• Assess the Environment and the Individuals
  response to a variety of sensory experiences
• Seeker?
• Active Avoider?
• Under-Responder?
• Overwhelmed

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Individualize the Sensory Diet

• What has worked for one person may not work at
  all for someone else!

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Considerations for the Sensory Diet
SEEKER Provide sensory experiences frequently
proactively May need to limit excitatory
experiences
UNDER-RESPONDER Increase the use of visual
supports and routines. Structure the
environment. Time to respond Careful
encouragement to try new experiences
ACTIVE AVOIDER Modify the environment to reduce
the need to escape Gentle introduction to new
experiences
OVERWHELMED Control the environment Limit
stimulation Limit change but prepare for
changes when they need to occur.
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Environmental Supports

• Other People
• Organization
• Predictable, Structured, Consistent
  Environment
• Task or Curriculum
• Visual Supports
• Escape Environments

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The Power Senses

• Vestibular
• Movement
• Proprioception
• Input through
  joints and muscles
• Tactile
• Deep Pressure Touch

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• Why Focus on
• The Power Senses?

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Tofill the sensory bucket quickly use the
Power Senses

• Three Power Senses will provide
• more input
• more quickly
• to make changes that are more rapid

Sensory Bucket
Based on Work of Bonnie Hanshu www.sensoryprocessi
ng.com
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Proactively Schedule Sensory
Activities

• Use the Power Senses throughout the day in order
  to help a person
  alert, attend, act, and react
• Activities should be non-contingent on behavior!
• At times, additional activities or input may be
  needed based on the behaviors observed

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The Power Senses
Tactile System
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The Power Senses
Tactile System
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Two Tactile Systems
Protective
Discriminative
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Tactile System

• Pertains to the sense of touch
• Alerts to danger
• Gives body boundaries
• Helps provide a basis for body image

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Protective System

• Activates Fight, Fright, or Flight
• Born with this system- Primal
• Stimulated by light touch, pain, temperature
• Processed through the emotional, excitatory
  portion of the limbic system
•  NOT a cognitive response

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Discriminative Pressure Touch

• Deep touch/pressure, and vibration
• Activates Parasympathetic System
• Calms and organizes
• Allows for more cognitive response
• Helps us learn and think

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Dysfunction of the Tactile System

• Distractibility
• Hyperactivity
• Over/Under Sensitivity
• Hyper-vigilant
• Inappropriate pain sensation
• Avoids getting hands dirty
• Difficulties with clothing/textures
• Avoids whole hand
• Disorganized when touched
• Intolerant of wearing glasses/hearing aide
• Difficulty with Social Space

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Tactile Defensiveness is when

• - Sensitive to light touch
• Touch causes difficulty
  organizing behavior and
  concentration
• Touch causes negative emotional responses
• Can become aggressive, if feeling threatened or
  stressed

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Interventions for Tactile Defensiveness

• Brushing Protocols
• Wilbarger Protocol
• PRR
• Brushing over arms, legs, back with a soft brush
  , followed by joint compressions
• Caution
• A brushing protocol should
  only be implemented after
  
  an assessment and training by a
  qualified professional

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• Program Supports Specific to Tactile Challenges

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Environmental Supports

• Access to an escape/private area
• Caution with placement.
  Student may want to sit where no
  one is behind him
• Some feel secure with boundaries that keep others
  at a distance..
• Others need space in
  order to make a quick
  escape

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The Front Porch
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Quiet Sensory Area
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Other Tactile Supports
Heavy Blankets, Pillows, Lap Pads
Pencil Grips
Fidget Items
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Choose carefully..
Seeker may want this.....
....but need this to avoid getting too "high"...
Avoider Overwhelmed
Under-Responsive
Or
Some can alert and excite (light touch) instead
of cognitive calming responses
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Other Tactile Supports

• Consider the type of clothing and
  the way it fits
• Tight?
• Loose?
• Fabric?
• Swimming/Water Play
• Body Sock

Remove tags from clothing
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Body Sock
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People Supports What Others Can Do

• Avoid unnecessary touch
  and Ask Permission
• Avoid touching face to gain attention
• Move slowly and
  provide Waiting Time-
  up to 10 seconds
• When touch is necessary, use
  Deep Pressure Touch

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The Power Senses
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Proprioceptive System

• Muscles, joints, and tendons provide a
  person with a subconscious awareness of
  body position via the feedback
  from receptors in the muscles,
  tendons and joints

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Proprioceptive System

• Motor
  Planning
• Awareness of body in
  
• time and space without
• constant visually monitoring

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Dysfunction of Proprioceptive System

• Clumsiness, a tendency to fall
• Lacks awareness of body position/odd posture
• Difficulty with small objects (buttons/ snap)

• Disorganized.. Materials Thoughts
• Poor or resistance to handwriting
• Eats in a sloppy manner
• Resists new motor movement activities

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What Happens when Proprioception Occurs?How
Does it Work?
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Calm Response
Decreases Excitability ("Brakes" Dopamine)
Recycles Serotonin in the Synapse
Proprioception
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Activities that Provide Proprioceptive
Input 

• Joint compression or extension
• Heavy work activities
• The larger the joint, the more proprioceptive
  input

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Examples of Heavy Work

• Passive Joint Compressions
• Jumping/Trampoline
  (floor may be better..)
• Stacking Chairs
• Weight Lifting
• Bungee Cord on Chairs
• Chewing Gum
• Pretzel Hugs

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Fine Motor Supports

• Hand-prep exercise
• Limit Handwriting Requirements
• Alternatives to handwriting
• Keyboarding
• Software
• Set of notes
• Grips
• Velcro on Shoes

• Alternatives Accommodations
• Options in Word and PowerPoint
• Sensory Breaks between tough fine motor
  activities

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ALL will need environmental supports

• Organizational Supports
• Visual Supports
• Color coding
• Timers/Watches
• Written directions
• Written rule reminders

Under-Responders will need clear and noticeable
supports
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What Can Others Do

• Stay on schedule
• Pace language
• Use Concrete Language
• Use Wait Time

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The Power Senses
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Vestibular System

• The vestibular system refers to structures
  within the inner ear (the
  semi-circular canals)
• These structures detect movement
  and changes in the
  position of the head.

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• The brain needs
  vestibular input in
  order to function
• Vestibular input
  provides the
  Strongest Sensation

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• Movement can change an individuals attention,
  arousal and alertness in the shortest period of
  time
• The effects from vestibular input can last longer
  than any other input.

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Hyper-sensitiveActive Avoider and Overwhelmed

• Fearful reactions to ordinary movement activities
  
• Apprehensive walking or crawling on uneven or
  unstable surfaces
• Seem fearful in open space
• Appear clumsy
• Want their feet on the ground!
• These folks need gentle experiences and support
  as they become more comfortable

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Hypo-sensitive Under-Responders and Seekers

• Seeker Actively seek and demonstrate a need for
  intense movement experiences (whirling, jumping,
  spinning, spinning objects, pacing)
• May includes visual stim
• Be aware Seeker can become over-excited
• Needs monitoring
• Cap-off vigorous vestibular activity with
  proprioception (heavy work or joint
  compression)
• Under-Responder may need gentle encouragement to
  engage in movement activities

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Activities that Provide Vestibular Input 

• Seeker/Avoider/Overwhelmed
• Linear, Calm, Slow, Controlled movement to gain
  attention
• Under-Responder
• Unpredictable, multi-directional, spinning (if
  individual requests), to alert and orient someone
  who is under-responsive
• Be very cautious imposing vestibular movement
  can be very frightening

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Selected Strategies

• Swinging
• Rocking Chair
• Sit Spin/Dizzy Disc
• Therapy Balls as Chairs
• Moveable Cushions
  or Deflated Beach Balls
  as Chair
  Cushions

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Selected Strategies

• Delivering Messages or Packages (or any job that
  requires walking, moving, bending, etc.)
• Running Track or possible a Treadmill
• Movement breaks placed proactively in the day
• Non contingent on behavior or work completion!

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Remember

• Do NOT withhold recess/gym based on the childs
  behavior or inability to
  complete work
• Movement and activity may
  be the input the
  child needs in order to
  maintain behavior, concentrate
• and learn!

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Environmental Supports

• Firm Supportive seating
• Feet on floor
• Desk and chair that fit
• Railings on step
• Cushion for movement
• Space to move and pace and stretch
• or
• Items within comfortable reach and area.

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• Alecia Video Example
• Monday

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Creating The Sensory D.I.E.T.

• D ..Do an Informal Assessment
• I ..Individualize
• E ..Environmental Supports
• T ..The Power Senses

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Post-Assessment

• More alert?
• More tuned in?
• Able to respond more quickly?
• Able to focus on task?
• Able to attend for longer periods?
• Less explosive or unpredictable?
• Calmer?
• More interactive?
• Less stressed?
•