Sensational Kids integrated child therapy
Sensational Kids Pty Ltd Australia 2007
Think about if we had a chat on the side of a busy highway: We could tune in to each other’s voice, notice but tune out the trucks going past (even though they have greater volume, we can tune in to the frequencies of human voice) and when the loud busy street starts to bother us we can go back in to a quiet building to feel calm and alert and not on edge. Often children with sensory modulation difficulties miss important sensory details and have trouble tuning out the irrelevant. They may have trouble tuning into the teacher’s voice, particularly when the dull sound of the air conditioner is going. They may have trouble manipulating small objects or the tag on their shirt may feel like a spider all day.
Back on the highway, if we didn’t have the choice to leave that over-stimulating setting, we may choose other sensory strategies to keep us calm and paying attention: we may rock on our feet (movement or vestibular and proprioceptive input), lean on a post (deep touch or proprioceptive input) or chew on a piece of gum (oral motor proprioceptive input).
Now what if this chat on the highway was happening after a 9 hour work day and one of those trucks had just splashed water on you? Would you still be feeling calm and would you be attending as well as you were in the earlier scenarios?
This is how many kids with one type of sensory modulation challenge, sensory defensiveness, feel from the very start of their day. These children may be picky eaters, may only wear particular clothing such as cotton T-shirts with the tags cut out, may avoid movement activities like swings or may react negatively to sounds that others don’t notice or don’t find offensive like vacuums or fireworks. If you know a child like this, you may want to talk to an occupational therapist about the Therapressure Protocol.
What if that conversation was happening at 6am (when you normally don’t get up until 7:30am and even then it’s a slow process), you didn’t get your morning coffee… or shower, not a car was on the road and even the birds were still asleep and not making a peep? You may, or may not, be feeling calm but would you be feeling alert? I certainly would not be alert and so you would need to attend at an even higher level to make sense of my jibber jabber.
Children with another type of sensory modulation challenge, low arousal, feel like this all day and it may take a lot to get them feeling awake and alert. These children may not get in trouble, because they don’t tend to cause waves, but they may not be attending to all the information that is presented to them.
But what if you really had to get the information off me? You may pace, tap your foot, fidget with your nails, push on your hands, rub your face, open your eyes wide and nod vigorously in an effort to stay awake.
The child with the last type of sensory modulation challenge, often referred to as a sensory seeker, most closely relates to this scenario. Sometimes these children are told to sit still, don’t wriggle, don’t fidget with that toy, don’t rock on your chair, don’t put that in your mouth, and… listen!!!. As Sherri Shellengberger, co-creator of the Engine Program, says, “I’m sorry but you’ve just told that child to go to sleep!”
We all use sensory strategies to feel calm and alert. This child is just seeking input to help them feel calm and pay attention. Patti Oetter says that these children don’t need to be ‘calmed down’, they need to be ‘calmed up’! They always choose sensory experiences that help them to be more alert but sometimes they choose input that is also disorganising and may be inappropriate for a particular setting, like a classroom. That’s where it’s our job to help them get the input that their bodies need in a way that is organising to them and not distracting to everyone else.
Motor Planning
Motor planning (also referred to as ‘praxis’- meaning “to do”) is the brain’s ability to develop an idea, organize the steps, and carry out the motor response of a novel task (Wilbarger, J, 2005).
When children have motor planning difficulties (referred to as ‘dyspraxia’), they may have difficulty conceiving plans, sequencing plans and executing plans in a smooth and coordinated manner. The breakdown can occur at any or all of these levels and the ability to form efficient motor plans is highly dependant on the sensory information we take in about the demands of the task. Motor plan execution is also dependant on the person’s posture and body parts to work effectively as the plan requires.
These children may appear clumsy or uncoordinated. They may seem to approach motor tasks in strange ways. They may miss steps in tasks. They may have difficulty at sports. They may be the last to try activities in PE class, watching how everyone else does it. They may have messy or slow handwriting. They may have difficulty dealing with change and may appear controlling or rigid. If you set the expectations, you can set one’s you know are achievable. They may have trouble with dressing or hygiene tasks, using utensils, tying their shoes or learning to ride a bike.
Bilateral Integration & Sequencing
This is an area of motor planning difficulty where the child also has limitations in the parts of the body that sense body position and movement. Some children have difficulty coordinating both sides of their body in an organised way. The may also have difficulty following simple sequences of motor actions.
References:
Making it Easy, Sensorimotor Activities at Home and School. Haldy, M. & Haack, L. (1995).
MoveAbout ActivityCards. Jereb, D. & Koehler, K. (2006). sensoryresources.com
The Out of Sync Child. Kranowitz, C.S., M.A. (1998)
The Out of Sync Child has Fun. Kranowitz, C.S., M.A. (2003)
101 Activities for Kids in Tight Spaces: At the Doctor's Office, on Car, Train, and Plane Trips, Home Sick in Bed . . . Kranowitz, C.S., M.A.
Learning in Motion. Patricia Angermeier, Joan Krzyzanowski, and Kristina Keller Moir. (2006)
How does your engine run? The alert program for self regulation. Shellenberger S. & Williams M. (1998)
Take Five, Staying Alert at Home and at School. Shellenberger S. & Williams M. (2001).
Building Bridges through Sensory Integration. Yack, E., Sutton, S. & Aquilla, P. (1998).
Sensory modulation refers to the ability of the central nervous system (CNS) to regulate and organise the sensations that it takes in, and the responses it makes, based on the information from the senses (Ayres, 1972; Royeen & Lane, 1991; McIntosh, Miller, Shyu & Hagerman, 1999).
Sensory modulation disorders occur when the CNS is unable to do this and result in a profile that is either over- or under-responsive. Recently Lucy Miller and colleagues have conducted studies that support the concept of sensory modulation disorder as a discrete disorder (McIntosh et. al., 1999; Mangeot, Miller, McIntosh, McGrath-Clarke, Simon, Hagerman, & Goldson, 2001; Miller, McIntosh, McGrath-Clarke, Shyu, Lampe, Taylor, Tassone, Neitzel, Stackhouse, & Hagerman, 1999).
We all use sensory information to tune into information from our sense, judge the importance of the information (tuning it out where it is not important) and to keep ourselves calm and alert.
