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ASD and Sensory

Introduction to Sensory processing

 

WHAT IS SENSORY PROCESSING?

Sensory processing refers to how we use the information provided by all of the senses within our body and from our environments, how we interpret this information and respond to it.

All the information is received, processed and integrated to give us an understanding of

- who we are,

-where we are and

-what is happening around us.

When our senses are integrated correctly we are able to respond appropriately to the sensation. For example, we will shift in our chair when we become uncomfortable, take off the itchy woollen jumper or we may take a deep breath to smell the flowers.

WHAT HAPPENS WHEN A CHILD EXPERIENCES SENSORY PROCESSING DIFFERENTLY?

Children who have sensory processing difficulties may have difficulty in figuring out what is happening inside and outside of their bodies. The sensory information their body is registering may not be accurate.

Walking through a shopping mall, if you smell a powerful, sweet scent, you can identify it as a candle or essential oil and realise that you’re walking past an aromatherapy store. You may linger a moment to enjoy it or hurry by to escape it.

Imagine how it might feel in nursery when the pictures on the wall repeatedly grab your attention as their brain doesn’t register that this has been seen before. Or when every child around you make you on ‘high alert’ just in case someone brushes past you as you experience light brushing as painful. Imagine if putting on socks is very difficult as you cannot balance, and don’t know how to move your hands to your feet accurately. Children who have sensory processing difficulties aren’t receiving adequate information as to where their arms and legs are from their bodies, so they need to move to get that extra feedback!

Their bodies aren’t providing adequate information as to where their arms and legs are, so they need to move in their seats to get that extra feedback. There seems to be some faulty wiring somewhere, most people get used to their own sensory preferences and make choices about their daily activities appropriate to them. However, children tend to go with their instincts and may struggle to communicate

how they feel, they may be disorganised in a world they can’t quite make sense of. These children need support from those around them to learn strategies and consider their needs to make life just that little bit easier.

 These senses are the building blocks for all other skills we learn and use in life:

Our Senses:

There are seven senses explained in this resource pack, Tactile, Taste, Smell, Vision, Auditory, Proprioception and Vestibular.

Each sense has its own section which is divided into:

  • A description of the sensory system.
  • What happens when a child experiences this differently?
  • Ways to help – suggestions on strategies/activities that may help.

 

 

Proprioception

 What is Proprioception?

‘How the body senses itself’, this is our subconscious sense that tells us where our arms and legs are in space without us having to look at them. Small receptors within our muscles and tendons detect
the amount of stretch that occurs in muscle fibres and
tendons.  This allows us to sense the movements of our
body parts without having to look at where they are.

This information is being passed on from our muscle and joints to our spinal cord and to our brains even when we are still. This ensures that we can be upright and not slipping off our chair, it also provides us with an internal map of our bodies. It is also the sense that helps us to grade the force we place through objects and impacts on the resting tone of our muscles.

So, what happens if something isn’t quite right?

The common difficulties with the processing of proprioceptive information appear to be a lack of sufficient information. If difficulties exist, you may see the following behaviours in the classroom:

  • Fidgeting in their seat to gain more information from the muscles and joints as to the position of their body parts.
  • Heavy handed, struggling to grade the force they place through a pencil, or when playing with toys.
  • Jumping, running, always on the go
  • Continuously bumping into things on purpose
  • Struggles to stand in line or stay in their spot at circle time.

  How to help

Activities that provide feedback into the muscles and joints of the body promote coordinated movement.  Repetitive movement enables us to know where our arms and legs are in space.   In addition, there is much literature written about the benefits of using proprioceptive activities to organize all the senses in the treatment of sensory processing disorders (SPD).   This is especially noted when the
muscles are used in “heavy work” patterns.  "Heavy work" is any gross motor activity that involves moving against resistance to provide deep pressure into the muscles and joints of the body.

Pushing, pulling, carrying, lifting or jumping are examples.  Interestingly, many of the same heavy work activities that help reduce hyperactivity in children also help to engage children who appear listless, tired or floppy.  Below are some examples:

  • Pulling a wagon filled with toys or other items
  • Playing catch with a heavy ball
  • Animal and bug walks
  • Carrying a trash can, box or laundry basket
  • Biking, hiking, running
  • Walking, especially up hill
  • Jumping on a trampoline or jump rope
  • Tug of War
  • Deep "bear" hugs or massages
  • Squeezing clay, play doh or therapy putty
  • Relaxing in a squishy bean bag chair
  • Cocooning: wrap child up tightly in a blanket or large towel 

 

  

 

Touch

What is touch?

Touch serves two functions: one for protection and one for added detail.

 

Protective:

Our skin has receptors within it that respond to pain, temperature and light touch. This alerts us to potential threats and allows us to react appropriately. The information is interpreted, and our brain then decides as to how we should act.

 

Discriminative:

Our skin is our largest most sensitive organ, it has different receptors that give more detail about what the skin is feeling. This also responds to pressure applied to the skin. Through touch we gain information about where and how our bodies are positioned. We get information about objects and our environment and to develop refined fine motor skills.

 

With smoothly operating protective and discriminative touch a child will be comfortable and willing to interact with objects and people and will be in a perfectly alert, yet calm state to learn.

 

So what happens if something isn’t quite right?

 

One of the most common sensory difficulties is being overly sensitive to touch.

Children may show the following behaviours:

 

  • Avoidance of messy play and becomes distressed if pushed to do it
  • Get upset when their hands or face are messy
  • Being fussy with certain food textures
  • Avoid feeding with their fingers
  • Avoiding touching people or objects,
  • Becoming anxious or upset when in a crowd or close to others
  • Refusing to wear certain clothing, or constantly taking clothing off (or sometimes keeping clothing on to protect their skin from touching anything)
  • Toe-walking
  • Disliking having a hair-cut

 

You may however see the child seek out touch to control their environment.

On the other hand, a child may be more under sensitive to touch than usual:

 

  • Has messy face and hands and doesn’t seem to notice
  • Doesn’t know where they are being touched.
  • Leaves clothing twisted on their bodies and don’t seem to notice
  • Difficulties manipulating pencils, scissors etc.

 

How to help

When overly sensitive……

  • Try to reduce your child’s anxiety (if necessary), as anxiety can exacerbate a reaction or intolerance.
  • Make sure you use firm pressure when touching or holding your child, as this is easier to tolerate. Light, tickly touch is often unbearable.
  • Encourage your child to play with a variety of different-textured toys.
  • Your child may enjoy a deep-pressure massage. Try to use the palms of your hands, rather than your finger-tips, and press firmly. This is very calming for children and can help them to become less sensitive to touch.
  • Encourage your child to do resistive (push-pull) activities or activities which give deep pressure into his/her body. These activities can reduce sensitivity to touch. Activities may include: jumping on a trampoline, rough play, having a cuddle, tug-of-war, wheelbarrow walking, stomping hard on the ground, carrying shopping bags, etc.
  • Prior to activities which may lead to any anxiety for the child try some of the heavy work activities listed below. Any task that provides active pushing/pulling or deep touch/pressure is calming to the nervous system, so they are less likely to react in an inappropriate way

 

When under sensitive……

Encourage the child to experience as many tactile experiences as possible. Try integrating the following types of activities into their daily routine.

  • Feely Box - a box with a sleeve attached to one end over a hole. (You can use a pillowcase). Child feels for objects inside the box without looking. Start with familiar objects with different shapes/textures, and then try objects with similar shapes/textures.
  • Hide and Seek - Find objects of different shapes and sizes hidden in bowls of:

- rice/lentils/dried beans, dried pasta shapes etc

- polystyrene packing pieces of different shapes

- sand/fish tank or pot plant gravel

  • Play dough incorporating small hidden objects to pick out.
  • Messy Play Messy play is an important part of childhood play and helps to develop several important skills. Children who are sensitive to touch will often avoid these activities, so you need to be thoughtful about how you encourage your child to participate.
    • Let your child explore at his/her own pace. Don’t push your child to do anything he/she is not ready for. Keep the activity fun and pressure-free.
    • Wait for your child to touch something, rather than putting their hand into it. If your child is hesitant to touch, don’t force him/her to touch it. Rather let him/her watch you do it.
    • Provide frequent opportunities for messy play. With very little planning, messy play can become part of your daily routine:
      • If you are cooking, sprinkle a little flour on the table for your child to play with,
      • Whilst walking home from school, encourage your child to collect dry leaves, etc.
      • Gardening and outdoor play creates lots of spontaneous opportunities for messy play.

 

 

  • The typical hierarchy of textures (from easiest to most difficult to tolerate) is:

 

Hard, smooth, dry textures (e.g. plastic toys)

ò

Hard, bumpy, dry (e.g. textured plastic toys or dry lentils/rice/pasta)

ò

Soft, smooth, dry (e.g. smooth pillows or fabric)

ò

Soft, bumpy, dry (e.g. stuffed toys or lamb’s wool)

ò

Thin liquid (e.g. water)

ò

Combination of thin liquid and hard, smooth (e.g. plastic toys in water)

ò

Challenging, dry textures (e.g. leaves, feathers, sand)

ò

Thick liquid, not sticky (e.g. soapy water or shaving foam)

ò

Wet or sticky textures (e.g. finger-painting or mud)

ò

Very sticky textures (e.g. golden syrup painting)

 

Please note, this hierarchy is a guide only. Many children won’t follow this exactly. Try to choose textures at the beginning of this hierarchy and move down as the child can tolerate each level.

 

      

 

Taste and Smell

 

Smell travels directly to the centre of our brain that controls our emotions, memory and learning. Smell is closely linked to our sense of taste, think about how bland food tastes when we have a cold for example.

 

Our brains are wired so that we can respond appropriately to tastes and smells. A bad smell for example doesn’t go away our brains just stop noticing it; otherwise we would be totally distracted by it. If we smell burning, we know to act on this appropriately.

 

 

So, what happens if something isn’t quite right?

 

Again, there are two different kinds of difficulties that may occur, the first being an over sensitivity to smells and tastes and the second an under sensitivity to taste and smell. The latter of the two is less common.

 

Overly sensitive, these children may show the following behaviours in school:

  • Avoids food most children their age enjoy
  • Crave or get upset by certain tastes and/or smells and don’t appear to get used to the smell
  • Is distracted by a smell in the room and can’t refocus on the lesson.
  • Becomes nauseated or gags at smells others are only mildly affected by.
  • Finds cleaning teeth uncomfortable

 

Under sensitive, these children may show the following behaviours in pre-school

  • Sniffs people
  • Smells own faeces
  • Smells toys before playing
  • Chews, mouths everything
  • Grinds teeth
  • Favours strong flavoured food

 

How to help

ü  Try redirecting the child to carry out some of the heavy work activities to distract them and also calm their overly alert sensory systems down.

 

ü  Allow them to have their favourite scent or an object that they like the smell of to block out the ‘offensive’ smell.

 

The hypersensitive or "orally defensive" child dislikes experiencing
various taste and texture sensations in the mouth. The orally defensive child
often has a limited repertoire of foods he/she will eat, perhaps only mushy
foods, only crunchy foods or only bland foods, etc.  They may avoid chewy
foods and foods with mixed textures or lumps.  Some avoid foods of a certain
colour.  These children gag easily, may avoid using their lips (use teeth only)
when eating off of a fork or spoon.  Some may be overly sensitive to brushing
their teeth or being touched around the face and lips.

Food play is a good way to introduce new food tastes and textures:

  • Finger painting with desserts such as whipped cream, apple sauce, yogurt, angel delight. A brush can be used if your child does not want to use their fingers
  • Making shapes and pictures out of vegetable sticks
  • Gluing macaroni and pasta shapes onto paper to make a picture
  • Threading pasta tubes or Cheerio’s onto a piece of string or pipe cleaner

Preparing your child for mealtimes

  • Stroke your child's face firmly with your fingers (or have child do
    this to himself initially): Massage firmly from the jaws to the
    corners of the mouth, from the ears along the cheeks to the
    mouth and around the mouth.
  • Use a soft cloth or the back of a vibrating tooth brush in a
    similar manner
  • Hold a vibrating toy or toothbrush around, or in your child’s mouth
  • Play mouth games: whistles, harmonica, toy horn, blow bubbles
    or blow on windmills
  • Blow through a straw to race cotton balls, ping pong balls, corks,
    etc.

Activities that make the mouth and surrounding structures work hard
is helpful for the orally seeking child:

  • Blow bubbles in milk/juice with a straw
  • Suck drinks through a thin straw or squiggly straws
  • Drink thick milkshakes through a straw
  • Sip liquids through a sports bottle
  • Eat chewy foods (jelly sweets, bagels, raisins) and
    crunchy foods (pretzels, carrots, celery, crackers)
  • peanut butter,

 

     

Vision

What is Vision?

There are different aspects of our visual systems:

 

Eye movements - The movements of our eyes are controlled by muscles, these allow us to follow a moving object with our eyes, fix on an object, scan a page of writing, and focus our eyes on one object and then move to another and re focus quickly.

 

Visual processing - This is the brain selecting and responding appropriately to visual input.

 

So what happens if something isn’t quite right?

If there are difficulties with your child’s eye movements, you may see the following difficulties:

 

  • Limited eye contact and difficulty struggling to maintain focus
  • Avoids bright light
  • Seeks out light up toys, things that spin and move etc
  • Looks at objects and people from the corner of his eye

If there are difficulties with your child’s visual processing you may see the following difficulties:

 

  • Struggling to notice pictures or people in a room
  • Covering eyes in response to bright lights being switched on
  • Complaining of headaches, rubbing eyes and/or squinting
  • Difficulty finding items in cluttered environment etc.

 

 

How to help

Strategies to reduce sensitivity to light or help with visual distractions

  • change the lighting in the home environment: lamp lighting is less visually stressful than overhead lighting, keep lights dimmed
  • at school or in other buildings, wear lightly tinted sunglasses or dark if necessary
  • wear sunglasses or a baseball cap outdoors
  • to reduce visual distractions, create a barrier such as a cardboard study carrel when reading and writing
  • reduce clutter and a "busy" room appearance
  • certain wall paint colours help in reducing visual stress
  • school worksheets should include as much white space as possible; if necessarily have information printed on more pages to increase white space
  • reduce the amount of colour used on written materials or run through a copier for a black and white version

 

Strategies to increase visual attentiveness (eye-contact, tracking, attention to detail)

  • play "flashlight tag"-- in a darkened room while on your back, chase each other’s' flashlight beams
  • play catch with slow moving objects: balloons, Gertie balls, scarves
  • pencil/paper mazes, hidden pictures, find the difference picture puzzles
  • fill a shoe box with lots a small item: locate specific items within this busy box
  • play "guess what I see" games:  describe an item in the room by its colour, size, shape, what it's used for, etc.
  • school writing paper: use dark lines (run through copier to make darker if needed) for writing on
  • high light writing lines in yellow
  • worksheets should be of high contrast, lots of white space and clear of spots, smudges, etc.
  • when colouring, teach child to trace around the lines of the design first and then colour it in

 

How to help – strategies for school

Eye movements

  • Child sits at the front of the class
  • Teacher provides a written sheet on the desk for the child to copy from rather than copying from the board
  • Use large print books/work sheets
  • Use a finger or ruler as a marker when reading
  • Use a typo scope when reading (cut out a window in a piece of card and show only what is needed to be read)
  • Use an angled writing surface to reduce the distance the eyes have to travel from the board to the paper

 

Visual processing

  • Build up the sides of a desk with cardboard to block out distracting stimuli
  • Keep visual (e.g. wall displays) and auditory distractions to a minimum to help facilitate child’s attention to classroom instructions. Have the child sit close to the Teacher to facilitate their ability to attend to directions and tasks
  • Teacher uses different colors for different lines on the board