Sensory Processing: Strategies for teaching kids about self-regulation Presented by Shannon Raybold Camas School District 2003 1. Intro. Self /name- district- teacher-member of autism cadre- work with preschool & primary grades mostly- so I have to admit there might be a bias in the written text of the presentation. However what I’m going to talk about today is applicable if you are 4, 14, 24, or 74. We all use various strategies to process sensory input from our environments everyday. SHOW HANDS TO SEE WHO’S IN THE ROOM -TEACHER/SCHOOL PERSONNEL, PARENTS/ AGE GROUPS- ELEMENTARY- JR. HI- HI SCHOOL-ADULT? So if you want examples for older kids, just raise your hand to ask me at any time. This presentation is based on the principles of the Alert Program a.k.a “How does your engine run?” My goal is to give you practical strategies that you can take back to your classrooms or home and try with your children I am going to provide an overview of sensory processing theory and how the ALERT program is structured, but I’m not going to teach you how to step by step implement the Alert program. For that information, I refer you to the wonderful creators of the Alert Program Mary Sue Williams and Sherry Shellenberger at Therapyworks Inc. They have several books, which are referenced at the end of this program which I highly recommend you read if you want to fully implement these strategies.

What is the Alert Program? It’s a program that that is designed with 2 goals in mind: Increase awareness of self-regulation Increase number of strategies for children to change how they feel It’s based on sensory processing theory This program was originally designed for children ages 8-12 with learning and attention difficulties. It has been successfully adapted however for everyone preschool through adults. Self-regulation is defined as a person’s ability to attain, maintain, and change arousal or alertness appropriately for a task or a situation. Jean Ayers PhD, OTR, FAOTA was a pioneer in the area of sensory processing. She described it in this way “The brain must organize all of these sensations if a person is to move and learn and behave normally. The brain locates, sorts, orders sensations-somewhat as a traffic policeman directs moving cars. When sensations flow in a well-organized or integrated manner, the brain can use those sensations to form perceptions, behaviors, and learning. When the flow of sensations is disorganized, life can be like a rush-hour traffic jam.” (Ayers, 1979, p.5) Explain sensory processing theory using the computer model The goal is to set up children’s nervous systems for success. Reprinted with permission from TherapyWorks Inc.

What can it do for you? Give teachers and students the language and understanding of how alert their body’s feel (i.e. low, just right, or high) Teach strategies to change those levels Knowing how to use these strategies can translate into kids who are able to self-regulate and thus less disruptive and more successful in class and at home b. i.e. kids with ADHD can learn strategies to calm themselves and to focus better - i.e. kids who always sleep through class can learn strategies to wake themselves up

How does YOUR engine run? Describing arousal states can be like describing a car engine Everyone’s engines run at different levels at different times of the day Numerous outside factors can influence our engine level, such as being ill, going into a stressful meeting, or being late. 1     For example: when you first get up in the morning, your engine might be in low gear. You sputter and crawl along until you get to the gas station (or espresso stand). Once you’ve got the fuel you need you are feeling just right. Your engine is running at a level where you are alert and ready to pay attention to the road (or math lessons) in front of you. But when that second cup of coffee kicks in, your engine shifts to high gear. Your engine is running too high to get very good performance out of it. It might make you spin your wheels, but never get anywhere. HAND OUT PERSONAL ENGINE SURVEY- HAVE PARTICIPANTS COMPLETE IT- TAKE 5 MINUTES (they can keep them) HOW MANY OF YOU LEARNED SOMETHING ABOUT YOURSELF? DO YOU DO THINGS YOU DIDN’T REALIZE? DID YOU KNOW THAT EACH OF THESE THINGS ARE SELF-REGULATION STRATEGIES? - Summarize by pointing out that everyone uses sensory motor strategies all of the time. The difference between kids and adults is that we have figured out how to do it in more socially acceptable ways. You don’t see many adults standing and spinning in circles in the parking lot to get sensory input, but you do see adults going on roller coaster rides or every spinning ride at the fair. NOW I WANT YOU TO TRY SOMETHING. FOR THE NEXT FEW MINUTES, I WANT YOU TO not DO ANY OF THE THINGS ON YOUR LIST. I WANT YOU TO SIT UP IN YOUR CHAIR- NO FIDGETING, NO BOUNCING, NO TALKING, NO PLAYING WITH ANY TOYS SO YOU CAN LISTEN. DOES THIS SOUND LIKE WHAT WE EXPECT KIDS TO DO IN CLASS? Dim lights and close blinds

Low Arousal This stage describes how one might feel before you’ve had that cup of coffee in the morning or maybe how you feel when sitting in a dark, warm room for a long meeting. -You could easily fall asleep. Your brain is not able to take in the information needed for optimal learning. -Might want to use a different word for secondary students!

Just right This is where we want kids to be When kids are internally feeling just right, then their minds are alert and ready to learn. They can sit in their seats and focus on what is being said to them

High Arousal This level describes how you might feel when you have 5 people talking to you at once and you’ve had 3 cups of coffee. You are not able to efficiently take in the information that’s being presented to you. a.      Too much information might be coming at you to process, as often happens with kids with ADD. They hear the teacher, the pencil sharpener, the gardener outside mowing the lawn, as well as the buzz from the lights. With all of these stimuli at once, they can’t efficiently pay close attention to any of them.

Why is self-regulation important? 1. Maryann Trott, a special educator and Kathleen Taylor, an occupational therapist used Ayers concepts to construct this graphic representation 2. All of these base systems must be functioning effectively to support the ones at the top. A break down in one area can lead the top of the structure to crumble.

Sensory diet The term “sensory diet” describes how our brains need input (sensorimotor input) to function properly. Everyone has a unique “formula” to help their brains maintain a balance. Before designing a sensory diet, consult an occupational therapist (OT) to help assess and design a diet that meets the needs of the individual. 1. Patricia Wilbarger, an occupational therapist coined the term “sensory diet.” 2. We need to sensory input, just as our bodies need nutritional input from food. Without the proper amount of food or nutrition, we become unhealthy and sick. Without the proper amount of sensory input, we become unable to focus and behave as we would if our sensory needs were being met. 3. HOW ARE YOU GUYS FEELING? WAS IT EASY OR DIFFICULT TO SIT AND LISTEN WITHOUT FIDGETING? LET’S HELP YOU OUT. Play “shake up game”

Ways to change our states Put something in your mouth Move Touch Look Listen Reprinted with permission from TherapyWorks Inc.

Tools for the Mouth Food items In general, foods that are altering tend to be cold, sour/tart, spicy, minty, or crunchy Foods that are calming tend to be warm, smooth, or sweet Some foods fall under heavy work (for the jaw and cheek muscles) which can either calm or alert PASS OUT FOOD ITEMS IN BASKETS

Tools for the Mouth “Brain Food” (term coined by Patricia Oetter) , a kindergarten teacher might give the kids a small cup of popcorn to keep their engines alert while listening to the story. Non Food Items Straws Gum (depending on class rules) Exercise water bottles Theratubing Humming Tongue twisters Lip gloss Vibrators T-sticks On the theratubing, it is tubing you can get from a speech language pathologist, you want to make sure is it is made for oral use. Some tubing is made for physical therapy exercises rather than chewing and it may have different chemicals in it or be made to a different strength HAVE ITEMS ON DISPLAY

Sucking and Blowing Activities Tools for the Mouth Sucking and Blowing Activities Deep breathing Blowing a cotton ball with a straw while tracking with eyes (to warm up eye muscles) Sucking thick liquids through a straw Musical instruments such as kazoos, harmonicas, or whistles Using curly straws Blow pens Blowing bubbles

Tools for the Body (Ways to move) Try different seating options such as A barely inflated beach ball A camping pillow partially filled with water as a lap weight A therapy ball A T-stool Allowing children to stand at their desks and work (often putting a piece of tape on the floor where they should stand/stay helps). 1. HAVE ITEMS ON DISPLAY

Tools for the Body (Ways to move) Up and down motions Jumping rope, spiking a volleyball, dunking a basketball, skipping, bouncing on a big ball or in a moonwalk, or marching Front and back activities Rocking in a chair, swinging, ice skating or roller blading Upside down activities Hanging on bars, wheelbarrow walking, roller coasters, head stands from furniture

Tools for the Body (Ways to move) Crash and bump activities Jumping into piles of pillows or on an old mattress, driving bumper cars, pillow fights, playing football Circles Sit n’ spins, merry-go-round, spinning on a tire swing, riding on a ferris wheel, spinning in an office chair

Tools for Touch Weighted blanket Lap weights Hug vests Chair hugs Body socks Hand fidgets, such as silly putty, string, paperclips, stress balls, koosh balls, gak, etc. Any kind of heavy work, such as lifting, moving heavy items, or stretching Define items as I go HAVE ITEMS ON DISPLAY Note on fidgets- it’s important for teachers especially to remember that these items, when used correctly can help kids focus better rather than distract them. The teacher needs to recognize that it is possible and even preferable for some student to listen to a lecture while keeping their hands busy- a student doesn’t have to be looking at the teacher to be listening. The “How is your Engine running” book talks more about how to introduce and use fidgets at home and in the classroom. PASS OUT FIDGETS

Tools for the Eyes Try dimming the lights and closing the blinds to calm students down Muted colors and plain walls tend to be calming Bright colors, “busy” walls and bright lights tend to be alerting Oil and water toys Spinners Shimmery pom poms Lava lamps Glitter wands Flashlights Tents with blankets on top to darken spaces 1. some students are very sensitive to fluorescent lights- be aware of how kids react in response to light

Tools for the Ears Sounds that are short, a rhythmical, loud, or novel tend to be alerting Sounds that are rhythmical, quiet, long in duration, and familiar are calming and easier to ignore Try using music of various types and volumes to change alertness levels to get kids ready for the next task Create “cozy corners” in the room where kids can be when the noise of the room is overwhelming to them

Tools for the Ears Try playing white noise (such as ocean surf or rain) in the background of the classroom Set up a listening center where kids can use headphones to get the right kind of auditory input for their engines For kids who are sensitive to noise, let them use earplugs or headphones in the cafeteria or assemblies or let them eat in a quiet room During tests, you can let kids wear headphones (with no sound) to help them block out distractions

How does this fit into a school setting? These strategies can be adapted for everyone from preschoolers to adults They can also be easily modified for use with kids who have developmental delays- it’s been used a lot for kids with autism and ADHD The Alert Program has a flexible time commitment from teachers show example of engine chart from preschool In some schools and classes, the OT teams with the teacher at the beginning of the year to teach these strategies to kids. Once they know and use them, the OT can fade out and can provide consultation to the teacher when necessary. Teachers have found that this reduces the amount of behavioral and attention problem in their rooms.

Examples for how to use levels in the schools In a resource room setting, you can integrate it into a social skills group During academic groups in a resource room, fidgets and other strategies can help students concentrate and focus The resource room teacher can provide in-services to other staff members and/or to classrooms Ex. Teach ALERT program directly, then move to skill maintence by embedding ALERT strategies into group time (I.e. check in with levels, use fidgets during class, taking sensory breaks as needed) as you move on to teach other social skills. Strategies I found very helpful were using alternative seating for several kids (I.e. T-stool, disc o sit, or therapy ball), using fidgets to help maintain attention, and taking sensory breaks as needed. For children with ADD, ADHD, autism, LD, FAS and other disabilities, these strategies were useful to all of them.

Examples for how to use levels in the schools In a general education classroom, the regular education teacher can team teach with the occupational therapist or special education teacher to introduce the strategies These activities can be done in 15-30 minutes per day Once the skills are taught, preferably in the beginning of the year, the teacher knows that children have a base knowledge of how to self-regulate and can draw on and enhance that throughout the year In some schools and classes, the OT teams with the teacher at the beginning of the year to teach these strategies to kids. Once they know and use them, the OT can fade out and can provide consultation to the teacher when necessary. Teachers have found that this reduces the amount of behavioral and attention problem in their rooms.

Examples for how to use levels in the schools Once the skills are taught, the classroom teacher can incorporate “Engine” lessons into the daily routine by: Talking about how characters in books may be feeling using “engine” language Regularly scheduling sensory breaks into the daily schedule Having a menu of sensory activities available for kids to select when they need to Having a “tool box” available with sensory options for kids as they need them Allowing water bottles and/or snacks in the class

Strategies for the classroom Below are some things that staff can do to help children meet their sensory needs. The goal is to help them meet those needs during naturally occurring activities throughout the school day. Have students carry heavy objects to the lunch room (i.e. lunch bags) Allow students to run notes to the office Have student unstack and restack chairs each day Push the library cart through the halls

Strategies for the classroom Crush cans for recycling Provide a quiet corner for students Allow for in-class movement breaks (i.e. sharpening pencil time or time to get up to get drinks) Have kids push on/”hold up” the wall while standing in line Do chair push-ups or table push-ups Erase chalkboards or whiteboards

Strategies for the classroom Wash tables in the cafeteria Help custodian or gym teacher put away equipment Encourage physical play at recess such as climbing, running, jumping, skipping, etc. Sort and move library books Allow student to work at desk standing Chew on appropriate items such as gum, jerky, or straws Ask for other ideas from audience

How does this help at home? The Alert Program principles can be applied whenever children are Once parents understand the concepts of sensory processing, they can very effectively help their children self-regulate

Examples of how to use levels at home Some families have added into their routines activities and strategies that help their child self-regulate Some families have made picture schedules and menus for sensory type activities to choose from Having a designated space (i.e. a basement room or play room) for sensory equipment and toys i.e. always scheduling active time before the child would need to sit for awhile, such as at the doctors office or at a sibling’s ballet practice or always leaving time for quiet time, such as after lunch- at scheduling activities or play dates then One family had a clip board in the kitchen for each child with visual representations of a variety of items they preferred to use to calm or alert themselves with. That way, it was always accessible to the child. If a certain choice wasn’t available (I.e swimming at 10pm) then the parents can simply remove that choice before the child can choose 2. I worked with a family who created a therapy room for their daughter with all sorts of big equipment such as swings, a ball pit, a trapeze, spinning toys, etc. We noticed a change at school after they got that room put together. She spent 45-60 minutes in the room every morning before she came to school. On the few occasions when she didn’t get to have her therapy time before school, we could really notice the difference in her ability to participate and focus on the group.

Strategies for at home Below are some strategies and activities that parents can use at home Involve children in sports teams/activities Install swings Get a trampoline Allow kids to chew gum Use weighted toys or dolls Have a quiet tent or fort for kids

Strategies for at home Invest in a ball pit Use a disc ‘o sit for sitting in chairs, such as during meals Allow kids to move furniture Visit playgrounds Cut tags out of their clothes Let kids help in the garden Make a tight sleeping sheet Have a fidget box for long car rides, during homework time, or for while listening to a story Using a disc o sit or other alternate chairs have really helped some families survive meal time with their kids. There are some chairs that can provide seat belts, which some kids love that tight feeling of security, others that may have tall arms and back, also providing extra support and feedback to a child. The sleeping sheet was made by Suzanne Larson, one of the autism cadre members for one of her family members. It is a lycra sheet that fits very tightly around the bed. The person get pressure all over the body from the tight sheet. It will be on display in the sensory lab this afternoon. Ask if there are other ideas of what can be done at home

Summing it up The strategies presented here I’ve used and my colleagues have used with great success, which is why I wanted to share this information with others. I believe that these strategies do make a difference in our children’s ability to take in and process information. There are many more strategies or suggestions that TherapyWorks suggests, if you have other questions or want more information, please come to the sensory lab this afternoon. Tell a story of how it has helped in our programs In the sensory lab we’ll have many examples of the equipment and items I have talked about as well as Lorraine in her sensory processing session yesterday. We will have information on where to get these materials as well as you can have the opportunity to play with and experiment with the items yourself.

Reference Information Check out the Alert Program website at www.alertprogram.com Ayer,A.J. (1979). Sensory integration and the child. Los Angeles: Western Psychological Services. Williams, M.S. & Shellenberger, S. (1994). “How does your engine run?” A leader’s guide to the Alert Program for self-regulation. Albuquerque, NM: TherapyWorks, Inc. Williams, M.S. & Shellenberger, S. (2001). Take 5! staying alert at home and school. Albuquerque, NM: TherapyWorks, Inc. - questions?