1. Sensory Processing Dysfunction How to Survive in the Classroom

2. What is Sensory Processing It is a normal brain functioning It involves becoming aware of sensations, then organizing, storing and then retrieving information which makes it possible to give meaning to what’s been taken in. Sensory Motor Processing is the foundation of motor skills, social behaviors, and the ability to accomplish more complicated tasks learned in school. To understand how immature systems affect learning on a higher level it is first important to understand the sensory system. The brain can be divided into three main parts: Brain Stem, Cerebellum, Cortex

3. Three Main Parts of the Brain Cortex Brain Stem Cerebellum

4. The Brain

5. Cortex Cortex is where higher level thinking and learning occurs. It is also involved in arousal Areas of the cortex are alerted during arousal, other areas of cortex must be inhibited during arousal to allow for selective attention and orientation to sensory stimuli

6. Cerebellum Cerebellum takes in information from muscles and joints Directs accurate body movements and balance Processes all over sensations

7. Brain Stem Brain Stem acts as a relay system for the senses: touch, movement, and proprioception. It’s filtering system is called the Reticular Formation It regulates arousals levels The information received through the RF helps us to feel safe, to focus and keep our attention on a desired task. It allows us to move without being fearful and to use our body in an automatic function. It helps to keep us alert and filter relevant and irrelevant information

8. What is Modulation? Modulation is the brain’s regulation of it’s own activity. Balances the flow of sensory information coming into the nervous system Turns on/off neural switches allowing all the sensory systems to work together Determines how quickly we self modulate

9. What is Habituation? Habituation is the neurological process of tuning out familiar sensations Messages initially alerted sense but then become meaningless For example the feel of shoes on feet. Initially aware when we put on, but then system becomes habituated and no longer needs to attend to that input

10. What is Inhibition? Inhibition is the neurological process that reduces unnecessary synaptic connections and checks one’s overreaction to sensations Shift in balance when walking; learn to ignore the messages Millions of sensations come in daily; most are irrelevant to current situation so we learn to inhibit them

11. Top Down Inhibition We sometimes use top down inhibition to regulate and modulate our actions. We may try and talk ourselves through. For instance a child comes in from recess over aroused. That child may try and “talk” to himself to get in a more optimal state by engaging the cortex. It is not an efficient way to concentrate or self- regulate and is most likely not possible for an entire school day.

12. Bottom Up Inhibition Input in through the cerebellum enters in through the brain stem and activate the reticular formation. The RF will help the body attain an optimal level of arousal A child taking in heavy work input through the cerebellum and RF, such as carrying a box of books or doing wall push up It is a much more efficient way to achieve and remain in an optimal state to complete school work.

13. Seven Sensory Systems Vestibular Tactile Proprioceptive Visual Auditory Taste Smell

14. Vestibular Receptors in the middle ear and senses movement of the head Gives us an awareness of body and head position in relationship to gravity Helps us to determine how fast/slow we are going; what direction; if we are still moving Allows us to go down slides or ride on a playground swing without falling off

15. Proprioceptive Receptors in joints, muscles, and tendons Activated by muscle contractions and movement Processes information about body position and body parts Helps to determine where body is in space Helps us to know what we are doing with out body so that we don’t have to pay attention to what our body is doing while we are concentrating on something else Proprioceptive input has both calming and alerting effects; input is rarely overloading to the nervous system

16. Tactile Processes information about touch which it receives through receptors primarily in the skin Helps be able to differentiate between light tough and heavy touch sensations Light touch alerts the protective portion of the brain; assists with assessing the possibility of danger (flight, fright, or fight) (i.e. feel of spider crawling on arm) Light touch is often unexpected Heavy touch or pressure tends to be predictable and familiar, soothing and comforting (i.e. firm back rub)

17. Auditory Receptors are located in the inner ear Stimulated by air and sound waves Provides information about sounds in the environment (loud, soft, high, low, near, far)

18. Visual Receptors are located in the retina of the eye Stimulated by light Provides information about objects and persons Helps us define boundaries as we move through time and space

19. Taste Chemical receptors are located in the tongue Closely entwined with the sense of smell Provides information about different types of taste (sweet, sour, bitter, salty, and spicy)

20. Smell Chemical receptors are located in the nasal structure Closely associated with the sense of taste Provides information about different types of smell (musty, acrid, putrid, flowery, pungent)

21. Sensory Processing Dysfunction Is a condition that exists when sensory signals don't get organized into appropriate responses. A person with SPD finds it difficult to process and act upon information received through the senses, which creates challenges in performing countless everyday tasks. Motor clumsiness, behavioral problems, anxiety, depression, school failure, and other impacts may result if the disorder is not treated effectively.

22. How Common is it? Research by the SPD Foundation indicates that 1 in every 20 children experiences symptoms of Sensory Processing Disorder that are significant enough to affect their ability to participate fully in everyday life. Symptoms of SPD, like those of most disorders, occur within a broad spectrum of severity. While most of us have occasional difficulties processing sensory information, for children and adults with SPD, these difficulties are chronic, and they disrupt everyday life.

24. What may proprioceptive dysfunction look like in the classroom? Children who are over responsive may look: – Clumsy – May hang onto teacher – Walk into you Children who are under responsive may: – Press really hard when writing or coloring – Chew on shirts – Run into people and objects – Crash and fall

25. What can you do? HEAVY WORK!!!

26. Heavy Work Resistive input obtained through heavy work activities is generally organizing and can improve attention, arousal level, body awareness, and muscle tone, as well as decreasing defensiveness. Heavy Work Activities are both calming and alerting for children who have both under and over aroused proprioceptive systems Heavy work activities are rarely overloading to the nervous system

27. Heavy Work Activities Include Whole Body actions involving pushing, pulling, lifting, playing and moving Oral actions such as chewing, sucking, and blowing Use of hands for squeezing, pinching, or “fidgeting”

28. More Heavy Work Activities Staple paper to the bulletin board Fasten a large phone book to the bottom of the student’s chair with heavy duty duct tape. Arrange student’s schedule so the student has to move the chair to different location within the classroom (pushing or pulling) Climb on playground equipment Swing from the bars

29. More Heavy Work Activities Perform sports activities that involve running and jumping Have student’s push against a wall. (For younger students use the idea that the “room feel small-can everyone help me push the walls out to make the room bigger Open doors for people Use squeeze toys that can be squeezed quietly on the student’s lap under the desk

30. More Heavy Work Activities Do chair pushups Do Animal Wlaks Stack chairs Take Isometic exercise breaks Help rearrange furniture in classroom Place chairs on tables Push a cart to deliver library books or retrieve lunch trays Use milk crate to move books to various parts of the school Erase the chalkboard/dry erase board Take chewy candy breaks (licorice, fruit roll-ups, Starbursts or Tootsie Rolls) Blow whistles, bubbles, balloons

31. What may vestibular dysfunction look like in the classroom? Children who are under responsive to vestibular movement might: – Swing and swing and never stop – Be moving rocking all the time – Spinning in their chair – Frequently moving about the room – Approaching teacher frequently – Seek movement Children who are over responsive to vestibular movement might: – Not like to climb or be off the ground – Be very sendentary – Avoid playground equipment

32. What can you do? For children who are under responsive to vestibular input: -Allow child to stand at table while working -Provide lots of opportunities for movement -Provide recess -Encourage active play at recess: running, jumping, swinging from bars, etc -Heavy work activities -Use seat cushions -Allow to rock in rocking chair in classroom

33. What can you do? For Children who are over responsive to vestibular input -Heavy Work Activities -Stand and Twirl in place -Bend over and place head between legs -Sit and bounce on therapy balls -Do jumping jacks - avoid quick or suden changes in movement

34. What auditory dysfunction looks like: Children who are over responsive to sounds might: - cover ears -strong reaction to fire alarms, PA announcements, toilet flushing, noise outside classroom -difficulty distinguishing what teacher is saying from noise outside -act out or shut down in music, PE, assemblies, or in the cafeteria -speak in a loud voice to screen out incoming noise Children who are under responsive to sounds might: - miss oral instruction given by the teacher -frequently ask what the teacher said -not respond when name is called out

35. What can you do? Children who are over responsive to auditory input: Listen to quiet music Work in quiet environment Use noise blocking headphones to shield from noise Prepare in advance for loud/strange noises

36. What can you do? Children who are under-responsive to auditory input need alerting activities: - Listen to music with varied pitch, sound, loudness, or uneven/fast beat - Speak with animated high/low voice - Enjoy frequent opportunities to examine novel sound producing toys (chimes, squeeze toys, rain stick) - Use sound producing materials to complete classroom projects (talking calculator, books on tape - Prepare in advance for loud/strange noises

37. What visual dysfunction may look like in the classroom: Children who are over responsive to visual input might: - close eyes or cover eyes frequently - squint -have difficulty with figure ground activity -look around the room, at objects and pictures on the wall -respond when new people enter the room -be unable to visually scan across a page without losing the sentence -often loses place while reading Children who are under responsive to visual input might: -look around the room, at objects and pictures on the wall -have difficulty recognizing shapes or colors -avoid coloring, puzzles, stacking blocks -difficulty visually attending to lesson on the classroom board -focus on shadows, reflections, or spinning objects

38. What can you do? Children who are over responsive to visual input need calming strategies: - Work in dim light or will lights turn off - Block distractions by using a screen, room divider or study carrel - Work in natural light rather then ordinary light - Work with soft light and pastel colors - Work at distraction free desk - Provide visual materials such as a glitter wand, oil and water toys; fish tank

39. What can you do? For children who are under responsive to visual input need alerting activities - Work in bright lights - Use a flashlight to point or highlight important Information -Use colored chalk or markers -Use a slant board to place materials at an angle -Use bright lights or colors

40. What tactile dysfunction may look like in the classroom: Children who are over responsive to tactile input might: – have difficulty tolerating touch by others – have difficulty tolerating close one-on-one instruction and hand- over-hand demonstration – be a picky eater, only eat a few foods or not like to mix – be picky about clothes, may take clothes off, or resist being dressed – have difficulty standing or walking in a line near other students, or sitting in a small circle – appear irritated with someone is in close proximity – avoid getting hands messy during art Children who are under responsive to tactile input might: – be a messy eater, have food all over face or stuff mouth full of food – play “roughly” – may not notice when hands are dirty – frequently fidgets with objects – have disorganized clothes: shoes on wrong feet, pants twisted

41. What can you do? Children who are over responsive to tactile input need calming activities - Heavy work activities - Wear weighted vests or ankle weights - Snuggle with blankets - Play with resistive putty

42. What can you do? Children who are under responsive to tactile input need alerting activities - Heavy work activities - Sustain light touch to the palm of the hand - Hold something cold - Gently and quickly rub the skin - Handle fidget activities

43. What taste and smell dysfunction may look like in the classroom: Children who are over responsive to taste and smell input might: – have a strong reaction to smells, perfumes, and air fresheners – avoid certain types of food or certain textures Children who are under responsive to taste and smell input might: – have a decreased ability to recognize different smells – difficulty with articulation

44. What can you do? Children who are over responsive to taste and smell need calming activities: - Chew or suck on mild flavors such as suckers, hard candy or chewy toys - Drink from a sports water bottle - Chew suck on keychain or necklace - Chew suck on pen top - Play a musical insturment - Blow whistles, bubbles, feathers, balloons, etc - Engage in chewing, sucking and blowing acitivities - Incorporate preferred scents within academic tasks (e.g. writing with scented markers) - Use scented markers or crayons

45. What can you do? Children who are under responsive to taste and smell need alerting activities: - Engage in eating, chewing, sucking or blowing activities - Eat crunchy foods such as pretzels, ice, carrots, celery, apples - Eat chewy foods such as licorice, taffy, beef jerky, gum - Blow whistles, bubbles, balloons - Eat crunchy, sour, chewy, salty, or cold foods

46. General Environmental Modifications for Children with SPD Use dim, natural lighting Use pale, pastel colors on walls Provide a quiet/less stimulating corner of the room for a child to go to/use to calm down Use blankets/ sheets/ play tents for a child relax in Use beanbag chairs and giant pillows to sit on and "squish" the child with Provide relaxing music on tape player or headphones. For example, ocean waves, rain, classical music, nature tapes, slow/rhythmic music, white noise or nature sound machines Reduce visual distractions Keep toys/items/supplies neatly organized in bins and/or in their proper place Avoid strong odors, use mild air freshening smells (vanilla works great!) Schedule gross motor/ deep pressure/ movement activities prior to sit-down activities (circle time, lunch, table top activities etc.) Show schedule in words and pictures Provide many opportunities for "sensory" experiences (learning through movement, sight, taste, smell, touch, and sound)

47. Physical Accommodations: Use carpet squares for each child when sitting on the floor to keep them in their own space. Adjust chairs, desks, tables so children sit with feet flat on the floor and hips bent at a 90 degree angle. If a child is easily distracted, make sure his seat is away from doorways or windows. Use alternative seating equipment; sit on therapy balls, t-stools, disco-sit, bean bag chairs, or positioning wedges Allow children to work in a variety of positions; laying flat on the floor propped on elbows, standing at a table or easel, or lying on side and using a clipboard to write on Use a soft, plush rug in play areas to help muffle noise. If possible, have a rocking chair or glider rocker inside the classroom, and/or a hammock or swing chair outside the classroom where a child can go to relax. Allow children to use sleeping bags or weighted blankets in a quiet reading corner. Use a small tent or play hut with soft pillows and/or bean bag chair for a child to go to if over aroused.

48. Visual Accommodations: Post a daily schedule with pictures. Tape alphabet and number strips on a child's desk for them to use as a reference or guide. Place a drawing of a clock with appropriate day/time for therapy or assistant sessions outside of the classroom. Use tape, hula hoops or carpet squares to reinforce personal boundaries in seated learning or play areas. Use visual cues such as words or pictures for organizing personal belongings, containers, or shelves Keep visual distractions to a minimum; hang art projects on the wall in the hallway, keep bulletin boards simple and uncluttered, reduce hanging pictures and decorations.

49. More Visual Accommodations Help the child stay organized and focused by: - using his finger or index card under the line he is working on during reading or math -use graph paper for visual help aligning numbers during math work -use minimal visual information on each page -cover other areas of the page not currently working on to keep the child focused Use study carrels to decrease stimuli Minimize amount of toys, games, and decorations in the environment Have enough organized storage space, containers, and shelves to put all items away (label containers) Keep chalkboard clean Use dim lighting and pastel colors. Turn off lights during quiet breaks Keep memos and informational posters away from the front of the classroom so children can focus on the teacher

50. Auditory Accommodations: Have earplugs or sound blocking headphones available for children who are sensitive to, or distracted by environmental noises Ask child to repeat directions back to you before they start their work to ensure they understand Establish eye contact with the child before speaking to them Teach children to ask for help and make yourself available to them if they are having difficulty Break directions down into steps and allow extra time for children to process them if needed Warn children of any loud noises before they occur (bells, fire alarms etc.)

51. Organizational Accommodations Give simple, step-by-step directions. Have child verbalize steps needed to accomplish the task. Use peer or yourself to demonstrate/model task first, then ask the child to try it Use a consistent approach when teaching a child a new skill and allow time to practice and master the new skill Present directions to the child consistent with their best modality for learning (i.e., auditory, visual, or multi-sensory). Model, demonstrate and repeat as needed. Monitor the child to make sure they understand and are able to start the task Help the child plan for each task by asking questions such as, "What materials will you need?" "What will you do first?" and/or "What do you need to do when you are done?" etc.

52. More Organizational Accommodations Provide a few suggestions or a peer brainstorming session if a child has difficulty formulating ideas for assignments Help children who have difficulty with transitions by using a timer or give them a verbal cue that it will be time to change activities Transitions may also go smoother if a list with pictures is on the blackboard showing the day's activities Help prepare the child for transitions with an orderly clean up and a consistent musical selection which makes it fun and signals it is time to move on to the next activity Give children a consistent and organized place to store materials when they are finished using them Provide pencil grippers for children who have trouble using a mature pencil grasp. Remind children to use their non-dominant hand to hold the paper. Adjust chairs and tables to the proper height for each child. (Feet should touch the floor. Table height should be just below the child's elbow when the fist rests under the chin.) If a child presses too hard on the pencil, give him a mechanical pencil. Always present information in the child's best modality. Visual, auditory, or multi- sensory learning activities can facilitate understanding and memory.

53. Behavioral Accommodations Empower and encourage the child, avoid rescuing when the child is struggling (i.e., "hang in there", "you can do this", "you're ok" and "way to go") Use positive praise and awards when the child tries his best, attempts something new, does something independently, initiates a project, asks for help, follows the rules, or accomplishes something even if the outcome is not exactly what it should be Be specific with constructive criticism; make positive statements about what the child DID accomplish then make suggestions or ways to improve clear, concise and/or elicit suggestions from the child on what is missing or how to improve next time Validate them, their efforts, choices and feelings no matter what! Establish firm, clear rules with appropriate consequences if the child breaks them. Follow through!

54. More Behavioral Accommodations Talk through a task/problem with the child if they are struggling Be aware of the child's signs when they are starting to lose control. Be proactive in dealing with the issues BEFORE the child has a meltdown Teach children about personal space and enforce staying within those boundaries and keeping their hands to themselves Help the child generate ideas, problem solve, make choices or think creatively Use alternative approaches (through the senses) to alert, calm, and stabilize the nervous system

55. What is a Sensory Diet? Just as a student needs food throughout the course of the day, his need for sensory input must also be met. A “sensory diet” is a carefully designed, personalized activity plan that provides the sensory input a person needs to stay focused and organized throughout the day. Just as you may jiggle your knee or chew gum to stay awake or soak in a hot tub to unwind, children need to engage in stabilizing, focusing activities too. Each child has a unique set of sensory needs. Generally, a child whose nervous system is on “high trigger/too wired” needs more calming input, while the child who is more “sluggish/too tired” needs more arousing input. It is important to implement it throughout the course of the day.

56. Sensory Diet The great news is that the effects of a sensory diet are usually immediate AND cumulative. Activities that perk up your student or calm him or her down are not only effective in the moment; they actually help to restructure the student’s nervous system over time so that he is better able to: – tolerate sensations and situations he finds challenging – regulate his alertness and increase attention span – limit sensory seeking and sensory avoiding behaviors – handle transitions with less stress Sensory accommodations help to provide for consistent, appropriate, arousal levels and decreasing distractibility

57. Alerting Activities For The Lethargic Child Allow the child to sip on ice water in a water bottle throughout the day Use bright lighting Have the child pat cool water on their face as needed Take frequent "gross motor" breaks during difficult tasks (i.e., jump, hop, march in place, sit ups etc.) Encourage an active recess with swinging, jumping, climbing, playing ball etc. Have the child chew strong/flavorful sugar-free gum or suck on sugar free candies (use sweet or sour gum/candy or fireballs)

58. Calming Activities For An Overly Active Child Use low level lighting, no fluorescent lights! Allow the child to listen to calming music with headphones Use a soft voice and slow down your speech and movements while talking Allow the child to lay on the floor in a secluded area with weighted blankets, heavy pillows or bean bag chairs on top of them during written work or reading Push down heavily on the child's shoulders, with equal and constant pressure Avoid rushing the child Have the child be responsible for the heaviest work at clean up time; putting heavy books or objects away, moving/pushing chairs in, wiping down tables etc. Plan ahead, allow enough time between and during activities Make the child the "teacher's assistant"; carrying books to the library, allow them extra movement breaks with in-school errands (taking notes to the office or another teacher, passing out papers etc.), or giving them "heavy work" chores such as sharpening pencils, erasing and cleaning blackboards and erasers, etc. Provide opportunities for the child to jump on a mini trampoline, bounce on a therapy ball or sit on one instead of their chair to give them extra input Allow the child to have quiet fidget toys, chew toys/tubing, or squish/stress balls to squeeze while sitting and listening or during desk work Encourage twirling, spinning, rolling and swinging during physical education or recess Have child do "chair push ups" (raising their body off the chair with hands next to them on their seat) and/or tie Thera-Band around their chair and have them stretch it using their legs while doing desk work

59. Sensory Seekers Some children are "sensory seekers" and become more organized and attend better to task if they receive periodic movement input.

60. Ideas For Your Sensory Seekers Allow a child to sit on a baffled camping pillow filled with a small amount of air. This allows for movement without leaving the desk. Suggest five minutes of swinging or climbing during recess, prior to coming back to class. Suggest some rhythmical, sustained movement (e.g., marching, washing desks, or bouncing), which can be organizing to the central nervous system. Ask the child to erase the blackboard or run notes to other teachers, to allow him to get some extra movement. Use a rocking chair in the classroom for periodic "pick-me-ups." Never discipline a "sensory seeker" by taking away recess privileges or physical education — you will intensify the random movements, fidgeting, and outbursts.

61. Some children also need extra sensory input to their mouths and hands in order to organize their behavior, such as: Drinking from water bottles kept at desk (send them home weekly to be washed). Chewing on a straw, a coffee stir stick, or rubber tubing placed on the end of a pencil. Fiddling with something in their hands (keep a bucket or fanny pack of "squeezies“ or “fidgets” handy; a "squeezie“ or “fidget” is a small object that is soft and can fit in the hand, such as a balloon filled with flour, a soft ball, a dog toy, or a koosh ball). Hanging by the arms on the monkey bars for 20-30 seconds at a time. Pushing/carrying heavy objects (e.g., carrying books, moving desks, or "pushing" against walls). Carrying a backpack weighted with books or bags of dried beans (this should be worn for only 15-20 minutes at a time, with an hour or two between wearings).