1. ‘Help me explore it’ Incorporating Sensory Strategies into Conductive principles
CYP information

2. Cerebral Palsy is the most common physical disability in childhood affecting individuals differently whom may also have associated learning, hearing, visual disabilities along with complex medical needs. As well as movement problems, many children with Cerebral Palsy have difficulties processing sensory information, for some these sensory processing problems can be as restrictive as the associated movement disorders.
Talk about the students in class. Diverse complex needs. 2 CP 2 syndromes present similar symptoms and patterns as CP

3. Children with Cerebral Palsy often show signs of problems with integrating sensory information in combination with motor function. This may be due to the nature of the brain injury caused by lack of oxygen, but may be made worse by the lack of independent movement and absence of typical development that helps children to integrate sensory inputs. A child with CP is hindered in his/her ability to move against gravity, integrate primitive reflexes, experience tactile, proprioceptive and vestibular inputs. In addition to this these children often miss out on ‘rough and tumble’ play activities further reducing their ability to efficiently develop their efficiency and accuracy of sensory processing, and thus preventing quality sensory motor experiences.

4. “Tell me and I might forget Show me and I might remember, Involve me and I will understand” (Chinese Proverb)

5. What is Sensory Integration?
“Sensory Integration is the organization of sensory input for use”.
All information goes through our senses
Input
sight, taste, hearing, touch, smell, movement, proprioception
Output
Behavior, attend, learn, social interaction, express feeling, self-regulate, self-esteem

6. The three different types of behaviors
1-Over Responsive
Does not like busy, crowded places
Covers ears to block out noise
Moving or tearing at clothes
Covers eyes, squints
Does not like messy play
Picky eater
Does not like walking on grass/sand bare foot
2-Under Responsive
Not responsive to noise
Clumsy (falling over things, dropping things)
Not feeling hot/cold
Does not taste bland food
Being on the ‘sleepy’ side, does not engage in activities
3-Sensory Seeking
Licking, biting, chewing
Rocking, spinning
Squeezing into small spaces
Often looking for lots of sensory input to the point of over stimulation
Likes big hugs, squeezes
Likes rough and tumble play

8. Preparation for learning
We need to teach the individuals appropriate sensory strategies for self regulation in order to be in the state of a ‘just right’ arousal level. We as conductors follow a sensory diet provided by OTs.
Talk about post lunch, reduced attention. Body focusing on digestion …

9. Flamingo
To improve arousal levels. Help us focus

10. Neuroplasticity
Sensory diet activities help to lay down new pathways in a person’s nervous system over time so that he/she is better able to:
Increase body awareness and spatial relations (motor co- ordination)
regulate alertness and increase attention span
tolerate challenging sensations and situations
limit sensory seeking and sensory avoiding behaviours
handle transitions with less stress

11. Sensory Diet
Is very person specific because everyone’s sensory needs are different It resembles a personalized activity plan that provides the sensory input a person needs to stay focused and organized throughout the day. Activities can be stimulating or calming depending on the person’s needs It addresses the person’s main difficulties by looking at the behavior, and the sensory explanation of this behavior. It provides strategies to enable the individual to be at a ‘just right level’ of arousal in readiness to learn, play or take part in social situations. by OT Patricia Wilbarger
We all have sensory needs and we all found our own individual ways of satisfying these needs to help us relax or focus. i.e. chewing our pens, clicking our pens, enjoy a relaxing massage

12. The twist
How did this position made you feel? What were you aware of? What strategies did you use to keep your balance? i.e. previous experiences, our senses etc.

14. Cortex Limbic System Brainstem Thinking
Memory and emotions can affect response depending on previous experience
Sorts and filters incoming senses of sight, touch, balance, hearing, taste, smell and proprioception

15. Vestibular Activities
Effects can last between 4-8hrs
Rhythmical and predictable vestibular activities are organizing and calming (linear movements on a swing, slow rocking, slow movements)
unpredictable vestibular activities are arousing (spinning, roller coaster)
Some people find vestibular activities very challenging (gravitational insecurity)

16. CE high arousal levels

17. Swinging in prone

18. Sitting on the swing

19. Examples of alerting vestibular activities
Fast erratic movements on a swing,
using the roundabout,
position changes where the individual takes part in,
rebound,
up down ramps in chairs/on foot
Driving/walking over bumpy ground

20. LA before arousing activity
Low tone and low arousal levels often go together

21. LA during and after arousing activity

22. LA on trampoline

23. LA sitting up on trampoline

24. Proprioception and deep pressure
Effects can last up to 2hrs They always have an inhibiting, calming effect on the nervous system
Charlotte brushing and joint compression

25. Example of proprioceptive and deep pressure activities
Roll up in a blanket, “Sandwich” between pillows
Heavy work activities, pulling and pushing, help with gardening
Vibrating toys - pens, balls, use Vibrating mattress, vibrating pillows, vibrating toothbrush
Swaddle, Bear hugs
Backscratch, Scrub with washcloth/scrubby
Joint compressions, Therapy brushing
Hydrotherapy, Rebound
Fall onto “crash pad”
Log rolling
Weighted blanket, vest, lap pad
Mix bread dough, kneading, use Play-doh, clay etc

26. C walking deep pressure required

27. Touch
Can be alerting and or calming depending on activity and sensory needs of the person and the type of touch
Some people have a very low threshold to tactile stimulation, we refer to them as tactile defensive.
Others need to touch objects all the time or do not notice touch, they have a high threshold (tactile seeking and poor registration)
Seeking deep pressure, massage/pressing/shaking parts of the body we are working on.

28. Low threshold to tactile stimulation
Modify environment to produce calm, safe and predictable surroundings with controlled sensory stimulation
Avoid touching or approaching the person from behind. Make sure the person sees you before giving instruction or asking for responses
Use firm touch, allow the use of weighted vests, etc
gradually incorporate a variety of tactile experiences in play, eating, bath time, etc. Demonstrate on yourself and make it fun. Encourage active exploration. Do not force participation.
Needs a very specific programme to address sensory defensiveness, need training to implement i.e. introduce one new experience at a time
Supplement by calming experience before during and afterwards

29. High threshold to tactile stimulation
Messy play opportunities throughout the day – use lots of tactile activities as part of a multisensory curriculum
Allow fiddle toys to aid concentration
Use deep touch to organise sensory system to allow for better concentration
Remember: sensory need has to be addressed before you expect optimum performance - do not use it as a reward

30. Vision
Visual input can often be too much and hard to cope with by somebody with sensory processing issues
Some individuals have a low threshold to visual information – they are easily distracted by environmental influences
Others need more intense visual experiences to engage in play or learning
Sensory room

31. Strategies for visual regulation – low threshold
Remove clutter from class rooms, cover shelves etc. in plain coloured curtains
Have floor areas that are plain coloured (no textured rugs, carpets etc.)
Position person away from areas that are visual distractive (either at front of class or at the back)

32. Strategies for visual regulation – high threshold
Use high contrast to draw visual attention to desired object
Use person’s favourite colour for folders, toy chest etc
Use light up toys or ball that lights up to engage child and help person to maintain visual attention

33. Auditory stimulation
People with a low auditory threshold find it hard to cope in noisy environments like the dinner hall or a busy street. They also have difficulties blocking out background noise when listening to a speaker
People with a high auditory threshold appear not to listen to what was said

34. Strategies for low auditory threshold
Warn person before a loud noise
Allow to leave class early to get accustomed to noise in dinner hall
Provide quiet space to withdraw to when it becomes too much
Use calming techniques before exposure to loud environments (deep pressure, head phones with calming music)
Wear ear defenders

35. Strategies for high auditory threshold
Use one step instructions in clear language
Give lots of time to respond
Do not whisper – use a projected voice when calling
Use a visual or tactile cue to gain attention

36. Sensory processing difficulties stay with the person for life, but the person is able to manage them through a sensory diet or other sensory strategies
Difficulties only need addressing if they are interfering with the persons day to day functioning
Everybody is different and has different sensory preferences
That’s why sensory diets are individually tailored to the person
On-going observation/re-evaluation of individual’s response to the sensory stimuli is key
The diet part means it has to become a component of every day life

37. In memory of Judit Blake (Delicsany) (1954-2014) Liora Abrams
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