Sensory Processing Disorders
and Executive Function
Presented by Doreit S. Bialer,
MA,OTR/L
December 8,2008
The Sensory Integration
Continuum
ADHD
PDD Asperger
Autism
Tourettes OCD RD
<MILD_________________________________SEVERE>
Who Has Sensory Processing Disorder?
K.Dorfman, MS,LN,LD 2004
Sensory Processing
• The ability to take in, sort, interpret, organize sensory
information from internal and external
Sensory Systems
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Vestibular(movement and gravity
Tactile
Proprioceptive(heavy work, input to mm. And joints
Auditory( hearing)
Visual(sight)
Olfactory/Gustation
Efficient Sensory Processing Develops
• Awareness of body in space
• Feeling safe
• Ability to discriminate, prioritize, filter ,organize
and integrate incoming sensory input
Responsiveness
• The way you respond to the demands in your
life
• 1. Hyper-responsive (overresponsive)
• 2. Hypo-responsive (underresponsive)
Sensory Seeking-high neurological threshold,
Sensory Avoiding-low neurological threshold,
Sensory Sensitivity-low neurological threshold
Sensory Processing Disorder
• Diag.1
Sensory
Symptoms
Auditory
•Responds negatively to unexpected or loud
noises
•Holds hands over ears
•Cannot walk with background noise
•Seems oblivious within an active
environment
Visual
•Prefers to be in the dark
•Hesitates going up and down steps
•Avoids bright lights
•Stares intensely at people or objects
•Avoids eye contact
Taste/Smell •Avoids certain tastes/smells that are
typically part of children's diets
•Routinely smells nonfood objects
•Seeks out certain tastes or smells
•Does not seem to smell strong odors
Body
Position
•Continually seeks out all kinds of
movement activities
•Hangs on other people, furniture, objects,
even in familiar situations
•Seems to have weak muscles, tires easily,
has poor endurance
•Walks on toes
Movement
Becomes anxious or distressed when feet
leave the ground Avoids climbing or jumping
Avoids playground equipment
Seeks all kinds of movement and this
interferes with daily life
Takes excessive risks while playing, has no
safety awareness
Touch
Avoids getting messy in glue, sand, finger
paint, tape Is sensitive to certain fabrics
(clothing, bedding)
Touches people and objects at an irritating
level
Avoids going barefoot, especially in grass or
sand
Has decreased awareness of pain or
temperature
attention,
Behavior
And Social
Jumps from one activity to another frequently
and it interferes with play Has difficulty
paying attention
Is overly affectionate with others
Seems anxious
Is accident prone
Has difficulty making friends, does not
express emotions
Sensory Processing vs. Executive
Function
Sensory Processing
• Occurs without conscious
thought or effort Involves
taking in, integrating,
organizing, storing
information from internal
and external senses.
• Important for giving us a
sense of our body in space
and feeling safe
Executive Function
• Set of conscious,mental
processes that help us connect
past experiences with present
actions. We use executive
functions when we plan,
organize, strategize and pay
attention to remembering
details.
• Important for decision making,
planning and strategies in goal
directed behaviors, furture
planning.
Sensory Processing vs. Executive
Functions
Sensory processing
• Gives us the ability to analyze
and integrate sensory
information. Gives us
perception of
texture,firmness, shape,
position,location, quantity and
quality of sensory stimuli.
• Involves sensory motor cortex,
occipital, temporal lobe, limbic
system, and ANS
Executive Functions
• Higher level process which
involves the ability to
start/stop actions,change
behavior,plan future
behavior when faced with
novel tasks.
• Involves frontal lobe, limbic
system, ANS functions
attention, memory and
motor skills.
Skills in Executive Functioning
Skill
• Working memory/recall
• Activation,arousal,effort
• Controlling emotions
• Internalizing language
• Taking an issue apart,
analyzing the pieces,
organizing it
Definition
• Holding on to facts,
accessing facts stored in
memory
• Getting started;paying
attention, finishing work
• Tolerate frustration,thinking
before speaking or acting
• Self talk, controlled
behavior
• Problem Solving
Dyspraxia
• Difficulty in conceiving, planning, organizing
and executing motor skills in an efficient
manner.
• Poor generalization to novel skills
• ADHD vs. SPD
Praxis Components
Involves Executive Functions and SP
ExampleDriving a carAm I driving like I should be???
1. Sensory Components, involves multisensory interaction,
providing feedback about where you are in space, how
much pressure to use on steering wheel, brakes,
2. Sequencing- directional signals, order in which things
must be done
3. Working memory, address and destination
4. Activiation, arousal
5. Controlling emotions- road rage?
Stragies to use:
INCLUDE:
HEAVY WORK, CALMING TECHNIQUES,
CHANGING LEVELS OF ALERTNESS
(AROUSAL), ORGANIZATIONAL
STRATEGIES
Promoting Arousal states through Foods
Alerting increases
attention
and
levels of arousal
Chewy foods are
organizing
Crunchy foods are
alerting
Sucking Foods are
calming
Changing How Alert You Feel
1.Put something in your mouth - Gum, crunchy foods ,chewy
foods, sour foods ,drink from a straw, deep breathing
2.Move (Before you need to concentrate)
Isometrics ,walking - shake heads, neck rolls yoga, exercise
3.Touch- Hold and fidget with something ,wash hands with
cool water
4.Look- Bright lights, dim lights, clear off table,read, look at
pictures, darken room
5.Listen-classical music, hard rock, jazz
Examples of Heavy Work Activities
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wiping off the blackboard and cleaning off the desks
Sweeping/mopping/vacuuming/digging
Isometric exercise
Pushing a weighted cart
Carrying heavy books
Playing sports
Weight bearing postures
20 Ways to Calm a Child
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Soften lights,
Bring child to a less busy room
Have child face a simple wall
Have a “chill out space or relaxation space always available
Temperature
Repeat affirmation, “I will be OK”
Dampen extraneous noise/ headphones
Have child straddle a chair backwards, chest on back support of chair
Firm pressure on shoulders
Firm back rub( If feasible)
Rocking chairs, bean bag chairs
Trampoline/ if not available jump up and down 10 times
Wall or chair push ups
Offer something to suck on, like a hard candy, or snack size applesauce, pudding or yogurt to eat through
a straw
Crunchy foods can calm, goldfish crackers, pretzel rods or carrot sticks.
Deep breathing…ahhhh
Have the child blow bubbles
Chew bubble gum
Provide,soft,slow, rhythmic humming, song or music ( no words) or metronome.
Strategies to Help
General strategies
• Take step by step approaches to work, rely on visual
organizational aids
• Use tools like organizers,computers, watches with
alarms
• Prepare visual schedules and review them several
times a day
• Ask for written directions with oral directions
whenever possible
• Plan and structure transition times and shifts in
actitivites
Managing Time
• Create checklists and “to do” lists, estimating
how long tasks will take to complete
• Break long assignments into chunks
• Use visual; calenders to keep track of long
term assignments,due dates, activities
• Use management software such as Franklyn
Day Planner, Palm Pilot or Lotus
• Be sure to write the due date on top of each
assignment
Manage Space and Materials
• Organize work space
• Minimize clutter
• Consider having separate work areas with
complete sets of supplies for different
activities
• Schedule a weekly time to clean and organize
the work space
Managing Work
• Make a checklist for getting through
assignments for ex. Get out paper, put name
and date, read directions, etc.
• Meet with the teacher on a regular basis to
review work, trouble shoot any problems
Bottom Line
• The brain continues to mature and develop
connections well into adulthood. A prson’s
executive functions are shaped by both
physical changes in the brain and by life
experiences, classroom and in the world by
large. Strategies are very helpful in developing
better organization and efficiency skills
essential for SP and EF.