The ASD Nest Model
YAI International Conference 2013
THE ASD NEST
INCLUSION MODEL
Sensory issues and interventions:
Contributions of the O.T. to classroom
operation and child functioning
Kristie Patten Koenig, PhD, OTR/L, FAOTA
Christene Maas, MS, OTR/L
Dora Sarkodie, MS, OTR/L
Learning Objectives
• Understand the role of OTs within the ASD Nest Program
• Understand types of sensory issues that may be seen
• Discuss and demonstrate the use of sensory strategies that
can be universally applied to facilitate participation in the
the classrooms.
• Describe the process and benefit of team collaboration
The ASD Nest Model
YAI International Conference 2013
DSM V…..sensory reactivity returns
• Hyper-or hypo-reactivity to sensory input or unusual
interest in sensory aspects of environment; (such as
apparent indifference to pain/heat/cold, adverse response
to specific sounds or textures, excessive smelling or
touching of objects, fascination with lights or spinning
objects).
Sensory Processing
• The ability to take in information through our senses
(touch, movement, smell, taste, vision, and hearing),
organize and interpret that information and make a
meaningful response
Challenges with Sensory Processing
• Individuals with SPD are unable to process sensory
information correctly. SPD affects the way their brains
interpret the information they take in and also how they
act on that information with emotional, attentional ,
motor and other responses
• A comment about normal variations
• What individuals with autism have taught us…
Challenges to Sensory Processing in
Context
• What is the impact of sensory modulation disorders in
home, school, work, community environments and how
does it vary?
• To what extent does it impact the individual?
• Are their goodness or poorness of fit characteristics
between sensory processing and environment?
• How can we obtain the optimal level of arousal?
Sensory Processing Disorders
(Miller, L.J. et. al. SI Focus, 2004)
Misses
Cues,
Impaired
Slow
Affect
Interactions
Overreacts
Social
Anxious
Needs
Stimulation
Attends to all
Stimuli
for Arousal
“Spacey”
“Slow”
Defective Attending Behaviors
“Distractible”
“Fragmented”
Learning is Impaired
L.J. King, 1982
Dunn’s Model of Sensory Processing
Threshold
Passive Response
Active Response
High
Low Registration
Sensory Seeking
Sensory Sensitivity
Sensory Avoiding
SUR/Hypo
Low
SOR/Hyper
UNIQUE ROLE OF OTS IN
THE ASD NEST
PROGRAM
Unique Role of OTs in the ASD Nest
program
• Similar to other programs, address educationally relevant
areas in which OTs can provide interventions and
strategies to help promote student success
• Functional fine motor skills (grasp of pencil, fine motor dexterity)
 Visual motor/perceptual skills affecting school participation
 Activities of daily living (self-care skills)
Unique Role of OTs in the ASD Nest
program
• Provide sensory strategies for improving academic and
social participation that generalize in classroom
• Incorporate principles of the program through sessions
and during Social Development Intervention (SDI)
• Attending weekly team meetings, and professional
development
What does OT look like in the ASD Nest
Program?
• Have groups for the whole class
• Complete the mandate in the least restrictive
environment
• The general education children have indirect benefit of
the activity, although focus of the group is the
mandated child/children
• Administrative support
• Can provide a letter to ALL children in the class to inform all
parents/guardians
What does OT look like in the ASD Nest
Program? (cont’)
• Examples of groups
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Fun Fridays (Fine motor group on Fridays)
Yoga
How Does Your Engine Run? (Self- regulation
S’Cool Moves (Academic activities to address sensorimotor
needs)
Handwriting Without Tears (Handwriting group)
Self-care groups
Lunch groups (lunch club)
Cooking groups
Courageous Pacers
Unique Role—Push In’s
• Frequent “Push ins” for individual sessions
• Providing service in least restrictive and natural environment
• Providing service where the student is having educational or social
participation issue
• Supported by IDEA, current practice trends, and evidenced based
practice
Unique Role-- SDI
• If caseload permits, attend Social Development
Intervention (SDI) session
• At least one time per week; prefer 2 times per week for
Kindergarten & 1 time per week for 1st grade and up
• Allows for transdisciplinary involvement
• Can plan for sensory strategies for individuals or sensorimotor
games for groups
• OTs observe pragmatic language to use
• Teachers/SLP can observe OT strategies that work
• Can address issues in SDI in individual sessions if needed
Expanding our Unique Role
• Transition curriculum for 4-5th graders preparing for 6th
grade/middle school transition
• For example: Unit 1Questions/Expectation/Concern/Fear
• Create checklists of skills needed for MS/HS
• I can pack my backpack
• I can organize my folder
• Finding a classroom in school
• COSA for assessment
SENSORY STRATEGIES
Sensory Strategies that can be
Universally Applied
Importance of addressing sensory processing issues:
-affects classroom participation
-affects social participation
-affects self-care
-affects fine motor/gross motor development
Sensory strategies for the classroom
•Sensory Diet
• Use of various schedules
• Power cards (See example done by OT/teacher)
• Posters or visual cues for self-directed activity
•Self-regulation programs
• The Alert Program®: How Does Your Engine Run?
• S’Cool Moves: activities for learning and self-regulation
•Movement Breaks
•Quiet Areas
•Universal Design Sensory Strategies
MOVEMENT BREAKS
These are some activities to help enhance your
student’s attention:
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Chair push ups
Wall push ups
Jumping Jacks
Pushing down into the top of the table
Getting a drink of water and/or using the bathroom
Movement to Head, Shoulders, Knees and Toes song
Doing a silly movement
Transition movements, i.e. swimming like a fish while
transitioning from rug to desk
• Allow child to be teachers assistant and pass out papers
Classroom Movement Breaks
• Before the first “lesson” (writer’s workshop, math
workshop, etc.) or right after morning meeting
• Before lunch
• Hour before dismissal
Universal Design-Sensory Strategies
• Environmental Modifications
• Lights – turning off/dimming after lunch, PE, and/or afternoons
• Avoid florescent lights
• Play music after students return from lunch and PE
• Deep breaths
• Yoga poses
• Head on desk
Universal Design-Sensory Strategies
• Head phones- to help with auditory distractions, sudden or unexpected
noises
• Placing plain cover pages on children’s hanging work, so that one
must lift it in order to see
• Office- creating private work space for children at their desk using tri-
fold poster board or blank/empty folder.
TEAM COLLABORATION
Team Collaboration
• Required whole team case conference weekly which is
supported by administration
• Plan with teacher, OT’s , SLP, PT’s
• Plan for SDI
Team Meetings
• Case Conferencing:
• Hear from all professionals working with the student
• Consider the social: SDQ goals, SDI unit, strategies, relationships
• Discuss behavioral, academic, sensory, and parent concerns
• Generate specific plan for follow-up
• Work collaboratively as a TEAM
Parent Communication
• The purpose of the home/school notebook is to foster
communication between home and school, supporting
collaboration to help the child be successful.
• Parent Meetings with Social Worker
Parent Communication-Notebook
• Help undo negative associations from the past
• Create new and positive association with their child in
the educational program
• Success stories
• Ideas for how school content can be explored and
practiced at home
• Information about upcoming events that the children will
be participating in and/or that the parents might want to
attend
For more information:
• http://steinhardt.nyu.edu/asdnest/
• cmaas@schools.nyc.gov
• dsarkodie@schools.nyc.gov
• kpk3@nyu.edu