Sensory Processing The ability to use one’s senses to quickly process information from the environment, and then use that information to guide behavior appropriately across a variety of activities and settings The Five Basic Senses • Sight- Visual processing including under-and over-responsiveness, excessive seeking of visual input, and problems with perception • Hearing– Auditory processing, over- and under-responsiveness, seeking behavior, and perceptual difficulties • Touch– Tactile processing including tactile defensiveness, or overresponsiveness to touch sensations, and under-responsiveness with and without tactile seeking behaviors • Smell– Olfactory processing including over- and underresponsiveness, avoidance and seeking behaviors • Taste- Over- or under-responsiveness to tastes, avoidance and seeking behaviors. This area is closely ties to olfactory processing. Not to be confused with oral-tactile processing deficits. The Complex Senses • • • Vestibular- This is our movement sense. It includes our ability to sense and use the force of gravity for movement. Balance is an important function of this system. The vestibular sense allows us to move smoothly and balance while engaged in activities. Under- or overresponsiveness in this system will impact a person’s ability to maintain sitting posture, as well as to execute and control coordinated body movements such as running, jumping, or riding a bike. Children may crave excessive movement or avoid movement, especially when feet are not on the ground. Proprioceptive- This is our body position sense. Proprioception is the ability to know where a body part is without having to look. It also helps us determine how much force is required to complete an action successfully. It is an essential component of coordinated movements, such as grasping a utensil or catching a ball. Under- or over-responsiveness in this system will impact a person’s ability to navigate around obstacles, use appropriate force when using tools, and perform precision fine motor tasks efficiently. Praxis- This is not itself a sensory system, it is a higher level cognitive function that depends on the integration of multiple sensory systems, particularly tactile perception and proprioception, in order to function efficiently. Praxis is the ability to conceptualize, plan and organize movements in order to complete an unfamiliar motor tasks and then adapt our movements to improve success in the future. Some Possible Signs of Sensory Processing and Integration Issues • • • • • • • • • • • • • Delays in speech, motor skills or academic achievement Overly sensitive or under-reactive to touch, movement, sights or sounds in the environment Unusually high or low activity level Easily distracted; poor attention to tasks (attending to TV doesn’t count!) Coordination problems; appears awkward or clumsy Decreased awareness of body in space or spatial relationships between body and items in environment Difficulty using both hands together to perform simple tasks Difficult with transitions between activities, environments, or states of arousal Resistance to changes in routine Difficulty learning new tasks or playing appropriately with unfamiliar toys Inability to come up with new ideas for play Immature social skills Impulsivity or difficulty with self-control Executive Function • From Executive Skills in Children and Adolescents, by Peg Dawson and Richard Guare • Executive function is a neuropsychological concept referring to the high level cognitive processes required to plan and direct activities, including task initiation and follow-throuhg, working memory, sustained attention, performance monitoring, inhibition of impulses, and goal-directed persistence. • Executive skills are mainly located in the prefrontal cortex of the brain. These areas are the last to fully develop in late adolescence. The executive functions operate like the conductor of an orchestra who selects the pieces of music to be played and then organizes the musicians – starting them, integrating, and stopping their playing, keeping them in time, and fading various players in and out as needed to play their respective parts. If the orchestra is not working with the conductor, each musician is just as talented as they were WITH the conductor, but the music the orchestra can make together will not be as well timed, balanced, or crisp as with the conductor. This is part of what leads to the misinterpretation that a person with executive skills deficits is willfully not achieving or meeting expectations. (Laura Ehlert, Psy.D.) • A child cannot have ADHD and not have deficits in executive function. • A child can have executive function deficits and NOT have ADHD. • Executive function can be situational…difficulties can be intermittent. • Don’t assume a child WON’T complete the task just because they didn’t yesterday. It may actually be that they CAN’T get it done today. • Fair does not mean equal! At home or at school, each child has differing needs to be successful. Helping teachers, parents, siblings and others to understand that accommodations are only “leveling the playing field” is important. You would not expect a paraplegic to walk up the stairs. You would expect them to take the elevator. Developmental Tasks requiring Executive Skills: Preschoolers: • Follow Simple Directions- go get your jacket • Pick up Toys • Brush teeth, clear dishes • Inhibit some behaviors such as not touching the hot stove, running into the street, don’t hit, begin to share things Kindergarten to grade 2: • 2-3 step directions- get shoes, jacket and backpack • Pick up their bedroom and make bed- with reminders/support • Be responsible to bring papers to and from school • Inhibit behaviors such as following general safety rules, poor language, raise hand at school before speaking, keeping hands to self Grades 3-5 • Can do time delayed errands: go to neighbor’s to pick up something, remember to do something after school • Vacuuming or dusting, clean up the kitchen (more complex) • Remember assignments and materials for homework • Complete homework independently, plan and complete a project (book report) • Keep track of daily schedule and changes • Save money/delay gratification for a long-term goal • Inhibit/self-regulate: behave even when no adult watching, no temper tantrums Developmental Tasks requiring Executive Skills: Continued Grade 6-8 • Help out with many chores/tasks at home • Baby-sit young siblings • Has system for organizing school work • Can follow complex school schedule involving multiple classes/teachers • Plan/carry out long-term projects with timeline, perhaps multiple projects at once • Plan time including after/during/before school, homework, family responsibilities • Inhibit rule breaking in the absence of visible authority High School: • Manage schoolwork on a daily basis, handing in and corrdinating time for completion by due dates for multiple teachers/activities • Make and keep long-term goals with realistic plans for meeting these goals • See the connection to high school and the long-term goal of college, what needs to be done in order to make that happen • Make positive use of leisure time, employment, sports, activities, etc. • Inhibit reckless and dangerous behaviors: drugs, sex, vandalism, etc Ten principles for Improving Your Child’s Executive Skills • Teach deficient skills rather than expecting the child to acquire them through observation or osmosis • Consider your child’s developmental level • Move from the external to the internal • Remember that the external includes changes you can make in the environment, the task, or the way you interact with your child. • Use rather than fight the child’s innate drive for mastery and control. • Modify tasks to match your child’s capacity to exert effort • Use incentives to augment instruction • Provide just enough support for the child to be successful • Keep supports and supervision in place until the child achieves mastery or success • When you do stop the supports, supervision and incentives, fade them gradually, never abruptly. Simple Accommodations and Modifications in the Classroom: • Accommodations are changes in how a student accesses information • The changes are made in order to provide a student with equal access to learning and an equal opportunity to show what he or she knows and can do. It levels the playing field • Modifications are changes in what a student is expected to learn • The changes allow for the opportunity to participate meaningfully and productively along with other students in the classroom Environmental Accommodations • Sensory breaks- drink, walk, send student on errand • Seat student away from distractions, quiet area • Behavior cue cards • Sensory stimulation- stress balls, fidget toys, etc. • Headphones • Lights • Carpet Content Instruction Accommodations • Give basic introduction to the subject immediately before starting the lesson for the whole class – elicit prior knowledge • Include hands-on experiences and manipulatives whenever possible • Rephrase the questions to check for understanding • Response time… ask the question and come back • Mnemonic devices • Partner students with strategically-capable peers • Graphic organizers • Study guides, notes, well in advance, page numbers Assignment Accommodations • Highlighting with colored highlighters, tape, using post-its • Compare notes to teacher’s or classmate’s • Color coding • Extended Time • Assignments can be turned in late • Reduced homework assignments • No penalty for spelling errors • Re-do’s, NO missing assignments or zeros Assignment Accommodations • Keep questions in the order of reading material • Provide word bank • Break materials into smaller parts • Take turns- you do a problem, the student does a problem • Visual organizers Modifications • • • • Changes in instructional level Changes in content/curriculum Changes in performance criteria Changes in assignment structure- paper/pencil work Content Instruction Modifications • Reduce the variety of tasks- less tasks on one sheet of paper. Give one sheet at a time • Make it meaningful… what do they need to know? Highlight the information…when lecturing…write this down…this is important…what is key • Eliminate less critical information • Find ways to involve students in class • Teach a system to prepare a student to answer a question • Books on tape, videos • Visual organizers • Differentiate instruction