Reflection

This blog has covered the six senses of...

• Vestibular
• Proprioception
• Tactile
• Visual
• Auditory
• Olfactory/Gustatory
  

Researching these topics for my blog has been incredibly helpful for me in terms of providing me with practical ideas for interventions for children with SID. I have learnt a lot about the different senses and ways to modulate these during treatment.

The specific activity examples made in this blog have been from Case-Smith 1998, Kranowitz, 2003 and suggestions from practicing occupational therapists.

Gustatory/Olfactory

(Retrieved from: http://www.great-home-based-businesses.com/baking.html)

Imagine...you walk into your neighbours house and her house smells like wonderful baking, but after a few minutes in the house you cant smell the baking anymore. This is an example of your olfactory system in full swing.

Working with a child to calm a hyper-responsive gustatory/olfactory system, activities for a child avoiding gustatory/olfactory input
Therapeutic activities should include:
Sweet or mildly salty flavours or scents (Case-Smith, 1998)

Specific activity examples:
Suck Push Pops or other hard lollies
Smell & tell, try to identify smells
Playing with round objects, kick, squeeze, throw balls or balloons then try round food like Cheerios.

Arousing a hypo-responsive gustatory/olfactory system or activities for a child seeking gustatory/olfactory input
Therapeutic activities should include:
Sour, bitter, spicy or smokey flavours or scents (Case-Smith, 1998)

Specific activity examples:
Lemonade in a drink bottle
Sour lollies or Big Red chewing gum
Spices
Taste & tell, lots of different smells, tastes and textures on a plate, e.g. raw onion, mustard and cornflakes

Case-Smith, J. (1998). Pediatric occupational therapy and early intervention (2nd ed.). Woburn, MA: Butterworth-Heinemann.

Kranowitz, C. S. (2003). The out-of-sync child has fun. New York: Penguin Putnam Inc.

This is a great website on SID, check it out!

http://www.sinetwork.org/

Auditory Sense

(Retrieved from: http://www.ftwilmingtonblog.com/one-client/days-13-travel-victory-nutrition-defeat)

Imagine... you are in a busy airport, there is a baby crying behind you, a couple chatting infront of you and you are listening to an announcement over the PA system about your flight. This is an example of your auditory system working to prioritise auditory information.

When working with a child to calm a hyper-responsive auditory system or providing activities for a child avoiding auditory input therapeutic activities should involve:
Low volume rhythmic music, vibration or speech (Case-Smith, 1998)

Specific activity examples:
Music with heartbeat rhythms
Nursery rhymes
Skipping rhymes
Soft music
Tapping tunes

Arousing a hypo-responsive auditory system or activities for a child seeking auditory input therapeutic activities should involve:
Moderate volume hard rhythmic, verbal language or music (Case-Smith, 1998).

Specific activity examples:
Loud music with a driving beat
Singing
Loud nursery rhymes
Loud skipping rhymes
Musical chairs
Matching sounds with beans or rice

Case-Smith, J. (1998). Pediatric occupational therapy and early intervention (2nd ed.). Woburn, MA: Butterworth-Heinemann.

Kranowitz, C. S. (2003). The out-of-sync child has fun. New York: Penguin Putnam Inc.

Visual System

(Retrieved from: http://www.wanguriprimary.nt.edu.au/grounds.html)

Imagine...you are sitting in a classroom, there are posters and banners covering the walls but you are concentrating on what the teacher is writing on the whiteboard. This is a visual system working well, you are able to concentrate on one stimulus and ignore the rest.

When working with a child to calm a hyper-responsive visual system or providing activities for a child avoiding visual input therapeutic activities should take place in:
A low lit small, uncluttered, closed in space filled with pastel or deep colours. For example:
Work in a small treatment room, tent or fort
Have bare (or minimal objects) walls (Case-Snith, 1998)

Specific activity examples:
Order balls by size, colour or shape
Treasure hunts


Arousing a hypo-responsive visual system or activities for a child seeking visual input
Therapeutic activities should take place in:
A large, busy, moderately lit room filled with bright colours. For example:
Work in a bright sunny area
Large areas such as a gym
Have lots of pictures and objects on the walls (Case-Smith, 1998)

Specific activity examples:
Beanbag toss and catch in cut off containers
Magnetic fishing
Flashlight tag

Case-Smith, J. (1998). Pediatric occupational therapy and early intervention (2nd ed.). Woburn, MA: Butterworth-Heinemann.

Kranowitz, C. S. (2003). The out-of-sync child has fun. New York: Penguin Putnam Inc.

Tactile System

(Retrieved from: http://www.goodhousekeeping.com/product-testing/from-the-lab-blog/clothing-swaps)

Imagine...you are rummaging around in your drawers to find your favourite top, you fingers brush the fabric and you pull it out, even though you couldnt see it. This is an example of your tactile sytem at work.

When working with a child to calm a hyper-responsive tactile system or activities for a child avoiding tactile input therapeutic activities should include:
Predictable moderate to deep slow skin pressure on locations such as the back, dorsolateral surfaces of the extremities or face (Case-Smith, 1998)

Specific activity ideas:
Messy play– shaving, cream, damp sand etc.
If this is too much, try non-messy play – Put multi coloured paint in a zip lock bag, mix and write with the paint through the bag.
Try to find hidden items in Playdough
Slow massage
Long, sustained stroking of the skin in one direction

Arousing a hypo-responsive tactile system or activities for a child seeking tactile input
Therapeutic activities should include:
Unpredictable rapid light movement on the ventromedial extremity surfaces (Case-Smith, 1998).

Specific activity ideas:
Play in a ball pit
‘Swimming’ through a fabric tunnel
Messy play
Playdough/Theraputty

Case-Smith, J. (1998). Pediatric occupational therapy and early intervention (2nd ed.). Woburn, MA: Butterworth-Heinemann.

Kranowitz, C. S. (2003). The out-of-sync child has fun. New York: Penguin Putnam Inc.

Proprioceptive System

(Retrived from: http://anadoptivefamilyslife-thedanielsons.blogspot.com/2010/11/hes-like-light-switch-and-you-never.html)

Imagine...you wake up early in the morning and its still dark, you reach over and switch on the light. How did you know were your arm was in relation to the light switch? This is your proprioceptive sense in action.

When working with a child to calm a hyper-responsive proprioceptive system or providing activities for a child who is avoiding proprioceptive input therapeutic activities should include:
Sustained moderate to deep pressure of the whole body or proximal joints (Case-Smith, 1998).

Specific activity ideas:
Swaddling activities such as ‘hot dog’
Pulling on stretchy objects like Thera-Band
Pushing/pulling/carrying heavy objects to build a fort
Pushing a swing
Carrying shopping or boxes

Arousing a hypo-responsive system or activities for a child seeking proprioceptive input
Therapeutic activities should include:
Whole body movement (Case-Smith, 1998)

Specific activity ideas:
Leaping onto a crash pad or bed
Obstacle courses
Playing with rope e.g. jumping, pulling etc.
Playing in boxes or tunnels
Carry, push or pull heavy items

Case-Smith, J. (1998). Pediatric occupational therapy and early intervention (2nd ed.). Woburn, MA: Butterworth-Heinemann.

Kranowitz, C. S. (2003). The out-of-sync child has fun. New York: Penguin Putnam Inc.

Vestibular System

(Retrieved from: http://www.scottbradley.name/elevator-pitch/)

Imagine...you step into an elevator, the doors close and you descend, but how do you know you are descending? You cant see anything moving down, you just know. This is an example of your vistibular system in action.

When working with a child to calm a hyper-responsive vestibular system or providing activities for a child who is avoiding vestibular input, therapeutic activities should include:

Slow, predictable linear movement in either horizontal or vertical planes.

Specific activity ideas:
Slow rocking
Slow swinging
Moving on a waterbed
Sitting in a car seat of a moving car

When arousing a hypo-responsive system or providing activities for a child seeking vestibular input therapeutic activities should include:
Moderate or fast speed unpredictable movement in any plane of movement (Case-Smith, 1998)

Specific activity ideas:
Jumping on a trampoline
Helicopter swinging
Hanging on a trapeze bar
A ‘storm’ on a bolster swing
Roughhousing activities
Wheelbarrow walks
Singing action songs such as the Hokey Tokey

Case-Smith, J. (1998). Pediatric occupational therapy and early intervention (2nd ed.). Woburn, MA: Butterworth-Heinemann.

Kranowitz, C. S. (2003). The out-of-sync child has fun. New York: Penguin Putnam Inc.

Occupational therapy and SID

For those of you who are still a little fuzzy on what occupational therapy actually is…

Here is the latest definition from the World Federation of Occupational Therapists

“Occupational therapy is a profession concerned with promoting health and well being through occupation. The primary goal of occupational therapy is to enable people to participate in the activities of everyday life. Occupational therapists achieve this outcome by enabling people to do things that will enhance their ability to participate or by modifying the environment to better support participation.”

(Retrieved from www.wfot.com/office_files/final%20definitioncm20042.pdf)


So in a very small nutshell the role of an occupational therapist is to facilitate engagement in meaningful occupation and for children this occupation is play.

But arent children just entertaining themselves when they play?
No way!!

Children do a lot of their learning and development in response to exploring their environment, their main means of doing this is through play. Play stimulates a child’s brain development and facilitates learning. While a child with incorrect sensory processing may have limited ability to participate in occupation.Therefore occupational therapists work with children with SID facilitating the regulation of sensory input providing opportunities to experience and develop adaptive responses and self modulation thus enabling them to participate in play.

Here is a great example of what a sensory integration room looks like :)

(retrieved from http://drkarthik.in/sensory-integration-paediatrics-unit/)

Here is a useful video i found that explains SID (SPD)...

So..what exactly is SID?

Sensory Integration Disorder (SID) is not a single diagnosis, rather, the term refers to a diverse group of disorders that reflect dysfunction within the brain’s ability to make sense of sensory information it receives from the body and the environment (Case-Smith, 1998)
There are six sensory systems within the body:

• Vestibular –
Interprets the position of the head and body movements

• Proprioceptive –
Interprets information from muscles and joints, as to where one part of the body is in relation to another

• Tactile –
Interprets information regarding touch

• Visual –
Interprets stimuli through the eyes

• Auditory –
Interprets sounds

• Gustatory/Olfactory –
Interprets taste and smell

In a typically developing child these systems work together to provide the brain with information regarding the body, its location or movement and the world around them. We need a mixture of the senses working together –“sensory diet” to fully understand our relationship to the environment.
However, in a child with SID, the brain cannot understand the information received from one or more of these systems. The sensory receptors are working but the brain has difficulty processing the information As SID usually affects more than one sense this disorder therefore produces a baffling amount of behaviours depending on which of the sensory systems are affected and whether the child is sensory seeking (hypo-responsive) or sensory avoiding (hyper-responsive).

Welcome!

Hi everyone and welcome to my blog exploring sensory integration.

Just a little bit about me…

Over my short 22 years I have had the pleasure of spending a large amount of time working with special needs children. This provided me with experiences which motivated me to study occupational therapy and sparked my interest in sensory integration disorder (SID) or otherwise known as sensory processing disorder (SPD). I have always been fascinated by the ins and outs of any disorder but SID was different with its large variety of presentations and that its treatment was always cleverly disguised as "play".

This blog will follow me on my quest to find out practical ideas for occupational therapy intervention for children with SID.

Enjoy!




References
Case-Smith, J. (1998). Pediatric occupational therapy and early intervention (2nd ed.). N.p.: Butterworth-Heinemann.