Sensory Processing, Motor Skills and Autism. Jill McCanney Specialist Occupational Therapist

Sensory Processing, Motor Skills and Autism Jill McCanney Specialist Occupational Therapist

Sensory Processing Sensory processing refers to the ability to register, integrate and respond to sensory input Examples: Catching a ball Walking around the classroom Social interaction

Sensory Processing The development of the sensory systems lays the foundation for the development of motor, social and academic skills

Gross motor skills Includes: Muscle tone Muscle strength Core/postural stability Balance Coordination Body awareness/body scheme

Fine motor skills Includes: Development of hand arches Finger and thumb isolation Grasp patterns Hand strength In-hand manipulation Bilateral coordination Eye-hand coordination Tactile and proprioceptive awareness

Praxis Praxis : doing, acting, deed or practice Also referred to as motor planning 3 main components: Ideation Planning Execution Requires conscious thought and attention

Importance of Praxis Praxis is essential for Learning new skills Refining skills Carrying out skilled tasks Fluent and coordinated movements Sequencing All activities of daily living e.g. dressing, handwriting, sports, toileting

Sensory Integration Theory Places emphasis on the development of the following systems: Tactile system Proprioceptive system Vestibular system This will then have a subsequent impact on gross and fine motor skills

Tactile System Efficient tactile processing is essential for: Development of grasp patterns Fine manipulation Functional skills e.g. handwriting, dressing Also speech and language development and eating Gait pattern

Proprioceptive System Efficient proprioceptive processing is essential for: Body awareness Position in space Motor coordination Control of force and pressure Handwriting Functional skills e.g. dressing

Vestibular System Efficient vestibular processing is essential for: Tolerance of movement Participation in gross motor activities Balance Bilateral coordination Speed and velocity of movement

Sensory Motor Skills in Autism Over 90% of children with autism have sensory processing difficulties This has a direct impact on motor skills Many children with autism have low muscle tone, affecting core stability and muscle strength Research study by Parham et al in 2000 showed that children with ASD achieved lower scores in praxis tests than their typically developing peers Specific difficulties in ideation

Sensory Motor Skills in Autism Other core features of autism will have an impact on sensory motor development: Difficulties in joint attention Difficulties in imitation Repetitive play and restricted interests Social communication difficulties Sensory sensitivities Low registration of sensory input

Pre-requisite Skills for Dressing and Toileting Dressing and using the toilet: Pre-requisite skills Body awareness Sequencing Fine motor skills Sitting posture/balance Maintaining attention to task Knowing when to use the toilet Tolerating smells

Pre-requisite Skills for Handwriting Pre-requisite skills Calm and alert state (attention to task) Tactile processing Proprioceptive processing Postural/core stability Shoulder strength and stability Grasp pattern (fine motor skills) Hand strength Bilateral integration

Developing Sensory and Motor Skills within the Curriculum

Topic: Minibeasts MINIBEASTS Opening activity: Throwing spider ball, koosh ball etc. Gross motor: Insect walks Fine motor: Play-dough snails and spiders Closing activity: Caterpillar in cocoon (rolling in blanket) -Eye contact -Tactile tolerance -Name recognition -Eye-hand coordination -Muscle strength/ stability -Proprioceptive input -Auditory processing -Motor planning -Tactile input -Joint attention/imitation -Motor planning -Fine motor skills -Calming (deep pressure input) -Body awareness -Imaginative play

Topic:People who help us-builder PEOPLE WHO HELP US: BUILDER Opening activity: Building tower with blocks Gross motor: Wheelbarrow walks, dressing up, ladders Fine motor: Lick and stick picture of a house Closing activity: Song: Down on the building site -Eye contact -Attention -Eye-hand coordination -Motor planning -Imaginative play -Weightbearing (calming) -Sequencing -Self-care skills -Handwriting -Scissor skills -Oral motor processing -Visual matching -Fine motor control -Grading vocalisation -Language development -Linking listening to action -Making sounds with body

Activity ideas tactile system Messy play Sand and water play Finger painting Tracing in trays of flour, shaving foam etc Sandpaper letters Walking barefoot on different surfaces Hiding toys in boxes of different textures (e.g. rice, lentils, polystyrene) Feelie bag

Activity ideas proprioceptive system Body awareness activities Simon Says (N.B. use visuals if required) Carrying a beanbag Twister Resistance activities Pushing with body parts Pulling a rope Therabands Weightbearing activities Crawling Wheelbarrow walks Lying over an exercise ball Gymnastics Climbing

Activity ideas vestibular system Trampoline Jumping, skipping, hopping etc. Space hopper Scooter board Balance beam (or wider bench) Balance board Tall kneeling and half kneeling Bilateral activities

Activity ideas core stability Lying on stomach and propping up on elbows (e.g. when reading a book, completing a puzzle or watching TV) Lying on stomach over a chair or therapy ball Scooter board activities Activities in tall kneeling and half kneeling Jumping Standing on one leg/hopping

Activity ideas shoulder strength Crawling Wheelbarrow walks Lying on stomach and propping on elbows Lying on stomach over therapy ball Press ups (on chair/against wall) Specific shoulder exercises

Grasp pattern/fine motor skills Finger and thumb isolation Finger painting Finger puppets Pincer grip Pinching along dough Threading, lacing, pegs, blocks etc Using tongs or rookie stix Tearing paper Sponge painting

Activity ideas hand strength Squeezing water out of sponge or cloth Squeezing water out of sports bottle Play dough, plasticine, clay and putty Clothes pegs Tongs/rookie sticks Tearing and scrunching paper and card Tug of war games

Activity ideas bilateral integration Use activities which require two hands e.g.: Dealing cards Tearing paper e.g. collages Construction toys (putting together and taking apart) Threading beads Crawling Climbing

ADDITIONAL CONSIDERATIONS IN P.E.

Following Instructions Many children with autism appear to ignore instructions or refuse to participate This is likely to be due to: Difficulties with receptive language Lack of clarity in tasks/unsure what is expected Distractibility

Visual Structure Visual structure is effective for children with autism because: Most children with autism are visual learners It clarifies verbal language It provides a constant prompt of what is expected It increases participation and independence Visual strategies are often effective with other children also e.g. ADHD, DCD

Using Visual Structure in P.E. Visual schedules Support verbal instructions with visual symbols/photographs Structure the activities: Clear sequence Goal directed/clear beginning and end Written instructions if appropriate Modelling if appropriate Video modelling

Examples of Adding Structure Colour matching Floor puzzles Finding items hidden in room and categorising Posting/putting away Alphabet Finding numbers to complete sums Counting e.g. when jumping Knocking over cones or skittles on space hopper or scooter board

Sensory Overload Reduce visual distractions Store equipment Cover resources Consider acoustics Use visual communication strategies Control noise level Volume control/traffic lights Avoid contact games Teach new activities one-to-one in a quiet area and then generalise into main group

Changing for P.E. Tactile sensitivity Is changing essential? Sequencing Visual work systems Attention Quiet area Motor skills Backward chaining Adaptations e.g. velcro

Working in Pairs and Groups New activities should be first taught by the adult before extending into a group setting Select appropriate classmates Ensure group members are familiar with the visual and communication strategies Give the child a clear role in the group but rotate the roles e.g. goalkeeper, collecting the beanbags, holding the target, keeping score

Just Right Challenge Select activities which are sufficiently challenging so the child develops new skills BUT remember to consider the child s limitations: Low muscle tone (NB risk of injury) Fatigue Coordination Sensory sensitivities ENSURE SUCCESS

Appropriate activities For children with sensory processing difficulties: Avoid activities which require fast changing responses e.g. football, netball Select sports which allow slower responses e.g. swimming, bowling, golf

Recommended activities Solitary activities (e.g. swimming, athletics, bowling) are recommended for children with sensory motor difficulties because: Fewer distractions so can focus on their own movements Does not require an awareness of the position and movements of others Repetitive movements which can be practised Tend to be more calming Still allow participation with others e.g. running club Improves the visual attention of children with ADHD Kirkpatrick (2012)

Visual strategies Taking Turns Photographs to show sequence of turns Whose turn? card Waiting Allow child a high preference distractor e.g. ipad Use of visual timer

Winning and Losing Children are more willing to participate in sport when it is not competitive and there is no pressure to win (Kiluk et al, 2009) Limit the amount of competitive games Give the runner up team an alternative reward Introduce the concept of winning and losing through the use of a social story

Social Story Sometimes I will win games and this will make me happy. Sometimes my friend will win and this will make them happy. This is good. I will say Well done and shake hands. It will be my turn to win another time.