How Sensory Integration Impacts on Behaviour and Anxiety by Wendy Usher Sensory Integration Disorder (S.I.D.) is sometimes known as Sensory Processing Disorder (S.P.D.) Many children will never be diagnosed but will still have the signs of a sensory disorder. A. Jean Ayres, PhD (neuroscientist) suggests it is similar to a brain traffic jam where certain parts of the brain are confused when interpreting sensory information. If the process is disrupted, the brain does not receive messages, messages are received inconsistently or the messages may not connect properly so the receiver only gets part of the picture. Children may be hyper or hypo sensitive to stimuli The prefix derives from the Greek word hyper, meaning simply over. Hypo-, on the other hand, means under, defective or inadequate. It means different things to different people. For some it may mean being over or under sensitive to stimuli known as hyper or hypo sensitive. Others may not be able to distinguish between different senses and they get muddled up, people taste a smell or see a sound. Some may have a compulsive need to seek out sensory experiences such as smelling everything. Others may do anything to avoid particular sensations The disorder impacts people s lives in different ways. Some signs may include: Hyper or hypo sensitivity to touch, movements, sights, smells, taste or sounds Particularly high or low activity levels Difficulty with transition making the change from one situation to another Difficulty in concentration, easily distracted, limited attention Social/emotional difficulties 1
Impulsiveness and may have difficulty in being still (even when still may like to rock) Difficulty in reasoning (lack of self-control, inability to unwind or calm down) Being clumsy or uncoordinated And as the child grows the response may include anxiety and worry Case Study A young gentleman on the autism spectrum was brilliant at maths. He could add/subtract/divide numbers at rapid speed and always find the correct answer. He was asked how he did it and explained that he saw numbers in the form of colours. The maths problems he was given would create a rainbow in his head, he would sort the colours into a rainbow strip and read back the colours he saw in his head. This amazing story is true and has been repeated by various people with savant autism where the individual has a highly specialised skill. This is linked to Sensory Integration as the brain replaces one sensation hearing numbers with seeing colours. So what does it mean for you? Do you ever turn the radio down when a song comes on that grates on your nerves? Do you choose to avoid places that you know you will feel uncomfortable like being in close contact with other people on the tube? We each have our own sensitivities, likes and dislikes. Normally we are able to control our reaction to our environment by taking a logical approach and deciding on appropriate behaviour, that may be avoidance, distraction (reading whilst on the tube) or walking away from a situation We use these all the time think about yourself right now what senses are you aware of? Simple things we take for granted may be difficult for children with sensory impairments such as listening what is more important, someone s voice, the clock ticking or the projector making a humming sound? Can you override and prioritise sound not easy for some! How does it affect people we know on the spectrum? Some examples. 2
Case study A teaching assistant was being attacked by a child on the autism spectrum and after observation it was noted it only happened on the days she wore a bright red fleece. The child did not have the skills to say I m terribly sorry, but your red fleece is annoying me so instead he tried to take it off her which was deemed as an attack. Often children cannot explain why they behave in the ways they do, it is up to us to observe carefully and find out what the messages are behind the behaviour. In this case study the child was seen to be attacking his teaching assistant. This could have been identified as dangerous behaviour. The response of the adults around him reading the situation may escalate his response if they have not understood the reasons behind the actions. With the knowledge that the child has a hyper reaction to colour, the school can begin to think of the learning and play environment and begin to observe and plot when and where meltdown s occur. Do they occur when the child is near to bright colours? Does the child also have a sensitivity to bright lights? Once you begin to look out of the box, it becomes more obvious and easier to recognise what is seen as poor behaviour is really a reaction to sensory stimuli. Case study A child once said in class I like Michael Jackson. The comment was completely random and had no relevance to what was going on. When asked why he had made the comment he said well he s on the radio. The radio in question was switched off, but still plugged in. The child s sensitivity to sound was so great that he could hear the radio when it was on standby. Imagine living a life where for 24 hours a day you can hear everything around you and never cut off. Sounds become overwhelming when you are constantly being bombarded. It can result in the child not wanting to step out of the door, irrational behaviour (when the child hears something we cannot, such as plane flying over), fear of open space, anxiety and worry. When trying to evaluate the messages behind the behaviour consider the whole picture by taking a helicopter view and considering the sensory environment. Sometimes we judge behaviour, without realising that the reasons behind the behaviour are related to a wider picture. 3
Love it? Hate it? Case Study A child on the spectrum needed to have very strong flavours before he would consider eating anything. Bread, potatoes, vegetables and meat were a definite no. However, he loved Marmite. Provided that food was coated in Marmite he was very happy to eat things. He got the calories and vitamins he needed through normal food with the addition of this spread! How might the child react to a hyper or hypo response to taste? Perhaps the child throws food on the floor, refuses to come to the table, only decides to eat certain foods that have particularly strong or weak flavours. We tend to see the behaviour first, before we look at what is behind it. We need to observe children carefully and begin to read what messages are being voiced behind their behaviour. Are you seeing children: Fight and get angry or emotional in certain situations Flight - Run away from things they find hard Refusal even refusing to move or having a sit in protest Use avoidance tactics worry and anxiety, fearing the world because of their sensory integration difficulties. Using a person centred approach and seeing the world through a child s eyes helps us to identify the best way to support children who have sensory difficulties. It is not always easy to identify exactly what the child is sensitive to and will take time to observe times the child finds hard. Consider the 7 senses and take an observational look at what is happening at the time relating to these senses. These include: Sight Sound Taste Touch Smell Balance Body Awareness 4
We cannot assume that we know or understand how another is receiving sensory information from the world. All we have to guide us is often their reaction to various stimuli. Be aware of individual children and consider who else knows them well and holds information that may be useful to you. Case study An early years setting reported that a child would not go anywhere near messy play and it was thought the child had a sensitivity to touching messy things. On observation it was noted that the child would pick up his choice toys and activities and move them to a particularly dark area within the setting to play. The messy play table was based beneath a window in a particularly bright spot. On moving the messy play table over to the darker area within the setting the child participated well and was enjoying messy play. It was not the feel, smell or look of the messy play he did not like. In fact he had a sensitivity to bright light. Emotional impact of S.I.D. Emotional impacts of Sensory Processing Disorder Often people with Sensory Integration or Processing Disorders (diagnosed or undiagnosed) often react emotionally to stimuli they find difficult. The response may seem unnecessary and far beyond a typical reaction. Children with Sensory Processing Disorder often have problems in other areas of their lives. As a result, they often become socially isolated and suffer from low self-esteem and other social/emotional issues. Recognise the sensory integration issue through observation and record keeping. Speak to others to see what they have observed and compare notes Think about the world from a child centred perspective what seems to be bothering them. Consider how you could simply adapt the activity/environment Prepare for sensory experiences help the child to know what they will be facing, use a visual aid to help the child expression how they are feeling and give you warning if the experience is becoming too much Provide Distractions for someone facing a difficult situation Provide helpful options case studies: 5
Case study Ben hates going shopping. His world is driven by a hyper sensitivity to smell. He needs to smell everything to make sense of it. During a trip to the supermarket his sensory receptors are overloaded with information and he finds it very hard to stay still, to listen and see. Before going, his Mum puts some of her perfume onto a scarf and takes it with them. Ben is used to his Mum s scent and it is calming. At the supermarket Ben wears the scarf and the scent overwhelmes other smells. This allows him to focus on one smell and helps to keep him calm. Case Study Carrie has a sensitivity to sound and will hold her hands over her ears, spin in a circle and scream at the top of her voice when she is overwhelmed or finding things hard. This can happen at any time and it is necessary to take out a pair of ear defenders to help diminish the sound. In addition to this she carries 3 pieces of short fine rope. When she is getting stressed she plaits, undoes and re plaits her rope. This helps her to cope. At home her parents have insulated her room using sound proofing. Having done this they found that she sleeps much better and can take herself away from noisy play activities if her children are being a bit boisterous. Where do I find out more? Useful websites Please note we cannot guarantee these links or the content of the websites http://www.spdfoundation.net/index.html http://www.sensoryintegration.org.uk/ http://www.webmd.boots.com/children/guide/sensoryprocessing-disorder http://www.autism.org.uk/sensory http://www.royalfree.nhs.uk/paed_ot.aspx?top_nav_id=1&tab_i d=1033 Thank you 6
Inclusion Matters in Education and Childcare Accredited Distance Learning Programme Level 2 has 4 Credit Value Points 40 hours min Early Bird Booking Offer 300 (inc VAT) Level 3 has 80 Credit Value Points 80 hours min Early Bird Booking Offer 420.00 (inc VAT) a wide range of learning materials are used to respond to different learning styles, includes interactive electronic workbooks. TPD Education has teamed up with the Open College Network to create a unique Level 2 and Level 3 Distance Learning Training Programme. All participants undertake a Core Element Inclusion Matters and make a choice of 3 from the following options Including children with ASC/D Communicating Effectively with children and young people Encouraging Positive Behaviour 8-12 years Encouraging Positive Behaviour under 8 s Understanding and Supporting Sensory Integration Disorders Supporting children with undiagnosed social communication disorders This is a brand new training programme and will be on-line from September 2015 To find out more or register your interest and get the early bird discount please visit or call us on 01234 391436 TPD Education is a trading arm of Ltd Co. No. 773578 7