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Saturday, September 24, 2016

Part Three: Strategies for Treating a Child with Sensory Processing Disorder

Guest Blog by Elise Siak, Occupational Therapist

Because Sensory Processing Disorder is complex and the challenges associated with it are unique to the individual, it is difficult to provide strategies which can help any and all children with a sensory processing disorder. However, because of the way the sensory systems are organized and the way the input is processed within the brain, there are a few strategies that tend to work to improve sensory processing in most children! Before we get to the strategies, a short overview of the sensory systems and sensory integration is necessary.

The Sensory Systems
We all know the basic 5 senses we’ve been taught in school: sight, hearing, taste, smell, and touch. However, sensory information is a bit more complicated than that! There are 2 other systems which are integral to sensory processing and which are a bit more complex than the basic 5 senses.

  The Vestibular System: This system helps us understand the position of our heads in space and any movement that may be occurring. Within the inner ear are small compartments, some of which contain small hair-like receptors and some which contain fluid. The compartments which contain the hair-like receptors help to communicate to our brains how our head is positioned in space based on gravity acting on these receptors and pushing them in one direction or another. The compartments which contain the fluid help to communicate to the brain the direction and speed of movements of the head, and therefore the body. All of this input together helps us to understand where we are located in space and if we’re moving or not. This system is highly sensitive but is often not part of our conscious awareness unless we are engaged in intense vestibular input like that which would be experienced on a rollercoaster or when spinning repeatedly.

 The Proprioceptive System: This system helps us to understand the position of our joints/limbs in space and the amount of force needed in order to complete a task appropriately (think an appropriate "high five" versus a "high five" that’s too hard). Within our muscles and joints are small receptors called proprioceptors which send our brain information about our position, movement, and the amount of force being used. This system, even more so than the vestibular system, is outside of our conscious awareness. However, imagine trying to button a shirt if you can’t understand how your hands need to move and the force they need to use in order to complete the task! Now think about tying something or buttoning something behind your back or with your eyes closed. Your proprioceptive system allows completing tasks like this to be possible. When the proprioceptive system is not functioning properly, movements become discoordinated, slower, and require increased effort to achieve the same result.

Sensory Integration
Sensory integration itself is widely misinterpreted and the phrase itself is often used incorrectly. Sensory integration is the process by which the brain brings together information from all of our sensory systems to make a cohesive picture about what it happening around us in order for us to respond effectively. 

Sensory Processing needed for sportsSensory Integration Necessary for SkatingImagine stepping onto an ice rink with ice skates on for the first time. Your eyes will be able to see the sheen of the ice, the tracks of others on the surface of the ice, and the proximity of others to yourself. Your ears will hear the sounds of others around you as well as the sound of the skates moving across the ice. Your vestibular and proprioceptive systems will work together to provide you with information about where you are in space, how you need to respond in order to keep yourself upright, and how much force needs to be exerted with your legs when skating across the ice. Imagine not being able to fully and effectively interpret some part of the information described above. Ice skating would be really hard! This is precisely why effective sensory integration is so important. Without a detailed and complete picture of the sensory input happening around oneself, formulating an effective and adaptive response to novel experiences is nearly impossible. This helps to explain why children with sensory integration challenges often demonstrate difficulty across a variety of skill sets, including fine motor, gross motor, and language skills. Playing, learning, and growing, the main jobs of childhood, become really difficult when you are only able to understand and use a portion of the sensory input your body is receiving!

Treatment Ideas
Again, because each and every child with sensory processing challenges is so unique, it is difficult to provide a “one size fits all” blueprint for how to help. However, some strategies tend to be effective for the majority of children with sensory processing challenges and a sensory processing disorder. The most important system to consider is the proprioceptive system. Think of it as the highway of all of the sensory systems. If there’s a traffic jam on the highway (the proprioceptive system), it affects traffic on all the surrounding roads (all of the other sensory systems). This is why the proprioceptive system is often targeted first when treating children with sensory processing disorder.

               Proprioceptive Strategies

               Strategies targeted at the proprioceptive system include any opportunities for deep pressure and/or weight bearing across the major joints.

Adding Deep Pressure as a strategy for Proprioceptive Input
Sensory Sandwish
Deep pressure strategies will always involve providing strong pressure across most of your child’s body, but be sure to leave their head out so they can breathe during the squeezing.

Strategies include:
-        making a “sandwich” between pillows/couch cushions by pushing along your child’s body with deep pressure
-        using a “steamroller” (large ball) to roll across your child’s body while they lay on a padded surface
-        bear hugs with deep and prolonged pressure across the torso
-        weighted materials including weighted blankets, lap pads, and vest; note that weighted materials should not be used for more than 20-30 minutes at a time with at least a 1-2 hour break between uses and that it is best to consult with a healthcare professional with knowledge of sensory processing (i.e. occupational therapist) prior to beginning any sort of weighted material use with your child

Sensory Strategies for Kids
Deep Pressure Strategy

Deep Pressure using a weighted blanket
Weighted Blanket

Weight bearing activities often involve moving from one place to another in a novel manner, including bearing weight on the arms.

Strategies include:
-        wheelbarrow walking

Wheelbarrow Walk

Crab Walk


Scooter Board Activities
-         various animal walks including crab walking, bear walking, and frog hopping

Tunnels and Tents
-        using a scooter board while lying on the stomach and using only the arms to pull along the ground in order to move

-        crawling through tunnels, forts, etc.; these activities can be made even more intense by including weighted materials while crawling

-        carrying heavy objects including grocery bags, laundry baskets, books, etc.

-        any activity which requires pushing or pulling like tug of war or climbing a rock wall or rope

Vestibular Strategies

Strategies targeted at the vestibular system will involve movement in one or more planes. Note that linear movement (back and forth or side to side) tends to be calming and rotary movement (in a circle) tends to be very alerting. It is not recommended that children spin for more than a minute at a time, as this type of input is incredibly complex and can require up to 3-4 hours for a child to fully process. 

Strategies include:
-        swinging on a playground swing or hammock
-        using a scooter board

Bouncing on a Therapy ball for sensory input
Bouncing on a Therapy Ball
Trampoline for Vestibular Input
Jumping on a Trampoline

-        jump rope
-    slides
-        jumping on a trampoline
-        bouncing on a large therapy ball with parent assistance to stabilize
-        bike riding

Guest Blogger Elise Siak:

I have always been interested in working in pediatrics, even before discovering occupational therapy. Since discovering OT, I have thrived on the creativity and connections with clients with which this profession provides me. I have passion for working with children with sensory processing and self-regulation challenges. I have experience working with both children and adults on the autism spectrum, as well as children with a variety of developmental challenges and delays. I hope to be able to provide both parents and other therapists alike with some insight into sensory processing disorders!

Next week we will conclude our series on Sensory Processing Disorders with:

Part Four:  Parent Tips for Children with Sensory Processing Disorders or Children on the Autism Spectrum

Blog Administrator:  Trisha Roberts

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