To comply with professional boards/associations standards: • I declare that I (or my family) do not have a financial relationship in any amount, occurring in the last 12 months with a commercial interest whose products or services are discussed in my presentation. Additionally, all planners involved do not have any financial relationship. •Requirements for successful completion are attendance for the full session along with a completed session evaluation. •Vyne Education and all current accreditation statuses does not imply endorsement of any commercial products displayed in conjunction with this activity. Session 302: Supporting Self‐Regulation Through Assistive Technology Angela Ingram, OTD, OTR/L Leading the Way in Continuing Education and Professional Development. www.Vyne.com Learning Objectives O Define Self-Regulation O Identify Assessments of Self-Regulation O Identify Difficulties in Self-Regulation that can be supported by Technology O Examine Technology Supports for Self-Regulation
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To comply with professional boards/associations standards:• I declare that I (or my family) do not have a financial relationship in any amount, occurring in the last 12 months with a commercial interest whose products or services are discussed in my presentation. Additionally, all planners involved do not have any financial relationship.•Requirements for successful completion are attendance for the full session along with a completed session evaluation.•Vyne Education and all current accreditation statuses does not imply endorsement of any commercial products displayed in conjunction with this activity.
Session 302: Supporting Self‐Regulation Through Assistive Technology
Angela Ingram, OTD, OTR/L
Leading the Way in Continuing Education and Professional Development. www.Vyne.com
Learning Objectives
O Define Self-RegulationO Identify Assessments of Self-Regulation O Identify Difficulties in Self-Regulation that can be
supported by TechnologyO Examine Technology Supports for Self-Regulation
Self‐RegulationO Sensory System Perspective
O Manipulation of Arousal State:O Attaining, Remaining in, & Change(Williams & Shellenberger, 1994)
O Arousal / AlertnessO Increased neuron activity to maintain
alertnessO Adequate arousal levels support
attention & learning(Fischer, Langner, Birbaumer, & Brocke, 2008)
Self‐Regulation
O Cognitive-Behavioral PerspectiveO Using External Feedback to: OContinual ProcessOMake Self-Correcting
Adjustments O (Vohs, & Baumeister, 2016)
Self‐RegulationO Emotional, Behavioral, & Cognitive
ControlO Using Goal Setting, Feedback Loops &
Self-Monitoring (Vohs, & Baumeister, 2016)
O Requires Insight & Coordination of: O Thoughts, feelings, actions, language O Appropriate Responses to:
O Internal & External Environments (Bronson, 2000)
Self‐Regulation & Self‐Monitor
ONoticingO Insight
OResponding appropriately (Bronson 2000)
Self-Monitor
Self-Regulate
(Giola, Isquith, Guy, & Kenworthy, 2013)
Self‐RegulationO Pre-Frontal Cortex
O Exerts control over multiple other brain areas to coordinate control of thought and behavior
OSensory & Emotional ConnectionO During conflict- anterior cingulate
correlate w/ sensory and emotion systems (Posner, & Rothbart, 2009)
Self‐Regulation
ODecreased Self-Regulation: OLearning State Effected (Zelazo & Lyon, 2012)
OBetter Self-Regulation Increases: OParticipation & Motor Skills (Galantino,
Galbavy, & Quinn, 2008)
Image from clip art
Sensory AssessmentO The Sensory Profile 2O Dunn’s Model of Sensory Processing
O Thresholds (notice stimuli)O Responsiveness of self-regulation (how
you react)O Sensory Patterns are Not Static or
FixedO Fluid and different under different
environment interactions(Dunn, 2015)
LearningSelf‐Regulation Measures
O The Motivated Strategies for Learning Questionnaire (MSLQ) (Pintrich et al., 1993)
O Motivation & Learning Strategies
O Perceived Responsibility for Learning Scale (PRLS) (Zimmerman & Kitsantas, 2005)
O Motivation, Deportment , Learning processes
O Self-Efficacy for Learning Form (SELF) (Zimmerman & Kitsantas, 2007)
O Confidence that they can do a particular task
Self‐Regulation Measure
O Self-Regulation Questionnaire (SRQ) (Brown, Miller, & Lawendowski, 1999)
O Measures self-regulation of youthO 7 subscales: Receive, evaluation, trigger,
search, formulate, implement, & assessO Preschool Self-Regulation Assessment
(PSRA) (Smith-Donald, Raver, Hayes, & Richardson, 2007)
O Emotion, Attention, Behavior
Difficulties
O Arousal/alertness level regulationO Emotional controlO Behavior controlO Controlling AttentionO Motor developmentO Task Performance
Self‐Regulation Technology Supports
O NeurofeedbackO SoundO MindfulnessO YogaO MetronomeO Emotional/Behavioral Program Apps
Neurofeedback Training
O BiofeedbackO Uses Auditory & Visual Feedback O Trains EEG (brainwaves) O Use Operant Conditioning to Reward When
Brain Reacts in Desired MannerO Mixed Evidence, No Clear Guidelines
Neurofeedback ResearchO Parent Response
O 90% at 6-month follow-upO Post-intervention
O Conners 3-P Significant Effect SizeO Attention, EF, Hyper/Impulsive
O BRIEF subscales & GEC (ES = 0.31) O 6-Month follow-up:
O NF maintain stimulant medication doseO CT/control statistical &clinical
significance (9 mg [P = .002] and 13 mg [P .001])
(Steiner, Frenette, Rene, Brennan, & Perrin, 2014)
Play Attention
O By: Unique Logic & Technology, Fletcher, NCO Detect 2 Frequency Ranges: Theta & BetaO Measured by EEG sensor embedded in standard bicycle
helmet O Learn to manipulate figures on the screen:
O Suppresses theta and increase in betaO Learn how to improve attention on the 6 exercises(Steiner, Frenette, Rene, Brennan, & Perrin, 2014)
Neurofeedback Results
O Maintenance of learned self-regulationO 3 initial neurofeedback sessions across 3 weeksO Learned self-regulation of visual cortex activityO Re-scanned 6 and 14 months: results maintained(Robineau et al.,2017)O Take Away:
O Overall Mixed EvidenceO Best Used as Part of an Overall Intervention Plan
Sound Interventions
O Auditory ProgramsO Often used to supplement traditional interventionsO Listening to processed musical selections (modified music)O Designed to supplement other sensory-based strategiesO Based on Tomatis and AITO (Fischer, Langner, Birbaumer, & Brocke, 2008)
Sound Interventions
Auditory Integration Training (AIT): The Berard MethodO Study ASD Children after 20 AIT sessionsO Aberrant Behavior Checklist (ABC): Statistically Significant
Improvements in Irritability & Hyperactivity subscales O Repetitive Behavior Scale (RBS-R): Decrease in overall score and
stereotype repetitive and restricted behaviorO (Sokhadze, Casanova, Tasman, & Brockett, 2016)
Tomatis
O Study ASDO significant differences among mean scores of autistic
symptoms in the 2 groups.O ConclusionO increase social interaction, communication, and reduce
stereotypical movementsO (AbediKoupaei, Poushaneh, Mohammadi, & Siampour,
2013)
The Listening Program
Used with permission from the Listening Program
The Listening Program (TLP)O Case Study: 7 year Old ASD
O 10 weeksO Functional decrease negative (avoidant,
verbal/physical negative) & self-stimulatory(Gee, Thompson, & St John, 2014)
O Single-Subject Case StudyO Child with PDD-NOS O 20-week TLP intervention O Sensory Profile and Listening ChecklistO Results: Improved behavior & sensory tolerance (Nwora, & Gee, 2009)
Therapeutic Listening (TL)O Retrospective of Study
O Motor, Sensory, & Social Emotional Capacities O TL as part of comprehensive OT (Sheehy, & Brasesco, 2016)
O Pre-School Support InterventionO 15 preschoolers: TL & Typical therapyO 6 assessments: FM, VM, Social, Language, & SensoryO Statistically Significant Inc.: All areas except S-P &
behaviorO Proportional Change Index: Accelerated Development
O FM, V-M, Nonverbal ability, & Language (Bazyk, Cimino, Hayes, Goodman, & Farrell, 2010)
Integrated Listening Systems (ILS)
O Bone Conduction: VibrationO Modified Music
O Program Includes:O Listening to acoustically processed musicO Low frequency music via air conduction & bone
conduction O Concurrently with balance, movement, & visual-motor
tasks
Integrated Listening SystemsPilot Study using the ILS Focus Series
O 7 Children in a 40-session interventionO At home and in a clinic settingO Repeated Measure: Individualized Family Goals O Exploratory Analysis: Physiological ArousalO Improvement: Home & Education Goals O Changes in physiologic arousal noted in 5/7 O Standardized scales demonstrated sensitivity to
change(Schoen, Miller, & Sullivan, 2015)
BackgroundWhite Noise
O ADHDO Positive cognitive effect ADHD group O Negative effect on control grp performance O ADHD: More noise for optimal performance
(Söderlund, Sikström, & Smart, 2007)
O Attention & Memory Secondary StudentsO Episodic verbal recall task with & w/out noiseO Improved performance for inattentiveO Decreased performance for attentive children
(Söderlund, Sikström, Loftesnes, & Sonuga-Barke, 2010)
b‐CalmO B-calm System ($139) App ($10)O Audio Sedation Sounds
O Acoustic Masking: Typically distracting noises less obvious
O Live Nature Recordings: Relax & “reboot” O Can be optimized for various environments
O Adding control of sounds in environment, help increase on task behavior and reduce irritability
O No studies of the system
Mindfulness
O Mindfulness ConceptO By Bishop et al.
(2004)
O Consists of two facets:O Self-regulation of
attentionO Focus on present
experience
Breathing & Mindfulness
O Breathe DeepO Apple app
O Deep BreathO Android app
O Simple visualsO Easy way to teach
breathingO Customize:
O Overall breathing duration
O InhalationO Hold and Exhalation
Mindfulness Research
O Mindful Awareness Practices (MAP)O EF improvements in elementary school
kidsO MAP training 30 min 2xper wk: 8 wksO Improvements
O Behavioral regulation, metacognition, & overall global executive control
(Flook, et al., 2010)
WebsitesO Calm.com
O Visuals, sound, option of guideO Mindyeti:
O For kids: http://www.mindyeti.com/O UCLA
O Body scans, Breathing & Meditation http://marc.ucla.edu/body.cfm?id=22
O Fragrant Heart.comO Wide variety of guided breaks, no
visuals
Calm.com or appO Available Free Sections
to AnyoneThe Calm Classroom Initiative:O Teachers K-
12 classrooms O Anywhere in the world O Free access Calm’s
paid subscriptionO Includes CalmKids PK-
K
Used with permission from Calm.com
MindYeti
Used with Permission from MindYeti
Mindfulness/Meditation Apps
Free AppsO CalmO MindyetiO OMGMeditateO HeadspaceO Settle your glitter
O TheMindfulnessappO OmvanaO SmilingMindO Takeabreak!
The 2 minute “Reset”O Lay on stomachO Prop on elbowsO Wt. blanket on back or legsO Watch:
O Fluidity & Suspension (ipad)O Fluid Monkey & Flasia
(Android)
O Timer: 2 minutes
Used with Permission from Angela Ingram
Mindfulness with Movement
O YogaO Research:
O Stretching & Deep Breathing
O Must include mindfulness for executive function and self- regulation improvements
(Manjunath & Telles, 2001; Razza, Bergen-Cico, & Raymond, 2015)
Mindfulness with MovementApple
O YogaKids App- $3O Demonstrates MovementsO Relaxing VisualsO Inspirational Messages
- No Sanskrit / Religious- No Banners / Ads.- No Internet connection- No in-app purchases
O Super Stretch Yoga HD- FreeO Animated Video Examples of 12 poses
Mindfulness with MovementAndroid
O Yoga for Kids (Yoga Kids)OPictures with Timeframe
O My little yoga for kids appOStill Pictures
O Kids Fitness YogaO10 Daily Poses with Focus on
Autonomy & Fitness
Yoga
O WebistesO YoKid.org
OFind ResourcesO Yoga Journeys
OWebcast VideosO GoNoodleO Cosmickids
Video Modeling
O Video-Based InterventionO Videos of others or of the person taughtO View Point
O First Person O Third Party
O Performing a functional sequential task O Model self-regulation strategies in real Tasks
O Participating in social or communication tasksO Model Perspective Taking
Video Modeling EvidenceAutism Research:O Gain/maintain/generalizing:
O Settings, Materials, People (Delano, 2007; Rayner et al., 2009)
O Improvements:O Imitation & Attention (Delano, 2007; Shukla-Mehta et al., 2010)
O Preschool (Green et al., 2013)
O Increased time in positive social interactions
Video Model
O Frequency & Duration (Shukla-Mehta et al., 2010)
O Repeatedly View Video O < 5 min in length O Better Compliance with Adult ModelO Always Model the Correct Way to Do the TaskO Watch Frequently & Right Before a Routine Task
Video Model ProgramsO Lifelog technology
• Record & Review (Cureros-Urbano et al. 2016)
O AppleO iModelingO ModelMeKids
O AndroidO Model Me Going PlacesO Social Skill Builder liteO My Pictures Talk- Video
Video Model Example
Used with permission from Angela Ingram
Make Your Own Video Model
O Written PermissionO Be Time and Task Specific O Use Work Device O Only Use to Teach That PersonO Only Model the Correct WayO Do Task Analysis Prior to Attempting
Interactive Video Games/ Instruction
O Challenge SoftwareProgram
Challenge Software Video
Image from https://www.youtube.com/watch?v=ek_C9jR7hUg
Video Games
Logic and Social Awareness Games
O Timeframe set 10-30 min. not more than 2 hours
O Children Complied with Playing with More “Game Like” Applications
O (Ke, 2009; Shaw, Grayson, & Lewis, 2005)
Logic & PlanningVideo Games
Video Games Rules & Recommendations
O RushHourO MinecraftO Legend of ZeldaO MindsweeperO The BridgeO SimCityO NancyDrewO CrazyMachines
O Set GoalsO Set Time LimitO Report ResultsO Reflect on What Worked Well
and Did Not
Academic SkillsVideo Games
O Nessy- Reading/MathO MathBlasterO FunBrainO ABCMouseO My Word Coach: Wii Nintendo
DS, verbal communication skills
O Smarty Pants: Trivia game
O Why They Help:O Frequent
RewardsO High Interest
or Value by the Player
Metronome Research
O Interactive MetronomeO Improved attention, motor, lang., read & behavior
(Shaffer, et al., 2001)
O Visual motor control & reaction time- no attention impulse (Cosper, Lee, Peters, & Bishop, 2009)
O In DD pilot study grp SI and IM: concentration, motor control, and reflex integration (Kim, Bo, & Yoo, 2012)
Interactive Metronome Intervention
O 50 minutes per week totalO 10 minutesO 5 times per week O 1 monthO Part of a total 45 minute session O OT based in SI theory(Kim, Bo, & Yoo, 2012)
Metronome Video
Used with permission from Angela Ingram
Metronome Integration
O Spelling, Reading, Multiplication tablesO Recalling sequences
O Grocery listO Numbers, LettersO ChoresO Schedules, HEPO Safety PrecautionsO Pace for Exercise, Walking, ADLs
Integrating Technology
Used with permission from Angela Ingram
Free Metronome Apps
GuitarTuna/GuitarTunerMetrotimer
Prometronome
Self‐Regulation apps (free!)
O Moodzie Oh! Play, Learn, ChillO Woop (Wish Outcome Obstacle Plan)
O Self-regulation through mental contrastingO PowerPacks Pre-K Self-Regulation
O Lessons for parents to guide children through
Self‐Regulation iPad AppBrad Chapin
O Physical, O Emotional O Cognitive
Regulation O SkillsO No Research
Used with permission from Brad Chapin
http://www.selfregulationstation.com
Helping Young People Learn Self‐Regulation by Brad Chapin www.selfregulationtraining.com
Used with permission from Brad Chapin
The Zones of RegulationApp Supporting the Curriculum
O Regulate Emotions & BehaviorO Learning regulation techniques facilitates self-
control & problem solving skills
Intervention to Increase Self-Regulation in Kindergarten Students (Yack, n. d.) O Findings Limited: Interpret with Caution
O Overall Positive ChangeO Functional Relationship between Self-
Regulation and the Intervention
Summary of Zones App
O 4 Zones Represented by Interactive Color VisualsO Track Your ZoneO Learn to Use Strategies to Move Between Zones or Remain
in a ZoneO Explore Calming Techniques O Learn Cognitive StrategiesO Choose Sensory Strategies to Assist Regulation
The Zones of Regulation App
Used with permission from The Zones of Regulation
Summary ofExploring Emotions App
O Facial Expressions O Recognize a Range of Emotions O Perspective TakingO Examine Reactions to Other’s Behavior O TriggersO Problem solving skills
Exploring Emotions App
Used with permission from The Zones of Regulation
Case StudyO Henry, 10 years old, ADHD & LDO Sensory Profile 2-
O Seeker movement, deep touch, proprioceptionO Avoider- Sound, crowds, visual, light touch
O VMI- Low average VMI, average visual perceptual, below average motor
O Implications: O Fidgets, Distracts self, get up and moves around,
makes everything into a game, difficulty with initiation, sustaining, completing tasks, sensitive to clothes, sounds at ball games/movies and in class, difficulty with crowds
OT Intervention
O Use Zones app to Identify Current ZoneO Breathe Deep App- 1 minO Heavy Work
O Theraband Routine Supported by a Song
O Sound InterventionO Therapeutic Listening while performing heavy work, prone on
ball, mazes
Classroom Program
O b-Calm while doing desk or independent workO Use metronome during spelling wordsO Follow Yoga poses app for 3 poses between sides of
worksheetO Use exploring emotions app prior to reading
Questions
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