Sensory Discrimination Disorders - WordPress.com · improved communication in preschoolers with ASD (Silva et al., ... 2007; Mays et al., 2011; VanRie et al., 2010) with matched sensory

Sensory Discrimination Disorders copy Copyright 2016 by John Pagano PhD OTRL

1 Sensory Discrimination Disorders-difficulty distinguishing interpreting and organizing sensory information for functional use contributing to disorganization and school difficulties Sensory Discrimination Disorders can be for tactile proprioceptive vestibular and interoception sensory input eg hunger (Miller amp Collins 2012 Miller et al 2007 Watling et al 2011)

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SENSORY MODULATION DISORDERS copy Copyright 2016 by John Pagano PhD OTRL

2Sensory Modulation Disorders-Difficulty regulating sensory registration to respond to functionally important environmental information and screen out functionally irrelevant input 2-5 year olds with PDD had significantly greater hyper-reactivity hypo-reactivity and self-regulation difficulties (Ben-Sasson et al 2007 Silva amp Schalock 2011) Assessed by Sensory Processing Measure Preschool (2-5 yrs) Home or Classroom (5-12 years) or Sensory Profilea Sensory Underresponsivity- (Low RegistrationHyporesponsive) do not notice sensory input habituate quickb Sensory Overresponsivity- Sensory SensitiveHyperresponsive) react more to sensory habituate slowc Sensory Seeking- actively seek out sensory inputd Sensory Avoiding- actively avoid sensory input (Watling et al 2011 Schaaf amp Mailloux 2015) 2

Copyright copy 2016 by John Pagano PhD OTRL fabstrategiesorg

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References (Corrigan et al 2011 Kuypers 2016)

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Individual Therapy

Small Group Tx

ClassroomSchool

WHERE should school therapists TREAT

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SBI (Sensory-Based Interventions) copy Copyright 2016 by John Pagano PhD OTRL wwwfabstrategiesorg20160511

sensory-based-interventions-improve-behavior

bull SBI are the guided use of sensory strategies to improve school behavior by addressing specific sensory modulation and sensory discrimination challenges (Watling et al 2011)

bull SBIs used in research proven school PBIS Greenspan Floortime for ASD Collaborative Problem Solving Approach for ODD amp DBT (Dialectic Behavior Therapy) for chronic self-cutting

bull SBIs can help reduce studentrsquos Aggression amp Self-stimulation behaviors (Murray et al 2009)

bull Parent and therapist massage amp sensory-motor activities improved communication in preschoolers with ASD (Silva et al 2011 Woo et al 2015 Woo amp Leon 2013)

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SBIrsquos Integrating Mindfulness Music Movement Exercise Adaptive Equipment amp Massage

copy Copyright 2016 by John Pagano PhD OTRL

bull Develop preferred goal-directed individualized coping strategies

bull Mindfulness music movement exercise adaptive equipment self-touch equipment touch amp massage can address common goals

bull Combine movement massage amp occupational tasks bull Goals of modulating arousal improving body

awareness and increasing attention bull Independent group amp one-to-one intervention bull Include regular long-term amp crisis strategies

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Integrating Behavioral With Sensory Tx copy Copyright 2016 by John Pagano PhD OTRL

Sensory input as Reinforcement- Deep pressure mat sandwich functioned as reinforcement of behaviors

that immediately followed it for ASD students (McGinnis et al 2013) Sensory match for problematic self-stimulation- Non-contingent reinforcement NCR (Machalicek et al 2007 Mays et al

2011 VanRie et al 2010) with matched sensory stimulation and reinforcing progressively longer periods with out self-stimulation (Richman 2008) for automatic reinforcement reduces problematic self-stimulation for improved school learning in children with Autism Spectrum Disorders (Murray et al 2009)

Conditioning Calm Recall-For severe developmental disabilities andor cognitive challenges pair therapy activity (unconditional stimulus) that consistently relaxes the child with a conditioned stimulus (eg smell song) When child starts becoming upset or for pre-correction provide the conditioned stimulus and reinforce the child for not acting aggressively (Lieberman 2010)

Individualized antecedent use of the Movement Break and Sensory Match Strategy can improve school attention and learning in children with Autism Spectrum Disorders (May et al 2011 Thompson 2011 Van Rie 2010)

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Expanded School Therapistrsquos Role as SISP amp School Behavior Goals

copy copyright 2016 by John Pagano PhD OTRL

bull OT PT SLP SW SC are now SISP Specialized Instructional Support Personnel Mandated under the new ESSA ldquoEvery Student Succeeds Actrdquo (2015) SISP expanded role in addressing the needs of at risk students which may include school-based mental health specialized instructional support parent engagement and school climate programs wwwnasisporgESEAhtml

bull Identify and utilize sensory adaptive equipment and techniques to maintain attentionseated attention and a quiet alert state for 30 minutes

bull Increase attention span for individual classroom learning tasks to an average of 5 consecutive minutes

bull Increase to ten the variety of foods he will taste with out resistancebull Increase use of safe hands and a safe mouth by demonstrating less than 2

incidences of hitting or biting others dailybull Increased self-control with less than 3 incidences of self-injuriousrepetitive non-

purposeful behavior hourlybull Increase frustration tolerance by waiting for four minutes for individual teacher

attention without yelling wwwDrKathySeifertcom 8

Sensory-Based Interventions Resources

bull Autism Visuals lthttpelearningautismnetvisualsmainphpgtbull Behavioral Strategies (feeling wheel Tucker Turtle) ltwwwchallengingbehaviororggt bull Brown R P amp Gerbarg P L (2012) The healing power of breath Boston MA Shambhala wwwbreath-

body-mindcombull Committee for Children (2009) ltwwwcfchildrenorggt Second Step PBSbull DECA Assessment amp PBS ltwwwdevereuxearlychildhoodorggtbull Dunn W Sensory Profile ltwwwsensoryprofilecomgtbull FAB Treatment Videos wwwyoutubecomchannelUCS2D8OPEx6aDzsgad0zQy0A bull Field T Touch Research Institute ltwww6miamiedutouch-researchgtbull Greenland SK (2010) The Mindful Child New York NY Free Press lthttpsusankaisergreenlandcomgt bull Kazdin AE (2008) The Kazdin Method for parenting the defiant child NY NY Mariner Booksbull Koester C (2012) Movement Based Learning Braingym for special education

ltwwwmovementbasedlearningcomgtbull Laugeson E A (2014) The PEERS curriculum wwwsemeluclaedupeers bull Silva et al (2009) QST program Sensory Massageltwwwqstiorggtbull Schaaf R C amp Mailloux Z (2015) Clinicians guide for implementing Ayres Sensory Integration promoting

participation for children with autism Bethesda MD AOTA Pressbull Stahmer amp Suhrheinrich 2011 Classroom Pivotal Response Teaching NY NY Guilford Press bull Valkanos C Huber-Lee C amp Cahill S M (2016) Teaching self-regulation skills to first graders OT

Practicebull Watling R Davies P L Koenig K P amp Schaaf R C (2011) Occupational therapy practice guidelines for

children and adolescents with challenges in sensory processing and sensory integration American Occupational Therapy Association 9