Are clouds forming?Then it’s time to expose
the silver lining!
Winnie Dunn PhD OTR FAOTAWinnie Dunn PhD OTR FAOTAProfessor & ChairProfessor & Chair
Dept. of OT EducationDept. of OT EducationUniversity of KansasUniversity of Kansas
What are the cloudsmade of?
Changes in the way we provide serviceChanges in the way we provide service
Discontent about how we label childrenDiscontent about how we label children
Changes in the way we provide Changes in the way we provide serviceservice
Findings from studies in Autism[as reported in Baranek, 2002]
• We need to design educational programs that accommodate unique sensory processing patterns
• We need to make task/ environ modifications
• We need to employ systematic data collection to chart progress
• Traditional SI therapy is beneficial ANECTODALLY, but evidence does not substantiate effects
• Functional activities in daily routines within natural contexts increases generalization
Discontent about how we label childrenDiscontent about how we label children
Is this disorder for real?TIME magazine, Thursday, Nov. 29, 2007
Claudia Wallis
“Some kids just cant handle life’s sights, sounds and sensations, but experts are split over whether to recognize sensory processing disorder” p. 62
You and Your Quirky KidThe girl who wears her clothes inside out, the boy who loves plumbing. What parents and experts say about the children who just don't fit in.By Lorraine Ali | NEWSWEEKSep 17, 2007 Issue
“…there is something unexamined in our
thinking when we elevate the need for normalcy to a state of spiritual grace, and
live under a constant anxiety that we fail to
measure up to its demands…” p. 50
Lorraine Ali, Newsweek September 17, 2007
Harnessing the Power of ADD
Sophia Dembling, Delta Sky, december 2007
“Oftentimes you find people with ADD spending years trying to develop what they’re bad at instead of what they’re good at” [Ned Hollowell]
“…When it comes to a child with a disability, [professionals
& parents] can easily spend too much time on what the
child cannot do, …We can be so busy dealing with what is
absent that we ignore what is
right before our eyes. …what we need to make
visible is not darkness but light...” p.280
Exposing the silver lining!
Tapping our inner capacityTapping our inner capacity
Changes in the way we provide Changes in the way we provide serviceservice
Micro level: Micro level: the child, family & schoolthe child, family & school
• When practices are family centered, we achieve better family and child outcomes
• Ackland, 1997• Joyce & Showers 1995• Law, Darrah etal, 1998• Marchant & Young 2001
• When practices are family centered, we achieve better family and child outcomes
• Ackland, 1997• Joyce & Showers 1995• Law, Darrah etal, 1998• Marchant & Young 2001
FAMILY CENTERED CAREFAMILY CENTERED CARE
NATURAL ENVIRONMENT INTERVENTIONS
• Parent facilitated child
learning is equally or more
effective than practitioner
implemented interventions
• Gibbard, Coglan & MacDonald 2004
• Law, Garret & Nye, 2004
• McLean & Cripe 1997
CHILD PARTICIPATION
Children’s development is enhanced when they
interact and practice in settings which demand
use of skillsKelllegrew, 1998; Law etal, 1998; Roper & Dunst, 2003; Dunst, 2001,
2006
Discontent about how we label childrenDiscontent about how we label children
Peeking in onPeeking in onThe macro levelThe macro level
“If we examine ourselves and those around us—the husband who shuns picnics because he can’t stand the texture of grass… we have to admit that everyone, to some extent is odd.” p. 50By Lorraine Ali | NEWSWEEK: You & your Quirky KidSep 17, 2007 Issue
“…parents need to ask themselves, Is this making him unhappy or just making me unhappy? [Dr. Perri
Klass].” p. 50
By Lorraine Ali | NEWSWEEK: You & your Quirky KidSep 17, 2007 Issue
“Autism is less a disease to be hidden than a disability to be accommodated; it is
less a stigma, reflecting badly on her
family, than a variation of
human existence.” p.33
“…Can we make the world they’re going to grow up in sufficiently kind and welcoming to them and their quirks, and can we provide them with the basic skills they need to navigate in that world?.” p. 50
By Lorraine Ali | NEWSWEEK: You & your Quirky KidSep 17, 2007 Issue
From The LONDON Times newspaperOctober 20, 2007
Are you a sensory junkie or a nervous wreck?
How do you respond to bright lights, soft clothes, loud music and spicy food?
Juliet Rix investigates the psychology of sight, sound and smell
“Isabel has taught me that the unexpected,
even the beautiful, can emerge even from the
undesirable, …—no, not something “normal”, but a brilliant light or
an inner truth struggling to blossom.”
p. 35
“…at the end of the day when I
tuck her in, she’s not a case of
autism…. She’s simply my
daughter….” p. 35
Let’s consider an Let’s consider an example at the example at the MACRO level…MACRO level…
…is imbedded in Sensory Processing
…is imbedded in Sensory Processing
The experience of being HUMAN …The experience of being HUMAN …
“…I don’t know what a pear tastes like to you.”
“…sweet, juicy,
Soft on your tongue,
grainy---Like sugary sand that
dissolves in your mouth…
How’s that?…” [City of Angels, 1996]
How do you react to sounds?
SEEKERS…Make noises, e.g., hum, tap throughout the day
BYSTANDERS…Don’t really notice
sounds around them
AVOIDERS…Wear ear plugs to keep sounds away
SENSORS…Ask people to stop
making noises
How do you react to touch?
SEEKERS…Touch others when talking to them
BYSTANDERS…Bump into people
when walking
AVOIDERS…Keep their distance from others
SENSORS…Flinch when
touched unexpectedly
How do you react to movement?
SEEKERS…Choose intense sports & amusement park rides
BYSTANDERS…Don’t know how they got scrapes
and bruises
AVOIDERS…Prefer sedate activities
SENSORS…Want to be the driver on trips
How do you decorate?
SEEKERS…Have busy dense decorating schemes
BYSTANDERS…Have crooked wall
decorations & don’t notice
AVOIDERS…Decorate as little as possible
SENSORS…Select clean lines & uniform color
palates
What are your clothing choices?
SEEKERS…Want layers, textures & lots of accessories
BYSTANDERS…Are casual, &
sometimes mismatched
AVOIDERS…Have a few pieces used over & over
SENSORS…Use only specific brands and fabrics; sparse accessories
How do you prefer to dine?
SEEKERS…Prefer busy & entertainment venues
BYSTANDERS…Do best with buffet style or multi course
AVOIDERS…Prefer to eat at home, use carry out or delivery
SENSORS…Prefer off peak hours, low lighting, favorite venues
How do you organize you workspace?
SEEKERS…Have many projects available at one time
BYSTANDERS…Have casual
spaces that may appear
disorganized
AVOIDERS…Close doors, find isolated places, may telecommute
SENSORS…Clear surfaces each day; have
precise organization
How do you vacation?
SEEKERS…Create a busy, vigorous schedule
BYSTANDERS…Have no schedule & change plans easily
AVOIDERS…Repeat the same trip, select solitary venues
SENSORS…Create a precise
timeline of activities & don’t
deviate easily
Example of sensory processing pattern
Amt of trait
Seeker
Bystander
Sensor
Avoider
Wears layers& accessories
Home décor isCasual and eclectic
Tidies up workspace at end of dayWhat and where to eat doesn’t Matter too much
They create excitement & change all around them
They create excitement & change all around them
SEEKERSalwayswant more
[high thresholds + active self regulation]
AVOIDERS want more of the same thing and nothing more
[low thresholds +
active self regulation]
[low thresholds +
active self regulation]
They create routines to keep life
peaceful & manageable
SENSORS keep track of everything SENSORS keep track of everything
They notice what is going on & have precise ideas about how to handle situations [low thresholds +
passive self regulation] [low thresholds +
passive self regulation]
They are easy going and can focus even in busy places
They are easy going and can focus even in busy places
BYSTANDERS don’t know what they are missing
BYSTANDERS don’t know what they are missing
[high thresholds + Passive self regulation]
[high thresholds + Passive self regulation]
What sensory pattern does What sensory pattern does this person have for this person have for
dressing?dressing?
What sensory pattern does What sensory pattern does this person have for this person have for dressing?dressing?
34% 34%14% 14% 2%2%
less than othersless than others more than othersmore than others
Same as othersSame as others
whole
Sensory Profile measures are based on the Bell Curve
- - -=
+ + +
This is the range of
typical performance
So, at the macro level, intervention
takes the form of
A change in the contextA change in the contextSo more people can So more people can
function successfullyfunction successfully
ISBN # 978 1 84310 871 9
Jessica Kingsley Publicationswww.jkp.org
October 2007
Are you a sensory junkie or a nervous wreck?Juliet Rix investigates the psychology of sight, sound and smell
LONDONMaking sense Of your senses
By Claudia Wallis
Our sensory profile:Who we really are How we react to smells and sounds all but defines us By Heidi Dawley Oct 29, 2007
Eating and Dining
Let’s practice…..
Low
Registration
Sensation
Seeking
Sensory
Sensitivity
Sensation
Avoiding
What is the optimal dining experience??
The location for eating and dining
BYSTANDER
Places that provide interest and changes throughout the meal
SEEKER
Loud, active, busy places during peak hours
SENSOR
Favorite places and menus during off-peak hours
AVOIDER
Eat at home with a predictable menu
The foods we eatREGISTRATION
Contrasting flavors, textures, colors; in many serving dishes
SEEKING
Ethnic foods with Varied/ unusual spices
SENSITIVITY
Familiar menu items always selected
AVOIDING
Have a routine menu
LIVING SPACESLIVING SPACES
Features of the living spacesLOW REGISTRATIONUnusual floor plans with changes in flooring room to room
SENSORY SEEKING Open living spaces
SENSORY SENSITIVITYFloor plans with functions grouped together
SENSORY AVOIDING Self contained spaces in floor plan
Decorating your home
REGISTRATIONEclectic style with unusual arrangements
SEEKING Bright, contrasting color schemesUneven placement of windows, doorways
SENSITIVITYHomogeneous color palateFavorite piece of art on wall
AVOIDING Sparse with separate areas for being alone
A SEEKERAN AVOIDER
A BYSTANDER A SENSOR
e.g., how life is SENSATIONAL for…e.g., how life is SENSATIONAL for…
So, how can we use these ideas in
everyday life?
So, how can we use these ideas in
everyday life?
The older girl needs a lot of
sensory input…
The older girl needs a lot of
sensory input…
So what about getting dressed?So what about getting dressed?
This baby cannot stay alert to eat…This baby cannot stay alert to eat…
So how could we change the sensory environment to helpEating?
So how could we change the sensory environment to helpEating?
This man needs a quiet place…
…so what do we offer him for when his grandchildren are coming over?
“…Isabel hated things that vibrated. She
didn’t like pressure on her fingertips so much
that she refused to even try to learn to button…or tie… or hold a pen...” p.277-278
“…Isabel at first refused …; eventually she stuck with it [cello playing]. The sound and touch sensitivities didn’t go
away, but they lost their grip on
her...” p.277-278
“…in order to help people with autism, we don’t
always need to …pretend that they are not
different…. Rather, we need
to provide roles in our communities for people with autism, some of which they may in fact, be able to perform better
than anyone else...” p.291
Intervention must not be solely focused on fixing children’s behaviors.
Sometimes we need to create a context that is more supportive,
a strategy which acknowledges that the challenges children face do not reside within them,
but rather in the space between the children and their contexts…
The essence of INTERVENTION
The essence of INTERVENTION
so that differences are just a DIFFERENCE,
not a source of disorder, but rather what makes a person interesting, quirky, funny…HUMAN.
This is how we reduce judgment,
create resilience &
increase acceptance,
So, we return home.So, we return home.The clouds openThe clouds open
And reveal And reveal New possibilitiesNew possibilities