A parenting blog about tricks and tips for sensory issues & integration strategies,
I’m highly grateful to the genius founder of Sensory Integration theory, Dr A Jean Ayres whose unstoppable hard work and passion towards her work have made the world of neuroscience so interesting and engaging.
Thank you so much, Dr Ayres!
Classrooms need to be Multisensory for better learning!!
A.Instructions should be simple, clear and short for the child to follow easily.
B.Be precise and slow while giving instructions. One step at a time since brain’s information processing is slow.
C.Encourage the child to learn and practice the task. Practice! Practice! Practice makes a lot of difference.
D.Keep Fidgets handy! They reduce anxiety levels in different environments and facilitate attention on a task in hand. Use of different magnetic balls, paper clips, blue tac, or mechanical pencils can work well too. Other common fidgets can be giant nut and bolt, key chains, fidgeting fleece bags, finger squeezers, tactile balls (koosh ball): Resource:
E.Let child do heavy work activities such as jumping, chair push-ups, wall push-ups, clearing cluttered desk,carrying the heavy bag.
F.Give verbal instructions with visual demonstrations where ever possible. Showing child how to do activity is better than telling him about it. Demonstrate how to do the obstacle course and then let him perform.
Carrying heavy books has to calm effect
G.Give extra time in the classroom to complete written work. Teachers need to have patience and calm!
H.Remove visual distractions from the classroom. All wall decorations, notices should go on the back wall. Whiteboard should be clear (except when teaching!) with a date in the corner.
I.Use colourful marker pens for teaching particular topic or concept.
J.Child should sit near to teacher’s desk and in front of a classroom.
K.Organise child’s desk, textbooks, supplies. Label different folders. This makes a lot of difference.
Supplies should be adequate
L.Keep the supplies and textbooks in the good amount within a classroom.
M.Introduce and encourage calming music.
N.Let child submit written assignments rather than hand written since handwriting can be illegible or messy.
O.Labelling and Categorisation: Use sticky tags for labelling folders such as work done, work to be done, notices, to be read and other labels can be made according to requirements and relevance. It supports the child to distinguish and different folders and binders as well as subjects.
Sticky Notes for Organisation & Labelling
P.Lighting: Use of Halogen lighting system is considered better than fluorescent lighting system in classrooms.
Q.Homework Print Outs: It is better to post homework on school website so it is easier for parents and kids to understand the given assignments.
R.Visual Reminders: These can be in the form of picture posters, sticky notes, widgets or coloured writing on the board.
S.Sensory Diet: A sensory diet is a carefully designed, personalised activity plan that provides sensory input to a person needs to stay focused and organised throughout the day (Occupational Therapist Patricia Wilbarger). It is developed by an Occupational Therapist specifically according to person’s sensory needs and abilities
T.Movement Breaks: A child should be given a break for 2-3 minutes’ maximum. This for stress release and reassure that child can re-focus well on topic again. Doing deep Breathing or Stretching exercises can be beneficial. Going to an office to hand over paperwork is one example of movement break.
U.Pencil Grips: Children respond well to pencil grips as it improves handwriting, legible and provides tactile-proprioceptive feedback. Resource:
V.Wobble Cushions: Good for ADHD kids especially. Keeps good posture and maintains focus.Resource:
W.Ergonomics for Seating:
a.While sitting on chair hips, knees, and ankle should be perpendicular to each other.
b.Back should be straight and ninety-degree angle should form at an elbow.
c.Wrists should be in resting position.
d.Table and chair should have appropriate height.
e.The seat back should be angled at 15 degrees.
f.The child should lean forward with body weight supported by the floor with feet on the ground.
g.Provide slanting desk or tilt table desktop for achieving ideal reading and writing angles for vision and spine.
h.Elbow rests prevent straining of shoulders and neck muscles.
i.Reading angle should be about 60 degrees from horizontal.
j. Writing angle should be about 10-20 degrees.
X.Introduce Theraband Stretching exercises or Deep Breathing as a part of Daily morning routine to concentrate well in a classroom.
Y.Weighted Items: Use of appropriately weighted items should be done within the classroom on discussion with Occupational Therapist. Shoulder, Shoulder and neck weights, lap weights, wrist, ankle weights, snakey weights, weighted scarfs are weighted products for Calming down, reducing impulsivity, hyperactivity, and aggression. Resource
Stress is a reaction to a stimulus that disturbs our physical or mental equilibrium. A stressful event can trigger the “fight-or-flight” response, causinghormonessuch asadrenalineand cortisol to surge through the body.
Stress is the sometimes strong hidden cause of Anger among children. This can be from positive as well as negative event however majorly it is destructive in nature due to its unconstructive occasion. Reasons of stress related anger may be, parent's angry and negative behaviours, separation, rejection from peers or parents, lack of trust, perfectionist tendencies, school stress, loss of grandparent etc.
As parents, we should be considerate enough towards ourselves as well as kids. Expecting too much from both the sides is like living in a fantasy World of Alice in Wonderland or Disney Worldwhere everything is charming, sumptuous, resplendent and magical. Expecting too much from our kids in areas such as academics, behaviour, socialisation can be unrealistic and unjustified and we might look like an immature parent who is still not ready for truthful parenting. Every child, parent and parent-child relationship is different.
According to Carrie Wendel-Hummell, a researcher at the University of Kansas, there are various factors contributing to stress among parents as well as children. It is not just because of too much of work and responsibilities added towards new parents after the birth of a baby too but also social and peer pressure to project themselves as perfect families within the society.
Everyone is eager to see each other’s photographs and status updates on Social media (Facebook, Twitter, Instagram) and make judgements of their good being. Seeing X friend’s vacation album mount’s unseen pressure and stress on parents to provide better support and luxuries to their children.
Tim Elmore, in his book entitled “Twelve Huge Mistake Parents Can Avoid” mentions that parents should have high BUT healthy expectations for themselves and children. He states that parents should not be guilty of failing on different as care takes rather they should prepare kids for the real world and its true colours.
Having marital discord or separation from spouse affects the child adversely leading to extremely complicated relationship with the left-behind parent. In some cases, unfortunately, child not only loses the separated parent but also faces unintentional negative and un-genuine side of left behind parent. Another massive cause of stress can be bullying in school that can cause personality
development failure in both typical and atypical children. A popular child can also be bullied in school, regardless of any reason. Bullying which can be verbal or physical germinates stress, anger along with fear to be accepted among peers.
So there can be infinite reasons of stress among teens and children which can be reduced using appropriate strategies after analysis of exact reason of stress within child.According to Lancet2007 Global Mental Health Report, the commencement of mental health issues is most likely between the age groups of fifteen and twenty-four, making it a primary time for problems to emerge if parents are not careful. Numbing behaviours like over- or under-eating, cutting, drinking, drugging and, ramping up perfectionistic behaviors are modern traps for our children and teens.
As a paediatric OT, I have seen a number of parents being concerned about their child’s behaviour within the community. A common concern for parents is how to support their children in dealing with stress-related anger, and how to prevent them from resorting to aggression. Many parents are concerned about a number of violence children are exposed to at school, on the television, while watching video games, and in their friend circles.
Here are Six practical strategies which can be used by parents to reduce Stress levels among children and improve parent-child relationship.
Improve Socialisation: Let your child have a good number of friends. Making and keeping friends reduces stress. This also helps to get rid of anxiety or depression. This supports a child in becoming well-connected to peers as well as makes them a good communicator. Facilitation of positive behaviour among peers helps in establishing cognitive and emotional skills that are required to engage competently. This reflects child to be socially accepted by his crowd and he is able to understand the relevance of gestures, facial expressions and other social cues.
However, this does not mean that parents should not be aware of (Four Ws) where, when, with whom and why their child is going. One should be inquisitive about child's
behaviour in home and outside. Discuss with the child that there can be a possible solution to his or her problem or situation. ImplementingProblem Solving Approach is advantageous. Reassurance is important from parent’s side so that child can trust them and share any issue, for example, being bullied in school or stressed due to a school trip. He should be sure that my mummy and daddy have a solution to every problem. This confidence among parents will make their bond strong.
Hugs and Kisses for Reassurance: Often children find nothing better than hugs and kisses for calming down and getting support from parents. Hugs give deep pressure (proprioceptive input) to our bones, joints and muscles which help in calming down and
reducing stress level. This helps raised levels of Cortisol hormone to decrease. This hormone is often measured as means of quantifying physiological response to a stressor. Therefore, any reason (bullying, loss of the pet) which can raise Cortisol levels (stress) can be decreased by hugging or kissing the child.
Stories Make a difference:Telling stories about children with similar problems and feelings make your child realise that he is not the only one to struggle from stress.Discussing problems on Stress Forums or Groups can be a Self-helpor joining Stress Help Communitiescan reduce anxiety and stress. Parents may share their childhood situations to overcome stress and anger. I find this
as one, of best ways to change child's negative behaviours. Parents should mention their struggle and hard work to stressed children. Sharing own stories will motivate kids to stay calm and think better. Watching movies together or telly shows related to the hyper-competitive world of today will support the child to discuss professional issues with parents. Stress due to academics, competition, bullying or grief will disrupt the learning and healthy development of individual physically, mentally and emotionally.
Praise the Child:Appreciation and encouragement help children realise that they are worthwhile doing a particular given task. This also helps to develop self-confidence.
Notice, praise and encourage good behaviour rather than focussing on bad behaviour. One of my student diagnosed with Asperger’s Syndrome always faced high levels of stress just before couple of weeks before exams. On talking to him, I discovered it was high parental expectations to achieve good grades in exams. Rather than being focussed, this young boy had big struggle to concentrate on studies. During one to one session, we sat down with a white sheet and a colour pen of his choice. We started listing his achievements and failure in past 6 months. Lastly, it was concluded that his sports, extra-curricular, and Information Technology achievements are greater than his failures This discovered fact about himself, made him feel better and positive. Therefore, it’s important to improve child’s self-esteem and confidence level time and again to make him feel affirmative and relevant towards himself.
Charity Work or Fund raising for a cause:Children should be encouraged, to help others (E.g. making the cross road to elderly or differently able) or perform Community Workthrough charity. Parents may develop habit of performing, at least one good deed or favour per month
which involves children in charity. This makes a child more resilient.Charity can be to spread awareness about a particular topic or to help for a cause. This can be a marathon for Macmillan Cancer Patients or even picking litter for community welfare. Many charities focus on the environment, for example, work to help people to learn about threats to the climate and too fragile ecosystems. Sparing out time for charity not only improves self-esteem and kindness skills but also gives opportunities to meet and communicate with new people from different spheres. Charity begins at home, they can even support the mother in cooking or washing dishes after dinner. This will not only improve parental relationship but also enhance child’s skills on particular task.
Apart from five basic senses (vision, auditory, touch, olfactory and gustatory), we have three more hidden senses called as Proprioception, Interoception (recently discovered) and Vestibular Sense. The following discussion is about our proprioceptive sense and how it works in typical and atypical children.Awareness about one’s own body position happens due to this sixth sense is known as proprioception.
Proprioception is also called as “position sense” since it tells us, where we are we sitting, standing, lying or walking in relation to any object or surrounding. The word Proprioception comes from Latin word, “proprius” meaning “one’s own”. This sense supports a child to regulate their responsiveness to sensations.
This sensation occurs when our muscles move or work.Consequences of poor proprioceptive functioning are the poor academic achievement, lack of self-care skills, difficulties in self-regulating emotions, attention and stress.
To know more about proprioception, let’s consider a simple example.
Suppose, you are blindfolded and asked to ascend and descend stairs you have never seen. Now your eyes do not have any experience or measurement of these stairs.The depth of every stair is unknown that can actually help your body to go up and down without falling or tripping. It is obvious that your balance will lose while doing this activity. So what role does body play to protect you? To be careful and protect you from falling, your hands will try to search and hold railing or any other external support. Your dominant foot will step forward slowly and attempt to judge how much is the height of the first stair so that you can climb the second step easily, with a swift movement. As you will climb further, your body will be confident enough to take steps confidently and instantaneously with controlled balance. Moreover, descending stairs will be easier for you now since the body can easily judge and feet can measure the steepness of staircase.
So how does this all happen?
This all happens because of our Proprioceptive sense! It is a hidden sense, that carries sensory information telling us about our own body’s movements and positions. It allows the brain to understand body's position, posture and place in relation to surroundings and other individuals. Whether we are standing under the tree, over the bed, in the sand or on the top of the cliff, this unconscious awareness happens due to this sense. Being able to walk in the dark room without losing balance control, typing without looking at the keyboard, driving a car without looking at brakes and other components, or performing ballet will not be possible without this sense.
This sense is the foundation for our body postures and actions. It makes us feel where are we sitting standing or lying in relation to our surrounding.
Consider, while sitting on the chair, how does our body know, where it has to sit? How much our knees need to bend according to chair’s height? Is chair comfortable or not?This all work is done by Proprioceptive sense.
It informs body about direction, velocity and force needed by one’s body
for doing any task. Finely graded movements, body coordination and body scheme are some of the areas that are affected due to lack of proprioception.Heavy work activities are calming for these children.
The functions of proprioception are to increase body awareness and contribute to motor control and motor planning (praxis). Children with poor proprioceptive sense have poor body awareness which causes difficulties in carrying out a gross motor and fine motor activities such as playing football, get dressed, zipping a jacket, buttoning a shirt or doing handwriting tasks.
Characteristics of poor prop (short form used by OTs) sense can be easily observed within the classroom or home setting among SPD (Sensory Processing Disorder) children such as, they would slap feet on ground while walking, or hold pencils too tightly to make a clear impression, or that the points break, there can be erasure holes on sheet producing messy work.
Unlike typical children, atypically developing children are not able to judge space around themselves. They might bump into other people or objects. They may enter into other person’s intra-personal space which is considered weird and uncomfortable by most of the people. Such a child might be considered strange however reason behind this action is not his intentional bad behaviour but the lack of body awareness.
People's strange reactions causeanger,depression and emotional liability in the child since he is not doing all this deliberately or intentionally but indirectly trapped by his own body.
The perception of judging ordinary tasks such as the weight of a coffee mug, holding a pencil efficiently in order to write, poor balance while standing, tripping while walking, difficulties in planning actions are some of the examples of poor proprioception. Moreover, children with poor proprioception usually slip from their chairs while sitting in classrooms or other settings. These children have affected body positions and difficulties in organising their sensations therefore falling is usual. Providing Wobble cushion or wobble wedge provides combined tactile-proprioceptive input helping the child to sit appropriately. Moreover, it helps in preventing slouch and increases attention on the task. These resources can be purchased from different websites such as Amazon at cheaper prices.
Other classroom activities to can be Brain Gym andyoga exercises to improve child’s focus in academics. Mediation has very calming and long lasting effect.
Sensory Diet designed by Occupational Therapist is essential to be incorporated in child’s schedule specifically to meet the needs of the individual's own nervous system. Its purpose is to help the person become more focused, adaptable and skilful. It is the combination of alerting and calming activities that helps in organising child’s behaviour and needs.
Home activities can include jumping on a trampoline, riding scooter or bicycle, participation in running, jumping, hopping activities, obstacle courses, sand play, hopscotch play, gymnastics, horse riding.
This post is all about Tactile Defensiveness explanation.
Hope it makes sense to readers!!
Tactile defensiveness means a sensory issue related to unusual sensations or heightened sensitivity when a person or child is being touched anywhere on his or her body. It is a tendency to react negatively and emotionally to touch sensations.
Let’s consider an example of lovely boy referred to me for Occupational Therapy by a class teacher called as Jack (pseudonym). He is 6 years old and has got special needs. The reason for referral is functional difficulties in activities of daily living (ADL’s). The observations made about Jack stated that he is accident prone, drops things from his hands, dislikes hair being washed, or being touched in the face or unexpectedly, prefers standing last in the queue, misbehaves on being instructed, and cannot manage buttons, zippers, laces and ties. He is distractible and hyperactive (home /school environment) which makes his learning difficult. Moreover, he was very impulsive and aggressive on Fridays due to whole week fatigue. He is often in fight and flight mode on being touched or spoken about his behaviour.
Now from above mentioned observations regarding Jack’s behaviour what can be concluded?
Well, the child doesn’t behave well in the classroom or at home.
Is this behaviour due to his attention seeking behaviour or Sensory Sensitivities?
The answer is, Sensory! It can be hypothesised that he has a disorder in tactile processing, showing tactile defensiveness and poor tactile discrimination characteristics.
Most of the times children with ADHD, Developmental Delay, Autism or Dyspraxia show tactile defensiveness in their behaviours and have difficulties in concentrating or paying attention to a particular topic. Their behaviour is antisocial, not because of their bad intentions but due to lack of parent’s and teacher’s understandings about child’s struggle caused by sensory sensitives. These children avoid touch interactions with other people often exhibiting hyperactive and distractible behaviour at home and classroom in an everyday situation.
Making sense of Sensory experiences, let's discuss another example, how would you feel if you are completely wet from top to bottom and you are not allowed to change clothes rather being asked to focus in a lecture fully. Definitely, you will be unfocused and distracted easily since your clothing is not comfortable.
Furthermore, consider, no one understands your problem, rather the lecturer in lecture room instructs you to be attentive on the topic and stay calm without being distracted. That moment will be so frustrating for you which can lead you to misbehave or speak rudely with the lecturer.
The same issue happens with our sensory kids, they do not misbehave intentionally or on purpose, however, they are trapped by their own body sensitivities. It will be so wrong to reprimand a child who is vulnerable, frustrated and emotional due to his own sensory issues.
Usually, parents show great concern to Occupational Therapist (OT) regarding child's learning processes and behavioural issues. Mostly, they ask whether their child’s learning will be affected due to TD.
The answer to this is NO!
TD does not interfere in child’s learning process academically, socially and developmentally, however, it may cause discomfort leading to (emotional liability, distractibility) behavioural problems that can affect his learning to some extent. The emotionally child has to be given extra attention since TD sometimes makes emotions upset.
Due to tactile defensiveness,child’s In-Hand-Manipulation skills are affected means doing buttons, laces or ties can be difficult tasks.
Sensations received from clothes or their tags can be disrupting in nature. Child in classroom will not be able to focus however will constantly keep on scratching himself all over the body. Avoidance for getting hands messy or dirty in glue or finger paint. He may not like walking barefoot in grass or on sand. Fabrics such as synthetic wool or rough textured may cause discomfort He would like to stand last in a queue to avoid touch from other people and also does not like games such as Tag.
To understand physiology of this system in simple terms, consider that brain as an electric circuitry system which has numerous wires (neurons pathways and fibres) working together so that power supply (appropriate functioning & behaviours) can constantly run in the house. Now imagine, one-day power supply of partial house has stopped suddenly however, it is available in other half of house.
Electrician is being called and mistakenly he reconnects wrong wires together which results in high voltage (hypersensitivity towards touch, hugs) and current over flow in half of house however no light supply (hypo-sensitivity towards touch, poor fine motor skills) in other half of house.
Since the pathways don’t send appropriate messages in required (correct) brain centres therefore child reacts adversely, negatively and shows escape-like behaviour on being touched, hugged or kissed.
Protective system is automatic reaction whereas discriminative system involves complex refinement in brain. Human body switches to which ever system is needed at the particular moment. Pain sensations activate protective touch system however deep pressure sensations activate discriminative touch system.
The child with TD will do too much of protection of himself so that he does not get any pain stimuli and therefore his discrimination activity will also be less.
Different intervention strategies include Deep firm pressure, Wilbarger's Brushing technique, vibration, heavy work activities, Wall or chair push-ups, swing play or therapy ball exercises for core strengthening.
There are no shortage of resources regarding Tactile Defensiveness,