HOW BALANCING SENSES CAN IMPROVE QUALITY OF LIFE IN AUTISM

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HOW BALANCING SENSES CAN IMPROVEQUALITY OF LIFE
IN AUTISM

• Nusrat Hussan
• Occupational Therapist

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Outline of Lecture

• Sensory system
• How all senses work together
• Altered use of senses/sensory dysfunction
• Symptoms of sensory dysfunction
• Remediation (or balancing senses)

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Sensory System

• We explore or learn about the world around us
  through sensory experiences
• Our body get sensory inputs from sensory systems
  

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Seven Senses

• Visual (we see)
• Auditory(we hear)
• Oral/gustatory(we taste/smell)
• Tactile(we touch)
• Proprioceptive(we use muscle and joints)
• Vestibular (we move against gravity
• To learn and respond appropriately in different
  situations, an individual depends on these
  functions

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Sensory Responses

• In addition to the core features of autism.
• Children and adolescents with Autism Spectrum
  Disorder (ASD) respond to sensory experiences
  differently from those without ASD
• Which can interfere with the individuals ability
  to complete important activities successfully

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How all senses work together

• Sensory Integration
• The process of the brain organizing and
  interpreting information from all sensory systems
  is called as sensory integrations.
•  

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Sensory Integration is

• The neurological process that organizes sensation
  from ones own body and from the environment and
  makes it possible to use the body effectively
  within the environment. (Ayres, 1979)

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Sensory Integration

• This complex set of interactions between the
  brain and the body and can be broken down into
  three complementary processes
•  
• Sensory Modulation
• Sensory Discrimination
• and Motor Planning
•  
•  

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Sensory Integrations Dysfunction

• .

Sensory Integrations dysfunction
Sensory modulation dysfunction
Sensory discrimination dysfunction
Functional dysfunction
Sensory Avoidance
Sensory Seeking
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Sensory Integrations Dysfunction

• Threshold / Capacity
• Some children have a
• very large sensory or
• neurological threshold for sensory input
• Some children have a very small sensory
• Beaker

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• .

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Some features reported of people on the spectrum

• Differences in auditory processing.
• Auditory hypersensitivity as
• The child being troubled or distracted by noise
• Not being able to work or focus in the presence
  of background noise.

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Hypo activity to auditory Stimuli

• This has been an early diagnostic
  consideration for autism.
• Diminished response to name
• seems to be deaf
• Not responding to certain sounds.

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For visual responding

• Avoidance of eye contact
• Inefficient use of eye-gaze seen as early social
  feature of autism
• Inspect different objects as their own flapping
  hands
• other moving objects in an unusual way with their
  peripheral vision

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Vestibular symptoms

• Vestibular hypersensitivity
• Seek Vestibular stimulation (rocking,jumping)
• and are on the go
• While those who are hypersensitive to Vestibular
  movement avoid inputs and exhibit gravitational
  insecurities. e.g.
• avoids going up and down stairs,
• fear of heights and falls,
• prefers to sit for every activity

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Tactile

• Tactile hyper-reactivity
• When exposure to different textures of clothing
  makes a child extremely anxious, distracted, or
  fidgety
• Toe walking,
• Preference for walking bare foot
• Avoiding messy activities

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.

• On the other hand the hyposensitive seeks all
  types of tactile inputs like touching people and
  objects.
• Sensitivity to tastes of certain food, excessive
  mouthing of objects is also seen in children with
  ASD

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Dealing with Sensory Dysfunction

• Change in inputs of
• Tactile,
• Vestibular,
• and Proprioceptive systems
• along with other systems may reduce the mentioned
  behaviours and increase participation and
  independence in functional tasks.
•  

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Sensory Diet

• These sensory inputs can be provided as a
  balanced sensory diet through
• Sensory integration therapy
• which uses a planned, controlled sensory input in
  accordance with individuals specific sensory
  needs.

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Throughout the day

• Our levels of arousal change frequently
• and we develop strategies to improve our level of
  alertness which are individualised based on past
  experiences
• However, children with a sensory dysfunction are
  unable to self-regulate and sustain an
  appropriate level of alertness

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Purpose of a Sensory Diet

• Is to provide sensory experiences throughout the
  day to help the child to maintain a functional
  level of arousal.
• Necessary for learning.
• Sensory diet must be individualised for each
  child based on his needs and responses to sensory
  inputs

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Designing a Sensory Diet 

• Sensory inputs can be of different intensities.
• May require longer durations and more or less
  frequent inputs.
• The outcome of the sensory input is monitored to
  determine a calming or alerting effect on the
  individual

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Activities that can be considered whilst
designing a Sensory Diet

• Tactile activities
• Hypersensitive (defensive)
• Activities that let the child take support on the
  hands, feet, and stomach
• Make child lies on his stomach on the floor, and
  a large gymnastic ball is rolled on his/her back
• Expose the child to various textures (walk,touch
  with hands or whole body)
• Different kinds of sand and water play

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.

• Hyposensitive (seeks tactile input)
• Climbing up, rolling, jumping, wheel-barrow
  walking
• Play doh activities as rolling, cutting, making
  balls Tracing designs with a fingers on
  different textures like sand-paper, fur, etc
• Ball pool activities,Obstacle course
• Pillow fight

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Auditory Activities

• Listening to music or environmental sounds such
  as a cooker whistle, a motorcycle revving (for
  the hyposensitive )
•  
• Identify and avoid the sound, Barrier such as
  ear plugs, Camouflage the perception of the sound
  with music - iPod (for the hypersensitive)

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Proprioceptive Activities

• Wearing a heavy weighted vest, carrying weights
  in a bag, walking with heavy loads
• Cocooning
• Animal walks
• Jumping activities
• Chair or wall push-ups

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Vestibular Activities

• Hypersensitive and gravitational insecurities
• Having fun moving around while experiencing
  different possibilities of movement.
• Sitting on a low swing and spinning, turning,
  rolling.
• Activities with a large gym ball
• Walking through an obstacle course

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.

• Hyposensitive (hyperactive) and seeks movement
• Using the swing in the playground daily
• Spinning, jumping and running along a target
• Physical activities and sports to channelise
  extra energy
• Frequent movement breaks

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Visual Activities

• Turning lights off (to calm)
• Turning lights on (to alert)
• Using flashlights to focus.
• Use tracking methods with torch in dark room to
  improve peripheral and central vision.
• Working with children at eye level so they can
  look directly into the eyes

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Olfactory Gustatory Activities

• Oral motor exercises including sucking, blowing
  and chewing
• Providing an oral massage before meals
• Providing a smell box with smells on various
  ranges

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Sensory Diet for Adolescents

• Ability to successfully perceive and integrate
  sensations also promotes socialisation and
  emotional well being.

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.

• Teens may engage in sensory seeking activities,
  such as impulsivity and aggression
• In contrast there may be teens that avoid social
  situations, limit social participation and
  withdraw to the point of isolation

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.

• We need to respect their
• independence and choice,
• teaching them to meet their own sensory needs.
• Done by
• appropriate equipment
• environmental modifications that accommodate
  their needs.

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.

• Sensory integrative therapy can teach.
• Relaxing and calming activities,
• Gradual desensitisation to stimuli
• And coping strategies, that can help the
  adolescent achieve success in daily activities

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Alerting

• Light touch
• Tickling
• Hot or cold food (strong temperature)
• Playing in textures (rice, sand, beans, finger
  painting, playdoh)
• Go barefoot, use textured towels/ blankets/
  objects
• Chose crafts with touch feedback (gluing, clay
  molding, etc)

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Calming

• Firm pressure on skin, longer duration
• Hold hand firmly
• Weighted vests, blankets, etc.
• Wilbarger Brushing Program (under OT direction)
• Oral tactile defensiveness strategies

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• Queries

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• Thanks ?

Nusrat Hussan Occupational Therapist