Category Archives: Sensory

Investigate evidence-based sensory integration strategies and therapeutic tools designed to help individuals of all ages regulate sensory input, enhance emotional regulation, and improve behavior, attention, and participation across a variety of environments.

Sensory Differences & Mealtime Behavior in Children with Autism

Events & Conferences, Feeding Therapy, Sensory, ,

Jeanne-Zobel-Lachiusa presenting on sensory differences in mealtime behavior for children with autismEvidence-based practice (EBP) involves the integration of:

  1. Clinical expertise,
  2. Scientific research, and
  3. Patient/caregiver perspective.

The goal of EBP is the improvement of patient outcomes. It holds us accountable for our treatment plans, strategies and outcomes among our peers and other health care professions. According to the AOTA, generating research in the field of occupational therapy is “critically important for advancing the field and ensuring the viability of the profession.”

Jeanne Zobel-Lachiusa, EdD, OTR/L was the featured December Saturday Seminar Series speaker, who shared her research on Sensory Differences and Mealtime Behavior in Children with Autism (AJOT September/October 2015, Vol. 69, No.5).  In summary, the study results helped to identify problem eating behaviors in children with ASD that may be associated with sensory differences. Children with ASD were compared with typically developing age-matched peers. The study concluded that children with ASD who receive occupational therapy that offers sensory strategies might result in less stressful mealtimes.  The findings supported the need for further research in this area of self-care with children who have been diagnosed with ASD.

The seminar attendees were from varied backgrounds, including occupational therapy, speech therapy, special education, social work, psychology, child care, medicine, and parents. They engaged in a lively brainstorming session on sensory strategies in the different sensory domains that might provide mealtimes with less stress for both the child and family. They shared innovative as well as tried and true ideas with the group.

Just a few examples of the many suggestions include ideas for tactile and oral sensitivity:

  • systematic desensitization
  • using a Nuk Massage Brush paired with singing a song, and
  • vibration with a vibrating teether or Z-Vibe.

Hush Buddy headphones to help those with sensory differences For auditory sensitivity, Jeanne suggested:

  • noise reducing Hush Buddy Ear Muffs,
  • rhythmical background sound like drumming or a metronome, and soothing music.

For children with sensitivity to fluorescent lights that flicker and glare in the cafeteria or classroom, Fluorescent Light Filters, which are magnetic were recommended. Another suggestion was for the student to wear a visor to reduce vision sensitivity.

Jeanne suggested a number of resources for the group including the book, Autism Interventions, and recommended the AOTA website for its user-friendly handouts on mealtime and feeding.

Producing research is essential for validating assessment and treatment strategies. Jeanne shared that her research was motivated by the question of whether interventions are actually effective.  Her current research demonstrated that there was a statistically significant difference in sensory differences and in mealtime behavior between children with ASD and the typically developing group she tested.  This groundbreaking research paves the way for further studies to investigate specific treatment strategies discussed today for their effectiveness in helping make mealtimes a pleasurable experience for children diagnosed with ASD and their families.

To view Jeanne’s PowerPoint slides, click here.

Following the seminar, attendees provided feedback about the seminar.  Please see a few remarks below:

“It provided an opportunity to review recent literature and share strategies with other therapists.” Kristyn S., Occupational Therapist

“Loved the topic and the format. Jeanne was great!!   Diane H., Occupational Therapist

“Informative, interactive, insightful. It was interesting listening to other OTs experiences and suggestions.”  Sylvia K., OT student

“Helpful to organize sensory treatment with a food tolerance/mealtime behavior perspective.”  Anonymous Occupational Therapist

Thank you, Jeanne!

Filomena Connor, MS, OTR/L

A Sensory Approach to Supporting Teens with Emotional Regulation

Events & Conferences, Sensory Regulation, , ,
Karen Moore, OTR/L presented on Sensory Approaches for Emotional Regulation

Karen Moore, OTR/L presented a superb seminar on Saturday entitled: A Sensory Perspective on Helping Adolescents and Young Adults Learn to Deal with Difficult Emotions. Working in the area of mental health has been Karen’s passion and career focus.  She is a highly respected and renowned therapist in her area of practice. In her seminar, Karen shared information from her most recent publication of The Sensory Connection Program called The Sensory Connection Program: Curriculum for Self-Regulation, which teaches self-regulation skills through the use of sensory strategies and social engagement. It was evident from her creative and heartfelt approach that her clients benefit greatly from her knowledge and experience. Today she focused on the emotionally charged years of middle and high school, when students benefit from learning fun and engaging strategies to help them deal with emotions. She described how to teach adolescents to recognize signs that they are having emotional difficulty, how to teach them to seek help, and how to help them learn to use effective self-regulation skills.

Karen’s discussion of the value of mastering self-regulation made good sense; when an individual is able to cope with emotions, he/she is able to “tune back in” to the self, which in turn results in being back in control and greater self-confidence.  She emphasized that without mastery of self-control, it would be difficult for an individual to explore new adventures including higher education, travel, or entering the job market. When applied to adolescents, whose pre-frontal cortex and cerebellum are still developing, the need for learning self-regulation strategies is crucial.

Sensory Connection Program- An example of an Approach used for Emotional Regulation

When Karen reviewed the evolution of the stress response, it was easy to see that the vagal level of “freezing” when confronted by a stressor is not a useful response because it results in being overwhelmed by fear.  In the next level in the hierarchy she explained how the sympathetic “fight or flight “ response is more effective than the “freeze” response, but has a long recovery time.  The optimal response to stress involves appraisal of the situation and communication, which promotes a calm state. She shared research evidence that shows that adolescents who have experienced trauma respond with more primitive responses, have difficulty with communicating verbally, and are more reliant on sensory responses than cognitive strategies for coping. Teaching adolescents self-regulation skills prevents them from resorting to the dangerous lower levels of the hierarchy when responding to stress.

Karen employed some of techniques for calming with her audience today, including several different ways of using deep breathing as a group activity, resulting in a feeling of socialization and engagement.  The pneumonic “Pause – Connect – Engage” helps adolescents to “short-circuit” fear by signaling them to stop and think what made him/her upset, make a social connection by reaching out to someone trusted, and then do something positive that helps, which may be tool-based or non tool-based, i.e. squeeze a ball, do deep breathing, exercise, use a fidget, etc. The group tried out several calming strategies, but one called “seaweed” which involved rooting the feet on the floor and swaying gently and slowly with body and arms, was simple and effective immediately.

Karen guided us in learning how to avert a crisis by helping adolescents gain self-control with the use of a variety of sensory strategies that can be personalized.  The strategies are highly effective for the teen population, but can be valuable tools for any individual who is in a state of emotional distress.

Here’s what attendees had to say about Karen’s seminar:

“As a pediatric OT at elementary school level, learning about sensory curriculum at adolescent level guides me in treatment.  Really enjoyed Karen’s stories/real examples to associate to curriculum.” Jen M., Occupational Therapist

“This topic is relatable to everything I do as a COTA. It ties emotions and sensory input. Every student I work with will benefit!” Beth M., COTA

“Very informative.  Wonderfully explained with explanations in brief & practical exercises to experience.”  Rajini K., Parent

“I would recommend this seminar to a colleague because of the scientific/physiological information, therapeutic activities, and hands on demonstrations.  Very knowledgeable speaker.  Excellent examples.” Joann W., Occupational Therapist

“Useful information for sensory techniques to calm/alert children effectively. New concept/less traditional routes for sensory strategies.” Megan Z., OT student

Thank you, Karen!

Filomena Connor, MS, OTR/L

Autism Challenges in Public Entertainment Venues

Community-Based Practice, Daily Living, Sensory, , , ,

Ironically, the reasons why we go to these venues are the reasons people with Autism do not like them! Here are a few challenges that may be faced in public entertainment venues:

  1. Sensory: People with Autism often struggle with sensory input and how to deal with it.
    • Many of these venues may smell strange (or someone may be wearing perfume) and cause a negative reaction for some people. This can be so subtle that the person with autism may not even know that it is causing him/her to act out of control.
    • Sudden and loud chaotic noises can cause confusion for them in addition to all the chatter and background music in the room.
    • Sitting too close to other people can cause unwanted light touch that we know can be very irritating. Speaking of touch, a theatre setting may have textured chairs that are uncomfortable
    • And not to mention all the visual stimuli that occurs – all the bright lights, some moving and others flashing can put a nervous system into overload.
  2. Social Skills: These venues involve social environments which is an area of real challenge for people with Autism
    • They may be highly anxious in knowing how to interact with the rest of the group.
    • As a result they may seem aloof or, on the other hand, blunt.
    • In an attempt to communicate, they may not be able to read the body language or facial expressions of the other person and then their behavior may appear to be inappropriate.
    • People with Autism take things very literally which may cause misunderstandings with others at the venue.
  3. Routine and Anxiety: Routine is very important for people with Autism
    • Going somewhere new outside of routine can cause a lot of anxiety.
    • Even if a person with Autism is used to going to a venue each week, even the absence of a staff member, different layout, etc. could cause anxiety.
    • Unexpected events are anxiety producing for them.

Other diagnoses that might experience similar challenges:

  1. We as occupational therapists working with people with developmental disabilities are trained to assess their ability to process sensory information as part of their evaluation.
  2. We are finding that many people with no known diagnoses also have challenges with entertainment venues. Recently, I have been privileged to attend professional baseball games in Baltimore, Philadelphia and San Diego. That venue has changed since I went to baseball games as a child – now there is loud music, flashing lights, huge TV screens and people getting up and stepping on your toes which all make me wonder why I am there. It is challenging for me!

Suggested Solutions

Preparation, Preparation, Preparation:

  1. Social Story:
    A social story can be a written or visual guide describing various social interactions, situations, behaviors, skills or concepts and were introduced and described by Gray and Garand (1993). They are designed to improve the social skills of people with autism spectrum disorders (ASD). Social stories are used to educate and as praise. Social stories model appropriate social interaction by describing a situation with relevant social cues, other’s perspectives, and a suggested appropriate response. About one half of the time, the stories are used to acknowledge and praise successful completion of an accomplishment. These have been used successfully in preparation for entertainment venues. For further information, Therapro, Inc. offers the Newly Revised Book on Social Stories here.
  2. Sensory Stories:
    sensory_story_cards
    Sensory Stories, published by Therapro, are similar to Social Stories but with the specific approach to teaching children with autism and over-responsive sensory modulation issues to successfully engage in social activities within the home, school, and community. Sensory Stories comprise 30 individual stories about daily activities. These Sensory Stories instruct the child to use calming sensory strategies in order to deal with the unpleasant sensory aspects of that particular situation. When read on a regular basis, Sensory Stories assist the child in developing effective routines to manage the sensory experiences surrounding typical daily activities. The authors have conducted several studies to demonstrate their effectiveness. They can be viewed on the Therapro website.

The Venue Itself

  1. Call ahead and see if the facility has a visual tour for an iPad of the venue. A 360 degree tour to show as much of the rooms, location of bathrooms, etc. would be helpful for knowing the physical layout.
  2. Find out what the venue rules are, how services operates so everyone knows what to expect of the routine
  3. Ask if there could be dedicated time that can be with just families with autism
  4. Would there be a quiet area or small area available for families and individuals who might experience stress during the venue? Here at the Therapro Showroom, we have a sensory area for individuals including a bean bag chair and a basketful of sensory tools. This helps when the parent or caregiver want to look around the showroom. Also, our showroom does not have all products out as that could be overwhelming to individuals. Instead, we ask the parent to make a list of interested products and we go into the warehouse to pick them. Shoppers can sit comfortably at a table and make their decisions as to what they want – no rush.

Helpful Tools During the Venue Visit

  1. Fidgets:
    During stressful times, fidgets help reduce agitation. Therapro’s selection of fidgets have increased through the years as each nervous system finds a fidget helpful and others offensive. Please see our website for numerous fidgets. Our very popular Fidget Kit includes a variety of fidgets so a person can determine which ones they like or dislike. We have many quiet fidgets that can be used unnoticed!
  2. Additional Tools:
    • Sensory Strategy Cards: These are small cards with such strategies as “I can grasp my elbows and squeeze hard”, “I can put a heavy backpack or fanny pack in my lap”, “I can do an elbow-check to make sure no one is too close.” They are visual reminders of the various strategies that children can use. They can be tucked in a shirt or pants pocket for a quick reference to a preferred strategy or put on a belt loop or backpack.
    • Noise-reducing headphones
    • sunglasses

Guest Blogger: Karen Conrad Weihrauch, PhD, OTR/L