SENSORY PROCESSING DISORDER - INTERVENTION STRATEGIES

Environmental modifications and initial sensory strategies :

Signs of atypical sensory processing	Environmental modifications and initial intervention strategies
Proprioception : Child may: •      Grasp objects too lightly or loosely •      Be un aware of changes in the body position •      Be clumsy and break toys •      Seek activities in which he has to jump, push, hit, pull, or bump. •      Grind his or her teeth •      Chew on non-food items such as toys •      Seems weak	•      Use heavy toys to provide more proprioceptive feedback •      Perform activities that require weigh tbearing, pushing and pulling, resistance joint traction and compression. ( playdoh, moving heavy objects, tug of war, weighted vest, heavy blankets, theraputty, theraband, backpack, etc.)
Tactile discrimination/ Hyporesponsiveness : The child may :         Like exploring through touch        Place object in his/ her mouth to explore it      Prefer to go barefoot       Have difficulty with tasks that require hand   manipulation        Have difficulty with gross motor coordination tasks        Have oral motor difficulties	•      Provide activities that require localization of tactile input and discrimination •      Suggested activities : ball bath, finding objects in sand or other textures, brushes, bubbles •      Observe motor skills – see motor planning
Tactile modulation : Child may :        Dislike changes in the temperature such as going in or out of the bathtub         Dislike going barefoot or taking his/her shoes off         Pull away from light touch         Seem irritated by fuzzy clothing        Prefer to touch rather than being touched         Resist wearing new clothing       Dislike eating messy foods with his/ her hands       Dislike having hair / teeth brushed , or face   washed         Avoid getting hands in finger paint, sand, paste, clay        Get irritated by tags on clothing         Have difficulty transferring to table food         Get irritated when being handled by people other than the primary caregiver ( cries during treatment)         Weight bear on finger tips         Have a tendency to walk on his/ her toes        Cry when hair is washed, nails are clipped         Avoid using hands or weight bear on open hands	Modify your social interaction with the child:         Respect personal space         Do not impose         Allow the child to have control over the tactile input he/ she receives – expect a response         Gentle and firm intervention style – a challenge Modify the physical environment:         Avoid activities that include light touch. Provide inhibitory input such as deep pressure and proprioception        Avoid tight clothing. Wash clothing before child wears it.         Provide a sensory diet : Pressing child between two large pillows, rolling down an incline, rolling a child inside a blanket or sheet, and brushing body
Vestibular system : modulation •      Be fearful of movement, going up and down stairs, playground equipment •      Get nauseous or vomit after movement experiences such as riding in a car •      Avoids having feet off the ground or balance activities such as walking on curbs •      Dislike being moved backward in space even when trunk support is provided •      Move very carefully •      Avoids jumping off a step or other surfaces •      Appear fearful when lifted up in space or when moved in space	•      Respect the child’s fears. Do not force movements •      Give the child control over his/her movements in space •      Treat near the ground •      Provide activities that require proprioception •      You may start by providing the child with the opportunity to experience linear vertical input (sitting on a wide based platform swing placed near to the floor) •      Start with antero-posterior movement of the trunk before you move to lateral and rotational movements
Vestibular - Hyporesponse: •      Seek large amount of movement experiences such as spinning, rocking, and twirling •      Not get dizzy when other children do •      Have difficulty with balance and protective reaction •      Tend to lean on hands when performing table top activities •      Have difficulty with tasks that require maintaining a stable visual field •      Have difficulty with activities that require bilateral motor coordination such as riding a bicycle or tricycle	•      Provide opportunities for movement experiences •      Provide activities that promote extension against gravity and proximal joint stability in the neck and the shoulder girdle area. Examples include swinging in prone while propelling on the floor or by pulling a rope, working in prone on the mat, etc. •      Work on maintaining stable visual field while moving(e.g., swinging and hitting a target) •      Activities that promote bilateral motor coordination •      While on the swing, pull on rope or providing an equipment to bump on, to change direction, speed and tempo of the swing’s movements.

Other daily activities (For propriocepion and vestibular hypo) :

}  Try having your child do some activities such as reading, playing a game, or coloring, while lying on his stomach and propping himself on his elbows.

}  Encourage activities that require balance, such as cycle riding, bike riding, kicking and so on.

}   Include “bilateral” or two-sided activities, such as jumping rope, swimming, rowing, playing a musical instrument and so on.

}  Try activities that involve coordination of movement of the eyes, head and hands, such as target games, catching, throwing, ping pong, tennis, and so on.

For hyper responsiveness

}  Adding weight ( for example, wrist or ankle weights or a backpack filled with bags of beans or rice) can help a child feel more secured when climbing or moving

}  If your child is fearful when walking up stairs, try holding him at the hips and applying gentle pressure. This may help him to feel more secured than when holding his hands.

}  Allow increased time for your child to explore and attempt activities that seems scary

For motor planning:

}  Play games like “ follow the leader “ help child to be able to plan actions based on watching and copying your/peer actions.

}  Encourage games that involve simple verbal directions to plan actions such as “Simon says” to help a child to plan actions without visual cues.

}  Ask child to help in activities like cleaning and arranging rooms, arranging items, unpacking, packing, wrapping a gift etc.