Wednesday, July 18, 2012

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.



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