Sensory Presentation7 2009 3

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Linda Gilles-Zirbes, OTR/LLinda Gilles-Zirbes, OTR/L

Occupational TherapistOccupational Therapist

Palatine, ILPalatine, IL

The Sensory Systems, Processing and

Strategies

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The Sensory SystemsThe Sensory Systems

Work togetherWork together

Give us accurate picture of the world Give us accurate picture of the world and our place in itand our place in it

The brain uses sensory info in an The brain uses sensory info in an organized wayorganized way

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Sensory ProcessingSensory Processing

Is the receiving and perceiving of Is the receiving and perceiving of sensory infosensory info

Usually integration of sensory info is Usually integration of sensory info is done without effortdone without effort

Function of sensation is to aid in Function of sensation is to aid in perception, the control of movement, perception, the control of movement, and maintenance of arousaland maintenance of arousal

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Sensory ProcessingSensory Processing

Components of Sensory Components of Sensory ProcessingProcessing

1. Sensory modulation 1. Sensory modulation

2. Sensory discrimination2. Sensory discrimination

3. Praxis 3. Praxis

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Sensory Processing ProcessesSensory Processing Processes

1. Registration1. Registration

2. Orientation2. Orientation

3. Interpretation3. Interpretation

4. Organization of a response4. Organization of a response

5. Execution of a response5. Execution of a response

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Sensory Processing ProblemsSensory Processing Problems

Possible causes and theoriesPossible causes and theories::• Do not adequately receive or process Do not adequately receive or process

information from these sensory systems as information from these sensory systems as different wiringdifferent wiring

• Genetics: quirkiness within the family treeGenetics: quirkiness within the family tree• Prematurity: immature/ disorganized nervous Prematurity: immature/ disorganized nervous

systemsystem• Birth trauma, medical procedures, medically Birth trauma, medical procedures, medically

fragile all put one more at riskfragile all put one more at risk• Deprivation Deprivation • Problems coexisting with other conditionsProblems coexisting with other conditions

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The Sensory SystemsThe Sensory Systems1. Tactile System1. Tactile System

Largest and first system to developLargest and first system to develop Tactile receptors throughout the bodyTactile receptors throughout the body This is the primary map of ME This is the primary map of ME

(homunculus)(homunculus) Touch is important as an embryo and after Touch is important as an embryo and after

birthbirth Touch gives us info and puts the Touch gives us info and puts the

boundaries in MEboundaries in ME

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The Sensory SystemsThe Sensory Systems1. Tactile System cont.1. Tactile System cont.

Types of Touch:Types of Touch:

Light touchLight touch Pressure touchPressure touch VibrationVibration TemperatureTemperature Pain SensationsPain Sensations

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The Sensory SystemsThe Sensory Systems1. Tactile System cont.1. Tactile System cont.

Primary function of the tactile system Primary function of the tactile system is to help one feel comfortable with is to help one feel comfortable with self and environmentself and environment

DiscriminativeDiscriminative

ProtectiveProtective

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The Sensory SystemsThe Sensory Systems Tactile System Problems Tactile System Problems

More input More input Needed BehaviorsNeeded Behaviors

(passive under responsive (passive under responsive or active seekers)or active seekers)

Avoiding Avoiding BehaviorsBehaviors

(over responsive)(over responsive)

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The Sensory SystemsThe Sensory Systems2. Vestibular System2. Vestibular System

It is located within the inner ear and has It is located within the inner ear and has strong ties to the auditory and visual strong ties to the auditory and visual systemssystems

It is the primary organizer and modulator It is the primary organizer and modulator of sensory input for self regulationof sensory input for self regulation

System is needed for balance, postural System is needed for balance, postural stability, muscle tone, use vision, plan stability, muscle tone, use vision, plan actions, move, calm and regulate behavior actions, move, calm and regulate behavior

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The Sensory SystemsThe Sensory Systems2. Vestibular System cont.2. Vestibular System cont.

This input can either quiet, stimulate This input can either quiet, stimulate or organize one’s activity and or organize one’s activity and alertness levelalertness level

It is the strongest sensationIt is the strongest sensation

It puts the ME in my spaceIt puts the ME in my space

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The Sensory SystemsThe Sensory Systems2. Vestibular System cont.2. Vestibular System cont.

Functions of the vestibular system:Functions of the vestibular system:

ProtectiveProtective

DiscriminateDiscriminate

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The Sensory SystemsThe Sensory Systems Vestibular System Problems Vestibular System Problems

More input More input Needed Needed BehaviorsBehaviors

(passive under (passive under responsive or active responsive or active seekers)seekers)



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The Sensory SystemsThe Sensory Systems3. Proprioception System3. Proprioception System

Is the unconscious awareness of body Is the unconscious awareness of body position and important for postural stability, position and important for postural stability, motor planning and grading of movementsmotor planning and grading of movements

Receptors located in muscles, joints, Receptors located in muscles, joints, tendons, ligaments, and connective tissuetendons, ligaments, and connective tissue

Function of vestibular system and Function of vestibular system and proprioception system overlap as the prop. proprioception system overlap as the prop. receptors respond to movement and gravityreceptors respond to movement and gravity

Can not “overdose” on proprioceptive inputCan not “overdose” on proprioceptive input

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The Sensory SystemsThe Sensory Systems3. Proprioception System cont.3. Proprioception System cont.

Certain prop. senses help with brain Certain prop. senses help with brain regulated arousal states and many of us regulated arousal states and many of us use different strategies for self-regulationuse different strategies for self-regulation

Proprioception and self-stimulation/ self-Proprioception and self-stimulation/ self-injurious behaviorsinjurious behaviors

Prop. input can filter out other unpleasant Prop. input can filter out other unpleasant sensations sensations

Puts ME in the picture- usable body mapPuts ME in the picture- usable body map

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The Sensory SystemsThe Sensory Systems Proprioceptive System problems Proprioceptive System problems





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The Sensory SystemsThe Sensory Systems4. Auditory System4. Auditory System

Receptors are located in the ear and give Receptors are located in the ear and give us info about soundus info about sound

Has close connections with the vestibular Has close connections with the vestibular systemsystem

Auditory processing : how the brain and Auditory processing : how the brain and central nervous system recognize and central nervous system recognize and make sense of soundsmake sense of sounds

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The Sensory SystemsThe Sensory Systems Auditory System Problems Auditory System Problems





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The Sensory SystemsThe Sensory Systems5. Visual System5. Visual System

Sensory receptors located in the eye with Sensory receptors located in the eye with info sent to the brain to be perceived, info sent to the brain to be perceived, sorted and processedsorted and processed

Visual and vestibular connection Visual and vestibular connection

Visual system is important to the learning Visual system is important to the learning of new motor skills until it becomes of new motor skills until it becomes familiarfamiliar

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The Sensory SystemsThe Sensory Systems5. Visual System Problems5. Visual System Problems





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The Sensory SystemsThe Sensory Systems6. Olfactory System6. Olfactory System

Primitive system with receptors located in Primitive system with receptors located in the nose and give us our sense of smellthe nose and give us our sense of smell

Smells travel directly to the limbic system, Smells travel directly to the limbic system, the center of our emotions, memory, the center of our emotions, memory, pleasure, and learningpleasure, and learning

Smell and taste are intimately connectedSmell and taste are intimately connected

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The Sensory SystemsThe Sensory Systems6. Olfactory System Problems6. Olfactory System Problems





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The Sensory SystemsThe Sensory Systems7. Gustatory System7. Gustatory System

Receptors located in the mouth and Receptors located in the mouth and tongue are plentifultongue are plentiful

Tastes: sweet , salty , bitter, sourTastes: sweet , salty , bitter, sour

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The Sensory SystemsThe Sensory Systems7. Gustatory Problems7. Gustatory Problems





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A A littlelittle about Neurotransmitters/ about Neurotransmitters/ NeurochemicalsNeurochemicals

DopamineDopamine: Activation chemical: makes us : Activation chemical: makes us want to move, helps us feel focused, want to move, helps us feel focused, enables us to concentrate enables us to concentrate

• is the pleasure chemical, is the chemical is the pleasure chemical, is the chemical of the emotional brain centerof the emotional brain center

• pressure touch with TLC enhances pressure touch with TLC enhances dopamine the fastestdopamine the fastest

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A A littlelittle about Neurotransmitters/ about Neurotransmitters/ NeurochemicalsNeurochemicals

SerotoninSerotonin: this is the master modulator, : this is the master modulator, makes us feel that all is okay and we makes us feel that all is okay and we are safe/ contentare safe/ content

• responsible for working memory and for ME responsible for working memory and for ME in the picturein the picture

• gets depleted under stress, can go into gets depleted under stress, can go into shutdownshutdown

• proprioception/ joint input/ heavy work proprioception/ joint input/ heavy work enhances Serotonin which can enhance enhances Serotonin which can enhance DopamineDopamine

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A A littlelittle about Neurotransmitters/ about Neurotransmitters/ Neurochemicals cont.Neurochemicals cont.

Norepinephrine:Norepinephrine: chemical for selective chemical for selective attentionattention

• novelty triggers Norepinephrinenovelty triggers Norepinephrine• contributes to the activation of fight/ flight/ contributes to the activation of fight/ flight/

fright responsefright response• use proprioception/ joint compression/ heavy use proprioception/ joint compression/ heavy

work to enhance activation of Norepinephrinework to enhance activation of Norepinephrine

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Arousal levels and sensoryArousal levels and sensory

Modulation: brain regulation and activity Modulation: brain regulation and activity level via the balance between external level via the balance between external and internal sensory stimuliand internal sensory stimuli

the way we modulate input affects our the way we modulate input affects our arousal statearousal state

our arousal levels change throughout the our arousal levels change throughout the day, we try to keep an optimal arousal day, we try to keep an optimal arousal level using various strategieslevel using various strategies

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Arousal Levels and Sensory cont.Arousal Levels and Sensory cont.

Types of arousal levels:Types of arousal levels: • lowlow• optimal/ just rightoptimal/ just right• high: often respond to sensory stimuli with a high: often respond to sensory stimuli with a

strong response, frequently in fright/ flight/ strong response, frequently in fright/ flight/ fight response, may remove self to get away/ fight response, may remove self to get away/ may scream in fright with too much input may scream in fright with too much input

those that spend more time in high and low those that spend more time in high and low arousal maybe constantly seeking or avoiding arousal maybe constantly seeking or avoiding input to regulateinput to regulate

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Sensory Behaviors and Sensory Behaviors and Sensory StrategiesSensory Strategies

Behaviors we note with students often are proprioceptive: to Behaviors we note with students often are proprioceptive: to get ME in the picture? To get the chemistry needed?get ME in the picture? To get the chemistry needed?

sensory strategies will help with the chemistry sensory strategies will help with the chemistry (neurochemicals)(neurochemicals)

Hand flapping (proprioception): provide hand fidgets, wall/ Hand flapping (proprioception): provide hand fidgets, wall/

chair pushchair push --ups, weighted vest/ blanketups, weighted vest/ blanket

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Sensory Behaviors and Sensory Behaviors and Sensory Strategies cont.Sensory Strategies cont.

Head banging/ ear flicking (vestibular /proprioception/deep Head banging/ ear flicking (vestibular /proprioception/deep tactile/ rhythm): provide strong movement/ proprioception as tactile/ rhythm): provide strong movement/ proprioception as swinging, swimming, biking, use ball/ mini-tramp, chair/ wall swinging, swimming, biking, use ball/ mini-tramp, chair/ wall pushupspushups

Humming/ other vocalizations (proprioception/ vibration/ Humming/ other vocalizations (proprioception/ vibration/ auditory): provide mini-massager to mouth/ face/ ear, blow auditory): provide mini-massager to mouth/ face/ ear, blow toys, calming musictoys, calming music

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Excessive mouthing/ chewing on non-food items Excessive mouthing/ chewing on non-food items (proprioception/ tactile): chewy, crunchy-chewy foods, strong (proprioception/ tactile): chewy, crunchy-chewy foods, strong flavors of food, battery toothbrush/ massagerflavors of food, battery toothbrush/ massager

Masturbation (proprioception/ tactile deep pressure): ball, seat Masturbation (proprioception/ tactile deep pressure): ball, seat inserts, jumping and crashing, weighted vest/ beltinserts, jumping and crashing, weighted vest/ belt

Spinning self (vestibular/ visual): provide strong rotary Spinning self (vestibular/ visual): provide strong rotary movement on sit n spin, hold hands while person spinsmovement on sit n spin, hold hands while person spins

Smelling (gustatory/ olfactory): provide strong flavors as Smelling (gustatory/ olfactory): provide strong flavors as cinnamon/ lemon/ peppermintcinnamon/ lemon/ peppermint

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Complains about performing hygiene, clothing and food Complains about performing hygiene, clothing and food textures (tactile defensiveness): provide deep touch input the textures (tactile defensiveness): provide deep touch input the whole body as wrapped in blanket/ sheet, heavy work input, whole body as wrapped in blanket/ sheet, heavy work input, analyze clothing and food textures, social storiesanalyze clothing and food textures, social stories

Rocking –standing (proprioception, vestibular, rhythm): Rocking –standing (proprioception, vestibular, rhythm): appropriate rhythmical activities, seat inserts/ ball, movement appropriate rhythmical activities, seat inserts/ ball, movement breaksbreaks

Fecal smearing (vestibular, proprioception, tactile) very Fecal smearing (vestibular, proprioception, tactile) very primitive reaction to identify who/ where they are: heavy work, primitive reaction to identify who/ where they are: heavy work, movement, deep pressure activitiesmovement, deep pressure activities

Lunging (vestibular, proprioception): joint compression, heavy Lunging (vestibular, proprioception): joint compression, heavy work, movement activitieswork, movement activities

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Rocking in chair/ seat (vestibular/proprioception, rhythm): Rocking in chair/ seat (vestibular/proprioception, rhythm): provide movement breaks, sit on cushion/ ball, play/ sing provide movement breaks, sit on cushion/ ball, play/ sing rhythmical musicrhythmical music

Teeth grinding (proprioception, auditory, vibration): mini Teeth grinding (proprioception, auditory, vibration): mini massagers, battery toothbrush, blow toys, chewies, crunchy massagers, battery toothbrush, blow toys, chewies, crunchy and chewy foodsand chewy foods

Physical strategies for those that are more active/ difficulty Physical strategies for those that are more active/ difficulty sitting: cushion/ ball, varied positions as on stomach/ standing sitting: cushion/ ball, varied positions as on stomach/ standing (with marked off space), rocking chair, sit in small tent/ quiet (with marked off space), rocking chair, sit in small tent/ quiet areaarea

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For those distracted by noises/ difficulty with auditory For those distracted by noises/ difficulty with auditory processing: ear plugs/ headphones, simplify directions, use processing: ear plugs/ headphones, simplify directions, use gestures to reinforce verbal messages, visual assistsgestures to reinforce verbal messages, visual assists

Decrease distractions for those who are sensitive/ easily Decrease distractions for those who are sensitive/ easily distracted: minimize all objects around, store unnecessary distracted: minimize all objects around, store unnecessary items, turn lights on low, put work in hallwayitems, turn lights on low, put work in hallway

Attention getters for those who have difficulty attending: plan Attention getters for those who have difficulty attending: plan language activities after gross motor time, preferential seating, language activities after gross motor time, preferential seating, use proximity and touch to help focus, soft voice with use proximity and touch to help focus, soft voice with expression, open windows/ turn on fanexpression, open windows/ turn on fan

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Calming ActivitiesCalming Activities

For those that are over active:For those that are over active:• Visual: dim lights, unchanging visual stimuli, quiet Visual: dim lights, unchanging visual stimuli, quiet

corner/space, preferential seating looking away from corner/space, preferential seating looking away from doors/ windowsdoors/ windows

• Auditory: use soft voice/ slower speech, familiar, Auditory: use soft voice/ slower speech, familiar, rhythm sounds, 60 beats per minute, rain stickrhythm sounds, 60 beats per minute, rain stick

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Calming Activities cont.Calming Activities cont.

• Tactile: items that Tactile: items that are simple shapes, are simple shapes, smooth, warm, smooth, warm, familiar, soothing, familiar, soothing, wrap snugly within wrap snugly within blanket, neutral blanket, neutral warmth is relaxing, warmth is relaxing, being squished in a being squished in a mat, steamrollermat, steamroller

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• Proprioception: provide Proprioception: provide activities that have slow activities that have slow push-pull, slow stretch, push-pull, slow stretch, wall/ chair/ hand push-wall/ chair/ hand push-upsups

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• Vestibular: slow, rhythmical/ predictable Vestibular: slow, rhythmical/ predictable movement as swinging/ rocking/ swayingmovement as swinging/ rocking/ swaying

• Olfactory: relaxing scents as lavender and Olfactory: relaxing scents as lavender and vanillavanilla

• Gustatory/ Tactile: sweet tastes and sucking Gustatory/ Tactile: sweet tastes and sucking are also relaxingare also relaxing

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Alerting ActivitiesAlerting Activities

To wake up the system or provide one with what To wake up the system or provide one with what they seekthey seek

Always provide some type of organizing activity Always provide some type of organizing activity afterward (proprioception usually) so does not afterward (proprioception usually) so does not become over arousedbecome over aroused

Remember: Proprioception and heavy work are Remember: Proprioception and heavy work are the good modulators of sensory input the good modulators of sensory input

• Visual: bright lights, unexpected lights, bright colors, red-Visual: bright lights, unexpected lights, bright colors, red-yellow shadesyellow shades

• Auditory: music with erratic, fast beat, unexpected noisesAuditory: music with erratic, fast beat, unexpected noises

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Alerting Activities cont.Alerting Activities cont.

• Tactile: light touch, unexpected touch, rough textures, Tactile: light touch, unexpected touch, rough textures, intricate shapes, cold temperaturesintricate shapes, cold temperatures

• Proprioception: sudden stopping, jerky/ quick/ fast / Proprioception: sudden stopping, jerky/ quick/ fast / unexpected/ variable changeunexpected/ variable change

• Vestibular: head inverted, rapid/ jerky/ angular changing Vestibular: head inverted, rapid/ jerky/ angular changing directions movement: twirl, roll…directions movement: twirl, roll…

• Olfactory: arousing scents as peppermintOlfactory: arousing scents as peppermint

• Gustatory: use spicy / sour flavors and spices, crunchy / Gustatory: use spicy / sour flavors and spices, crunchy / chewy foodschewy foods

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Organizing ActivitiesOrganizing Activities

For a “just-right” arousal levelFor a “just-right” arousal level• Visual: natural lightingVisual: natural lighting

• Auditory: music with heavy drum rhythmAuditory: music with heavy drum rhythm

• Proprioception/ Tactile/ Gustatory: provide chewy foods Proprioception/ Tactile/ Gustatory: provide chewy foods (licorice, raisins, carrots, roll-ups, gum) (licorice, raisins, carrots, roll-ups, gum)

• Vestibular: Trampoline, jumping jacksVestibular: Trampoline, jumping jacks

• Respiration: blow whistles, blow art, kazoosRespiration: blow whistles, blow art, kazoos

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Classroom heavy work activities:Classroom heavy work activities:

- Carrying heavy objectsCarrying heavy objects- Pulling self using rope Pulling self using rope

when on scooterboardwhen on scooterboard- Pulling heavy crate, Pulling heavy crate,

bolsterbolster- Pushing weighted ball, Pushing weighted ball,

teacher in wheeled chairteacher in wheeled chair– Erasing boardsErasing boards– Using play dough/ clayUsing play dough/ clay– Constructive toysConstructive toys– Squeezy fidget toysSqueezy fidget toys– Hammer toysHammer toys

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Classroom heavy work activities:Classroom heavy work activities:

- Working on vertical surfacesWorking on vertical surfaces- Adding weights to chairs, boxes, etc. Adding weights to chairs, boxes, etc. - Rolling, crawling up inclinesRolling, crawling up inclines- Caterpillar tunnel made of lycraCaterpillar tunnel made of lycra- Body sox made of lycraBody sox made of lycra- StretchingStretching- Tug of war, rough housing and wrestling with Tug of war, rough housing and wrestling with

structurestructure- Lying on blanket, being swung, then crash into Lying on blanket, being swung, then crash into

pillowspillows- Movements as wheelbarrow walk, row, row your Movements as wheelbarrow walk, row, row your

boat, animal walks, crawlingboat, animal walks, crawling

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SummarySummary

Development of foundational skills needed for Development of foundational skills needed for learning is partially dependent upon the nervous learning is partially dependent upon the nervous system’s ability to process and integrate sensory system’s ability to process and integrate sensory information accuratelyinformation accurately

Sensory processing is related to arousalSensory processing is related to arousal Sensory behaviors need to be looked at first in Sensory behaviors need to be looked at first in

terms of regulation and modulationterms of regulation and modulation We all have our own sensory preferences and notWe all have our own sensory preferences and not Proprioception and heavy work are the big Proprioception and heavy work are the big

sensory modulators with activities that can be sensory modulators with activities that can be done throughout the daydone throughout the day

Decrease stress Decrease stress

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Sensory Presentation7 2009 3

Health & Medicine

Transcript of Sensory Presentation7 2009 3