Sensory Processing Concepts and Applications in...

Dunn’s (1997) Model of Sensory Processing

Responsiveness/Self-Regulation StrategiesResponsiveness/Self-Regulation Strategies

Thresholds/Reactivity Passive Active

HIGH

Registration Seeking

LOW

Sensitivity Avoiding

Notes:

Sensory Processing Concepts and Applications in Practice

Notes Pages

Copyright © 2009 by Winnie Dunn, PhD, OTR, FAOTA. Used with permission. 1

Comparison of Sensory Processing and Sensory Integration approaches using the Occupational Therapy Practice Framework (American Occupational Therapy Association

[AOTA], 2008)

Notes:


Notes Pages


Occupational Therapy Intervention Approaches

Notes:


Notes Pages


Explaining Sensory Processing Concepts to Others

Common “Sense” Key Points• Use regular words, no jargon.• Use [person’s, teacher’s, family’s, colleague’s] own words to link everyday life to

sensory processing knowledge.• Listen—really listen—to what they need.• Learn how to coach them toward finding solutions.

Coaching: Reflective QuestioningAwareness • What do you know about . . . ? • What have you tried? • What happened when you . . . ? • What supports were most helpful?

Analysis• How does that compare to what you did before? • What do you think will happen if you . . . ? • How is that consistent with your goals?

Alternatives• What else could you have done? • What would it take for you to be able to . . . ?• What might make it work better next time?

Action• What do you plan to do? • What supports do you need to take that step? • Where will you get the resources you need?

Creating Friendly Reports

Keep participation in the FOREFRONT.• Link sensory patterns with participation.• Do NOT write about every score!!!

– Report on patterns.– Emphasize links to participation:

○ Findings that support participation○ Findings that seem to interfere with participation.


Notes Pages


Assessment and Interpretation of Results

Identifying participation challenges:• Review the referral concern and record.• Interview client, family, and teacher.• Conduct skilled observations:

– Participation is successful.– Participation is challenging.

• Complete formal assessments:– Performance-based testing– Informant questionnaires.

NOTES:

Interpretation Strategies

• Keep participation in the FOREFRONT.• Link sensory patterns with participation.• Report about supports to participation.• Look for patterns in data:

– Apply concepts from Dunn’s (1997) Model of Sensory Processing – Consider which sensory systems support or interfere.– How do interviews, observations link with test data?

• Prioritize findings within the person’s life.

NOTES:


Notes Pages


Evidence-Based Intervention Planning From Baranek, 2002• Design educational programs that accommodate unique sensory processing patterns.• Make task and environmental modifications.• Use systematic data collection to chart progress.• Consider that traditional sensory integrative (SI) therapy is beneficial ANECTODALLY, but

evidence does not substantiate effects. • Increase generalization with functional activities in daily routines within natural contexts.

From Pollock, 2006• Refer to Evidence Brief: Keeping Current in Sensory Integration (www.canchild.ca/

Default.aspx?tabid=1237).• Some studies report positive changes in behavior; treatment efficacy is still unknown

because of limitations in designs.• Better designed studies do not show a difference in SI therapy.• SI therapy (classical) should be considered a trial.

From Knight, 1998, 2004; Showers & Joyce, 1996• Teachers are 4 times more likely to implement practices learned through partnerships than

in traditional in-service training• Implementation of strategies rates:

– From traditional in-services: 10%– From partnership approach: 85%

From Dunst, 2001; 2006; Dunst, Bruder, et al., 2001; Dunst, Trivette, & Hamby, 2006; Gibbard, Coglan, & MacDonald, 2004; Kellegrew, 1998; Law et al., 1998; Law, Garret, & Nye, 2004; McLean & Cripe, 1997; Roper & Dunst, 2003; Trivette, Dunst, & Hamby, 2004• Using children’s routines provides more varied opportunities for practice.• Using everyday activities has a positive impact on children’s development.• Parent-facilitated child learning is equally or more effective than therapist-implemented

interventions.– Must be active, intentional, purposeful, and contextual.– Must be interest-based, responsive interactions.

From Davies, 1995; Dempsey & Dunst, 2004; Dunst, Trivette, & Snyder, 2005; Law et al., 1998, 2004; Shelton & Stepanek, 1994; Trivette et al., 2004• Family-, person-, and school-centered care has a capacity-building effect.• Build capacity by teaching care provider how to interact with the child within natural learning

opportunities.• Capacity building:

– The therapist supports strengths and abilities.– The care provider recognizes, learns, and uses his or her abilities.– The therapist and care provider assume responsibility for working toward desired

outcomes.

From Baranek 2002; Dunst et al., 2000, 2001, 2002, 2004; Hanft & Pilkington, 2000


Notes Pages


• Providing theoretically sound interventions during daily life routines improves PARTICIPATION.

• Skill development develops isolated skills.• Sensory processing interventions need to be part of the natural context to support

generalization.

Summary of Evidence-Based StrategiesSummary of Evidence-Based Strategies

Here’s What to Do Here’s Why

Create partnerships with care providers.

To increase implementation fidelity and achieve better child outcomes

Provide person-centered care. To increase capacity of care providers and achieve children’s developmental outcomes

Imbed your expertise within children’s daily routines and natural contexts.

To provide more practice and foster generalization

Provide theoretically sound interventions.

To provide a structure for data collection and decision making

Notes:


Notes Pages


Applications to School

Sensory Profile School Companion

• Comparable information to Sensory Profile: – Quadrant Scores: SEEK, AVOID, SENSITIVITY, REGISTRATION– System Scores: Auditory, Visual, Touch, Movement, Behavior

• New information available: School Factor Scores

– School Factor 1: Degree to which a child needs someone else to manage or influence the actionso Teacher interacts to change the course of events with the childo External influenceso Combination of SEEK and REG [registration]

– School Factor 2: Level of child’s attention/ awareness of self and environmento Busy, engaged, alert, responsive, detail orientedo Combination of SEEK and SENS

– School Factor 3: Range of tolerance for what is going on in the environmento Hyper Awareness, rigidity, bothered, defiant o Combination of SENS and AVOID

– School Factor 4: Level of availability for learningo Removed, stoic, distant, disengaged, inactiveo Combination of AVOID and REG

[see next page for examples of items in each School Factor]

Notes:


Notes Pages


Examples of Items From the Sensory Profile School Companion (Dunn, 2006a)Examples of Items From the Sensory Profile School Companion (Dunn, 2006a)Examples of Items From the Sensory Profile School Companion (Dunn, 2006a)Examples of Items From the Sensory Profile School Companion (Dunn, 2006a)Examples of Items From the Sensory Profile School Companion (Dunn, 2006a)

School Factor 1Requires Teacher’s

Attention

School Factor 2Engaged in the

Learning Environment

School Factor 3Exacting About


School Factor 4Autonomous Within


Seeking • Hums, whistles, sings, or makes other noises throughout the day

• Touches people and objects to the point of irritating others

• Gets up and moves around more than other students

• Adds more details to drawing and coloring than other students

• Seems more curious than other students

• Watches other students when they move around the room

Sensitivity • Comments on small details in objects or pictures that others haven’t noticed

• Notices even small changes in the room or desk organization

• Is bothered by rules being broken

• Is distracted or has trouble functioning if there is a lot of noise in the area

• Is easily upset by minor injuries (e.g., bumps, scrapes, cuts)

• Can be described as overreactive or dramatic when compared to classmates or peers

Avoiding • Refuses to participate in activities that are messy (e.g., art projects; using glue or paint)

• Withdraws when there are changes in the environment or routine

• Perseverates to the point that he or she cannot move on (e.g., can’t shift gears)

• Withdraws self from activities

• Stands or sits at the side of the playground during recess

• Doesn’t express emotions (e.g., has a flat, unresponsive affect)


Notes Pages


Examples of Items From the Sensory Profile School Companion (Dunn, 2006a)Examples of Items From the Sensory Profile School Companion (Dunn, 2006a)Examples of Items From the Sensory Profile School Companion (Dunn, 2006a)Examples of Items From the Sensory Profile School Companion (Dunn, 2006a)Examples of Items From the Sensory Profile School Companion (Dunn, 2006a)

School Factor 1Requires Teacher’s

Attention

School Factor 2Engaged in the


School Factor 3Exacting About


School Factor 4Autonomous Within


Registration • Leaves items blank on a busy worksheet even when he or she knows the answers

• Rests head in hands on desk or table during class time and seatwork

• Doesn’t seem to notice when face and hands remain soiled

• Seems oblivious within an active environment (e.g., unaware of activity)

• Shows little emotion regardless of the situation

• Appears inactive (e.g., seems to lack energy)

Directions for the Future

Consider Other Points of View

• Is normalcy . . .– Over rated? – Under rated?– An artificial parameter?

• Are too many people being labeled with illnesses?

• Is our perspective about disability . . .– Too negative?– Too narrow?

• Does our perspective about intervention . . .– Need to be more universally focused?– Need to be reconsidered?


Notes Pages


Returning to Sensory Processing

. . . with new considerations.

Sensory patterns contribute to who we are.

Seeker:Creates

excitement and change

Bystander: Easygoing

and can maintain

Avoider:Creates

routines to manage the

Sensor: Notices

details and has precise

http://

Tell your stories on this Web site.

Dunn, W. (2008) Living sensationally: Understanding your senses.

London: Jessica Kingsley Publishers


Notes Pages


We can use our wisdom to help the public understand themselves and those around them. Living Sensationally is one example of a vehicle for communicating with others about what we know.

http://livingsensationally.blogspot.com/

http://livingsensationally.blogspot.com/

Image reproduced with the permission of Jessica Kingsley Publishers.


Notes Pages


Sensory Processing Concepts and Applications in...

Documents

Transcript of Sensory Processing Concepts and Applications in...