Are clouds forming?Then it’s time to expose

the silver lining!

Winnie Dunn PhD OTR FAOTAWinnie Dunn PhD OTR FAOTAProfessor & ChairProfessor & Chair

Dept. of OT EducationDept. of OT EducationUniversity of KansasUniversity of Kansas

What are the cloudsmade of?

Changes in the way we provide serviceChanges in the way we provide service

Discontent about how we label childrenDiscontent about how we label children

Changes in the way we provide Changes in the way we provide serviceservice

Findings from studies in Autism[as reported in Baranek, 2002]

• We need to design educational programs that accommodate unique sensory processing patterns

• We need to make task/ environ modifications

• We need to employ systematic data collection to chart progress

• Traditional SI therapy is beneficial ANECTODALLY, but evidence does not substantiate effects

• Functional activities in daily routines within natural contexts increases generalization

Discontent about how we label childrenDiscontent about how we label children

Is this disorder for real?TIME magazine, Thursday, Nov. 29, 2007

Claudia Wallis

“Some kids just cant handle life’s sights, sounds and sensations, but experts are split over whether to recognize sensory processing disorder” p. 62

You and Your Quirky KidThe girl who wears her clothes inside out, the boy who loves plumbing. What parents and experts say about the children who just don't fit in.By Lorraine Ali | NEWSWEEKSep 17, 2007 Issue

“…there is something unexamined in our

thinking when we elevate the need for normalcy to a state of spiritual grace, and

live under a constant anxiety that we fail to

measure up to its demands…” p. 50

Lorraine Ali, Newsweek September 17, 2007

Harnessing the Power of ADD

Sophia Dembling, Delta Sky, december 2007

“Oftentimes you find people with ADD spending years trying to develop what they’re bad at instead of what they’re good at” [Ned Hollowell]

“…When it comes to a child with a disability, [professionals

& parents] can easily spend too much time on what the

child cannot do, …We can be so busy dealing with what is

absent that we ignore what is

right before our eyes. …what we need to make

visible is not darkness but light...” p.280

Exposing the silver lining!

Tapping our inner capacityTapping our inner capacity

Changes in the way we provide Changes in the way we provide serviceservice

Micro level: Micro level: the child, family & schoolthe child, family & school

• When practices are family centered, we achieve better family and child outcomes

• Ackland, 1997• Joyce & Showers 1995• Law, Darrah etal, 1998• Marchant & Young 2001

• When practices are family centered, we achieve better family and child outcomes

• Ackland, 1997• Joyce & Showers 1995• Law, Darrah etal, 1998• Marchant & Young 2001

FAMILY CENTERED CAREFAMILY CENTERED CARE

NATURAL ENVIRONMENT INTERVENTIONS

• Parent facilitated child

learning is equally or more

effective than practitioner

implemented interventions

• Gibbard, Coglan & MacDonald 2004

• Law, Garret & Nye, 2004

• McLean & Cripe 1997

CHILD PARTICIPATION

Children’s development is enhanced when they

interact and practice in settings which demand

use of skillsKelllegrew, 1998; Law etal, 1998; Roper & Dunst, 2003; Dunst, 2001,

2006

Discontent about how we label childrenDiscontent about how we label children

Peeking in onPeeking in onThe macro levelThe macro level

“If we examine ourselves and those around us—the husband who shuns picnics because he can’t stand the texture of grass… we have to admit that everyone, to some extent is odd.” p. 50By Lorraine Ali | NEWSWEEK: You & your Quirky KidSep 17, 2007 Issue

“…parents need to ask themselves, Is this making him unhappy or just making me unhappy? [Dr. Perri

Klass].” p. 50

By Lorraine Ali | NEWSWEEK: You & your Quirky KidSep 17, 2007 Issue

“Autism is less a disease to be hidden than a disability to be accommodated; it is

less a stigma, reflecting badly on her

family, than a variation of

human existence.” p.33

“…Can we make the world they’re going to grow up in sufficiently kind and welcoming to them and their quirks, and can we provide them with the basic skills they need to navigate in that world?.” p. 50

By Lorraine Ali | NEWSWEEK: You & your Quirky KidSep 17, 2007 Issue

From The LONDON Times newspaperOctober 20, 2007

Are you a sensory junkie or a nervous wreck?

How do you respond to bright lights, soft clothes, loud music and spicy food?

Juliet Rix investigates the psychology of sight, sound and smell

“Isabel has taught me that the unexpected,

even the beautiful, can emerge even from the

undesirable, …—no, not something “normal”, but a brilliant light or

an inner truth struggling to blossom.”

p. 35

“…at the end of the day when I

tuck her in, she’s not a case of

autism…. She’s simply my

daughter….” p. 35

Let’s consider an Let’s consider an example at the example at the MACRO level…MACRO level…

…is imbedded in Sensory Processing

…is imbedded in Sensory Processing

The experience of being HUMAN …The experience of being HUMAN …

“…I don’t know what a pear tastes like to you.”

“…sweet, juicy,

Soft on your tongue,

grainy---Like sugary sand that

dissolves in your mouth…

How’s that?…” [City of Angels, 1996]

How do you react to sounds?

SEEKERS…Make noises, e.g., hum, tap throughout the day

BYSTANDERS…Don’t really notice

sounds around them

AVOIDERS…Wear ear plugs to keep sounds away

SENSORS…Ask people to stop

making noises

How do you react to touch?

SEEKERS…Touch others when talking to them

BYSTANDERS…Bump into people

when walking

AVOIDERS…Keep their distance from others

SENSORS…Flinch when

touched unexpectedly

How do you react to movement?

SEEKERS…Choose intense sports & amusement park rides

BYSTANDERS…Don’t know how they got scrapes

and bruises

AVOIDERS…Prefer sedate activities

SENSORS…Want to be the driver on trips

How do you decorate?

SEEKERS…Have busy dense decorating schemes

BYSTANDERS…Have crooked wall

decorations & don’t notice

AVOIDERS…Decorate as little as possible

SENSORS…Select clean lines & uniform color

palates

What are your clothing choices?

SEEKERS…Want layers, textures & lots of accessories

BYSTANDERS…Are casual, &

sometimes mismatched

AVOIDERS…Have a few pieces used over & over

SENSORS…Use only specific brands and fabrics; sparse accessories

How do you prefer to dine?

SEEKERS…Prefer busy & entertainment venues

BYSTANDERS…Do best with buffet style or multi course

AVOIDERS…Prefer to eat at home, use carry out or delivery

SENSORS…Prefer off peak hours, low lighting, favorite venues

How do you organize you workspace?

SEEKERS…Have many projects available at one time

BYSTANDERS…Have casual

spaces that may appear

disorganized

AVOIDERS…Close doors, find isolated places, may telecommute

SENSORS…Clear surfaces each day; have

precise organization

How do you vacation?

SEEKERS…Create a busy, vigorous schedule

BYSTANDERS…Have no schedule & change plans easily

AVOIDERS…Repeat the same trip, select solitary venues

SENSORS…Create a precise

timeline of activities & don’t

deviate easily

Example of sensory processing pattern

Amt of trait        

Seeker              

Bystander              

Sensor              

Avoider              

Wears layers& accessories

Home décor isCasual and eclectic

Tidies up workspace at end of dayWhat and where to eat doesn’t Matter too much

They create excitement & change all around them

They create excitement & change all around them

SEEKERSalwayswant more

[high thresholds + active self regulation]

AVOIDERS want more of the same thing and nothing more

[low thresholds +

active self regulation]

[low thresholds +

active self regulation]

They create routines to keep life

peaceful & manageable

SENSORS keep track of everything SENSORS keep track of everything

They notice what is going on & have precise ideas about how to handle situations [low thresholds +

passive self regulation] [low thresholds +

passive self regulation]

They are easy going and can focus even in busy places

They are easy going and can focus even in busy places

BYSTANDERS don’t know what they are missing

BYSTANDERS don’t know what they are missing

[high thresholds + Passive self regulation]

[high thresholds + Passive self regulation]

What sensory pattern does What sensory pattern does this person have for this person have for

dressing?dressing?

What sensory pattern does What sensory pattern does this person have for this person have for dressing?dressing?

34% 34%14% 14% 2%2%

less than othersless than others more than othersmore than others

Same as othersSame as others

whole

Sensory Profile measures are based on the Bell Curve

- - -=

+ + +

This is the range of

typical performance

So, at the macro level, intervention

takes the form of

A change in the contextA change in the contextSo more people can So more people can

function successfullyfunction successfully

ISBN # 978 1 84310 871 9

Jessica Kingsley Publications

www.jkp.org

October 2007

ISBN # 978 1 84310 871 9

Jessica Kingsley Publicationswww.jkp.org

October 2007

Are you a sensory junkie or a nervous wreck?Juliet Rix investigates the psychology of sight, sound and smell

LONDONMaking sense Of your senses

By Claudia Wallis

Our sensory profile:Who we really are How we react to smells and sounds all but defines us By Heidi Dawley Oct 29, 2007

Eating and Dining

Let’s practice…..

Low

Registration

Sensation

Seeking

Sensory

Sensitivity

Sensation

Avoiding

What is the optimal dining experience??

The location for eating and dining

BYSTANDER

Places that provide interest and changes throughout the meal

SEEKER

Loud, active, busy places during peak hours

SENSOR

Favorite places and menus during off-peak hours

AVOIDER

Eat at home with a predictable menu

The foods we eatREGISTRATION

Contrasting flavors, textures, colors; in many serving dishes

SEEKING

Ethnic foods with Varied/ unusual spices

SENSITIVITY

Familiar menu items always selected

AVOIDING

Have a routine menu

LIVING SPACESLIVING SPACES

Features of the living spacesLOW REGISTRATIONUnusual floor plans with changes in flooring room to room

SENSORY SEEKING Open living spaces

SENSORY SENSITIVITYFloor plans with functions grouped together

SENSORY AVOIDING Self contained spaces in floor plan

Decorating your home

REGISTRATIONEclectic style with unusual arrangements

SEEKING Bright, contrasting color schemesUneven placement of windows, doorways

SENSITIVITYHomogeneous color palateFavorite piece of art on wall

AVOIDING Sparse with separate areas for being alone

A SEEKERAN AVOIDER

A BYSTANDER A SENSOR

e.g., how life is SENSATIONAL for…e.g., how life is SENSATIONAL for…

So, how can we use these ideas in

everyday life?

So, how can we use these ideas in

everyday life?

The older girl needs a lot of

sensory input…

The older girl needs a lot of

sensory input…

So what about getting dressed?So what about getting dressed?

This baby cannot stay alert to eat…This baby cannot stay alert to eat…

So how could we change the sensory environment to helpEating?

So how could we change the sensory environment to helpEating?

This man needs a quiet place…

…so what do we offer him for when his grandchildren are coming over?

“…Isabel hated things that vibrated. She

didn’t like pressure on her fingertips so much

that she refused to even try to learn to button…or tie… or hold a pen...” p.277-278

“…Isabel at first refused …; eventually she stuck with it [cello playing]. The sound and touch sensitivities didn’t go

away, but they lost their grip on

her...” p.277-278

“…in order to help people with autism, we don’t

always need to …pretend that they are not

different…. Rather, we need

to provide roles in our communities for people with autism, some of which they may in fact, be able to perform better

than anyone else...” p.291

Intervention must not be solely focused on fixing children’s behaviors.

Sometimes we need to create a context that is more supportive,

a strategy which acknowledges that the challenges children face do not reside within them,

but rather in the space between the children and their contexts…

The essence of INTERVENTION

The essence of INTERVENTION

so that differences are just a DIFFERENCE,

not a source of disorder, but rather what makes a person interesting, quirky, funny…HUMAN.

This is how we reduce judgment,

create resilience &

increase acceptance,

So, we return home.So, we return home.The clouds openThe clouds open

And reveal And reveal New possibilitiesNew possibilities