Utilizing Sensory Integration Strategies
Transcript of Utilizing Sensory Integration Strategies
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Utilizing Sensory Integration StrategiesPromoting Healthy Self-Regulation and Caregiver-Child Bonding Throughout Early Development
Presented by Jacqueline Schafer-Clay, OTD, OTR/L, C-SIPT
Learning Objectives1. Examine self-regulation and caregiver-child bonding, how it typically develops, and how therapists can foster
improved self-regulation and bonding using sensory integration strategies.
2. Analyze sensory integration strategies that promote healthy self-regulation and caregiver-child bonding, encouraging caregiver and child to be together in emotionally healthy ways.
Disclosures• Guidelines exist whereby all speakers must disclose any relevant relationships. All relevant relationships are published
on the course page at www.summit-education.com.
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• You will be notified if a presentation relates to any product used for a purpose other than that for which it was approved by the U.S. Food and Drug Administration.
Jacqueline Schafer‐Clay, OTD, OTR/L, C‐SIPT
Relevant Financial RelationshipsJacqueline Schafer‐Clay is compensated by Summit as an Instructor. She is the Director of Clinical Education and Assistant Professor at Presbyterian College for which she receives a salary.
Relevant Nonfinancial RelationshipsJacqueline Schafer‐Clay is a member of the American Occupational Therapy Association (AOTA), South Carolina Occupational Therapy Association (SCOTA) and the Roster of Accreditation Evaluators (RAE).
UTILIZING SENSORY INTEGRATION STRATEGIES TO PROMOTE HEALTHY SELF‐REGULATION AND CAREGIVER BONDING THROUGHOUT EARLY
DEVELOPMENT.
Presenter:
Jacqueline Schafer‐Clay, OTD, OTR/L, C‐SIPT2
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Learning Objectives
Objective 1
Immediately learn techniques to improve your ability to foster self-regulation, decreased behavior, and improved parent-child bonding for improved session outcomes and home follow through.
Objective 2
Review proven sensory strategies and implementation of skills during a case study allowing for application to OT/PT/SLP best practice in the early intervention setting.
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Course ScheduleExamine Self‐regulation, sensory integration, and evidence‐based ways to foster it.
● Explore and define Self‐Regulation
o Sensory Integration thefoundation ofdevelopment
● Self‐regulation andcaregiver‐child bondrelationship
● Factors Impacting Self‐Regulation development
Sensory Integration strategies to promote healthy parent/caregiver ‐child relationships and improve self‐regulation
● A variety of evidence‐basedstrategies to promote self‐regulation
● Deep Pressure Strategies tosupport self‐regulation andcaregiver bonding
● Heavy work Strategies tosupport healthy self‐regulation and caregiverbonding
● Case study to Practice andgain discipline specificinsight to implementation
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What is Sensory
Integration?
● “Sensory integration is the
process by which we receive
information through our senses,
organize this information, and
use it to participate in everyday
activities.”
(as retrieved from:
https://pathways.org/topics‐of‐
development/7‐senses/)
Everyone who touches, tastes,
moves, feels, smells, sees, and
hears uses sensory integration
strategies.
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Neuro Development Review
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Infant: A baby is learning through touch, taste, smell, and as the visual system develops, sight.
Toddler: A toddler continues learning through the senses. Language develops and they begin to express likes and dislikes more clearly.
Child: Focused on learning in a variety of ways, powered by sensory feedback system. Early development impacts.
Sensory Integration: Foundation of Early Development
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Self Regulation
HEALTHY SELF‐REGULATION:
Self‐regulation is the conscious and unconscious processes that affect the ability for one to control responses (Bandy, T. and Moore, K. 2010).
Dr. Steven Stosny defines self regulation as “the ability to act in your long‐term best interest, consistent with your deepest values (Self regulation, October, 2010)
Layman terms: Self‐regulation is the ability to stop, think and make decisions beyond an emotional based response.
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Any Questions About Development or Definitions?
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Do Positive Caregiver Bonds Really Impact Self‐Regulation?
Research:
89% of infants and toddlers who feel secure and safe with their caregivers (primary and secondary) feel less stress and can express and control their emotions in healthy ways
compared to children who have fearful or anxious relationships with their caregivers…. Only 6% demonstrate some ability to control their emotions.
(Gunner & Cheatham, 2003; Gunner & Quevedo, 2006; Julian, et al., 2019; Sideroff, 2016; Veijalainen, et al., 2019)
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WHY IS HEALTHY
SELF‐REGULATION IMPORTANT?
Fundamentally important for a child’s ability to achieve:
‐homeostasis
‐school success
‐happiness
‐coping skills
frustration tolerance
And is critical for:
successful adaptation to the environment and sensory input.
(DeGangi, G., 2000; Golding, K., 2008; Schore, A., 1994)
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Recent Research:
Kalu, Menon, Quinn (2020) Youth who demonstrate regular externalized
behavior are documented as a high risk for later justice involvement, adult
crime, substance use, and violence. This is one of the strongest predictors of recidivism among juvenile justice
involved youth
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Recent Research:
Popham, et al., (2018) Self‐regulation intervention has resulted in
numerous benefits and success with improving the academic performance of children with emotional behavior
disorders.
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Self Regulation and Caregiver Bonding
Veijalainen, et al., (2019)
Good SR skills were related to persistent
coping strategies and not giving up in a
simulated situation. Weak SR skills related
more with uncertain or withdrawal coping
strategies, like giving up, or abandoning the
situation.
Self‐regulation skills have an important role
in guiding children with their use and
narration of suitable coping strategies on
overcoming the frustration effectively. The
concrete strategies would allow teachers to
work concretely with children in enhancing
their SR skills and coping strategies further.
Sideroff (2016)
High levels of early childhood stress
alter mechanisms of self‐regulation
and functioning. Stress caused by
disruption of normal mother‐child
bonding and attachment affects an
array of neural mechanisms.
Poor attachment with the primary
caregiver impairs endorphin brain
circuitry, making both reward and
self‐soothing more difficult.
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Importance of Self Regulation
Education
Liman & Tepeli (2019)
The effects of self‐regulation
skills program on self‐
regulation skills of six‐year‐
olds found that the
education program
significantly improved the
self regulation skills of the
children.
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Attendee PollHow often is your therapy session or progress derailed by behavior, or goals/objectives not met because child meltdowns happen frequently and s/he has difficulty moving on?
❏ Most or All Sessions❏ More often than I’d like to admit❏ Sometimes❏ Every now and then❏ Rarely
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WHAT IMPACTS DEVELOPMENT OF
HEALTHY SELF‐REGULATION?Self‐regulation is impacted by environmental factors in the
postnatal environment!
The most important environmental factor for healthy self regulation is:
POSITIVE CAREGIVER BONDS AND INTERACTION
(DeGangi, G., 2000; Golding, K., 2008; Vaughn, M., 2014)17
What Part Does Sensory Play?
The central nervous system (aka: sensory system) is the self‐regulation network.
Sensory strategies will help you:
★ build positive relationships★ provide interaction in fun easy ways★ will support child’s success and learning★ can support development of improved self‐regulation ★ helps children understand how to transition between states
with practice
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Questions?
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Who Needs Help ImprovingSelf‐Regulation?
1.Everyoneneeds improvement in this area!
1. Everyone needs positive relationships,
caregiver bonds, and social interaction.
2. When uncertain see #1
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What helps children have healthy self‐regulation?
1. Self‐regulation does not develop automatically…positive caregiver relationships
2.Positive caregiver relationships are essential especially for children who are struggling with self‐regulation
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The Mind is Driving Sensory and Self Regulation
Encourage creativity, problem solving, pretend play, & make‐believe
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Building Positive Caregiver RelationshipsTherapists are caregivers, too!
➢ Be involved, hold, hug, and talk to children on their level about their
interests.
○ Beware... sensory sensitive children may not want to be touched.
➢ Engage in turn taking activities.
➢ Teach children to wait (and/or work) for things they want.
➢ Help children engage in cooperative play with peers (sharing and taking
turns).
➢ Clear, consistent, and concrete age appropriate expectations.
➢ Don’t give in, unpredictable (child needs to practice)
➢ Use positive language and praise often (when warranted)23
Supporting Healthy Self‐Regulation
Be a Role Model and Parent
Educator
➢ Meet children where they are.
(look at the big picture and
give space or grace as
needed).
➢ Re‐assure a child he or she is
OK as needed
➢ Be responsive, respectful,
culturally sensitive, and caring
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Helping Children Learn Healthy Self‐Regulation Skills
BOND and build trusting relationships
interact with children in interesting positive
ways (according to child’s viewpoint)
Practice, Practice, Practice:
You practice giving self regulation
opportunities to children…..
So children have ample chance to practice
and improve self regulation skills.
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Attendee PollQuestion:
What Strategies have you attempted to improve self‐
regulation?
Answers:
❏ Suspended equipment
❏ tactile activities such as sand‐
box or rice bin
❏ movement or playground
activities
❏ Take a walk with child
❏ I use more behavior
modification strategies
❏ Reason and Logic
❏ Giving child what they want
❏ Something else
❏ I didn’t know what to try to
improve self regulation
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How Do I Find Time to Add Sensory to My Already Busy Day or Session?
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If You Think Your Schedule is Too Busy!Let’s Talk Tricks and Tactics...
● Ways to easily add to things you already do.
● Can use relationship building, play, and sensory all together.
● Can be fun and motivating for you and them.
● May start out as a lot of work but as it becomes part of your
regular routine it’s easy!
● Let kiddos help!! They want to and everyone benefits!
● Children need opportunities to practice self‐regulation (making
things easy and keeping them always entertained does not allow
for practice).
● When children are able to self‐regulate you will have more time
and satisfaction!
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Take a breath, Break it downand
Focus on two essential sensory (self‐regulation) strategies you can easily incorporate into daily
activities
Deep Pressure
and
Heavy Work29
Examples: strategies you can incorporate into your day
DEEP PRESSURE HEAVY WORK
● Massage (heavy hands)
● lotion rub (heavy hands)
● Big bear hugs
● Swaddling (older child
burrito roll)
● squeeze
● squish or steam roller
● Hopping or skipping
● Climb
● Carry a load
● 2 footed jump‐ups
● pushing a load
● Pulling
● Child/child pull and push
● Adult/child pull and push
● Me versus gravity
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Let’s Practice!
● Make sure you try both some Deep Pressure and Heavy
Work activities.
● Try to swaddle!!! No one is too big!
● Take notes and self analyze how some of these activities
impact your self regulation
● Experience….. We will come back together in 10 minutes to
discuss our experience and self reflection.
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Timer:
Online Timer: Timer
http://timer.onlineclock.net/
10 minutes
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Home Exercise Program Compliance
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Parent Education and HEPImproved Compliance: Work it into
Daily Activities
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Diaper Change Opportunities:
Deep Pressure:
• rub with lotion and a heavy hand.
• Massage• Squeeze hands and feet• Joint compression
You are already :‐ looking and engaging
Incorporate other good bonding strategies here also! (i.e.: smile and talk, sing, read while rubbing with lotion and looking at baby/child).
Heavy Work Opportunity:• Instead of moving
child through paces have child pull himself up after changing (can hold on to you for help).
• Gently push knees toward chest and have child try to push them straight
• Tug of war• Incorporate several
strategies together. 36
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Teach Caregiver to Incorporate into: Bath Time
Consider:
★ Is bath positive for child
★ water temp
★ make it fun (toys, games,
etc).
Adding Deep Pressure:★ Body Washing (what type of
cloth/scrubber)★ Hair washing (shampoo,
pressure, decrease discomfort)
★ Drying/Towel Swaddle
Adding Heavy Work:★ Climbing in and out of tub.★ Wringing out
washcloth/sponge★ Turning water off, opening
drain, etc.
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Incorporate into: Dressing
Adding Deep Pressure:➔ Child pushes feet into
shoes/boots➔ Compression clothes➔ Child pushes arms into
long sleeves➔ Child pushes legs into
tights, long pants
Adding Heavy Work:➔ Putting on sweatshirt,
winter coat, over sweater➔ carrying own or parent’s
backpack, bag➔ Knees to chest child
pushes them straight➔ fine muscles: putting hair
up (ponytail, braid, etc).
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Household chores ☺Psychosocial Benefits:
Helping with chores is GOOD for you and them!
For the Child:
‐teaches competence‐gives them a part‐builds confidence‐makes them feel important
For the Caregiver/Parent (&
even the therapist):
When they help it gives YOU opportunity to:‐praise for work well done‐teach life skills‐build a positive relationship ‐collaboration/cooperation‐have help
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Deep Pressure Opportunity: Chores
• While helping with chores: march, hop (2 feet together), skip or gallop.
• While you are busy doing chores have children do wall or chair push ups nearby.
• Clothes pins or chip clips.
• Whistle while you work.
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Heavy Work Opportunity: Household Chores
• Carry items for you (dishes, laundry, any cleanup task)—5‐10% of body weight.
• Help set or clean off table (add marching, walking backward etc. especially with lighter items)
• Pull heavy big baskets (toys, laundry, trash, recycle, etc.)
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Chair Push Up Demonstration
https://youtu.be/0p_1ArwHDhc
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Play
Play is the way children learn! It is the perfect opportunity to practice!! ‐turn taking‐social games‐cooperative play and sharing‐model and praise as appropriate
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Deep Pressure Opportunities in Play:
• Climb• Grasp with heavy hands• Jump• Peddle• Crawl (various surfaces)• Hop• Bounce• Squeeze• Blow (bubbles, raspberries)• Body against gravity!
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Heavy Work Opportunity: Play
• Pump legs and propel self on swing
• push a friend on a swing• Climb up• Crawl up• Bear walks or other animal
crawls• Older children Crab and crab
soccer excellent!• Pull a wagon• Push a full laundry basket on
carpet • Swimming or wading (water
with current +)• Monkey bars
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Case Study: Application
18 month old male, parents concerned with self limited diet, withdrawn and disconnected from others including parents (especially mom who is primary caregiver). Dad works full time and travels weekly for work.
Evaluation: Mom is disconnected during eval. Child was ridgid about play routines, and disruptions to his routine resulted in a meltdown frequently lasting over 30 minutes. Per mom’s report the only “normal food” he will eat are “pouches” and has refused to eat for more than 24 hours when mom refuses.
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CASE STUDY BRAINSTORM
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What might you try to help improve caregiver bond?
What Sensory strategies might help the child?
How would you go about parent education?
What might you Rx for HEP?
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Any Questions?
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