In Service for Teachers on "Is it Sensory or Behavior"

Title:  “ Using common senses to help solve learning and behavior problems”

Presenters:  Corinne Presley, and Diane Gaffney, MBA, OTR/L, FAOTA

Description:  More and more school-aged children have learning and behavior problems. Teachers around the country are learning to add structured sensory input as an instructional technique to help counter the problem…and it can be fun.   You will go home with tools you can use and maybe the door prize!   (3hr participative session)

Instructional Method:  3hr session with break.  Lecture and participation with participant opportunity to experience and use various sensory tools.

Learning Objectives:

1. Participants will be able to describe basic sensations and how they impact academic performance.
2. Participants will be able to identify classroom behaviors that point to sensory processing problems and assess them using a worksheet.
3. Participants will be able to choose several sensory tools/techniques appropriate to the classroom and use them to increase student ability to focus and perform.

Course Outline:

15min               Introduction

30 min              Discussion of sensory vs behavior

30 min              Discussion of sensations, sensory processing, and related classroom behaviors (visual, auditory, olfactory, gustatory, touch), introduction to tools/techniques and a small group experiential task

15 min              Break

45 min.             Discussion of sensory processing problem and related classroom behaviors

                        (vestibular,  proprioceptive), instruction to tools/techniques and a experiential component

30 min              Assessing behaviors

15min.              Conclusion and questions

 SENSORY PROCESSING AND BEHAVIORAL GLOSSARY

Sensory Processing:  Sensory processing is how the brain takes in, analyzes and responds to sensory input from any of the senses.  We receive information from sense receptors in our skin, ears, neck, head, joints, muscles, tendons and ligaments as well as from our eyes, ears and mouth.  Problems with sensory processing interfere with our ability to learn, our social skills, our emotional responses, and our ability to move our bodies in a way that is coordinated and functional.

Sensory Integration:  The ability of the brain to combine sensory information with memories and other knowledge stored there and use it (respond) in a functional way.

Sensory Registration:  The ability of the brain to respond or attend to sensory input in their environment.

Sensory Modulation:  The ability to regulate, organize and prioritize incoming sensory information.  Some people over-respond or under-respond to sensory information.

Over-responsive (hypersensititive):  The person misinterprets normal sensory input as life-threatening requiring them to become immobilized by fear, run or defend themselves.  They avoid situations or activities that are viewed as threatening and/or may rely on routines and predictable activities to keep anxiety in control.  They react negatively to sensations that most people would barely notice and have difficulty with change.

Under-responsive (hyposensitive): The brain perceives sensory input much less intensely than others.  They will actively seek out or obtain needed sensory input and are referred to as ‘sensory seekers’.  (i.e. touches everything, always moving, may often bump into object or others, may not notice when they injure themselves or others, doesn’t pay attention to instructions, etc.)

Sensory Defensiveness:  Avoidance of specific types of sensations.  (i.e. touch, pressure, textures, temperatures, tastes, smells, sounds, etc.)

Vision:  tells us what is in the environment around us.  It is closely linked with the vestibular system to give us information as to where our body is in space and in relation to other people or objects.  It is also closely linked with memory and communication.

Auditory(hearing):  tells us what sounds are around us and what they mean.  It is an important protective system as well as a primary part of communication.  Vision, hearing and speech are closely linked.

Olfactory (smell):  tells us what odors are present and is closely linked with our ability to taste.

Oral Motor/Gustatory (taste):  tells us what shape, texture and consistency items are in our mouth as well as how they taste. 

Touch:  tells us where we have been touched and how much pressure was felt.  It registers pain and temperature and helps us to realize the shape of an object that we are touching or that is touching us without using our eyes.  Some children may seem insensitive to touch and may seek stronger input and others may be oversensitive to touch and respond adversely or avoid touch.  Our mouth is very sensitive to touch.  Touch receptors are located in our skin, but also respond to proprioceptive and other types of input.

Proprioception:  is the mechanism by which we recognize and control the movement and position of our joints and body in space.  It helps us to know the rate and timing of our movements, how much force we are using with each movement or touch, and it helps us to realize where our bodies are in relationship to other objects.  This information, combined with information from our vestibular system, helps modulate muscle tone throughout the entire body and helps us develop motor planning skills.  The proprioiceptive system gets its information through receptors in our joints, tendons and muscles.  It is also the most effective system in helping to calm and organize our brain, including our emotions and physiologic responses.

Vestibular:  is how we process movement and its effects on our posture, balance, eye movements, and motor planning.  Because of its effect on our muscles, it can impact our diaphragm and thus speech.  If our vestibular system is under or over registering information, it can impact behaviors related to movement or changes in movement.  The vestibular system is located in the inner ear.  A history of ear infections, tubes or allergies often lead to a poorly functioning vestibular system.  The vestibular system is also closely related to vision.

Behavior:  Any action or response an individual makes.  A behavior may be positive or negative. 

Willful Behavior:  An individual’s willful response to internal and external stimuli based on past actions that brought a perceived benefit.  A conscious decision or choice to act in a particular way that is within the individual’s control.

Learned Behavior:  An individual’s behavior, action, or coping strategy, based on past experience but not based on a conscious decision or choice.   Those followed by success or a reward are quickly learned and most frequently repeated and considered ‘established’.  Once a behavior is established, it may appear willful, but often the individual acts without conscious awareness.

Reinforce:  Provide reason to repeat or stop an action/behavior.

Reinforcement/Reinforcer:  Consequence of an action.

Positive:  A reward or something the individual seeks.  (i.e. cookie, attention, preferred activity, etc.)

Negative:  Although perceived as undesirable by most, it may give an individual something they seek.  (i.e. punishment, scolding, attention, time out, etc.) and may actually increase a behavior.

Ignore:  Avoiding ANY response (includes verbal interaction, facial gestures, touch, display of emotion or anger, etc.) to an action.  (If safety is an issue, first ensure safety with as little response as possible, then ignore.)

Attention:  Looking at, touching, speaking to an individual.  Attention is one of the strongest types of reinforcers for children.  It doesn’t matter if it is positive or negative in nature.

Intermittent: Reinforcement given at irregular or unexpected intervals.  This is the strongest type of reinforcer and results in quickly established behaviors that are difficult to eliminate.

Differential: Type and intensity of reinforcer/reinforcement varies based on quality of performance of desired on undesired action/behavior.

Prompt:   Provid assistance or cue to an individual in order to help them accomplish or stop a task or action.  Prompts may be visual (picture, First/Then, redline timer, picture schedule, watching other students), demonstrated (someone performs required task or action first, then individual is expected to perform, watching other students), gestural (pointing, sign language), auditory (command, verbal cue, timer), written (written instructions, or single words, schedule), kinesthetic (standing up, sitting down, getting books out, standing in line).

Extinquish a behavior:  Decrease the frequency or intensity of a behavior or coping strategy to either eliminate it or bring it to an acceptable level.  Undesirable behaviors will usually get worse initially as individual tests consistency of follow through.

Chaos Theory:  Chaos is a form of order disguised as disorder (Coffee 1988).  This suggests that even in cases of extreme disorder, what appears to be chaos actually has an underlying pattern or order (Royeen 2003).   Individuals behave for specific reasons, but are complex, changing beings.  A behavior may arise for one purpose, and then be repeated for a different purpose or a learned result.

This theory states that Chaotic systems have five key underlying assumptions:

1. Interaction between and among variables is nonlinear – All inputs (internal, external) may impact behavior variably depending on the situation.
2. Variables affect one another and are interdependent – All things are interrelated in some manner, but not in a linear (straight line) relationship.
3. Chaotic systems exist in states of flux or turbulence, not in equilibrium – When forces inside the body are equal to forces outside the body, chaos is never seen, but when internal and external forces are unequal, behavioral problems arise.
4. Chaotic systems are self-guided, self-organizing, not hierarchical, and demonstrate emergent behavior – Behaviors arise from a need, whether internal or external, and are the individual’s attempt to organize themselves and their world in order to function.
5. Chaotic systems possess an underlying order – In spite of the apparent disorder, there is an underlying order to what we see.  If we know or understand the system that explains it.

KEY SENSORY CONCEPTS:    Based on neuro-physiological and learning research

Concept #1:  Movement increases vocalization.  

(Use of a fidget toy while stationary helps decrease vocalizations and increase quiet)

Concept #2:  Never, never, ever take recess away UNLESS there is danger.

            (Recess provides opportunities for proprioceptive and vestibular input and helps maintain control)

Concept #3:   Movement can increase attention.

            (Movement ‘wakes’ up senses so take in more information)

Concept #4:  Sensory is FUN.

            (A child’s work is to play and to learn.  Most learn more when it is seen as fun.)

Concept #5:  Don’t make people wrong.

            (Validate their reality and experience rather than imposing yours)

Concept #6:  Sensory is non-judgemental.

            (Performance is individual – not right or wrong)

Concept #7:  Results of vestibular (movement) activities usually last 4-8 hours.

            (Use movement activities before deskwork – start the day, class, lesson, that way, it pays off)

Concept #8:  Results of pressure touch (proprioceptive) strategies usually last 2-6 hours.

            (Unlikely to cause any problems, use frequently during day)

Concept #9:  Sensory tools/strategies are for “now”, NOT as rewards for ‘good’ behavior.

            (Learn to use at the right time/place.  Prevent instead of resonding -provide BEFORE problem)

Concept #10:  Fast movements tend to be alerting.  Slow, rhythmic movements tend to be calming.

Concept #11:  Extension (stretches) tends to be alerting.  Flexion (bending) tends to be calming.

Concept #12:  Linear movement tends to be calming (up and down, forward and back, side to side). 

                         Rotation tends to be alerting (spinning, twisting, turning)

Concept #13:  If a sensory tool is helpful, it is used.  If it becomes a distraction, they don’t need it.

Concept #14:  A classroom that plans for sensory activities is an effective learning classroom.

                        Brain power spaces: learning, academics, computers, manipulatives

                        Kid power space:  safe space for movement, jumping, rolling, spinning, bouncing

Quiet space : calming, hide out

Sensory inputs are rarely perceived or used in isolation.  Normally, we use them in combination with others.  The following gives examples, but examples may actually include more than one type of sensory input.

VISUAL

Everyone reacts to visual stimuli differently due to how their eyes function and how their brain perceives what is seen.   Any individual with vision deficits (wears glasses/contacts, squints, tips head, frequent headaches, complaints of blurred or fuzzy vision) may have to work harder to register, make sense of and use visual inputs.

What does that mean in a classroom?

1. Individual may be irritable, distractible, not follow instructions, have unexpected bursts of anger, avoid participating in activities, misunderstand instructions on board or written.
2. Flickering lights, bright or low level lights may increase problem for some individuals even when most people don’t notice a problem.
3. Individuals may have difficulty seeing the important visual information on a page, board, or wall with many different visuals.   For some this results in frustration, anger, or withdrawal.
4. USE a SIMPLE and easily read SCHEDULE placed where there is little other things to look at.  BE SURE TO CHANGE the schedule when special activities occur.  Schedules give individuals the opportunity to plan their day, prepare for change, and know how long to expect an activity to last.
5. IF an individual is having difficulty reading, try limiting their vision to a singe word, phrase or line using a cutout piece of construction paper, ruler, or other tool.
6. Communicate with parents if child appears to be having visual problems – may need an exam.

AUDITORY

Everyone reacts to sounds differently due to how their ears function and how their brain perceives what is heard.  A history of ear infections, allergies or tubes may result in reduced or distorted hearing and cause the individual to have to work harder to register, make sense of and use auditory inputs.

What does that mean in a classroom?

1. Individual may appear to be ignoring instructions, not listening, or being distractible.
2. Background noise such as fans, hallway noises, humming equipment or lights may decrease the ability to isolate specific sounds such as instructions or teaching for some individuals.  This may be true even though most do not perceive a problem.
3. SIMPLIFY VERBAL INSTRUCTIONS.  Avoid multiple words when a few will do.  Cue the class that instructions are coming.   Look directly at the individual.
4. Experiment to see if a different position in the room makes it easier for the individual to hear and pay attention.  (away from the A/C, computer or fish tank)
5. Communicate with parents if child appears to be having hearing problems – may need an exam.

GUSTATORY

‘Picky’ eaters often have taste, temperature, or texture issues with foods that most enjoy.

What does that mean in a classroom?

1. Have class list foods they like and dislike.   Observe their choices.  Look for patterns such as like crunchy/chewy, dislike slippery/soft.
2. During planned food activities in class, offer choices that cover a variety of textures, tastes, temperatures.
3. Do not force individual to eat foods they dislike.  Discuss with parents.  Child may need assessment and recommendations for intervention by OT or SLP.

ORAL MOTOR

Many children may not have fully developed their oral motor skills.  They may have weak lips, cheeks, tongue or jaw movements.  They may have difficulty using a straw, cup, or taking food from a spoon or fork.  They may have difficulty chewing, moving food within their mouth or swallowing.  These problems may be more obvious with specific types of texture, taste or temperature foods.

What does that mean in a classroom?

1. Communicate with parents if child appears to be having problems – may need an exam or referral to OT or SLP for an evaluation.
2. Observe what works or doesn’t work for the child and encourage what works.
3. Difficulty with oral motor control is common in the lower grades, but needs attention.  In the upper grades, it is an indication of other problems that require intervention.

TOUCH (TACTILE) 

We all react differently to touch, textures, temperatures based on our past experiences and how our brain perceives the stimuli.  Many individuals are either over-responsive (ticklish, doesn’t like to be touched) or under-responsive (constantly touching things, does everything hard) to touch.  Light touch tends to be more irritating than firm touch.  Some individuals react negatively to specific types of touch, textures or temperatures.  Extreme behaviors indicating potential for harm to self or others and the need for immediate evaluation and intervention include hitting, throwing, biting or chewing on fingers, hands, objects or others.

What does that mean in a classroom?

1.      Have class try touching a variety of objects with different textures, temperatures and weights.  Have them check the items they like, dislike, or to which they have no strong response.

2.      Give the class choices of what they will use or how they will use it whenever possible.

3.      Allow individuals to try new or more difficult tactile sensations at their own speed.  Do not force.  Use textures that are less intense, but similar if acceptable to child.

4.      If you observe a very strong reaction (positive or negative) to a specific type of touch, texture or temperature, this may indicate a problem requiring intervention.  Consult briefly with OT who will suggest things for you to try.

PROPRIOCEPTION (heavy work)

We all use proprioception when upset – we wrap our arms around our abdomen, fist our hands, hit something, stomp our feet or hug someone.  Some individuals need more proprioceptive input than others in order to know where they are in space, how hard they are holding something, or to keep themselves calm or alert.  Bumping, hitting, biting others indicates need for evaluation.This is an easy type of sensory input to give in a school situation and is very effective to enhance learning and decrease behaviors.

What does that mean in a classroom?

1. Use ‘heavy work’ activities (using joints and muscles) before or during difficult academic tasks.
2. Fidget toys, ball chairs, wall push ups, chair push ups, resistive bands for feet/legs all can be used with very little distraction to class.  IF they ARE a distraction, they are either the wrong sensory tool for that child, OR are being used incorrectly.
3. Combine ‘heavy work’ activities with academics.  For example, a student must stand and lean on their desks while reading a sentence or answering a question, or create an academic obstacle course where after completing the physical activity at each station, an academic task must be performed.
4. If the class is becoming restless or attention is decreasing, try a simple movement activity such as standing up, clapping hands, touching their toes, or switching desks
5. Recess and PE are VERY important enhancements to learning IF child is required to be active.  For those with difficulty moving themselves, have classmates help…a good option for those children needing more proprioceptive input.

VESTIBULAR (movement)

We all use movement to help us wake up and pay attention.  Some of us use it to calm ourselves and help us to sit still.  Rocking, swinging a leg, tapping a pencil, walking to the restroom are all examples.

What does that mean in a classroom?

1. Be alert to actions of the children in your classroom.  Provide acceptable opportunities for movement soon enough and you will prevent many problematic behaviors.
2. Include movement before and during academic tasks and activities.
3. Because the vestibular system is located in the inner ear, any change of position of the head provides direct stimuli.  Bending, turning, leaning, jumping, swinging, rocking, etc. all work.
4. Encourage playground activities including use of swing, slide, running, rolling, ball play, bending to locate 4-leaf clover or pretty rock, etc.

BEHAVIORS

1. Never assume the behavior is willful. 
2. Use the behavior worksheet to determine possible sensory or other causes.
3. Try providing sensory or other option consistently
4. Monitor results and modify approach based IF needed
5. IF approaches are not working, request consult from psychologist (behavior plans) or OT (sensory issues.

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