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diagnosed conditions

Sensory Processing, Regulation and attachment from a sensory perspective

An Explanation of Sensory Processing Difficulties

Sensory Processing Difficulties are characterised by the inability to accurately process information coming to the brain from the senses. This results in inaccurate judgement of sensory information such as touch, sight, movement, balance, taste, smell and sound.
• Our experience of ourselves and the world is unique and we can all experience ‘hiccups’ in our sensory processing.
• A person can be under or responsive when processing information coming into the different sensory systems, and this can fluctuate across the day.
• This becomes a problem when it is persistent and interferes with daily life and learning.
• Three main areas of difficulty are:
o Turning messages into behaviour that match the intensity and duration of sensory input (tuning in or out, over or under reacting, or regulation)
o movement (planning or stabilising) difficulties (eg dyspraxia or postural problems)
o sensing similarities and differences between sensations.

Sensory Regulation
Our unconscious autonomic nervous system is constantly making minor adjustments to enable our body to match the demands of the environment around us. Eg: when we stand up our heart rate increases and blood pressure rises so that we don’t feint.
• Our autonomic nervous system is divided into
o the sympathetic (fight or flight/ anxiety/survival response), designed to speed up our bodies ready to cope with a perceived threat
o the parasympathic (feed and breed/relaxation response) designed to enable us to sleep, digest food and relax.

Although we can influence our unconscious nervous system by our thoughts ( eg thinking about a worry can trigger an anxiety attack for some, or remembering a holiday can make you relax), it responds largely on an unconscious level to sensory input.

• Our arousal or ‘alert state’ is governed by a balance between these two unconscious systems: if our sympathetic nervous system is triggered we become anxious or aggressive, if our parasympathetic nervous system is triggered we become lethargic.
• If totally overloaded , our parasympathetic nervous system can be triggered and we completely ’shut down’ as a survival behaviour.
• Ideally, we should spend most of our time with an even balance between the two. This balance is central to our emotional wellbeing and ability to learn (see Appendix II: Alert States).

Emotional Regulation and Attachment Behaviours

The sensory processing mechanisms, alarm system that triggers arousal levels, and emotional centres of the brain operate largely unconsciously, are closely linked, and influence each other greatly.
• In infancy we develop attachment behaviours to draw caregivers to us so that our physical and emotional needs can be met.

• Caregivers in turn respond to our signals for help and meet our needs through comforting and nurturing us primarily through touch, eye contact, movement and meeting our physical needs (hunger, thirst, sleep etc).

• Our sensory systems develop through these caring activities (eg bathing, feeding and play) and our caregivers provide the right balance between calming and alerting sensory stimulation.

• Through this we begin to develop our capability to regulate our sensory and emotional responses more independently and can separate from our caregivers for increasing lengths of time without undue distress.

Trauma in infancy can disrupt this process and set the alarm system to mistakenly interpret sensory and emotional events as dangerous and threatening to our survival.
• This can cause the child to over-respond emotionally (Reactive ‘Fight or Flight’) or shut down (Avoidant). These automatic survival behaviours can develop into patterns that interrupt the child’s ability to learn, play and relate to others.
• Supporting the child to use sensory strategies to regulate their emotional state can be a useful tool in changing these patterns over time.
• Learning to use regulating sensory strategies for themselves can help to change stress patterns and ‘reset’ their alarm system, helping them to feel calmer and ‘just right’ in themselves and begin to learn how to stay more emotionally regulated.
• From this position, children are more able to understand their own feelings and then other peoples- this is key for relating to others, developing play skills and learning.
• This approach:
o Uses environmental enrichment to support the child in finding the sensory input they need to feel regulated in their immediate environment at school and home
o Supports key caregivers and the child to link survival behaviours and sensory strategies that calm and organize, or feel ‘just right’.

Sensory Attachment Children’s Books: available from Aldertree Press.
o ‘The Scared Gang’ by Éadaoin Bhreathnach:
http://www.sensoryattachmentintervention.com/scared%20gang.aspx

For online information about sensory attachment interventions:

o http://www.sensoryattachmentintervention.com/Documents/Just%20Right%20State%20Programme%20Executive%20Summary.pdf

(with thanks to my very clever and brilliant colleague, Isabel Ball, for putting it so succinctly).

Developmental Delay

Developmental Delay is a diagnosis often given to a child with overall learning difficulties and problems such as low tone, cognitive, sensory and physical delay. Often these children do not fit criteria to be seen in the NHS by OT teams however this does not mean that Occupational Therapy is not a really important therapy for them.In my experience these children can make some of the best progress. Therapy Space offers 1:1 consultations with parents related to children of any age with developmental delay.

Often children with developmental delay miss essential milestones due to their physical, emotional and cognitive limitations so Therapy Space offers them the chance to progress through developmental stages which are vital for progress and learning. As Occupational Therapists we treat the child as a whole so we will work on developing head control, balance, rolling, crawling and general coordination. We also work on hand skills and development of play and cognition (thinking skills).

We have experience and knowledge about all the relevant stages children should go through. It is vital to go through basic stages otherwise primitive and postural reflexes stay retained instead of being integrated which can affect coordination throughout the child’s life.

Sensory integration therapy is a fantastic way to encourage children to play and develop skills in a safe nurturing environment. Almost all children with developmental delay have sensory processing difficulties which is exactly what an occupational Therapist can help with.

Services offered:
Initial telephone consultation free of charge.(up to 30 minutes)
Initial assessment to identify strengths and needs.
Regular Therapist: Parent:child sessions where play is used to develop skills based on sensory integration intervention.
Report writing optional.

Conditions frequently seen: Developmental Delay, Downs Syndrome, Cerebral Palsy, genetic conditions, ASD, Dypraxia, DCD, SPD

Recommended Book List

Book References and useful websites

Sensory processing disorder


List Price: £15.95
Price: £15.01
“The Out of Sync Child” by Carol Stock Kranowitz

This is a fantastic starter book when you are just getting to grips with sensory processing. It relates to young children mostly but is an excellent introduction. Written by a teacher who has input from OT it is insightful and brilliant and compares normal with dysfunctional sensory processing.





 


List Price: £15.95
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“The Out of Sync Child has Fun” by Carol Stock Kranowitz

This is a follow up book from the one above with loads of excellent ideas for home therapy ideas, it gives good descriptions of each of the sensory systems and checklists for parents. A really useful book. A therapy bible.





List Price: £14.22
Price: £13.91

“Sensory Integration and the Child” by A.Jean Ayre

This was written by the founder of the Theory of Sensory Integration and is invaluable to understand the basis of this amazing understanding of children with sensory processing problems. It is quite scientific so not for laymen but for therapists needing to understand more it is fantastic. wholly recommended.





List Price: £10.75
Price: £10.95

“Too loud, too bright, too fast, too tight- what to do if you are sensory defensive in an overstimulating world” by Sharon Heller

This book is fascinating when looking at the perspective of adults with sensory processing problems. They are able to describe how hard it is to function in daily life and how inhibiting it is when sensory problems persist and interfere.





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“The Sensory Sensitive Child” by Karen Smith & Karen Gouze

Wonderful and moving story related to a true story. Enlightening is one of the words to sum it up.





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“Understanding Sensory Dysfunction” by Polly Godwin Emmons & Liz McKendry Anderson

A small A5 book easy to read with lots of useful checklists and definitions. Brilliant as an introduction to sensory processing.





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“Living Sensationally” by Winnie Dunn

Written by the brilliant Winnie Dunn who designed the Sensory profile often used by therapists to identify problems. She relates how we all live sensationally and has various types of descriptors for different types of sensory processing such as seekers, avoiders and so on. very good to help understand from layman’s perspective.





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“Sensational Kids” by Dr Lucy Miller

One of the best books read yet about the subject with up to date terminology and diagnostic criteria. Extremely useful and lots of references for OTs and parents to use endlessly. A must buy in my opinion.




Dyspraxia


List Price: £9.95
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“Developmental Co-ordination Disorder” by Morven F Ball

Developmental Co-ordination Disorder (DCD) is a term used to describe children who have difficulty with movement and specific aspects of learning, and includes dyspraxia, Asperger Syndrome and associated conditions. This booklet seeks to answer commonly-asked questions about DCD and presents information to aid parents, carers and professionals in selecting the best options for their child; sometimes correcting the little things can lead to big results.





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“Dyspraxia: Developmental Co-ordination Disorder” by Dr Amanda Kirby

An excellent very readable book to start you off on your journey to understanding the condition.





 


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Price: £11.44
“Living with Dyspraxia: A Guide for Adults with Developmental Dyspraxia” by Biggs, Colley

An excellent guide for adults and lots of useful information about rights in education and employment.





 

 

Autistic Spectrum Disorder /Asperger’s Syndrome.


List Price: £13.95
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“Asperger Syndrome and Sensory Issues: Practical Solutions for Making Sense of the World” by Smith Myles, Cook, Miller

This is a wonderful introduction to sensory issues with Asperger’s Syndrome. It has many useful ideas and practical solution with examples in the back of the book, brilliant for home and classroom management and understanding the source or trigger of problem.





 


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“Asperger Syndrome and Difficult Moments: Practical Solutions for Tantrums, Rage and Meltdowns” by Smith Myles, Southwick

This book is a must for any parent or teacher of a child, adult with Asperger’s or ADHD as many of the strategies for both are similar. It gives practical solutions and encourages the adults to be aware of their own behaviours and how this can exacerbate emotional blowouts. It talks about rumbling behaviours and knowing what to look out for. In my opinion this is one of the best out there for anger management strategies.





 

 


List Price: £26.50
Price: £26.50
“Building Bridges Through Sensory Integration: Therapy for Children with Autism and Other Pervasive Developmental Disorders ” by Aquilla, Sutton and Yack

This is a brilliant book with loads of photocopiable sheets, checklists, therapy ideas and masses of information to help understand autism and how it affects individuals and why sensory behaviours occur.An excellent resource for schools and therapists.





 


List Price: £12.00
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“Martian in the Playground: Understanding the Schoolchild with Asperger’s Syndrome ” by Clare Sainsbury

This is an eexcellent book written by people with Asperger’s with anecdotal evidence about how it feels to have the syndrome when at school and growing up. A real eye opener, very moving to read.





 

ADHD and other neuro diverse conditions.

 


List Price: £9.99
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“The Explosive Child: A New Approach for Understanding and Parenting Easily Frustrated, Chronically Inflexible Children ” by Ross Greene

A wonderful introduction to the types of behaviour children with inflexible conditions such as ADHD and other neuro diverse conditions. Very useful to understand how to manage their behaviours and how it differs to typical parenting skills.





 

 


List Price: £16.24
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“Kids in the Syndrome Mix of ADHD, LD, Asperger’s, Tourette’s, Bipolar, and More!: The One Stop Guide for Parents, Teachers, and Other Professionals ” by by Martin L. Kutscher; Tony Attwood; Robert R. Wolff

This is a brilliant book giving examples of some all the neurodiverse conditions. It looks at more subtle symptoms that are not often appreciated by professionals especially relating to conditions like ADHD. A very good resource book. One of my favourites





 


List Price: £12.99
Price: £12.32
“How to Detect Developmental Delay and What to Do Next: Practical Interventions for Home and School” by Mary Mountstephen

An excellent book which looks at primitive reflexes and their effects on learning and the special education system. Lots of useful information in very readable language. Mary is a wonderful colleague whose work is invaluable.





 

Reactive Attachment Disorder

Reactive Attachment Disorder (RAD) arises from a failure to form normal attachments to primary caregivers in early childhood. Such a failure could result from severe early experiences of neglect, abuse, abrupt separation from caregivers between the ages of six months and three years, frequent change of caregivers, or a lack of caregiver responsiveness to a child’s communicative efforts.

Not all, or even a majority of such experiences, result in this disorder.

Attachment disorders can be treated using an innovative new type of working with children and their carers called Sensory Attachment Intervention “SAI”. I have had specialist training with the founder of this whole practice called Eadiaone Breathnach who is truly inspiring and has given me a different way of approaching difficulties.

I am able to offer Sensory attachment intervention for children and parents and the usual course would be anything from 6 weeks to 12 weeks. Working with the child from a sensory perspective is fascinating and can help address many difficult behaviours through sensory strategies applied at home.

Please call for more information if you are a parent, adoptive parent, foster parent and require support in this matter.

 

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Sensory Processing Disorder

Sensory processing disorder or SPD is a neurological disorder causing difficulties with taking in, processing and responding to sensory information about the environment and from within the own body (visual, auditory, tactile, olfaction, gustatory, vestibular and proprioception).

For those with SPD, sensory information may be sensed and perceived in a way that is different from most other people. Unlike blindness or deafness, sensory information can be received by people with SPD, the difference is that information is often registered, interpreted and processed differently by the brain. The result can be unusual ways of responding or behaving and finding things harder to do.

Difficulties may typically present as difficulties planning and organising, problems with doing the activities of everyday life (self care, work and leisure activities including work and play), and for some with extreme sensitivity to sensory input, sensory input may result in extreme avoidance of activities, agitation, distress, fear or confusion.

Difficulty taking in or interpreting this input can lead to devastating consequences in:

daily functioning
social and family relationships
behavioral challenges
regulating emotions
self-esteem
learning

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ADHD

Attention deficit hyperactivity disorder (ADHD) is a group of behavioural symptoms that include inattentiveness, hyperactivity and impulsiveness.

Attention deficit disorder (ADD) is a type of ADHD.

Common symptoms of ADHD include: a short attention span, restlessness, being easily distracted and constant fidgeting. Many people with ADHD also have additional problems, such as sleep disorders or learning difficulties. However, ADHD has no effect on intelligence.They often have sensory processing problems and modulation difficulties (hence behaviour can be out of control).

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Asperger Syndrome

Children with Asperger syndrome have milder symptoms that affect social interaction and behaviour. Their language development is usually unaffected, although they often have problems in certain areas of language. For example, understanding humour or figures of speech, such as ‘she’s got a chip on her shoulder’ or ‘it’s raining cats and dogs.’

Children with Asperger syndrome usually have above-average intelligence. Some children are skilled in fields requiring logic, memory and creativity, such as maths, computer science and music. (But only 1 in 200 children are exceptionally skilled, so-called ‘autistic savants.’)

Children with AS are often severely affected by sensory processing and this is often overlooked during typical health assessments. Behaviour therefore is a big problem for these children who fear change and are often oversensitive by nature.

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Autistic Spectrum Disorders

Autistic spectrum disorders (ASD) are a range of related developmental disorders that begin in childhood and persist throughout adulthood. ASD can cause a wide range of symptoms, which are grouped into three broad categories:

Problems and difficulties with social interaction such as a lack of understanding and awareness of other people’s emotions and feelings.

Impaired language and communication skills such as delayed language development and an inability to start conversations or take part in them properly.

Unusual patterns of thought and physical behaviour. This includes making repetitive physical movements, such as hand tapping or twisting. The child develops set routines of behaviour, which can upset the child if the routines are broken.

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Dyslexia

Dyslexia is a common type of learning difficulty that primarily affects the skills involved in the reading and spelling of words. Dyslexia should be recognised as a spectrum disorder, with symptoms ranging from very mild to very severe. In particular, people with dyslexia have difficulties with: phonological awareness, verbal memory, verbal processing speed.

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Dyspraxia

Dyspraxia, also known as DCD (developmental co-ordination disorder), is a disability that affects movement and co-ordination. It is thought to be caused by a disruption in the way messages from the brain are transmitted to the body.

Dyspraxia is characterised by difficulty in planning smooth, co-ordinated movements. This leads to:clumsiness, lack of co-ordination, problems with language, perception and thought. Symptoms are normally noticeable from an early age and often have difficulties with fine motor control with handwriting, fastenings and scissors causing problems.

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