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SEN/HC/1107t005edo
                               CONTENTS


1.      Introduction

2.      What is Sensory Integration?

3.      Indicators of Sensory Intervention Difficulties including the
        Referral Route

4.      The Role of the Occupational Therapist

5.      The Role of the Educational Psychologist

6.      SENCo and School Role

7.      Whole School Approach

8.      Classroom Strategies

9.      Specific Strategies

10.     Sensory Integration and the Environment

11.     Partnership with Parents

12.     Child's View

13.     Parents’ View

14.     Useful Books

15.     Useful Websites

16.     Glossary




SEN/HC/1107t005edo
SENSORY INTEGRATION


INTRODUCTION


Somerset Local Authority recognises the impact of Sensory Integration
difficulties on learning. The Local Authority is committed to supporting
schools, children and young people and their parents/carers through
multi-professional and multi-agency intervention. Increased knowledge of
Sensory Integration from medical professionals enables those working in
Education and Social Care to further support meeting the needs of
children and young people with a range of learning difficulties.

A multi-professional and multi-agency working party was set up in the
Autumn Term 06 to develop a guidance pack for those professionals
working with children and young people with these needs.

Members of the Working Party

Chair      -    Rosemary Latham, SpLLD Team
           -    Kerry Laing, Senior Occupational Therapist
           -    Peter Harnett, Autism Service Manager
           -    Ali Jary, Educational Psychologist
           -    Eileen McHale, Advisory Teacher Autism Service
           -    Karen Bass, SENCO, Knights Templar/Parent
           -    Hilary Cankett, Specialist Intervention Services Manager

This guidance should be read in conjunction with information and advice
related to Developmental Co-ordination Disorder/Dyspraxia, Autistic
Spectrum Disorder, Cerebral Palsy.

Significant Sensory Integration difficulties must be diagnosed by a
medical professional (Paediatrician, Occupational Therapist, Speech &
Language Therapist, Physiotherapist, all of whom will have had
experience or additional training in this field) and the programmes
recommended must be overseen by one of the above.

This guidance document provides up-to-date information on the nature of
Sensory Integration difficulties , the impact on the lives of children /
young people and the creation of the appropriate learning environment.




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WHAT IS SENSORY INTEGRATION?



       Sensory Integration is the ability of the brain to organise
        information received from the senses so an appropriate response is
        made. We all learn about ourselves through our bodily senses. As
        well as the five senses of touch, taste, smell, sight and sound, the
        body also senses movement, force of gravity and body position
        through the muscles and joints. This is referred to as
        proprioception – the ability to sense one‟s position in relation to the
        space around one.
        The body also senses where the head is in relation to gravity. This
        keeps us upright and balanced. This is known as the vestibular
        sense. These senses give us information about the physical
        condition of our body and the environment around us.

       The brain must organise all of these sensations if we are to move,
        learn and behave normally. This is known as Sensory Integration.
        We all depend on Sensory Integration in order to carry out daily
        tasks in work, play and self-care. It also provides a crucial
        foundation for later, more complex learning and behaviour.

       Sensory Integration takes place in the central nervous system
        where complex interactions such as co-ordination, attention,
        arousal levels, autonomic functioning, emotions, memory and
        higher level cognitive functions are carried out.

       Sensory Integration takes information through the senses, puts it
        together with prior knowledge, information and memories stored in
        the brain to make meaningful responses.




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Development of sensory integrative functions

        Sensory integrative functions develop in a natural order and every
         child follows the same basic pattern. The child uses each activity to
         develop “building blocks” that become the basis for more complex
         development
        Visual perception, emotional growth, academic learning and
         behaviour are all dependent upon the sensory motor foundation.

Ayres’ Model of Sensory Integrative Development


THE SENSES                           INTEGRATION OF THEIR INPUTS                             END PRODUCTS



Auditory (hearing)                                                           speech
                                                                             Language
Vestibular (gravity
And movement)          eye movements                                                             concentration
                       Posture                  body percept                                     organisation
                       Balance                  co-ordination of 2 sides                         self-esteem
                       muscle tone              of body                      hand-eye            self-control
                       gravitational security   motor planning               co-ordination       self-confidence
                                                                                                 academic
Proprioceptive                                                                                   learning ability
(muscles and joints)                            activity level             visual perception
                                                attention span             purposeful activity    abstract
                                                                                                  thought
                            sucking             emotional stability                               and reasoning
                            eating
Tactile (touch)                                                                                  specilization
                            Mother-infant                                                        of each side of
                            Bond                                                                 brain and body
                            Tactile comfort


Visual (seeing)

Ref: A.J.Ayres (1979). Sensory Integration and the Child.
                       Published by the Western Psychological Services




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Sensory Integration Dysfunction

For most of us Sensory Integration occurs automatically, unconsciously
without any effort. Sensory Integration Dysfunction is difficulty in
processing and organising sensory information, this causes dysfunction,
which can be compared to indigestion, which occurs when the digestive
tract malfunctions! Sensory Integration is a sort of „traffic jam‟ in the
brain. Bits of sensory information get tied up in traffic and certain parts
of the brain don‟t get the sensory information that they need to do their
jobs. (Jean Ayres 1979). As a result, the world is perceived incorrectly.
It provides a different learning experience from everyone else‟s.

Individuals who have a broad range of disabilities, from mild learning
disorders to severe neurological impairments may experience sensory
dysfunction i.e. Developmental Coordination Disorder, Autistic Spectrum
Disorder, Attention Deficit Hyperactivity Disorder and Cerebral Palsy.

Disorders in Sensory Integration greatly influence our ability to function,
but can be so subtle that they go unrecognised.

Some of the early signs of Sensory Integration Dysfunction

It is important to identify and address Sensory Integration Dysfunction to
enable a child to function at their optimum level.

         Overly sensitive to touch, movement, sights and sounds.
         Under reactive to touch, movement, sights and sounds.
         Easily distracted.
         Social and/or emotional problems.
         Activity level that is unusually high or unusually low.
         Motor coordination difficulties
         Impulsive, lacking in self control.
         Difficulty in making transitions from one situation to another.
         Inability to unwind or calm ones self.
         Poor self concept.
         Delays in speech, language or motor skills.
         Delays in academic achievement.
                                                  Ref: http://hunnybee.com




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SEN/HC/1107t005edo
THE SENSES

The Tactile System

Tactile system is developed by a baby through touch as a primary method
of communication and to establish social bonds. Through tactile
responses a child learns about feeding, dressing, language, movement,
perception, basic concepts and handwriting.

When skin is touched there are two types of responses:

1.       Discriminative – tells you where and what is being touched. The
         information is sent to the cerebral cortex and associated with
         vibration, pressure, proprioception and adaptive behaviour.

2.       Protective – response to danger and can trigger a flight or fight
         response. It is associated with pain, temperature and touch.

The two types of response must be balanced and interact appropriately in
an adaptive manner to ongoing sensations from the skin. The brain uses
vestibular and proprioceptive sensations to maintain this balance.

In both responses input from the skin travels up the spinal cord via
nerves to the brain stem and cerebellum and it is then processed along
with proprioceptive, vestibular, auditory and visual input.

In the brain stem the information is sent to the reticular formation which
arouses the cerebral cortex.

Discriminative response - sensory strip of cerebral cortex is aroused in
anticipation of incoming sensory information.

Protective response – in addition to the cerebral cortex being aroused, the
flight or fight response and strong emotions are triggered.

Signs of Tactile Dysfunction

Hypersensitive (over sensitive) – This is also known as Tactile
Defensiveness

         May dislike certain foods due to texture.
         May dislike brushing teeth or hair.
         Responds with alarm when face/body is washed.
         Avoids walking/crawling on surfaces such as rugs or grass.
         Prefers to wear clothes that totally cover the body or no clothing
          at all.
         Does not like the feel of certain clothing.
         Dislikes physical touching, especially light touch.
         May have poor social relationships.

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         If touch perceived as a threat they may act with physical or verbal
          aggression.
         Dislikes crowds.
         May avoid putting hands in sand, finger paint, glue and other
          “messy” activities.
         Dislikes being dirty.

Hyposensitive (under sensitive)

         Does not react to painful experiences.
         Difficulty manipulating tools and toys.
         Craves touch, may touch constantly or indiscriminately.

There are therapeutic activities to help with these perceptive difficulties.

The Proprioceptive System

Proprioception is the conscious and unconscious awareness of body
position and movement. The proprioceptive system is the muscle sense,
that tells the brain:

         when and how the muscles are contracting or stretching.
         when and how the joints are flexing, extending or being pulled and
          pushed.
         what the body parts are doing and where they are in space.
         the force muscles are exerting.
         how to modulate the vestibular system.

Proprioceptive input from the muscles and joints along with all other
sensory information travel to the brain stem, the reticular formation and
the cerebellum for processing.

After processing:

         Motor commands are sent down the spinal cord to muscles and
          joints to carry out gross and fine motor movements.
         Information is sent to the cerebral cortex where it is integrated
          with other input to give information about where the body parts
          are and how they are moving.

If the proprioceptive system is integrating effectively with other parts of
the brain the child can develop and co-ordinate smooth movements.
Therefore if the proprioceptive system is not functioning correctly the
child may have difficulty with fine motor skills, gross motor skills and self
help skills.




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Signs of Proprioceptive Dysfunction

         Stiff uncoordinated movements.
         Poor spatial awareness.
         Craves deep pressure sensations on body.
         Unaware of obstacles in their pathway.
         Difficulty in moving and maintaining posture without the use of
          direct vision.
         Difficulty getting in and out of chair, up and down stairs.
         Too tight or too weak grasp on pencil.

Proprioception is the key skill required to plan movements. It becomes
automatic with repetition.

Activities performed against resistance facilitate good proprioception.

Vestibular System

The vestibular system is the balance sense. It tells us:

         where one is in relation to gravity, i.e. when you are spinning,
          jumping and swinging.
         whether one is moving or standing still.
         how fast one is going and in what direction.
         where one‟s body is in space.

Its function is to:

         maintain muscle tone and posture in order to move efficiently.
         maintain a stable visual field by adjusting eye and neck muscles to
          compensate for movement of head/body.
         enable you to use both sides of body together.
         provide foundation for higher level learning.

Vestibular Organ

In the inner ear there are two sets of receptors – one static equilibrium
receptor responding to straight line movement of the head and one semi-
circular canal that responds to spinning movements of the head.

Vestibular input from the inner ear, along with visual input from visual,
auditory and somatic receptors travels to the brain stem, reticular
formation and the cerebellum for processing.

After processing, motor commands are sent to the eyes and down the
spinal cord and interact with other sensory input to control reflex
movements of the eyes and body. Information is also sent to the cerebral
cortex and interacts with other sensory input to give a perception of
space, position and orientation in space.

SEN/HC/1107t005edo
This sense is required for all daily functioning, i.e. learning to write,
buttoning shirts, holding head up without support, skipping with rope,
playing rhythm games, copying from the blackboard, reading without
following with fingers, distinguishing among letters and numbers and
knowing right from left.

The vestibular system interacts effectively with other areas of the brain,
helps to develop posture, balance, co-ordination, visual spatial skills and
auditory processing skills.

If NOT functioning properly the body has difficulty:

         standing with eyes open or shut.
         standing on one leg with eyes open or shut.
         walking on uneven ground.
         walking on a balance beam.
         kicking a football.

Signs

If a child‟s vestibular system is overactive the following may be
observed:

         Car sickness.
         Dislike of carnival rides.
         Fearful of jump up and down stairs, rolling in a barrel, climbing,
          leaning backwards, somersaults and swinging.
         They may try to control and manipulate events to avoid stressful
          sensations which may appear to others as obstinate and unco-
          operative behaviour.
         They often seek physical support from an adult.

If a child‟s vestibular system is under active the following may be
observed:

         Does not enjoy or do well in sports.
         Often stumbles and falls.
         Difficulty co-ordinating both sides of the body, lacks hand
          dominance, does not cross midline.
         Confusion of right and left.
         Reversal of letters
         Delay in speech, reading, writing and visual perception.
         Love of fast and moving equipment – without becoming dizzy.
         Inability to follow a moving object, draw a line, read a line of print
          of copy from blackboard.
         Trouble holding head up while sitting.
         Delayed balance and equilibrium reactions.




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Visual Perception

Visual perception is the ability to understand and interpret visual stimulus
in order to understand the world. There are several components of visual
perception which are:

         Spatial Relationships – orienting one‟s body in space and
          perceiving positions of objects in relation to oneself and to other
          objects.
         Visual discrimination – discriminating dominant features in
          different objects.
         Figure ground – distinguishing an object from its background.
         Visual memory – recalling dominant features of one stimulus item.
         Visual sequential memory – recalling a sequence of visual stimuli.
         Visual form constancy – distinguishing an object regardless of
          position, size, background or texture.
         Visual closure – being able to recognise a shape which is
          incomplete and being able to see it as a whole.

Visual perception skills develop when well organised vestibular,
proprioceptive and tactile systems at brain stem level support interaction
with the higher level function of the cerebellum.

Nerve fibres from the retina form the optic nerve along which visual input
travels to the brain stem. There it is processed with proprioceptive,
auditory, tactile and vestibular input.

It then goes to the brain stem, reticular formation and the cerebellum. It
is then integrated with motor messages going to muscles that move eyes
and neck so eyes can find and track objects. Information also goes to the
cerebral cortex where fine, precise discrimination of visual details occur.

Signs

If there is poor visual perception the following signs may be observed:

        Inability to avoid objects.
        Lacks personal space and boundaries.
        Disorganised possessions.
        Difficulty holding eye contact.
        Difficulty with depth perception.
        Poor attention to visual detail.
        Poor handwriting.
        May avoid reading, writing and drawing.
        Has difficulty with building and doing puzzles.
        Gets lost easily.
        Difficulty recognising and drawing letters, numbers and shapes.
        Unable to plan a path around objects guided by vision although not
         visually impaired.

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Auditory Processing

Auditory processing and language skills develop with well organised
vestibular, proprioception and tactile systems at brain stem level with
supporting interaction with higher level brain functions of the cerebellum.

It involves:

        Receiving information.
        Perceiving and discriminating between sounds.
        Sound association and decoding.
        Remembering what is heard.
        Attending to sound.
        Integration of what has been heard and expressing a response.
        Localising sound.

Information travels along nerve fibres to auditory and balancing
structures of inner ear. This forms the vestibulo-cochlear nerve which
carries information to the brain stem about sound, movement, change of
direction to head and gravitational pull. Auditory information, along with
information from skin, eyes, proprioception and vestibular receptors is
processed in the brain stem. The information goes to other parts of the
brain stem to reticular formation and cerebellum and ultimately to the
cerebral cortex, where sense is made of what is heard.

Signs of Poor Auditory Processing

         Difficulty pronouncing words.
         Difficulty using prepositions.
         Trouble hearing in groups.
         Difficulty focussing on foreground sounds and blocking out extra
          background sounds.
         Difficulty remembering and sequencing multi- step directions.
         May be hyper or hyposensitive to sound.
         May appear inattentive.
         Difficulty sequencing verbal directions.
         May need to make a lot of effort to concentrate.
         Short attention span.

Smell (Olfactory System)

Sensory organ for smell is the nose.

The sense of smell wanes rapidly with exposure to odour. Initially there
is sensitivity to a smell but this leads to adaptation.

Perception of smell depends on the interaction between the chemical units
of the odour and the receptor sites in the nose.



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Once all receptor sites are filled and interaction can no longer occur, the
olfactory region stops signalling to the brain and the “smell” is no longer
recognised.

Taste and smell are more than mere sensory decoration. They serve as
valuable early warning systems in situations where there are no auditory
or visual clues.

These senses can contribute to memorable experiences on a personal
level and memory associations may occur.

Taste

This is the least versatile of the senses. It is triggered by the chemical
content of substances in the environment. The chemical particles are
picked up by receptor sites on the tongue.

There are four tastes perceived:

         Sweet
         Sour
         Bitter
         Salt

The perception of taste depends on stimulation of taste receptors. The
substance being “tasted” must be in liquid form; therefore it is mixed in
the mouth with saliva.

Children have more taste buds than adults; therefore they have a more
highly developed sense of taste. A child may have difficulties perceiving
taste or be over sensitive to strong tastes, which can lead to issues at
meal times.

Touch and pressure receptors in the mouth perceive information about
texture and sensation of food. Taste also works very closely with smell.
It is rare to taste something without smell. It elaborates on the
information received about food.


Summary

This has just been a very brief overview of Sensory Integration and
Sensory Dysfunction. To identify, assess and treat children with Sensory
Integration Dysfunction a fully trained professional is required, however
there are many techniques and activities that teachers and parents can
use to aid the child with these types of difficulty to improve general
overall functioning.




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INDICATORS OF SENSORY INTEGRATION DIFFICULTIES

This could be used as a checklist with parent/carer

General indicators of sensory processing difficulties may include:-

         Overly or underly sensitive to touch, movement, sights or sounds
         Motor coordination difficulties
         Activity level unusually high or low
         Poor organisation of behaviour
         Delays in speech and language development
         Poor self concept
         Difficulties in activities of daily living
         Difficulties in learning
         Challenging behaviours

When looking at the specific sensory systems the following difficulties
may be observed:-

1.       Tactile system

                                                          Partially
                                                Present               None
                                                          Present
Child may react negatively to touch, being
hugged or bumped into
May avoid or crave certain textures which
has a significant impact upon choice of
clothing
May avoid messy play
Constantly touching and feeling certain
objects or people
Avoids being bare foot
Doesn‟t like splashing water
Difficulty standing in line

2.       Visual system

                                                          Partially
                                                Present               None
                                                          Present
Avoids bright lights
Difficulty finding objects in a competing
background
Covers eyes to protect from light
Stares at objects/people intensely



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3.      Vestibular system

                                                          Partially
                                                Present               None
                                                          Present
Difficulties with balance
Doesn‟t like playground rides
Doesn‟t like car journeys
Dislikes feet off the ground
Constantly moving
Twirls/spins or rocks frequently and often
unconsciously
Seeks out all kinds of movement activities

4.      Auditory system

                                                          Partially
                                                Present               None
                                                          Present
Holds hands over ears to protect from noise
Doesn‟t respond to name being called
Responds negatively to loud or unexpected
noises
Distractible when trying to work in a noisy
environment

5.      Proprioceptive system

                                                          Partially
                                                Present               None
                                                          Present
Holding a pencil properly
Always bumping into things
Doesn‟t appear to notice obstacles in the
environment
Difficulty judging the pressure of touch i.e.
hugging to tightly
Carrying out movement activities without
vision
Seems to like falling over or bumping into
things
Tends to prop themselves up on objects or
people
Poor motor coordination skills




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6.       Oral system

                                                            Partially
                                                  Present               None
                                                            Present
Avoids certain taste, smells and textures
Craves certain tastes, smells and textures
Gags easily on food textures or utensils
Mouths, chews or licks non food items
Picky eater

Other indicators of sensory integration difficulties are the social,
emotional and behavioural responses to sensory stimuli, which may
include:-

          Temper tantrums
          No sense of humour
          Cries easily
          Can‟t express emotions
          Uncooperative
          Anxious
          Poor self confidence and self esteem
          Immaturity
          Avoids eye contact
          Overly affectionate
          Can‟t read body language
          Frustration
          Difficulty coping with changes in routine




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SENSORY INTEGRATION – REFERRAL ROUTE

A child may experience a number of difficulties in the above areas. Those
of particular significance are tactile difficulties, vestibular difficulties and
proprioceptive difficulties.

If there are a number of areas where further guidance is needed please
discuss this with the learning support team or consider a referral to the
Occupational Therapy Service (see referral route).

1.     Concerns expressed by teacher, SENCo, parent/carers that reflect
       items from the Sensory Integration Checklist.

2.     School complete Indicator Checklist through classroom observations,
       then discuss with parent/carer and add to the profile.

3.     Refer to „Guidance Pack‟ for strategies to be used in school and at
       home.

4.     Identify appropriate strategies, implement and review.

5.     Monitor progress at school and home.

6.     If concerns continue discuss with Support Services to ensure
       appropriate referral.

7.     If progress is slow, consider with parent/carer referral to the
       Occupational Therapy Service via the General Practitioner.




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THE ROLE OF THE OCCUPATIONAL THERAPIST

An Occupational Therapist is a medically trained health care professional
who looks at helping a person meet goals of everyday life that are of
importance to them as individuals. They are concerned with looking at
occupation – not paid employment but occupations we participate in
during daily life. The areas of function that a therapist will look at are:-

             Self care
              This covers all the activities that are needed to look after
              oneself. As a young person grows they take on more
              responsibility for tasks and so needs vary with age.

             Productivity
              This area covers all the aspects of life that occur within a school
              day and allow a child to access the curriculum such as drawing,
              writing, to use scissors, pencils and rulers. For children, play is
              a means of developing their skills and so is a form of work. It
              also includes chores that a child may do within the home.

             Leisure
              This area covers our interaction with others and what we do to
              relax or for fun and pleasure.

It is the Occupational Therapists‟ responsibility to help students who have
recognised areas of fine and gross motor difficulties, hand/eye
coordination difficulties, visual perceptual difficulties and difficulties with
sensory functions. They help a child obtain their maximum potential in
tasks described in the 3 functional areas described above. This is done
through the use of meaningful and purposeful activities. Some
Occupational Therapists are also trained to work with children with
sensory integration difficulties.

 Once a child has been identified, by the school, as having difficulties in
the above areas and advice and strategies suggested from this pack have
been tried and proved unsuccessful the child may be referred to the
Occupational Therapy Services (this referral must be supported by a
medical practitioner). The child will then be assessed by the therapist
using a variety of standardised and non-standardised assessments, which
include:-

             The Movement Assessment battery for Children
             Berry‟s Test of Visual Motor Integration
             Test of Visual Perceptual Skills – Gardner
             Sensory profile – Winnie Dunn
             The Bruininks-Oseretsky Test of Motor Proficiency
             Handwriting sample
             Clinical observations
             Hawaiian Early Learning Profile – HELP charts

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             Play activities
             Parental Questionnaires
             Teacher questionnaires
             Medical notes
             Reports from other professionals involved in the child‟s care

Once the assessment is complete the Occupational Therapist will offer
helpful advice and strategies for the child, parents and school. They may
also devise an individual programme of activities, unique to the child, to
help them achieve their potential in each of the functional areas and
sometimes they will offer 1:1 treatment in order to achieve specific goals.

When treating a child the therapist will employ a number of treatment
models such as a neuro -developmental approach,a developmental
approach,a rehabilitative approach,a cognitive approach,a sensori-motor
approach, a perceptual-motor approach and sensory integration
approach.

Occupational therapists practising sensory integration view a child‟s
exhibiting behaviours as an attempt to avoid certain types of sensation or
to seek preferred stimuli in order to balance out their nervous system.

When specifically looking at the sensory integration approach the
following treatment principals are suggested as unique to sensory
integration therapy (Ayres, 1972; Clark, Maillous and Parham, 1985;
sensory integration international, 1990; Merril, 1990; Fisher, Murray and
Bundy, 1991; Kielhofner, 1992; and Kimball, 1993):-

1.     Creation of a therapeutic environment

       Throughout our lives we interact with, explore and master our
       environment therefore the environment needs to provide multiple
       opportunities for interaction, challenges the child, who through
       activities, initiates interactions for the purpose of learning.

2.     Implied or stated goal of improving neural processing and
       organisation of sensation

       Treatment should aim at tackling the underlying deficits in sensory
       processing rather than train in specific skills or behaviour.

3.     See movement think sensory

       Movement activity is valuable in that it provides the sensory input
       that helps to organise the learning process.




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4.     The use of planned and controlled sensory inputs

       Therapy will involve activities that provide vestibular, proprioceptive
       and tactile stimulation, and are designed to meet the child's specific
       needs for development.

5.     Emphasises on the elicited adaptive responses

       Adaptive response is an appropriate action in which the child
       responds successfully to the environmental demand. In therapy the
       child will be guided through activities that challenge his or her ability
       to respond appropriately to sensory input by making a successful,
       organised response.

6.     Gradation of activities for simple to complex responses

       The activities will also be designed to gradually increase the
       demands upon the child to make an organised, more mature
       response.

7.     Child-centred approach

       Therapists consider the child‟s sensory needs so that appropriate
       intervention and therapeutic rapport can be established to nurture
       the child‟s development.

8.     The use of non-directive purposeful activities

       Emphasis is placed on automatic sensory processes in the course of
       a goal-directed activity, rather than drilling or instructing the child
       on how to respond.

9.     Balance of facilitation and inhibition

       The therapist should regulate the child‟s arousal level by using
       different facilitatory and inhibitory activities.

10. Encourage active participation

       The child should be encouraged to be an active participant in
       activities. It helps them to become a more mature, efficient
       organiser of sensory information.




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11. Capitalise on the child’s inner drive and self-direction

       Motivation of the child plays a crucial role in the selection of
       activities. Most children seek out those activities that provide
       sensory experiences most beneficial to them at that point in their
       development.

12. To learn how to learn

       Training of specific skills is not usually the focus of this type of
       therapy. A variety of activities will be used to develop the underlying
       abilities that enable a child to learn such skills efficiently.

13. Therapy must be fun

       Therapy is almost always fun for a child. If it is fun the child is more
       likely to benefit from their time in therapy.


This type of therapy should only be carried out under supervision of an
Occupational Therapist with the appropriate post graduate training, the
appropriate equipment and with experience in dealing with children with
sensory processing difficulties.

When a child is engaged in an intervention, whether they are following a
specific programme of activities, advice and strategies or receiving 1:1
therapy their progress will be continually monitored and their needs re-
evaluated. Once they have achieved their therapeutic goals this
intervention will finish.




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THE ROLE OF THE EDUCATIONAL PSYCHOLOGIST


Educational Psychologists (EPs) are often involved in the assessment of
children and young people with complex needs within pre- school and
school settings . Where it is appropriate they work alongside parents ,
teachers, and a range of other professionals such as speech and language
therapists , occupational therapists, social care and specialist CAMHS to
ensure strategies are in place to help and support young people with a
range of difficulties. They use their expertise in psychology and child
development to gain an understanding of the child /young person‟s
perception of the world and have a background in child development.
They are skilled in individual assessments and in observing the child in
many different contexts .

They may offer advice on the following :-

  Autism and autistic spectrum disorders               Sensory difficulties

 Mild to severe learning difficulties, including global developmental delay


       Learning and language                      Social, Emotional and
    difficulties in the Early years               Behavioural difficulties


     Physical Disability              Dyspraxia                 Dyslexia


Fine motor difficulties which may affect handwriting skills and therefore
may impact on the acquisition of literacy skills
Reading /spelling difficulties
Gross motor difficulties and self help skills
Attentional/concentration difficulties and ADHD

How can Educational Psychologists become involved?

Normally the school SENCO (Special Educational Needs coordinator)
will bring a child for discussion at a multi -professional consultation
meeting , which normally take place twice a year, and, if appropriate the
Educational Psychologist may become involved .

Parental permission is always sought for discussion at consultation
meetings and for EP involvement.

Some educational psychologists work within multi-agency teams for the
assessment of Autistic Spectrum Disorders and they might then work in
liason with occupational therapists if the child or young person has a
coordination or sensory integration difficulty .

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SENCO AND SCHOOL ROLE

There are children in all schools who show signs of Sensory Processing
Difficulties, in various degrees.

Sensory Processing

In school things are always changing and children who have processing
issues often take a lot longer to process information so transition is a big
issue.

Sensory Defensiveness

Children with this difficulty often get overloaded with sensory information,
they find either light, sound, touch and smells or a combination of these
very distressing.

Sensory Insensitive

These children can‟t sit still, they often rock, chew or fiddle and are easily
distracted and very distracting to teach. These children need extra
sensory input in order to concentrate, there needs to be flexibility in the
curriculum and class environment.


The good news for the school, SENCOs and teachers is that there are lots
of strategies that will help these children, and also benefit their
classmates.




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Strategies

WHOLE SCHOOL APPROACH


1.     Advocate flexible teaching and learning i.e. taking account of
       auditory, kinaesthetic (inc. tactile) and visual learning styles.

2.     Celebrate all learning whether within school or outside school so that
       children can excel in their own (sometimes narrow) interests.

3.     Provide safe (quiet, comfortable) spaces in school for calming at all
       times. Difficulties can occur especially during playtimes, change,
       times of less routine (i.e. Christmas).

4.     Whole school ethos promoting such activities as:

             Brain gym
             Yoga
             Motor control exercises
             Multi-skills
             Wake and Shake DASH (Do Activities Stay Healthy). These
             could be carried out at the beginning, middle or end of
       lessons.

5.     Partnerships with SASP (Somerset Active Sports Partnerships) Or
       Tone Sports. PPA time could be used to practise active skills.

6.     Encourage extended out of hours Activities (not always competitive)
       ie
             Drama Club
             Football
             Tai Kwando
             Multi-skills
             Dance
             Music

7.     Run courses/partnerships with family learning/SASP so that activities
       available in school can be extended to families.

8.     Celebrate different recording/learning styles through school display,
       ICT, performances, and tournaments.

9.     Increase awareness of all staff to sensory integration difficulties.
       Ensure that all lunchtime staff understand the issues both during
       dinners and in the playground.




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CLASSROOM STRATEGIES

The following strategies are suitable for all children and particularly those
children with sensory difficulties. These ideas will also complement any
advice given to the school by Occupational Therapy.

1.      Check that the class environment meets needs of different children.

        a.     Have an area (if possible) where there is less sensory stimulus
               so that they can work at times without distraction and they
               don‟t distract others.

        b.     Have an area where they can go and calm down (in class if
               possible in KS1 and KS2). These areas need to be separate
               from facilities for isolation and exclusion since they are there
               to prevent escalation and they should be seen as places of
               safety.

        c.     Clearly displayed.
               Timetables (visual and interactive if possible), capable of
               being changed on a day to day basis.
               Keywords/Topic vocabulary.
               Clearly labelled areas and resources.
               Clearly labelled expectations/rules and objectives.

2.      Consider splitting the lessons that involve a lot of sitting , for
        refocusing and calming through:

                Brain gym
                Yoga
                Multi-skills
                Drinking water
                Drama
                Rhythm and movement

3.      Adapt lessons to take account of social skills ie

                Paired learning rather than a group.
                Staff modelling cooperative skills.
                Mix groups by social ability as well as learning styles.

4.      Consistent routines, rules and boundaries from all adults including
        supply teachers.

5.      Plan transition times ie

                Around class activities.
                Lesson to lesson (especially important in Secondary schools).
                Playtime to classroom.

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                Children with sensory issues find change, crowds, noise and
                smells very difficult to cope with.

6.      Check understanding (success of processing) of information by:

        a.      Saying/displaying what you are going to teach.

        b.      Teach.

        c.      Say/ display what you have taught.

        d.      Practise what has been taught.

7.      Have a range of resources at your disposal ie

        a.      Different size/colour/shapes of writing implements.

        b.      Different methods of recording.

        c.      Fiddling aids (blue tac, bands, squidgy balls).

        d.      Different resources for calming ,extension, withdrawing.

8.      Don‟t assume what makes us feel safe/happy is the same for all ie

        a.      Some children may find messy play really challenging ( tactile
                defensiveness).

        b.      Eating can be difficult for some children with tactile or odour
                defensiveness.

        c.      Crowded situations including lining up can be very difficult for
                children with sensory integration difficulties.

        d.      Playtimes are difficult for many children across a whole range
                of sensory issues.

        e.      PE, whilst very good for many children with sensory issues is
                also very difficult for them and may lead to them attempting
                to withdraw.

        f.      Art is a lovely activity, but can be very stressful for children
                who have motor control issues or who are visually or tactile
                defensive.




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SPECIFIC STRATEGIES

The strategies below can be used at home or at school (some are more
practical at home and vice versa) and are designed to be used to
complement any programmes given to individuals or pending assessment.
Each section includes strategies which help specific sensory systems .
There are also activities adapted for different age pupils. Special
consideration needs to be given to extending curricular activities in
secondary schools since these pupils especially hate to be seen as
different by their peers. Back up aids will also often need to be used to
ensure that the main objective of the lesson is achieved.

Tactile System

Early Years and Primary Age Children

      Activity                           Comments
Rubbing different textures        Helps get tactile defensive
against the skin                  children to try different textures
                                  also can calm children who seek
                                  extra sensory input.
Water Play                        Pouring and measuring using
                                  different receptacles and
                                  textures often is therapeutic and
                                  educational at same time.
Water painting                    Use a brush or squirty bottle to
                                  create patterns with water on
                                  walls and pavements. Also useful
                                  for motor control difficulties
Finger painting                   A sensory seeker will love this.
                                  Someone who is defensive may
                                  need gentle encouragement
                                  (Never force)
Science and cooking activities    A brilliant way to explore
                                  different textures and shapes in
                                  a real context.


Handling pets                     Stroking animals is a very
                                  calming activity.
Oral Motor Activities             Licking stickers
                                  Blowing bubbles
                                  Drinking through straws
                                  Using sports bottles
                                  Chewing rubber tubing
                                  Chewing Wrist bands and watch


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                     straps
                     Chewing chewing gum
                     All provide additional sensory
                     input for sensory seekers.
Sand play            Use different objects (different
                     sizes and textures) bury them
                     and let children discover buried
                     treasure. Change the texture of
                     the sand by adding water.
Feely box            This helps children discriminate
                     without sight.




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Middle School/ Secondary Age Pupils

Rubbing different textures       Helps get tactile defensive
against the skin                 children to try different textures
                                 also can calm children who seek
                                 extra sensory input

Science and cooking activities   This activity incorporates tactile
                                 activities into the normal
                                 curriculum and helps to stop a
                                 child feeling different. A brilliant
                                 way to explore different textures
                                 and shapes in a real context
Art Activities                   Extend normal art lessons to
                                 allow cutting and sticking, messy
                                 art , and different textures.
Handling pets                    Stroking animals is a very
                                 calming activity. If school has
                                 any access to animals as
                                 projects including these pupils
                                 would benefit them.
Oral Motor Activities            Licking stickers
                                 Drinking through straws
                                 Using sports bottles
                                 Chewing Wrist bands and watch
                                 straps
                                 Chewing chewing gum (difficult)
                                 Providing    food    that  needs
                                 chewing.
                                 All provide additional sensory
                                 input for sensory seekers.




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Vestibular System


Most of these activities can be adapted for pupils of all ages.

          Activities                       Comments
Rolling                             Rolling on the floor or down a
                                    grassy hill.
Spinning                            On a tyre, swing or a merry go
                                    round, a swivel chair can also be
                                    used. Alternatively sit the child
                                    on the floor and allow them to
                                    spin.
Riding vehicles                     Trikes, bikes and scooters, these
                                    help children improve their
                                    balance , motor planning and
                                    motor coordination.

Walking on an unstable surface      A sandy beach ,a grassy
                                    meadow a cushion surface are
                                    good things to use because they
                                    require the child to adjust their
                                    bodies as they move.
Rocking                             A rocking horse, chair or
                                    gym(therapy) ball or space
                                    hopper provide a calming
                                    activity as well as an aid to
                                    organisation skills
Riding , balancing and walking      Helps them to organise their
on a see saw                        body when they move.




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Proprioceptive system

These activities are suitable for any age child

       Activities                         Comments
Lifting and carrying heavy loads.   Carrying heavy objects helps the
                                    muscle tone and can be a
                                    calming activity.

Pushing and pulling                 Helps build proprioceptive
                                    system by providing a resistance
                                    . This can also help as a calming
                                    activity.

Hanging by the arms                 Using monkey bars helps stretch
                                    muscles and develop upper body
                                    strength.
Hermit crab                         Place a lightweight on the
                                    child's back and get them to
                                    move.
Bear Hugs                           The pressure helps calm
                                    children, children can also self
                                    administer this by wrapping their
                                    arms around themselves.
Back to back standing up            2 children sit on the floor
                                    together back to back and then
                                    try standing up together.
Drama and PE                        These lessons are very useful to
                                    enable pupils with proprioceptive
                                    difficulties develop balance ,
                                    body tone , and to calm them.
                                    However they require over
                                    learning, so little and often is
                                    necessary.




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Auditory System

These strategies are suitable for children of all ages

Simplify language
Repeat sentence
Ask child to repeat back to check
understanding
Model good speech                   Even if child has trouble
                                    responding they may have
                                    understood what you said.

Allow a child to respond where      Don‟t interrupt, rush or
possible in their own time          pressurise the child.
Use rhythm and beat                 Use rhythm to help memory by
                                    substituting own words to a
                                    familiar tune.

Encourage the use of drama          This can be used reinforce
                                    auditory processing.



Get child's attention before        Use a physical prompt such as
talking                             patting a hand to ensure their
                                    full attention.

Reduce auditory and visual          These compete for a child‟s
distractions                        attention .Other conversation
                                    and movement are the worst.




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Visual System

Strategies for Primary aged Children

Making shapes                   Encourage a child to make
                                shapes using different materials
                                ie finger paint , play dough,
                                sand, clay, shaving foam.
Dot to dot or mazes             Have children follow mazes, on
                                paper or any other way you can
                                think of . Dot to dot is also very
                                useful.

Peg Boards                      Make designs and repeating
                                patterns getting increasingly
                                more challenging .
Cutting Activities              Cut along straight and curved
                                lines
Tracking activities             Lie on back and track birds or
                                clouds with the eyes without
                                moving the head. Some Brain
                                gym exercises are good for this.


Visual System

Secondary Age children

Visual tracking activities      Brain gym exercises are very
                                good for this.
Cutting and precision drawing   Adapt technology or art lessons
                                to use cutting and drawing skills
                                ie drawing and cutting patterns
                                or templates. Over learning of
                                these techniques needs to be
                                delivered little and often , and
                                alternative aids may need to be
                                used to ensure a successful
                                outcome of the lesson.
Design repeating patterns ,     Use various curricular activities
shapes.                         to extend pupils skills in visual
                                tracking, perceptions of space
                                etc.




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Sensory Integration and the Environment

The environment is the key to how effectively or otherwise a child will
learn. This is particularly true of school as it is a learning environment.
Children with Sensory Integration difficulties will require an environment
that is sensitive to their needs. These needs will vary according to the
child. What may suit one will not necessarily be ideal for another.
Children and adults have senses that respond with random and variable
effectiveness and this in turn has a significant impact on how they
respond to different and varying stimuli in a learning environment. A
child with SI difficulties will need to feel secure in their environment in
order to complete daily tasks. If they feel insecure this will hinder and
restrict both their willingness and ability to attempt standard everyday
tasks.

The ability to undertake a task will depend on the ability to screen out, or
inhibit, nonessential sensory information such as background noises and
visual information. An individual with sensory integration difficulties may
respond to sensory input without this ability to screen out non-essential
information which may produce distractibility, hyperactive, or uninhibited
behaviours. They may be unable to calm or console themselves and may
overreact or be unresponsive to different stimuli. Attention and regulatory
problems occur in balancing and regulating the sensory processes.
 Children may respond very differently to their peer group in the school
environment and will provide different challenges for the teacher.

The Environment

When looking at the environment the following need to be considered:-

         Lighting
         Acoustics
         Furnishings
         Odours
         Demarcation lines between environments, e.g. clear boundaries
         People
         Temperature




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    Lighting - Visual environment
    Modify the environment to suit the child‟s needs. Is the     Observe how the child responds in different
    environment:-                                                environments within the school and or within different
                                                                 spaces within the classroom. Once you have completed
            Too dark?                                           your observations, what changes are possible to
            Too light?                                          implement? For example is it possible to use a different
            Is there too much artificial light?                 coloured light bulb in a particular corner of the room.
            The wrong type of artificial light?                 This may allow the child a corner in which to relax.
            Too much daylight?
            Light that causes shadows that may panic a child?
    Acoustics
    If the child is hypo-sensitive to noise, they will require extra stimulation and may require mediation of information
    from the teacher via a TA. Written instructions will be very useful to ensure that the child is able to process
    teaching instructions if they experience difficulty processing verbal instructions. If on the other hand the child is
    hyper-sensitive to noise, a quiet calming environment will be required. A teacher should never raise their voice as
    this could cause significant distress to the child. Allow the child to work in a quiet room during paired or group
    activities if the volume of the other children rises too high for their level of noise tolerance.
    Furnishings
                             Seating should allow the child to sit with both feet on the ground and the hips, knees and
    Seating                  ankles should be at approximately 90 degree angles. It may be necessary for the child to sit
                             on a chair with armrests.
                             The desk should be at elbow height, when the arms are in a relaxed position. A sloping
    Desk
                             surface may be required but always check with the child‟s OT and parents first.
                             Seat the child directly in front of the teacher. This prevents the child from having to sit at
    Seating position         an angle to the teacher or to have to twist or turn the body unnecessarily. Do not sit the
                             child near distractions such as a door or a window.




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    Odours                Ensure that odours are neutral as far as possible.

    People
                          Ensure that you make opportunities available for friendships to flourish in the classroom,
                          encourage paired working and or group working. Friendships develop in the classroom; the
    Friendships
                          playground offers further opportunities to strengthen friendships but not necessarily to
                          foster them in the first instance.
    Extra supervision     The child is very likely to require extra supervision to stay on task
                          Verbal instructions should be repeated. Ideally all instructions should be written so that
    Instructions          they can be referenced as required. The use of STC symbols may be necessary if literacy
                          levels are low.
    Modelling             Whatever the activity, model what is required first.

    Temperature
    Temperature           Ensure the temperature is neither too hot nor too cold.



The following miscellaneous list may need to be considered for any child with sensory needs;

                          Ensure that the child is only required to write what is absolutely necessary, provide lesson
   Recording work         notes rather than expect the child to copy from the board. Use alternative methods of
                          recording, scribe/dictaphone/computer.
                          Allow sufficient breaks during the lesson to help refocus and to optimise learning
   Breaks
                          opportunities. An STC symbol could be used very effectively for this purpose.
   Professional advice    Ensure that professional advice is incorporated into your classroom.

   PE                     Ensure that you implement advice given by the OT.




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                        Ensure that all relevant information is passed to the next teacher and or school. Encourage
   Transitions
                        the next teacher to visit your classroom to observe the child in situ.
                        Offer incentives to speed up a desirable behaviour. If you finish (a) then you can do (b).
   Incentives           This gives the child a goal to work towards, the work in itself may not have any intrinsic
                        value for the child.
                        After an incident has occurred allow the child sufficient time to calm down. When the child
                        appears to be calm allow the child the opportunity to undo/or redo a given behaviour. This
   Incident retrieval   helps the child to understand that it is possible to retrieve a situation. Opportunities should
                        be given to help the child to understand why things went wrong on this occasion and
                        strategies should be offered to show how to do it differently next time.
                        What is the child trying to communicate via a given behaviour. How can we help the child
   Behaviour is
                        to understand the hidden meaning of their behaviour and how can we help them to adopt a
   communication
                        more appropriate behaviour and ways of communicating their needs, wants and desires.
                        It may be useful to write a social story with the child. Social stories are mainly produced for
   Social stories       children with autism but they can also be beneficial for other children. It is a simple
                        method used to help a child understand what is expected of them in a given situation




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PARTNERSHIP WITH PARENTS

It is really important that celebrations and successful strategies are
shared more than areas of concerns. Parents know their child‟s issues
better than anyone else but it is easy to fall into the trap of seeing only
the difficulties and the reasons for the child appearing „Out of Sync‟ rather
than exploring their learning potential.

COMMUNICATION

Consistency of approach

It is important that school staff try to continue with what works in the
home where practical , thereby making the child‟s life more consistent.
Reporting changes in patterns of behaviour to each other is also
important.
Reporting and celebrating successes in strategies or accessing previously
difficult sensory issues i.e. eating a new food, touching a new media
should be done as rapidly as possible to allow both parties to build on
each others‟ success.

Schools are unlikely to have time to meet all the needs of the child with
Sensory Integration Difficulties. It is important that schools work in
partnership with parents to provide the variety of sensory stimuli that
their child needs.


SUGGESTED ACTIVITIES TO GIVE TO PARENTS

Giving Access to Outside clubs (supportive not coaching)

       Swimming
       Cycling
       Football
       Music
       Drama
       Tai Kwando
       Dance
       Gym
       Trampolining

It is important that all these activities/clubs should be the choice of the
child not the adult however well meaning.

Home activities

Painting and various activities eg, cutting and sticking
Cooking
Playdoh and clay modelling

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„Helping‟ with construction activities
Rhythmic games/songs
Twister, Hopscotch
Ball games – Throwing and catching
                Bouncing and catching
                Throwing to targets

Incorporating chores which involve physical activity
Encouraging frequent movement breaks (decreasing isolated sitting
activities)
Making bubbles and bursting them by clapping


Activities to help with learning/coping

Help with organisational issues by having consistent and visual timetable
at home.

         Have consistent routines
         List of items to remember to pack
         Keep a duplicate school timetable and
         keep rehearsing it
         Go through home school communication
         and discuss any changes in routine
         Go through topics they are doing in
         school, to help with predictability.

Ensure that rules and expectations are shared between home and school.

To check your child‟s understanding discuss with them what they have
been doing in school.
Play clapping, rhyming and rhythmic games with young children.

Teach children calming activities that can be transferred to school or that
are working in school.

          Drinking from a water bottle
          Pushing against walls with hands, shoulders and back
          Isolating themselves to a favoured activity or toy

To help train concentration play memory games, jigsaw puzzles,
puzzles/games of the child‟s own choosing extending the time spent on it
gradually.

A big issue is self esteem so have a reward system agreed between
school and home which is based on something the child is successful at,
then extend to an agreed area to be developed. The system has to be
consistent and with the same expectations.



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CHILD/YOUNG PERSON’S VIEW

Gareth’s Views

When I was younger it took me ages to learn to ride a bike, I kept falling
off. I have never really perfected not falling off but I do it a lot less now !
I ride to school each day.

I still fiddle with stuff like my watch, bendy ruler and anything else really.
People think I am not listening when I fiddle or chew my tie and are really
surprised when I know the answers.

No-one can read my writing but I am really good on computers now.
People get frustrated because I fiddle with the computer as well.

I rock a lot on my chair and my friends and teachers try and stop me
because they are worried I will fall off.

I like my school work here now, I am good at Maths, but I still hate PE.
I get left out of the games because no-one wants to be my partner.
I like Maths and Science but hate homework. I always seem to lose it and
never get it in on time, Mum nags me which is really annoying
sometimes.

People have given me things to help, like a cushion to help me to stop
rocking and a writing slope, also a chewing band, but I don‟t want to use
them because I hate feeling different.

My temper can be a problem, I get angry with myself and others and find
it hard to calm down and control my feelings.
Most of my friends understand my problems but can be frightened
sometimes.

I like to try everything and am going on a school trip with school to an
adventure activities centre – I am not sure how good I will be at things
but am determined to have a go.


Gareth Bass – Age 12




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A PARENT’S VIEW

My son is 12 years old and was assessed as having Sensory integration
issues when he was 7 years old. He has difficulty processing auditory ,
proprioceptive and vestibular information.

What does this mean?

The theory is in this guidance but what it actually means is the following.

Gareth is a hugely intelligent child who definitely marches to his own
tune! He chews constantly, licks until his lips are sore, rocks his whole
body almost all the time, fiddles with anything he can get his hands on
and never appears to be listening to me. His writing is unreadable unless
painstakingly copied and he loses his temper far too often for comfort.

HOWEVER

He is also very loving, generous , witty, quirky and very good at science
and maths and an absolute genius on the computer.

It has been a struggle sometimes to get people to see past the strange
habits he has, to his potential. I accept that it can be very difficult to
understand his issues because I found it difficult to understand that the
fiddling , chewing and rocking were actually Gareth seeking additional
sensory information to enable him to concentrate. How I regret all the
times I said stop rocking/chewing and listen to me.

School

His school try very hard to understand him and he is making good
progress and he likes his school and teachers . I could not therefore ask
for more , except it has been frustrating over the years having to explain
his issues over and over again. His school recognise his potential and he
is now in the top groups for most subjects despite not being able to write.
He was issued with a laptop a year ago which helps him access the
curriculum at the right attainment level, although it is frustrating for his
teachers when he is fiddling with the computer rather than working. He is
included in activities , although PE continues to be an issue. Homework is
a total nightmare ! I make sure he does it when I finally get it home only
to find that he teacher never gets it or it looks like it has been dragged
through a puddle several times.

Gareth has matured over the last year and to reflect this I allow him to
ride his bike ( a skill very painfully acquired) to and from school every day
which is about 7 miles round trip. My hair is prematurely greying but
overall it is worth it. He still has demons to overcome, his temper being
the main one. However, things are much more settled and the future
brighter than I thought possible 3 years ago.

Karen Bass


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                      Books

                     Website

                     Glossary




SEN/HC/1107t005edo
USEFUL BOOKS

Author               Title                                              Publisher                 ISBN

                     Sensory integration – Information Booklet – a      Sensory Integration       0-9545434-0-8
                     Resource for Parents and Therapists                Network, UK and Ireland
ANDERSON, EJ &       Unlocking the Mysteries of Sensory Dysfunction     Future Horizons
EMMONS, P
AQUILLA, Paula       Building Bridges Through Sensory Integration
SUTTON, Shirley &    Therapy for Children with Autism and Other
YACK, Ellen          Pervasive Developmental Disorders
AYRES, Jean          Sensory Integration and the Child (1979)           Western Psychological
                                                                        Services
BUNDY, C             Sensory Integration: Theory and Practice
MURRAY Elizabeth
A & LANE, Shelley
J
CHARA, Kathleen      Sensory Smarts: A Book for Kids Struggling
A CHARA , Pat &      with Sensory Integration
BERNS, Joel M
DeGONGI, GA          Paediatric Disorders of Regulation in Affect and   The Psychological
                     Behaviour (2000)                                   Corporation
EMMONS, Polly        Understanding Sensory Dysfunction: Learning
Godwin               Development and Sensory Dysfunction in
ANDERSON, Liz        Autism, Spectrum Disorders, ADHD, Learning
McKendry             Disabilities and Bipolar Disorder




SEN/HC/1107t005edo
Author               Title                                            Publisher                  ISBN

FISHER, Anne G       Sensory Integration: Theory and Practice
MURRAY, Elizabeth
& BUN, Anita
GANZ, J              Including SI – A Guide to Using Sensory          Bohemia NY: Kapable Kids
                     Integration Concepts in the School Environment
                     (1998)
GRANDIN, Temple      Raising a Sensory Smart Child: The Definitive
BIEL, Lindsey &      Handbook for Helping Your Child with Sensory
PEAKE, Nancy         Integration Issues
HOROWOTZ,            Helping Hyperactive Kids: A Sensory
Lynne J & Cecile     Integration Approach – Techniques and Tips for
                     Parents and Professionals
KOOMAN, J            Answers to Questions Teachers Ask about
KRANOWITZ,           Sensory Integration: Forms, Checklists, and
Carol & SZKLUT,      Practical Tools for Teachers and Parents
Stacy
KRANOWITZ,           The Out of Sync Child                            The Benchley Publishing    0-399-53165-3
Carol Stock                                                           Group
KRANOWITZ,           The Out of Sync Child has fun                    The Benchley Publishing    0-399-52843-1
Carol Stock                                                           Group
KRANOWITZ,           101 Activities for Kids in Tight Spaces          The Benchley Publishing    0-312-13420-7
Carol Stock                                                           Group
MILLER, Lucy         Sensational Kids: Hope and Help for Children
FULLER, Doris A      with Sensory Processing Disorder




SEN/HC/1107t005edo
Author               Title                                          Publisher                    ISBN

MYLES, Brenda et     Asperger Syndrome and Sensory Issues           Autism Asperger Publishing   09672514-7-8
al                                                                  Co
TORRANCE, CA         A Parent‟s Guide to Understanding Sensory      Sensory Integration
                     Integration (1991)                             International
TROTT, Maryann       Sense Abilities: Understanding Sensory         Tucson AZ: Therapy Skill
Colby                Integration (1993)                             Builders
WILLIAM, Mary        How Does Your Engine Run? – The Alert          Albuquerque, NM: Therapy
Sue &                Program for Self Regulation (1992)             Works
SHELLENBERGER,
Sherry
WILSON, Shelley F    What‟s Wrong with My Child?: Struggling with
                     Sensory Integration Dysfunction




SEN/HC/1107t005edo
                         USEFUL WEBSITES

www.sensoryresources.com

www.sinetware.org

www.community.com/disability/sensory

http://www.out-of-sync-child.com

http://www.nashvillesid.com

www.sensory.integration.btinternet.co.uk

www.sensoryint.com/fag.html

www.alertprogram.com

www.telisplanet.net/public/hremis/sensoryintegration.htm

http://bjach.polk.amedd.army.mil/Bb/sihle.htm

www.tsbvi.edu/Outreach/seehear/fall97/sensory.html

www.hunnybee.com:au/autism/sensoryintegration.html

www.spdnetwork.org/research/miller.empinical.html

www.asatonline.org

www.autism.org

www.sensorytools.net




SEN/HC/1107t005edo
SEN/HC/1107t005edo
SEN/HC/1107t005edo

				
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