HELPING CHILDREN KEEP ALERT AND MAINTAIN SELF REGULATION Gloria Ng - - PowerPoint PPT Presentation

HELPING CHILDREN KEEP ALERT AND MAINTAIN SELF REGULATION

Gloria Ng Siok Kwan Senior Occupational Therapist Department of Child Development KKH

CONTENTS

 What is Occupational Therapy?  Sensory Processing and Self-regulation  3 approaches to helping our children

keep alert and maintain self regulation

 Q & A

3

WHAT IS OCCUPATIONAL THERAPY?

Occupational Therapy is a health profession concerned with people‟s abilities to perform the tasks that are important and necessary to their living successfully. “Occupation” in Occupational Therapy refers to the

everyday life activities a person does

that are meaningful to him.

A CHILD’S OCCUPATION

Self care Play Learning

Self care Learning Play Motor skills Self regulation Sensory Processing

SELF REGULATION



The body‟s ability to attain, maintain, and change arousal appropriately for a task or situation.



Arousal level



A state of the nervous system



A description of how alert one feels – level of alertness



Fluctuates through the day



Your level of alertness impacts on how well you:



Pay attention to the task at hand



Manage your emotions and behaviour

Optimal level of arousal

Low arousal Sensory overload

Sensory events over time

HOW DO WE MAINTAIN GOOD ALERTNESS LEVEL?

If my body is like a car engine…

 Our level of alertness fluctuates through the day

thus our „car engine‟ can sometimes be at

 High speed  “Just right”  Low speed  Our engines need to run at “just right” in order

to function well in and finish the things that we need to do everyday.

 Some tasks have a greater demand on our

engines to pay attention and some tasks have less demand.

SPEEDOMETER

LOW ENGINE



Tired



Couch potato



Sleepy



Day-dreamy



Spaced-out



Unwell

HIGH ENGINE



Fear



Anger



Excitement



Nervousness



Fight & Flight

JUST RIGHT!

 Attentive/ Focused  Concentrate  It‟s easy to learn  Get along with others  Have fun

WAYS WE CHANGE OUR ENGINE SPEED

Put something in your

mouth

Move Touch Look Listen

DEFINITION OF SENSORY INTEGRATION

The normal neurological process

• f

taking in information through the senses, of organizing and unifying this information, and using it to plan and execute adaptive responses to different challenges in order to learn and function smoothly in daily life (Kranowitz, 1998)

SENSORY INTEGRATION

The brain requires sensory information to

• perate. It operates based on thresholds.

All of us are sensory beings and we

experience sensations differently. Some need a more stimulation, some need less.

Each of us have a sensory preference  For example eat, exercise, sleep, music, etc.

SENSORY INTEGRATION – a feedback system

Our senses

SIGHT/ SEE SMELL TASTE HEAR TOUCH

 Propioception  Our nerve endings in our

joints and muscles tell us our body position in space

 A deep pressure  Calming and rhythmic in

nature

Our senses

 Vestibular  Movement and direction  Balance  Alerting sense in nature

HOW DOES YOUR ENGINE RUN?

A self discovery activity

EVERY PERSON AND CHILD’S SENSORY PROCESSING is

UNIQUE TO YOU!

SENSORY INTEGRATION

High Threshold More time to get more sensory input to react Low Threshold Notices sensory input mush faster

DUNN‟S MODEL OF SENSORY PROCESSING

Neurological Thresholds Self-regulation Passive (let sensory input happen to them and then react) Active (do things to control the amount and type of sensory input) High Threshold

Bystander Seeker

Low Threshold

Sensor Avoider

THE SEEKER

 An active high threshold person  Loves sensation and will actively seek more of it

whenever they can

 Strength: are creative in seeking out new and

interesting sensory experience. The life of the party!

 Challenge: getting through „boring‟

routines/activities without getting distracted. Need help staying on task.

THE SEEKER CHILD

 Needs sensory input throughout the day to keep

them regulated

 The need for sensory rich activities for work and

play to keep them engaged and attentive

 Toys and games that will incorporate movement  Regular movement breaks during learning  Use of visuals, textures, music or scents for learning

can help them stay at the table longer and be engaged

 Work better in stimulating environments (rug under

chair, white noise in the background, sitting on a water/air cushion, fancy stationary)

 Safety measures and clear boundaries are

recommended

THE AVOIDER

 An active low threshold person  Wants to control the amount of sensory information

they receive and nothing more of it as they need less sensory information to react

 Like order and routines and feels more comfortable

when there is a plan.

 Strength: tidy and organised people. Experts in their

interests.

 Challenge: Experiences discomfort quickly so to

avoid feeling this way often, they may withdraw or become stubborn.

THE AVOIDER CHILD

 Become overwhelmed quickly by sensory input so it is

important to manage how much they experience in a day

 Responds better to predictable sensory experiences

daily and reduce suprises. (keep the same toothpaste flavour! Keep steps in self care consistent)

 Needs less extra stimulation and needs consistent

routines with sufficient quiet breaks for them to regulate (clean work area, timetables and less random outings)

 Good to identify small activities that are quiet and

have less movement for them to relax and regulate in (reading, drawing, puzzles)

THE SENSOR

 A passive low threshold person  Notices quickly the sensory information around

them (e.g. change in smell or sounds)

 Strength: sensitive to changes and what is going

• n (e.g. mood or circumstance) and are creative

because they notice the small things.

 Challenge: Distractible and become easily

• verwhelmed by experiences as they can

sometimes find it hard to ignore it.

THE SENSOR CHILD

 Also needs less sensory input to manage in the

day as they get overwhelmed quickly

 Notices change faster so keeping a predictable

and consistent sensory experience can help them function and respond better.

 Switching on the fan to create even background noise

and to reduce the effect of an unpredictable sound.

 Even-tempo music for predictable sound input  Avoid too much light touch and use more sustained

touch

 Timetables or pre-empting your plans can help in

getting Sensory children to „cooperate‟.

 Do watch for their thresholds and plan the day

where they can have times to rest and regulate.

THE BYSTANDER

 A passive high threshold person  May not notice what others notice. They need

more sensory information to gain a reaction and to respond. Tune that up louder!

 Strength: The ability to pay attention and stay

focused in the midst of much activity. Easy going person as they can tolerate much sensory input.

 Challenge: Missing important information and

are less attentive to details. Probably need help to organize and plan bigger activities.

THE BYSTANDER CHILD

 Take time to respond to what is told and what

needs to be done. Work may appear sloppy and disorganised.

 A multisensory approach (touching, pointing, keeping

instructions short and sweet)

 Have timetables, to-do lists and possibly instruction

cards (like a recipe card)

 Label where things should go  Would need some extra help to „gear up‟ in the

morning and/or during times when the demands

• n attention is higher.

 Incorporating opportunities to get sensory input to

keep them regulated (getting up/bending down to get stationary, using scents and textures,

SO HOW DO I HELP MY CHILD MAINTAIN REGULATION?

• Healthy and consistent

routine (meals, play-learning

routine, bedtime, self care)

• Sleep
• Regular outdoor activity

(playground, parks, walks, cycling)

General tips to help keep our children alert and regulated

3 general approach:

 Sensory approach  Behavioural approach  External factors

SENSORY APPROACH

 Calming  Deep pressure (e.g. tight hugs or a massage)  Taking long, deep breaths  Making slow, rhythmic controlled movements  Sucking thick liquids (e.g. yoghurt or milkshake)  Warm food/ drinks  Heavy work

SENSORY APPROACH

 Alerting  Light touch (e.g. tickles)  Fast, irregular movement (e.g. shuttle running,

skipping, jumping)

 Sour snacks/ drinks  Cold snacks/ drinks  Heavy Work

Suggested activities

 Heavy Work  Getting propioceptive input through sustained

pulling/pushing/holding

 Helping out with house chores  Games: Tug of war, wheelbarrow walking,

cushion stacking.

SUGGESTED ACTIVITIES

 Giving a water break or movement break

during transition time for children to get these sensory input.

 Having a small container of sour sweets/

crunchy cereal (in small pieces) can help children who have an oral preference for regulation.

 Practicing deep breathing with your child

regularly can ensure they can use this strategy at school when they need to without prompts (increase oxygen intake and calms the „raging‟ mind)

BEHAVIOURAL APPROACH

Appreciate positive behaviour and effort

 Reward system e.g. star chart  Labelled praise (E.g. You did a good job in

writing your name on the line)

EXTERNAL FACTORS

Creating a conducive learning place

 Is it overstimulating?

 Keep it organised

 Change arrangement of furniture?

 From next to the TV into the room

 Where is my child sitting at the table?

 Face the wall or window/door

 How is my child feeling?

 Too hot/ too cold/ too bright/ too dim/ too thirsty/ hungry/ physical

discomfort

Curriculum adjustment

 Difficulty level of the activity  Child‟s interest  What is my child‟s natural learning style?

 Visual (e.g. visual cards, drawings)  Auditory (e.g. songs, rhymes, associations)  Hands on (manipulating objects or learning tools)  Kinesthetic (incorporating larger movements in

learning)

EXTERNAL FACTORS

IN CONCLUSION…

 Your sensory integration is unique to you.  How we maintain self regulation is also unique to

us based on our sensory preferences and our natural threshold level for sensory information.

 A healthy consistent routine helps us maintain

self regulation through the day (sleep, meals, regular physical activity)

 Appreciating your child‟s natural self regulation

and sensory processing ability can help you pitch and pace your teaching to make them a better learner.

REFERENCES

 Dunn, W. (2008). Living Sensationally.

Understanding your senses, Great Britain, Jessica Kingsley Publishers .

 Williams, M. S., Shellenberger, S. (1996). “How

does your engine run?” A leader’s guide to The Alert Program for Self-Regulation, Butte Place N.W., Albuquerque, TherapyWorks Inc.

Thank you for staying ALERT!