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

W HAT IS O CCUPATIONAL T HERAPY ? 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. 3

A CHILD’S OCCUPATION Learning Self care Play

Learning Motor skills Self care Self regulation Play Sensory Processing

S ELF 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 

HOW DO WE MAINTAIN GOOD ALERTNESS LEVEL? Sensory overload Optimal level of arousal Low arousal Sensory events over time

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 of 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 operate. 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

Our senses  Propioception  Our nerve endings in our joints and muscles tell us our body position in space  A deep pressure  Calming and rhythmic in nature  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!

S ENSORY I NTEGRATION High Threshold More time to get more sensory input to react Low Threshold Notices sensory input mush faster

D UNN ‟ S MODEL OF SENSORY PROCESSING Neurological Self-regulation Thresholds Passive Active (let sensory input (do things to control happen to them and the amount and type of then react) sensory input) High Threshold Bystander Seeker Sensor Avoider Low Threshold

T HE S EEKER  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.

T HE S EEKER 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

T HE A VOIDER  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.

T HE A VOIDER C HILD  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)

T HE S ENSOR  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 on (e.g. mood or circumstance) and are creative because they notice the small things.  Challenge: Distractible and become easily overwhelmed by experiences as they can sometimes find it hard to ignore it.

T HE S ENSOR C HILD  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.

T HE B YSTANDER  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.

T HE B YSTANDER C HILD  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 on 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

S ENSORY A PPROACH  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

S ENSORY A PPROACH  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.

S UGGESTED A CTIVITIES  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)