Week 3- Self Regulation

Sensory integration is a function of the brain and body that occurs in all humans….

Across the life span

What 3 components to know about sensory integration as it relates to OT

1. A specific clinical frame of reference for the assessment and treatment of people who have functional disorders in sensory processing

2. Multi sensory integration is used in basic science and neuroscience but does not reflect a behavioral or clinical OT perspective

3. Sensory processing has become common language in OT to differentiate from Ayer’s sensory integration and neuroscience constructs

What are the core concepts of sensory processing according to Dunn?

Sensory processing patterns apply to everyone, not just people with disabilities

Every has some amount of each sensory pattern; some are seen more intensely expressed in neurodiverse populations

Context and activities provide unique sensory experiences; differences in sensory processing is NOT A DISORDER

What are the core concepts of sensory processing according to Miller?

Sensory processing disorder is a complex disorder that affects the brain; the daily lives of 1 in 20 child read are affected by SPD

The disorder has unique symptoms not explained by other known conditions and is often misdiagnosed

Initiative to include SPD in the DSM-V as a novel diagnosis- FAILED

What theory regarding sensory processing what OT operates within?

Winnie Dunn’s

What is the low registration or bystander category according to Winnie Dunn’s theory?

An individual has a high threshold and needs a lot of sensory input but is passive when it comes to addressing their low threshold

What is the seeker category according to Dunn’s theory?

An individual has a high threshold and requires a lot of sensory input, this individual seeks out sensory stimulation in response to their low threshold

What is the sensor/sensitivity category according to Dunn’s Theory?

An individual has a low threshold and detects sensory stimuli sooner and at a higher rate than others, the individual is passive and does not do anything in response to their overstimulation

What is the avoider category according to Dunn’s theory?

An individual with a low threshold and detects sensory stimuli earlier and at a higher rate, they actively will remove themselves or get away from the stimuli to address their sensitivity

What sensory category does this sentence describe:

“These individuals are great at creating new ideas but can get distracted by their higher need for input”

Seeker

What category of sensory processing does this sentence describe:

“They are very easy going because they don’t notice all the details, but this can create a challenge when noticing details is important to a situation”

Bystander

What sensory processing category does this sentence describe:

“They are great at organizing and creating systems but can be challenged when something disrupts the routine”

Avoider

What sensory processing category does this sentence describe:

“They are great at noticing details that others miss and can get overwhelmed by this awareness”

Sensor

What is the process of evaluating sensory processing skills?

1. Review record

2. Occupational interview with the individual, family, teacher

3. Conduct skilled observations when: participation is successful and when participation is challenging

4. Complete formal assessments; performance based testing and informant questionnaires

What is important to know regarding “rarely”, “frequently”, and “sometimes”

Each phrase has a percentage tied to it that indicates how often the occurrence is, so its more subjective than objective

What are things you want to look at during the clinical observation portion of a sensory processing assessment?

Distinguish patterns of sensory processing behaviors in natural context

Assessment of occupational performance; supplemental information provided by standardized testing

Assessment of component skills

Group meaningful clusters of behaviors that are indicative of a pattern of function/dysfunction

What kind of information does standardized measures provide?

Information regarding sensory-related skills

Provide information about the child’s functional level in comparison to other children

Supplement the information provided by your other measures

What are examples of standardized measures used to assess sensory processing skills?

Sensory integration and praxis test

Sensory profile

Sensory processing measure

Preschool SENSE

Why would we evaluate sensory processing skills but not be considered sensory integrationist?

We want to identify sensory skills that affecting the child’s participation and performance in occupations; we are gathering this info to inform us but we will not be solely addressing it

In the North Carolina school setting, when is the OT required to complete a sensory processing evaluation

If the team is considering autism as an educational diagnosis

What is social emotional learning (SEL)?

The process through which children and adults understand and manage emotions, set and achieve positive goals, feel and show empathy for others, establish and maintain positive relationships, and make responsible decisions

What are the dimensions of SEL?

Self-awareness

Self-management

Social awareness

Relationship skills

Responsible decision making

What is self-awareness?

Know your strengths and limitations, with a well grounded sense of confidence, optimism, and a growth mindset

What is self-management?

Effectively manage stress, control impulses, and motivate yourself to set and achieve goals

What is social awareness?

Understand the perspectives of others and empathize with them, including those from diverse backgrounds and culture

What are relationship skills?

Communicate clearly, listen well, cooperate with others, resist inappropriate social pressure, negotiate conflict constructively, and seek and offer help when needed

What is responsible decision making?

Make constructive choices about personal behavior and social interactions based on ethical standards, safety, and social norms

What are some SEL approaches?

School-wide

RTI/MTSS

Individual

What does this chart demonstrate regarding SEL?

These are the environments we want to evaluate to identify factors that affecting a person’s SEL skills and identify how they use their SEL skills across multiple environments and settings

What SEL skills is a 2 month old exhibiting?

Start to smile and look directly at you

Cry to get needs met

Occasionally self-soothe by sucking on hands and fingers

What SEL skills is a 4 month old exhibiting?

Smile and play spontaneously

Cry when you stop playing

Begin to engage with you by imitating faces that you make

What SEL skills is a 9 month old exhibiting?

Start to show stranger anxiety

Start to prefer some toys over others

May cry when familiar faces are not around

What SEL skills is a 6 month old exhibiting?

Are more aware of which people are familiar and which are strangers

Can respond to your emotions by crying, smiling, or laughing

Enjoy looking at themselves in the mirror

What SEL skills would a 12 month old exhibiting?

Play favorites with familiar people

Are more interactive

Enjoy simple interactive games like patty cake and peak a boo

What are things that are hallmarks of SEL skills exhibited between 2- 12 months?

Attachment

Language exposure

Self-soothing

Routines

Shared interest

What SELs skills will a 18 months to 2 year old be exhibiting?

Have more temper tantrums and become more defiant as attempts at independence and communication increases

Begin simple pretend play, often by imitating what adults or other kids are doing

Becoming interested in having other kids around but are more likely to play alongside them (parallel play) than with them (cooperative play)

What SEL skills would a child between 3 and 4 being exhibiting?

Start to show and verbalize a wider range of emotion

Are interested in pretend play but may confuse real and “make believe”

Are spontaneously kind and caring

Start playing with other kids and separate from caregiver easier

May still have tantrums because of changes in routine or not getting what they want

What are the hallmarks of SEL skills for children between 18 months to 4 years?

Tantrums

Transitions

Independence

Wider range of emotions

Helpfulness

Separation anxiety

Routines

What SEL skills would a 5 to 6 year old be exhibiting?

Are aware of their gender and may prefer to play with same-sex peers

Enjoy playing with other kids and are more conversational and independent

Test boundaries but are still eager to please and help out

Begin to understand what it means to feel embarrassed

What SEL skills would a 7 to 8 year old child be exhibiting?

Are more aware of others’ perceptions

May complain about friendships and other kids’ reactions

Want to behave well, it aren’t as attentive to your directions

Try to express feelings with words, but may resort to aggression when upset

What SEL skills would a 9 to 10 year old child between exhibiting?

Start narrowing peer groups to a few close friends they share secrets and joke with them

May withdrawal from family activities and conversations to start developing their own identity

Are affectionate, silly and curious, but can also be selfish, rude, and argumentative

What are the hallmarks of SEL skills for children aged 5 to 10 years?

Gender roles

Initiating friendships

Awareness of perceptions

Even more complex emotions

Sense of humor

Trust, secrets, and boundaries

What are examples of SEL questionnaires?

Vineland adaptive behavior scale (VABS)

Devereux early childhood assessment (DECA)

Social skills improvement system rating scales (SSIS)

Social emotional assessment measure (SEAM)

What does the DECA assess?

Measures protective factors and resiliency; initiation, attachment, self-regulation

What are the different settings and age ranges the DECA can be used with?

Infant

Toddlers

Preschool

Student strengths K-8

Adults in the child’s life

What is the social skills improvement system?

3 to 18 years old

An intervention system/guide to assess social skills, problem behaviors, and academic competence (and how to address areas of concerns)

What are examples of social skills?

Communication, cooperation, assertion, responsibility, empathy, engagement, self-control

What are examples of problem behaviors?

Externalizing, bullying, hyperactivity and inattention, internalizing, autism spectrum

What are examples of academic competence?

Reading achievement, math achievement, and motivation to learn

What are active behaviors?

Direct refusals

Opposition

Aggression toward people or property

Self-injurious

What are passive behaviors?

No compliance

Withdrawal

Inattention

Lack of response

What are examples of why a child may be exhibiting a certain behavior?

For attention

To be alone/nonsocial

To escape

Tangible

Due to sensory stimuli

What are ways to manage behaviors during the evaluation process?

Have a preferred adult assist in the evaluation process

Use first and the language

Clear expectations

Incorporate occupational profile likes into the evaluation

Attempt to redirect

Encourage and uplift during challenging tasks

Stickers

Have the child determine the order of activities with you

Create a visual schedule

Use a time if transitions become challenging

What drives your approach regarding addressing a child’s behavior?

Differential assessment- identifying why that behaviors is occurring and getting to the root of the problem

What are the goals of addressing a child’s social emotional skills? (Skills they will improve or gain)

Awareness of social rules

Awareness of others

Self management or co-regulation

Problem solving

Self-awareness and self advocacy

What are the goals of addressing sensory regulation?

How participation in the activity or the environment that is causing the dysregulation is impacting them and their occupations

Self management and co-regulation

Self-awareness