1. Are clouds forming? Then it’s time to expose the silver lining!
Winnie Dunn PhD OTR FAOTA
Professor & Chair
Dept. of OT Education
University of Kansas

2. What are the clouds made of?
Changes in the way we provide service
Discontent about how we label children
@ winnie dunn University of Kansas 2006

3. Changes in the way we provide service

4. Findings from studies in Autism [as reported in Baranek, 2002]
We need to design educational programs that accommodate unique sensory processing patterns
We need to make task/ environ modifications
We need to employ systematic data collection to chart progress
Traditional SI therapy is beneficial ANECTODALLY, but evidence does not substantiate effects
Functional activities in daily routines within natural contexts increases generalization

5. Discontent about how we label children

6. Is this disorder for real?
TIME magazine, Thursday, Nov. 29, 2007
Claudia Wallis
“Some kids just cant handle life’s sights,
sounds and sensations, but experts are
split over whether to recognize
sensory processing disorder” p. 62

7. You and
Your Quirky Kid
The girl who wears her clothes inside out, the boy who loves plumbing. What parents and experts say about the children who just don't fit in.
By Lorraine Ali |
NEWSWEEK
Sep 17, 2007 Issue

8. Lorraine Ali, Newsweek September 17, 2007
“…there is something unexamined in our thinking when we elevate the need for normalcy to a state of spiritual grace, and live under a constant anxiety that we fail to measure up to its demands…” p. 50
Lorraine Ali, Newsweek September 17, 2007

9. Harnessing the Power of ADD
“Oftentimes you
find people with ADD
spending years
trying to develop
what they’re bad at
instead of
what they’re good at”
[Ned Hollowell]
Sophia Dembling, Delta Sky, december 2007

10. “…When it comes to a child with a disability, [professionals & parents] can easily spend too much time on what the child cannot do, …We can be so busy dealing with what is absent that we ignore what is right before our eyes. …what we need to make visible is not darkness but light...” p.280

11. Exposing the silver lining!
Tapping our inner capacity

12. Changes in the way we provide service
Micro level:
the child, family & school

13. FAMILY CENTERED CARE
When practices are family centered, we achieve better family and child outcomes
Ackland, 1997
Joyce & Showers 1995
Law, Darrah etal, 1998
Marchant & Young 2001

14. NATURAL ENVIRONMENT INTERVENTIONS
Parent facilitated child learning is equally or more effective than practitioner implemented interventions
Gibbard, Coglan & MacDonald 2004
Law, Garret & Nye, 2004
McLean & Cripe 1997

15. CHILD PARTICIPATION
Children’s development is enhanced when they interact and practice in settings which demand use of skills Kelllegrew, 1998; Law etal, 1998; Roper & Dunst, 2003; Dunst, 2001, 2006

16. Discontent about how we label children
Peeking in on
The macro level

17. “If we examine ourselves and those around us—the husband who shuns picnics because he can’t stand the texture of grass… we have to admit that everyone, to some extent is odd.” p. 50
By Lorraine Ali |
NEWSWEEK: You & your Quirky Kid
Sep 17, 2007 Issue

18. “…parents need to ask themselves, Is this making him unhappy or just making me unhappy? [Dr. Perri Klass].” p. 50
By Lorraine Ali |
NEWSWEEK: You & your Quirky Kid
Sep 17, 2007 Issue

19. “Autism is less a disease to be hidden than a disability to be accommodated; it is less a stigma, reflecting badly on her family, than a variation of human existence.” p.33

20. “…Can we make the world they’re going to grow up in sufficiently kind and welcoming to them and their quirks, and can we provide them with the basic skills they need to navigate in that world?.” p. 50
By Lorraine Ali |
NEWSWEEK: You & your Quirky Kid
Sep 17, 2007 Issue

21. Juliet Rix investigates the psychology of sight, sound and smell
From The LONDON Times newspaper
October 20, 2007
Are you a sensory junkie
or a nervous wreck?
How do you respond to bright lights, soft clothes, loud music and spicy food?
Juliet Rix investigates the psychology of sight, sound and smell

22. “Isabel has taught me that the unexpected, even the beautiful, can emerge even from the undesirable, …—no, not something “normal”, but a brilliant light or an inner truth struggling to blossom.” p. 35

23. “…at the end of the day when I tuck her in, she’s not a case of autism…. She’s simply my daughter….” p. 35

24. Let’s consider an example at the MACRO level…

25. …is imbedded in Sensory Processing
The experience of
being HUMAN …
…is imbedded in Sensory Processing

26. “…I don’t know what a pear tastes like to you.”
“…sweet, juicy,
Soft on your tongue,
grainy---
Like sugary sand that dissolves in your mouth…
How’s that?…”
[City of Angels, 1996]

27. How do you react to sounds? SEEKERS…
Make noises, e.g., hum, tap throughout the day
BYSTANDERS…
Don’t really notice sounds around them
AVOIDERS…
Wear ear plugs to keep sounds away
SENSORS…
Ask people to stop making noises

28. How do you react to touch? SEEKERS… Touch others when talking to them
BYSTANDERS…
Bump into people when walking
AVOIDERS…
Keep their distance from others
SENSORS…
Flinch when touched unexpectedly

29. Choose intense sports & amusement park rides BYSTANDERS…
How do you react to movement?
SEEKERS…
Choose intense sports & amusement park rides
BYSTANDERS…
Don’t know how they got scrapes and bruises
AVOIDERS…
Prefer sedate activities
SENSORS…
Want to be the driver on trips

30. Have busy dense decorating schemes BYSTANDERS…
How do you decorate?
SEEKERS…
Have busy dense decorating schemes
BYSTANDERS…
Have crooked wall decorations & don’t notice
AVOIDERS…
Decorate as little as possible
SENSORS…
Select clean lines & uniform color palates

31. Are casual, & sometimes mismatched
What are your clothing choices?
SEEKERS…
Want layers, textures & lots of accessories
BYSTANDERS…
Are casual, & sometimes mismatched
AVOIDERS…
Have a few pieces used over & over
SENSORS…
Use only specific brands and fabrics; sparse accessories

32. Do best with buffet style or multi course
How do you prefer to dine?
SEEKERS…
Prefer busy & entertainment venues
BYSTANDERS…
Do best with buffet style or multi course
AVOIDERS…
Prefer to eat at home, use carry out or delivery
SENSORS…
Prefer off peak hours, low lighting, favorite venues

33. Have many projects available at one time BYSTANDERS…
How do you organize you workspace?
SEEKERS…
Have many projects available at one time
BYSTANDERS…
Have casual spaces that may appear disorganized
AVOIDERS…
Close doors, find isolated places, may telecommute
SENSORS…
Clear surfaces each day; have precise organization

34. Create a precise timeline of activities & don’t deviate easily
How do you vacation?
SEEKERS…
Create a busy, vigorous schedule
BYSTANDERS…
Have no schedule & change plans easily
AVOIDERS…
Repeat the same trip, select solitary venues
SENSORS…
Create a precise timeline of activities & don’t deviate easily

35. Example of sensory processing pattern
Home décor is
Casual and
eclectic
Wears layers
& accessories
Amt of trait
Seeker
Bystander
Sensor
Avoider
What and where to eat doesn’t
Matter too much
Tidies up workspace at end of day
@ winnie dunn University of Kansas 2006

36. SEEKERS always want more
[high thresholds +
active self regulation]
They create excitement & change all around them

37. AVOIDERS want more of the same thing and nothing more
They create routines to keep life peaceful & manageable
[low thresholds +
active self regulation]

38. SENSORS keep track of everything
They notice what is going on & have precise ideas about how to handle situations
[low thresholds + passive self regulation]

39. BYSTANDERS don’t know what they are missing
They are easy going and can focus even in busy places
[high thresholds + Passive self regulation]

40. What sensory pattern does this person have for dressing?
@ winnie dunn University of Kansas 2006

41. What sensory pattern does this person have for dressing?
@ winnie dunn University of Kansas 2006

42. - = - - + + + 34% 14% 2% This is the range of whole less than others
more than others
Same as others -
- - +
+ + =
This is the range of
typical performance
Sensory Profile measures are based on the Bell Curve
whole
@ winnie dunn University of Kansas 2006

43. So, at the macro level, intervention takes the form of
A change in the context
So more people can function successfully

44. Jessica Kingsley Publications
ISBN #
Jessica Kingsley Publications
October 2007

45. Jessica Kingsley Publications
Our sensory profile:Who we really are How we react to smells and sounds all but defines us By Heidi Dawley Oct 29, 2007
Making sense
Of your senses
By Claudia Wallis
Are you a sensory junkie or a nervous wreck?
Juliet Rix investigates the psychology
of sight, sound and smell
LONDON
ISBN #
Jessica Kingsley Publications
October 2007

46. Eating and Dining

47. Let’s practice….. What is the optimal dining experience?? Low
Registration
Sensation
Seeking
Sensory
Sensitivity
Avoiding
What is the optimal
dining experience??
@ winnie dunn University of Kansas 2006

48. The location for eating and dining
BYSTANDER
Places that provide interest and changes throughout the meal
SEEKER
Loud, active, busy places during peak hours
SENSOR
Favorite places and menus during off-peak hours
AVOIDER
Eat at home with a predictable menu

49. The foods we eat REGISTRATION
Contrasting flavors, textures, colors; in many serving dishes
SEEKING
Ethnic foods with Varied/ unusual spices
SENSITIVITY
Familiar menu items always selected
AVOIDING
Have a routine menu

50. LIVING SPACES

51. Features of the living spaces
LOW REGISTRATION
Unusual floor plans with changes in flooring room to room
SENSORY SEEKING
Open living spaces
SENSORY SENSITIVITY
Floor plans with functions grouped together
SENSORY AVOIDING
Self contained spaces in floor plan

52. Decorating your home REGISTRATION
Eclectic style with unusual arrangements
SEEKING
Bright, contrasting color schemes
Uneven placement of windows, doorways
SENSITIVITY
Homogeneous color palate
Favorite piece of art on wall
AVOIDING
Sparse with separate areas for being alone

53. e.g., how life is SENSATIONAL for…
A SEEKER
AN AVOIDER
A BYSTANDER
A SENSOR

54. So, how can we use these ideas in everyday life?

55. The older girl needs a lot of sensory input…
So what about
getting dressed?

56. This baby cannot stay alert to eat…
So how could we
change the sensory
environment to help
Eating?

57. This man needs a quiet place…
…so what do we offer him for when his grandchildren are coming over?
@ winnie dunn University of Kansas 2006

58. “…Isabel hated things that vibrated
“…Isabel hated things that vibrated. She didn’t like pressure on her fingertips so much that she refused to even try to learn to button…or tie… or hold a pen...” p

59. “…Isabel at first refused …; eventually she stuck with it [cello playing]. The sound and touch sensitivities didn’t go away, but they lost their grip on her...” p

60. “…in order to help people with autism, we don’t always need to …pretend that they are not different…. Rather, we need to provide roles in our communities for people with autism, some of which they may in fact, be able to perform better than anyone else...” p.291

61. The essence of INTERVENTION
Intervention must not be solely focused on fixing children’s behaviors. Sometimes we need to create a context that is more supportive, a strategy which acknowledges that the challenges children face do not reside within them, but rather in the space between the children and their contexts…

62. The essence of INTERVENTION
This is how we reduce judgment,
create resilience &
increase acceptance,
so that differences are
just a DIFFERENCE,
not a source of disorder,
but rather what makes a person interesting, quirky, funny…
HUMAN.

63. So, we return home. The clouds open
And reveal
New possibilities