1. Sensory Needs & Behaviour
Briony Moore (Occupational Therapist)
Iona Bickham (Occupational Therapist)
Vicky Laute (Clinical Psychologist PBS Lead)
Rosalind Angier (Speech and Language Therapist PBS Lead)
Have checklist on each persons chair at arrival, request that it is completed as people come in.
NEED PENS!!!

2. AIMS Introduce sensory theory and its role in function
To encourage further learning
Start to develop your sensory goggles
To link sensory behaviour and PBS

3. What do we mean by sensory?
THE FAMILIAR THE UNFAMILIAR
Taste Proprioception
Vision Vestibular
Hearing
Smell
Touch
Video here: STOP AT 3.20.

4. What do we mean by sensory? Lets experience it…
Tables of exercises: 8 exercises (6?)
Different sense for each activity - Pin tail on the donkey (visual/vestibular), Movement breaks (proprioceptive), Tactile discrimination - finding recognisable objects in a box, activity with ear muffs on (auditory), eating sweets/crunchy foods (oral/taste), Balloon keep-ups
What senses were challenged
How did you feel- arousal

5. The functions of senses
Sensory Integration is the brains ability to understand and organise information we receive from the senses
Drives our development
Enables us to adapt to environmental demands
Protects us
Encourages us to explore and learn
So what is their function…

6. The integration of senses to deliver function
Theory of how senses are involved in development Ayres developed this and it is still referred to today…
We see referrals in the end products but sometimes we have to explore where it comes from and thats where our more complex sensory assessment would come in.

7. SI – the process
Your senses integrate to give you a complete understanding of who you are, your world and your place in it.
Sense
Input
Action
CNS
Sensory Integrate
Your brain organises the sensory information it receives and you assign meaning to it.
You then respond and behave accordingly to that meaning
Hot kettle/bee sting

8. SI – the process SENSORY INTERGRATION Via CNS INPUT OUTPUT Action
Via the Senses
OUTPUT Action
Vision
Hearing
Smell
Taste
Touch
Proprioception
Vestibular
Register
Orientate
Select/prioritise
Analyse
Organise/plan
Output/decide
Perception of body/world
Adaptive Response
Learning process

9. Sensory Integration
‘Ayres (1979) described sensory integration with an analogy comparing the brain to a large city with traffic consisting of neural impulses. Good sensory processing enables all the impulses to flow easily and reach their destinations quickly. Sensory integrative dysfunction on the other hand causes a traffic jam in the brain. Some sensory information gets tied up in the traffic, blocking certain parts of the brain from getting the information to do their job’ Murray-Slutsky and Paris (2005)
Sometimes with the people we support the senses aren’t integrating as effectively- well documented in autism for example.

10. Sensory Preferences Winnie Dunn
Explores how we all have personal preferences about sensory input.
Understanding those preferences can help you with activities choices and life planning

11. Compare your morning routines…

12. Sensory preferences Low registration/Bystander Sensory Seeker
Sensory sensitivity
Sensory avoiding
(Dunn 2002)
Dunn discussed 4 types of preference
Bystander – missing stimuli or responding slowly#
Seeker – characteristics such as enjoyment and pursuit of sensory stimuli
Sensitivity – distractibility, discomfort with sensory stimuli (startle easily)
Avoiding – deliberate acts to reduce or prevent exposure to stimuli, efforts to make exposure more predictable.
Back to checklists – go through with audience
Think about your own calming activities. What helps you to wind down after a long day?
Think about your own alerting activities and how you help to wake yourself up when you feel tired.
Think about things that are disorganizing to you? Things that make you feel “frazzled” or make you mad. How do you calm down after these times?
Where would they place themselves re: Winnie dunn categories

13. Sensory Preferences Sensory preferences change over the life span Age
Environment – who/where/when
Progressive conditions
Injury
Loss of dexterity
Visual and auditory changes
Age – changes to neuro pathways

14. Arousal
One of the areas we explore a lot is arousal- We all regulate through the day…. We amend sensory input coming in to keep at the just right level so we can all do what we need to do.
We self regulate very easily ( mostly) the people we support often don’t!
Fits well with PBS

15. Just Right ‘
Optimal range of arousal allows optimal functioning and adaptive behaviour’
We are more able to use our brains
Concentration
Organisation
Self-esteem
Self-control
Academic learning ability
Abstract thought and reasoning
Praxis – planning, sequencing, motor skills

16. Neurodiversity
‘There is a great deal of variation among human brains and human minds, and this variation is called neurodiversity. Different people think differently – not just because of differences in culture or life experience, but because their brains are “wired” to work differently’.
Examples:
For the people we support their sensory experiences can be profound- whilst we all have sensory preferences as neurotypical individuals some individual's we support will have such difficulty with sensory processing it is impacting their ability to function and ability participate in life
Recognised in DSM Autism And autism NICE Guidance as a an particular area.

17. Real life examples Case studies
What do they think is going on in the sensory systems?

18. Interventions Occupational Therapists use
Engage in meaningful activity- sensory preferences
Adapt the environment
Use specific sensory strategies
ASI® therapy – ‘Active, individually-tailored, sensory- motor activities contextualized in play at the just right challenge that target adaptive responses for participation in activities and tasks’ ( Schaaf 2017)
specifically trained
fidelity model
As a contribution to PBS plans

19. Sensory strategies Under responsive Over responsive Tactile
Under responsive
Over responsive
Tactile
Fidget toys, varied touch activities, scrubbing self with towel after washing.
Using firm pressure not light, forewarn about touch, individual should control touch, do not approach from behind.
Auditory
Gain eye contact before giving instructions, allow individual to make noise or find headphones for sound.
Reduce auditory stimuli (room acoustics, echoes, background noise), visual instructions.
Vestibular
Structure movement into daily routine, lean or sit down when engaging in activity, supportive seating.
Allow feet to touch the ground in movement, avoid fast movements before settled activity.
Visual
Highlight areas for attention, remove visual clutter, bright colours and clear borders.
Minimise bright lighting, reduce visual distractions, avoid flickering/flashing lights.
Oral/taste
Strong flavoured foods, sucking, blowing, whistles, crunchy snacks, sour and fizzy foods.
Chewing: tube, neutral gum, bland tasting foods, avoid strong perfumes, fabric conditioners, air fresheners.
Proprioceptive
Pushing, pulling, moving heavy objects, Push-ups, yoga, digging in the garden, carrying shopping.

20. The power of proprioception
Proprioception: our sense of body awareness and where we are in relationship to our surroundings.
Proprioceptive system has an important regulatory role in the sensory system.
Proprioceptive input can be calming for those easily overwhelmed by sensory stimulation or can be alerting for those who need more sensory stimulation to attend to activity.
Hand out Sheet with examples? Proprioception activity ideas to be shared here?

21. What is Positive Behaviour Support?
A framework for developing an understanding of behaviour that challenges encompassing a number of treatments and therapeutic approaches.

22. Examples of behaviours:
Behaviours that challenge could indicate attempts to seek or avoid sensory stimulation, and could be an indication of an attempt to regulate their sensory system.
Examples of behaviours:
Refusing to go outside
Rocking alone in a corner
Inability to sit at a table
Smearing
Self harm
However behaviours may also stem from other factors such as communication difficulties, physical health problems, and psychological factors.
Relate examples back to senses.

23. Components of a good PBS plan
Pen picture of the person
Likes and dislikes
Evidence of behaviour analysis
Support for communication
Meaningful engagement
Prevention strategies – EMPHASIS HERE
Reactive strategies
Sensory preferences
And more…
Prevention strategies – EMPHASIS HERE
Emphasise the importance of sensory preferences.

24. Take home See behaviour consider sensory needs
Don’t exclude other functions
Know your person, know their sensory preferences.
Ensure the person is engaged in meaningful activity
Seek specialist input if required

25. References
Ayres, J. (1979). Sensory Integration and the Child. Western Psychological Services.
Brown. E.B. and Dunn, W. (2002). Adolescent/Adult sensory profile User’s Manual. Pearson.
McLarty, H. (2010). Sensory processing, lets put the pieces together.
Dunn W (2009)Living Sensationally Understanding your Senses
PBS A competence Framework, PBS conference framework, March 2015.
Sensory Integration Network. (2012). Introduction to Sensory Processing.
Sensory Integration Network. (2013). SI module 1, Foundations and Neuroscience Handbook.
Neurodiversity. [ONLINE] Available at: [Accessed 8 September 2017].
Williams, M.S. & Shellenberger, S. (1996). How does your engine run. A leaders guide to the alert programme for self regulation. TherapyWorks Inc.