Understanding Sensory Development - nhsdg.scot.nhs.uk · digestive system, heart and voice Week 15: vision develops as the eyes become sensitive to light. Baby may register a bright

Understanding Sensory Development

Universal Presentation OCCUPATIONAL THERAPY FOR CHILDREN & YOUNG PEOPLE

2016

1 Occupational Therapy for Children & Young People, NHS Dumfries & Galloway

This presentation is aimed at parents and those who work with children, who would like to

know more about a child’s sensory development and how to support it


Objectives of Presentation

• Introduction to sensory development

• Gain understanding of our different senses

• Recognise sensory preferences

• Consider influences on sensory development

• Investigate and take “a closer look” at challenges

• What can help with challenges?

• How we use sensory information?

– Over-sensitivities

– Sensory-seeking

• Gaining Further support

• The role of Occupational Therapy


Introduction

• Our lives are full of sensory experiences • We all respond to sensory information • We

• Touch • See • Hear • Taste • Smell • Move

From: Making Sense of Sensory Behaviour, Falkirk Council. Accessed on 04/08/16

https://www.falkirk.gov.uk/services/social-care/disabilities/docs/young-people/Making%20Sense%20of%20Sensory%20Behaviour.pdf?v=201507131117

Occupational Therapy for Children & Young People, NHS Dumfries & Galloway 4

https://www.falkirk.gov.uk/services/social-care/disabilities/docs/young-people/Making Sense of Sensory Behaviour.pdf?v=201507131117






Activity: Do You Like or dislike..... ? Olives Fireworks Shaving foam Perfumes Coffee Spicy foods Woollen jumpers Roller coasters Wooden Ice cream sticks Cotton wool Having a massage Clothes tags Hand driers Working with the radio

Questions

• From those you liked, what did you like about them?

• From those you dislike, what do you dislike about them?

• Do your likes and dislikes have a significant impact on your day to day life?


Likes & Dislikes = Sensory Preferences

• Many of us have sensory preferences

• We can happily live with our preferences having very little impact on our daily lives

• We make decisions everyday around our sensory preferences

• These include which choices we make about foods we eat, clothing we wear, places we visit

Occupational Therapy for Children & Young Person, NHS Dumfries & Galloway 7

Sensory Development fundamental to a child’s health & well being

Senses help me

understand my world

Smell

Vision

Taste

Hearing Body awareness

(proprioception)

Balance

(vestibular)

Touch

(tactile)


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Vision

Our vision: - interprets information from what we see - receives and transfers information about what we see, to

the rest of our body which enables us to engage in our environment

Our vision helps us: - recognise objects/the environment - develop language – we see something, we name it - interact with objects in our environment - together with our tactile and proprioceptive sense, vision

helps us move efficiently - maps our world out and adds meaning


Hearing

Our hearing: - interprets information from what we hear - receives and transfers information about

sounds around us, to our body, and we react appropriately

Our hearing helps us: - make sense of our surrounding environment - enjoy experiences such as music - respond to danger in our environment e.g. road

safety


Taste

Our taste: - comes from our tongue which receives and transfers

information about how things taste, to our brain and we react accordingly

- has loose links with our smell and touch senses which enables us to understand our experiences with food

Our taste helps us: - recognise unpleasant tastes, such as meat that has gone

past it’s sell-by date – a way to protect ourselves from harm - add meaning to a multisensory experience e.g. The taste

of a meal, together with smell and touch

Occupational Therapy for Children & Young People, NHS Dumfries & Galloway

11

Smell

Our smell: - comes from our nose - feeds us with information about smells around

us Our smell helps us: - recognise unpleasant smells e.g. Milk that has

turned sour – a way to protect ourselves from potential harm

- adds meaning to a multisensory experience, e.g. The smell of a meal together with taste


12

Touch Our touch: - comes from the nerves under our skin - receives and transfers information about how things feel i.e. texture, temperature, pain Our touch helps us: - recognise and respond to pain - learn about and tell the difference between different shapes and textures - together with body awareness and vision, touch helps us to develop more precise hand skills, e.g. Enabling us to pick up a cup

13 Occupational Therapy for Children & Young

People, NHS Dumfries & Galloway

Body Awareness

Our body awareness:

– Is based within our muscles and joints

– Tells us where our muscles and joints are in the space around us

Our body awareness helps us:

– Recognise where our arms and legs are without looking at them

– Maintain good posture

– To move efficiently and effectively

– Learn and remember information from the environment around us


14

Balance

Our balance: – Is based within our inner ear – Tells us about our head position in the environment

around us – Tells us how we are moving (direction, speed) – Tells us where we are in relation to our centre of gravity Our balance helps us: – Maintain a link with gravity and balance – Maintain muscle tone and posture – Keep our vision stable – Work both sides of our body together


15

Activity: Play Experiences


16

Sensory Development

• The sensory needs of a person change with time • A child’s sensory processing will mature as they get

older • We all experience sensations in our own individual

ways • Some people can be extremely sensitive to noise,

light, touch, smell or movement • Others may under-respond to such sensations (COT April 2015)


17

Week 17: baby can

move in all directions

(balance & body

awareness) Later on,

you can even see the

baby kick!

Sensory Development – begins before we are born!


Week 28: baby

is able to smell

& taste

Week 15: Baby will start to hear

muted sounds from the outside world,

their mother’s digestive system, heart

and voice

Week 15: vision develops as the

eyes become sensitive to light.

Baby may register a bright light outside

mums tummy

18

Adapted from NHS Choices: You & Your Baby

& Baby Sense

Week 15: all joints

form and can

move – body

awareness

Week 36: less

space to move –

a tight squeeze

and time to learn

about touch!

Influences on Sensory Development

• Past experiences – What experiences has the child had? – Positive and negative experiences? – What are the experiences of the care givers and how may these have

been projected onto the child? • Do they dislike mess, certain food etc

• Possible opportunities – What opportunities for sensory development is the child currently

offered? – What further opportunities could be offered which could be beneficial?

• Safety and security – Are these experiences being offered in an appropriate and safe way to

the age and stage of development for that child? – Are these experiences fun and motivating?



How we use Sensory Information


20

1. Information received by our senses about an experience

2. Information sent to our brain for processing

which helps us to make sense of the experience

3. Our brain tells our body how to respond to the information given

4. Our brain stores information about past experiences which influence responses to future experiences

Many Babies/ Toddlers do not like the feel of grass

WHY Could This Be


21

Sensitive to Grass an example of a typical sensory sensitivity

Contributing factors

• Combination of textures

• Light tickly touch

• Experience – How often have

they been on grass/sand?

• Be aware of the sensitivity of a

young child’s hands and feet

• Appropriate developmental

experiences e.g. tummy time,

pushing self up on hands,

crawling

Ideas to Try

Having a blanket on the

grass/sand

Start with them having

shoes and/or socks on

Distract with age

appropriate play

Positive reassurance

Graded Approach e.g. Use

spade to dig sand first

Occupational Therapy for Children & Young

People, NHS Dumfries & Galloway 22

Investigate

-Identify any challenging responses to experiences

-Look for patterns in these responses

-What has happened before the response – is it sensory? Does this happen each time?

- Are there any other possible contributing factors?

-Use the “A Closer Look Tool” on the next slide to help you investigate



A Closer Look Tool


24

Contributing factors Ideas to try

Challenge 1

Challenge 2

Challenge 3

What Can Help???

Occupational Therapy for Children & Young Person, NHS Dumfries & Galloway

25

What can Help?

Opportunities Did you know....? • it takes 21 days to change a habit • It takes 10-15 exposures to foods to like it • It takes 10,000 hours to master a skill

It is important NOT to assume that a child has sensory difficulties when they don’t like it the

first few times.


26

What can Help?

• Graded Approach

– Allow the child to watch

– Talk about it

– Use tools/utensils instead of your body

– Time-lock it

– Gradually increase experience with the child at their pace

– Distract the child with a game that takes the focus away from the experience


27

What can Help?

Positive support: – Pointing out others enjoying the experience – Praise – Reassurance – Be aware of your own responses – avoid showing

negative responses – Keep Calm and Consistent

Avoid: – Negative words – Child being told off for doing the task


28

What can Help?

Control – Talk through what may happen – use simple and clear

language

– How can they stop the experience

– Use pre-warning – “First & Then” i.e. First, participate in activity, then be rewarded with a task of their choice

– In group situations, try staying at the edge and encourage the child to move in as ready

– Give the child a choice – i.e. ‘Would you like sand play or cotton wool picture?’


29

What can Help?

• Be prepared - Plan ahead

– Think about what you’re doing

– Be aware of the child’s sensitivities

– Have “Tool Kit” ready in their bag

– Distraction techniques

– Incentives – keep them simple

– Tools to help dampen experience down, should it be too exposing


30


31

https://www.google.co.uk/imgres

http://www.google.co.uk/url?sa=i&rct=j&q=&esrc=s&source=imgres&cd=&cad=rja&uact=8&ved=0ahUKEwjItpj1qqXOAhWMhRoKHU3JAKEQjRwIBw&url=http://www.keepcalm-o-matic.co.uk/p/keep-calm-and-be-consistent-12/&psig=AFQjCNHaLrMQJ12fLAdRktjx6TxWMRVhXA&ust=1470316764738995

Helpful Resources

• Ready, Steady, Baby • Play @ Home books start early and stay active for life

– Play @ Home Baby birth-1yr – Play @ Home Toddler 1-3 yrs – Play @ Home Preschool 3-5 yrs Developed by NHS Health Scotland – Gifted to expectant

mothers and children at appropriate developmental stages

• General Information on Play Activities in Dumfries & Galloway – available from Children’s Occupational Therapy



Comfort Stop

5 minutes Break


33

How we use Sensory Information


34

1. Information received by our senses about an experience

2. Information sent to our brain for processing

which helps us to make sense of the experience

3. Our brain tells our body how to respond to the information given

4. Our brain stores information about past experiences which influence responses to future experiences

Day to day influences on how we cope with

sensory information

• Are you getting sufficient sleep?

• Are you feeling well?

• Emotions – worried, nervous, angry, happy?

• What have you eaten? - Diet

• Have I had sufficient exercise?


35

Activity


36

Under-Sensitivities (Sensory Seeking)

Occupational Therapy for Children & Young People NHS Dumfries & Galloway 37

1. Low levels of information received by our senses about an experience

2. Low levels of sensory information sent to our brain for processing

This makes making sense of the experience harder

3. Our brain does not tell our body how to respond to the

information given

4. Our brain tells the body to look for more sensory information = sensory seeking

Occupational Therapy for Children & Young People NHS Dumfries & Galloway 38

Over-Sensitivities (Sensory Defensive)


1. High levels of information received by our senses about an experience

2. High levels of sensory Information sent to our brain for processing

This may lead to us feeling out of control

Information is being sent to our fight or flight brain centre

3. Our brain tells our body to fight or flight as a response, which can be seen as a negative behaviour

4 We begin to expect sensory experiences will be negative, often showing behaviour at the thought of the experience

Go Back and Consider


40

• A graded approach • Positive support • Control for the individual • Preparation/Planning ahead • A supportive and fun environment

Summary • Understanding we are all different

• We recognise individuals’ sensory preferences

• Recognise all children will show sensory-seeking behaviours and sensory-sensitivities – which are developmentally appropriate

• Be confident to take “a closer look” to explore other contributing factors – challenges are very often not sensory in nature

• To support sensory development through age appropriate opportunities and experiences, using:

– A graded approach

– Positive support

– Control for the individual

– Preparation/Planning ahead

– A supportive and fun environment


41

Any Questions??


42

The Role of Occupational Therapy

Occupational Therapy enables people to participate in daily life to improve their health & wellbeing

• Daily life is made up of many activities or occupations • Occupations for children or young people may include:

– Self-Care » Getting ready to go out » Eating a meal » Using the toilet

– Being Productive » Going to Nursery or School » Volunteering » Helping at home

– Leisure » Playing with friends » Participating in hobbies College of Occupational Therapy


Factors considered within an Occupational Therapy Assessment


(adapted from Fisher, 2013: Law et al., 1996) Cited by COT 2015

Person

Body Function, physical, sensory, cognitive, emotional

Values, beliefs

Habits, roles, routines

Occupation

Steps & Timing

Spaces

Tools & Materials (including sensory characteristics)

Purpose

Environment

Social

Physical

Sensory

Cultural

Virtual/ Technological

Occupational Performance

Gaining further support

• NHS Dumfries & Galloway Occupational Therapy for Children & Young People Service

• Open request for assistance - families can make contact with the service themselves and talk to a team member

• Professional can complete the Request for Assistance Form

• From this request, OT service will determine if; • We are the right service, or signpost onto the appropriate

service • We can provide advice and support as appropriate • The child may require an assessment by our service


Contact Details

OCCUPATIONAL THERAPY FOR CHILDREN & YOUNG PEOPLE The Willows - Children, Young People and Family Centre The Crichton, Glencaple Road, Dumfries, DG1 4TG Telephone: 01387 244470 - ALL requests & initial discussions

to this number Waverley Medical Centre Stranraer DG9 7DW Telephone: 01776707775 Email: [email protected]

46


Reference list

• Making Sense of Sensory Behaviour, A Practical Approach for Parents and Carers. Falkirk Council. Accessed on 04/08/16 https://www.falkirk.gov.uk/services/social-care/disabilities/docs/young-people/Making%20Sense%20of%20Sensory%20Behaviour.pdf?v=201507131117

• Adapted from NHS Choices: You & Your Baby. Accessed on 08/08/2016 from: http://www.nhs.uk/conditions/pregnancy-and-baby/pages/pregnancy-weeks-13-14-15-16.aspx

• NSH Health Scotland, Ready, Steady, Baby

• NSH Health Scotland - Play @ home baby birth-1yr

• NSH Health Scotland Play @ home Toddler 1-3 yrs

• NSH Health Scotland Play @ home Preschool 3-5 yrs









http://www.nhs.uk/conditions/pregnancy-and-baby/pages/pregnancy-weeks-13-14-15-16.aspx















Appendix


48

Acknowledgements

• Children's Occupational Therapy NHS Fife

• Children's Occupational Therapy NHS Highland

• Children’s Occupational Therapy NHS Tayside


49


50


Sensitive to grass/sand

• Combination of texture

• Light tickly touch

• Experience – How often have they been on grass/sand?

• Be aware of the sensitivity of young children’s hands and feet

• Appropriate developmental experiences, tummy time,

pushing self up on hands, crawling

Having a blanket on the grass/sand

Start with them having shoes and/or socks on

Distract with age appropriate play

Positive reassurance

Graded Approach e.g. Use spade to dig sand first

Avoids messy play

• Lack of opportunities

• Carer givers who dislike mess

• Young children’s hands are more sensitive – tolerance

requires development

• Child who has missed developmental milestones of tummy

time – pushing through hands, crawling

• Child who hasn’t had opportunities to self feed, using hands

• Developmentally appropriate messy play opportunities

• Positive praise

• Consider attending play sessions which offer this

• Have old clothes

• Choose an area in house/garden easy to tidy

• Think of daily activities they can help with, washing themselves at

bath time, gardening, mixing ingredients- baking, meal times

• Feeding self

Gets upset by loud noises – hand-drier, fireworks, aeroplanes, hover

Be aware children’s hearing is more sensitive than adults

The younger the child, the more sensitive their hearing

Experience – have they previously had a fright?

Exposure - what are the noise levels within the places they

spend time?

Ear health – do they have ear injections etc which may make

their hearing more sensitive?

Consider; is it developmentally appropriateness of their responses?

Give an explanation of the noises around them – reassurance

In areas where noise is going on, cover their ears with your hands,

consider ear defenders, background music – dull down the

foreground noise & protect their long term hearing

Positive support & reassurance

Graded approach

Dislike of hair washing

Consider their age, i.e. many toddlers dislike hair washing

Past experience, i.e. if they’ve had shampoo in their eyes and

are afraid of the stinging pain

Strong smelling products

Not prompted when to close eyes/hold breath

Use ‘Gentle on Tears’ shampoo

Make bath time fun

Use a small amount of shampoo, i.e. less to wash out afterwards

Use firm rubbing-in of shampoo and hand movements when rinsing

out

Avoid light touch, if this feels tickly etc

Examples of typical Sensory Sensitivities

A Closer Look Tool


51


Challenge 1

Challenge 2

Challenge 3


52

Age & Stage Taste Smell Vision Hearing Tactile Balance Body Awareness

Pre birth

28 wks –

baby is able

to smell &

taste

26-27 wks – baby

begins to open/close

eyes but can only

see infra-red rays

through mothers

body

13 wks – the ear

forms and

develops

21-22 wks – baby

hears sounds

in/outside through

amniotic fluid and

knows mothers

voice

23 wks – well

established

recognition of

some noises

15-16 wks –

baby begins

thumb sucking

21-22 wks –

baby grasps

hands

13 wks – ear

develops further;

inner ear

important in

balance;

movement within

the womb from

this time works on

vestibular system

12 wks – baby waves, moves

legs and curls fingers and toes

15 wks – sucks thumb and all

joints can move

21-22 wks – baby grasps

hands

28 wks – baby moves everyday

36 wks – baby has less space

to move movement against

uterus, which increases

sensory feedback. Foetal

flexion occurs now

Post birth Skin to Skin

contact

Baby

recognises the

mothers smell

at birth

Can see 20-30cm

(e.g. breast to face)

Can mirror sticking

out tongue

Preference for high

contrast/red colours

and human faces

0-12 wks – Visual

reflex integrates and

voluntary eye

movements occur

4-8 weeks – baby

responds to name,

responds to loud

noises by blinking,

startling, frowning,

waking if asleep

(baby is able to

settle again). Baby

responds to

familiar voices

Skin to Skin

contact,

swaddling

5-6mths –

baby mouthing

objects

Rhythmical

rocking, falls

asleep during

rocking/movement

of pram/car

Practise of early extension –

flexion movements (recoil)

Swaddling, slings, cuddling

effect

Boundary in crib, cot, car seat

Sensory Development Is a natural part of infant/child development & begins in the womb

Documents

Understanding Sensory Development - nhsdg.scot.nhs.uk · digestive system, heart and voice Week 15: vision develops as the eyes become sensitive to light. Baby may register a bright