HOLISTIC APPROACH TO TREATMENT OF CHILDREN WITH SPECIAL NEEDS

By Inna Olshansky

This book offers an integrative approach for treating and managing various disorders and conditions in children that OTs encounter in their practice. In this book I included traditional occupational therapy intervention along with complimentary strategies, such as the use of essential oils, crystal therapy, mindfulness, meditation, breathing, an

• Language: English
• Publisher: Inna Olshansky
• Release date: Aug 15, 2018
• ISBN: 9781532385476

Inna Olshansky

Dr. Inna Olshansky (Doctorate of Occupational Therapy) is an Occupational Therapy practitioner, a Certified Essential Oils Coach and a Certified Crystal Healer with 25 years of experience focusing on treatment of children and adults. Dr. Olshansky's experience includes providing direct intervention to children with various disorders, conditions and disabilities, affecting their development and participation in daily routines. In addition, she offers coaching to families, caregivers and teachers to facilitate children's progress toward their goals, and success in life. She incorporates traditional and complimentary approach in her intervention. Dr. Olshansky is a firm believer in the power of positive affirmations and visualizations; mindfulness, aromatherapy, crystal therapy, and play-based learning, in addition to traditional occupational therapy interventions. She utilizes medical and educational models to achieve the best possible results in meeting the child's and the family's goals and dreams. Currently, Dr. Olshansky provides an Early Intervention services, treating children with various disorders, conditions and delays, as well as educating, and coaching families and caregivers to facilitate their child's development, promote well-being and improve quality of life. Dr. Olshansky's website is listed below where you can find interesting information regarding alternative therapies, and contact her for specific questions, or to schedule a private occupational therapy consultation.

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Chapter 1

What Is Sensory Processing Disorder?

Sensory Integration is the ability to take in, sort, and organize sensory information for functional use.

-Dr. Jean Ayres

Sensory Processing Disorder (SPD) was previously called Sensory Integration Dysfunction. Sensory processing refers to the way the nervous system receives, interprets, and responds to messages from the senses (Visual, Auditory, Tactile, Olfactory, Gustatory, Vestibular and Proprioceptive systems). SPD is a neurological disorder in which the sensory information does not get appropriately organized in the brain. As the result, sensory system abnormally responds to the sensory stimuli it has received.

Individuals with SPD poorly detect, modulate and/or interpret sensory stimulation from their environment. This condition affects social, emotional, behavioral, and academic performance. As I stated earlier, sensory processing disorder refers to the child’s ability to respond to sensory stimulation (what he feels, tastes, sees, smells, and hears, as well as spatial body awareness and balance/movement). We have seven sensory systems in our body. The way we process incoming information, shapes our responses and our ability to explore the world.

Sensory systems include:

• Tactile -includes deep pressure, light touch, pain, and temperature. It facilitates tactile discrimination, safety awareness, and contributes to learning through touch.

• Vestibular- your balance, movement, and direction of body in space (horizontal, vertical position, against gravity). It coordinates movement of head, body and eyes, and maintains muscles strength. It facilitates motor coordination, motor planning, and increases body awareness in space and gravitational security.

• Proprioceptive- sense of body awareness in relation to the environment and other parts of the body. It facilitates body awareness, motor planning, and motor control.

• Visual- eyes receive visual images and interpret the information. It helps to identify objects in the environment and its distance. It has the ability to support balance, safety and maintain upright posture.

• Auditory- sense of hearing, involving inner, middle and outer ear.

• Olfactory- sense of smell; identification of various odors. It allows food exploration by smelling it.

• Gustatory- sense of taste: salty, sweet, bitter and sour. It allows to distinguish between safe and harmful foods.

Poor sensory processing skills negatively affect motor performance, including motor planning and coordination; fine motor and self-help skills. Decreased endurance and behavioral outbursts are observed. What are the typical responses to sensory stimulation? What are abnormal reactions to the sensory world we live in? How does it affect us? How can you handle and help your child to deal with over-responsive (hypersensitive) or under-responsive (hyposensitive) sensory system?

There are some children who are hypersensitive. Their response is exaggerated to a particular sensory stimulation. For example, loud noises (sirens, vacuum cleaners, loud music) or textured materials against their skin (clothing, lotions and even a touch of another person) may be very offensive, causing adverse behavioral reactions. Then there are some children who are hyposensitive and are seeking out sensory stimulation by touching, tasting, biting, running into walls and furniture, and pushing everything around them. The signs and symptoms of SPD may include:

• Does not like being touched

• Frequently touches everything around

• Does not tolerate wearing clothing of certain texture and tags

• Insensitive to pain, heat, or cold

• Spins and rocks frequently

• Overstimulated by bright lights, large crowds, and loud music

• Picky eating habits/food aversions

• Wants to wash hands every time he touches textured materials, foods, glue, paint (avoids getting hands dirty)

• Avoids using finger paints, play dough, glue

• Difficulty falling asleep

• Pushes self against walls, furniture, and people

• Bangs head against a wall, floor, and large objects

The cause of Sensory Processing Disorder has not been identified at this time. However, some research suggests that SPD may be inherited. Prenatal, birth complications, genetics, and environmental factors may result in SPD. Sensory Processing disorder is more prevalent in children with Autism, Fragile X syndrome, and ADHD than in the general population. One in twenty people in the general population is affected by SPD (STAR Institute for Sensory Processing Disorder, 2017).

Clinical assessments, parent/caregiver report, and informal observations are used to identify children with SPD. Research suggests that the sympathetic and parasympathetic nervous systems are not functioning properly in children with SPD. The sooner children are diagnosed with SPD and receive appropriate intervention, the higher the chances of improvements.

Occupational Therapy (OT) provides an effective intervention for treating the symptoms of SPD, supporting the child at home and in the classroom. OT sessions usually include sensory motor intervention, such as swinging, jumping on trampoline and into a large bean bag, or on a playground. In addition, exploring various textures through water play and sensory activities (playdough, finger paints, sand, rice, and bean activity boxes) and textured food exploration, help to regulate the child’s sensory system. Parent and caregiver coaching is another effective and efficient way to meet the family’s unique needs and sensory challenges of the child (Miller, 2014).

Early diagnosis and intervention of SPD is very important. It increases the chances of successful treatment and improved outcomes for the child and his family. As the child makes progress and starts to appropriately process sensory stimuli, behaviors, attention, and social challenges improve, thus promoting successful participation in daily routines at home and at school, as well as an awareness of the world around. In addition, social relationships, self-esteem, and self-regulation tend to improve.

Based on the research, SPD foundation identified 3 categories of SPD:

1.Sensory modulation is the ability to effectively regulate the degree to which a person is affected and responds to sensory input.

Sensory modulation disorder includes sensory over-responsivity, sensory under-responsivity, and sensory-seeking behaviors. Child may alternate from one state to the other.

2.Sensory discrimination is the process where specific type of sensory input is understood and perceived accurately.

Sensory discrimination disorder is difficulty perceiving sensory information from the environment, including Visual, Auditory, Tactile, Olfactory, Gustatory, Vestibular, and Proprioceptive awareness.

3.Body awareness is the internal understanding of where your body is in space in relation to other objects and people. It is influenced by vestibular and proprioceptive systems processing. It is critical to assist a child to stabilize and regulate his body awareness, as it affects so many different daily routines, including adaptive (self-help), physical, and social aspects.

Sensory-based motor disorder involves difficulty planning and executing motor tasks. The child may have low muscle tone, resulting in poor posture and balance issues.

How sensory processing difficulties make daily routines a challenge:

• Poor attention to task

• Social relationships

• Transitions throughout the day

• Learning novelty tasks

• Self-help activities and daily routines

• Limited acceptance of textured foods

• Self-stimulation behaviors (hand flapping, spinning, pushing against people and objects, using an object or a toy in non-purposeful repetitive manner).

Intervention Strategies: Sensory diet, feeding strategies, sleeping routines, management of behavioral outbursts (meltdowns and tantrums), provision of structured environment and incorporating predictable daily routines into the child’s day. All of these intervention approaches are discussed in the following chapters.

Classroom sensory accommodations may be very helpful for children with sensory processing challenges. Here are some suggestions for school-age children:

Desk location

• Desk in front of the classroom

• Desk close to the teacher

• Alternative desk in a corner for independent work with minimal distractions

• Sitting at the desk with feet flat on the floor and elbows on the desk

• Alternative sitting (therapy ball or bean bag chair) to maximize attention and participation

• Using weighted object on the child’s lap (10 percent of child’s body weight)

• Placing textured air cushion on the child’s seat

• Allowing the child to stand up as needed

• Motor breaks as needed (take a 2-minute run or jump)

Seating for a group activity

• Allowing the child to use a bean bag chair or a stool to sit on

• Providing a carpet square for boundaries

• Allowing the child sit next to the teacher

• Allowing the child to change sitting positions

• Allowing the child to move to the back of the group when he feels overstimulated

• Encouraging the child to use hand fidgets/manipulatives to self-soothe and increase attention during the classroom task

• Providing the child with weighted stuffed animal or a weighted ball to hold on his lap to improve focus and concentration

For writing activity

• Providing the child with a pencil grip to increase comfort and productivity with writing tasks

• Using sensory objects, such as putty, playdough, or textured squish ball prior to writing activity to provide sensory stimulation/tactile input

• Providing the child with a slant board and lined paper

• Providing visual and/or written simple instructions and modeling as needed

• Assisting the child to organize his thoughts and ideas on paper

• Allowing extra time to complete an assignment

• Allowing a scribe to assist the child with writing down his thoughts in order to successfully complete a written assignment

• Assistive technology may be helpful

• Having the child type his assignments

Reading activities

• Encouraging the child to read out loud

• Minimizing visual distractions

• Providing a book mark while following the reading material on a page

• Allowing for motor breaks as needed

• Sitting in a rocking chair or a bean bag for sensory input and increased focus

Classwork and homework

• Allowing extra time to complete an assignment

• Instructing the child and allowing for questions in a one-on-one setting

• Modifying assignments with less writing

• Allowing a scribe or typed work

• Providing visual instructions and modeling

• Presenting a small amount of work on each page

Transitions

• Preparing the child for transition verbally or setting a timer

• Providing the child with a visual schedule

• Allowing the child to use a transition toy, possibly a weighted sock or a small weighted stuffed animal, or a small back pack with a few books in it

• Allowing the child to be first or last in line when transitioning to another space or environment

Sensory breaks throughout the day as needed

• Allowing the child to go to the bathroom as needed

• Providing the child with a calming break, such as sitting in a quiet corner on a bean bag and looking through a book

• Letting the child walk around the room and pass out papers

• Singing songs with movement with the entire class

• Stretching/movement/chair push-ups breaks for the entire class

• Providing the child with opportunities to explore a sensory box (rice, bean, sand bins)

Facilitate general sensory success

• Giving a child a warning before a fire drill

• Allowing the use of head phones when appropriate

• Posting a visual schedule

• Allowing a water bottle or a cup with a straw to use when need it

• Chewy tube or hand fidgets can be used to help with attention

• Keeping visual distractions to a minimum (busy boards, excess pictures)

• Playing calming music (nature’s sounds or classical music)

• Providing a multisensory approach to learning by using visual, auditory, and kinesthetic activities

• Using recess as a recharge mechanism for improved attention in the classroom. Encourage the child to use playground equipment, run, or jump

Sensory-based school difficulties and how to address them:

Poor sitting tolerance during school work

• Fidgeting in the seat

• Poor sitting endurance and posture

• Unstable in the seat

• Sitting in a posterior pelvic tilt

• Putting head down on the desk

• Support head with hand while sitting

The cause of poor sitting posture

• Unstable postural control and poor pelvic stability

• Low muscle tone in abdominal core area

• Hypo-responsive to vestibular and proprioceptive input

Useful sensory strategies

• Theraband or another elastic band wrapped between the chair legs to provide feedback in the back of the feet

• Weighted lap sock or stuffed animal to provide deep pressure/proprioceptive feedback

• Non-skid rubber mat on a chair to help stay seated and prevent sliding

• Textured air seat cushion

• Appropriate height of desk and chair

• Preferential seating in the classroom

Simple tools for calming overstimulated sensory system

• Glitter jars (water filled with glitter, beads, etc.)

• Colored beads, sand, crystals in an empty closed water bottle or closed plastic jar

• Coloring books and crayons

• Visual schedules

• Timers for setting time boundaries for an activity or prepare for a transition

• Trampoline for jumping

• Climbing and jumping into pillows with supervision

• Rocking chair

• Swing, climb and slide on a playground

• Tunnel and obstacle course

• Hand fidgets

• Roll over a large ball while on tummy

• Sunglasses to decrease visual over-stimulation

• Play dough activities

• Blowing bubbles

• Nature music

• Pop bubble wrap

• Weighted animals to hold or place on the lap (10 percent of a child’s body weight)

• Blowing cotton balls on a table through a straw

• Deep pressure massage

• Deep pressure hug

• Build with weighted blocks (make large blocks using shoe boxes with bean bags inside of them)

• Yoga poses and stretches

• Using essential oils

• Taking a walk or a run

• Using positive affirmations

• Visualization-use calming nature pictures

• Visual board-making

• Various tactile bins (sand, rice, beans, beads, pasta)

• Warm bath with relaxing essential oils

• Breathing exercises

• Wheelbarrow walk

• Carrying a backpack in busy, loud places

• Wrapping self in a blanket to calm down

Affirmation - Today I look forward to feeling great and staying calm.

Inna Olshansky, OTD OTR

Essential Oil-Vetiver essential oil is calming, promotes sleep and relaxation.

Healing Crystal-Amethyst is calming and helps with restful sleep.

Chapter 2

What is Autism?

Autism facts

Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder that typically presents between 18 and 36 months of age. The characteristics of ASD include deficits in social skills,