Sensory Processing Disorder (SPD): When Everything Is Too Much

This presentation will provide a basic overview of sensory processing disorder (SPD), discuss behaviors related to SPD, as well as interventions and strategies to address behaviors and self-regulation. Children with sensory processing issues have difficulty coping in many environments. They cannot always interpret the input occurring in their surroundings. When this is the case the child may either act out or shut down. This presentation will help participants understand some of the triggers occurring in the environment; whether it be people or things, that do not allow the individual to function on a consistent basis in multiple environments. The participants will also learn what treatment is available for those with sensory processing issues as well as some strategies that may help instantaneously with a variety of sensory needs.

Felicia Castagna, MS, OTR/L, C/NDT, CKPT, CBIS, SIPT graduated in 2001 with her MS in Occupational Therapy. Before joining Weisman in 2004, her first job was at a specialized school for children with disabilities. At Weisman, Dr. Castagna has worked in their Outpatient therapy, Inpatient Rehabilitation, Day Hospital, Home Care, and Early Intervention (birth to 3 and 3-5). In 2003 she received her certification for Sensory Integration and Praxis Test (SIPT) and in 2009 received her certification for pediatric Neuro Developmental Treatment (NDT) – both of which are cornerstones in her practice and treatment sessions. In 2011 she received her post graduate pediatric certification. In the following years she also became a certified Kinesiotaping Practitioner (CKTP, 2012), Brain Injury Specialist (CBIS, 2015) and Service Practitioner for ADHD (ADHD-CCSP, 2020).

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0:06 Welcome and good evening. Thank you all so much for joining us tonight for the webinar Sensory Processing Disorder When Everything is Too Much presented by Felicia Castonia. 0:19 My name is Katie Delaney. I am the Family and Medical Outreach co-ordinator at the New Jersey Center for Tourette Syndrome and Associated Disorders, will be your facilitator for this evening. 0:31 Now before I introduce Miska Sonia, we have some housekeeping notes that I want to go over. All participants are muted. If you have a question, please type it in the bottom of your question box and click send. 0:46 If you have questions after tonight’s session, you can post your questions on the Wednesday webinar blog, which can be accessed from our homepage at WWW dot NJ C T S dot org. 0:59 Under the heading programs, this blog will be monitored for the next seven days. 1:05 The New Jersey Center for Tourette Syndrome and Associated Disorders, its directors, and employees assume no responsibility for the accuracy, completeness, objectivity, or usefulness of the information presented on our site. 1:21 We do not endorse any recommendation, or opinion, made by any member or physician, Nor do we advocate any treatment. 1:29 You are responsible for your own medical decisions. Now it is my pleasure to introduce our speaker for this evening, Ms. Melissa Castonia. Miska Sanya graduated in 2001 with her with her MS and Occupational therapy. 1:46 She worked at a specialized school for children with disabilities before joining weizman Children’s in 2004. 1:55 At Weizmann Miska Sonia has worked in their outpatient therapy, inpatient rehabilitation, day hospital, home care and early intervention. 2:06 In 2003, she received her certification, four, sensory integration and process test. 2:14 And in 2009 received her certification for pediatric neurodevelopmental treatment, both of which are cornerstones of her, both of which are her cornerstones in her practice and treatment sessions. 2:26 And 2011, she received her postgraduate pediatric certification, and the following years, she also became a certified, a certified gymnasium taping practitioner, Brain Injury Specialist and Service Practitioner for ADHD. That is a tongue twister. Tania are so so so happy to have you here tonight of Florence all yours. 2:54 Hi everyone. 2:57 I’m gonna go through some of these slides fast. Just because it’s an overview because I know the meat of everything that you are looking for are definitely more of what to do. 3:10 When you see some of the behaviors, whether it’s sensory or just behavioral. 3:17 So the objects are to go through sensory processing, understand the basis, the categories of sensory processing, and then from understand, standing, where they are aware that child is. 3:35 How did you react in interventions that are going to be the most useful for you to get more bang out of your buck? 3:43 So sensory processing, sensory processing is the ability to register process and use information taken in by all the census. 3:53 It allows us to make adaptive, appropriate and functional responses, and it directly impacts all development and functional skills. 4:03 So sensory systems. Everybody, everybody knows the five senses. You learn them very early on with naming them. You have your visual auditory, taste, smell, and tactile. 4:14 The other three senses are newer to a lot of individuals, but they’ve always been around. They just some of them are taught. Like, when you’re taught the five senses in elementary school, you’re not taught about your vestibular system, your receptive system or your interception. 4:33 … receptive and tactile systems are your precursors to development of visual and auditory systems. 4:42 With that being said, just so you know, actual visual and auditory systems are developed in utero, but this is talking about more advanced, higher level, not basic, criminal, criminal bring them up. 4:59 I’m so sorry, Um, basic reflex kind of systematic needs for auditory and visual. Those three systems of vestibular, perceptive and Tactile, are what help higher level skills to integrate within your environment. 5:17 So, understanding our senses, again, I’m not gonna go over the top five, because we’ve all learned about that, and we all know that we know how to name them. 5:26 The ones that I’m going to go over right now, or you’re near sunsets, there are the three that I said that not a lot of people have heard about before that vestibular sense. 5:36 That is processing movement, gravity balance, and it’s all received in your inner ear. 5:44 This is your movement since when your head moves in space, I can say, my head is my ear is going towards my right shoulder. My head is going forward. My head is going backwards. That is your vestibular sense. 5:57 Your appropriate step to sense is how your body is processing information. So body position body in relation to objects and body to body movements. So, I can close my eyes and know that I’m waving my right hand. I’m stopping my left foot. 6:17 I know where my body is in space related to the pressure that I’m receiving through my joints. 6:25 Interception interception is a new word, contemporary sounds, but those internal organs, the things that we kinda take for granted. But we don’t like, in the sense of knowing when you’re satiated. 6:45 Knowing when you’re still hungry, knowing when you’re about to have a bowel movement, or when you need to urinate. And I’m gonna apologize, so sorry, I live in a busy quarter. 6:56 So, if you hear anything, just ignore like i-well and keep on going. But I just wanted to warn you, I’m sorry. 7:03 Again, these are the hidden incentives, but we cannot control them, but we can directly observe them. So sometimes you’ll see if they would the interception. The other. 7:15 one thing I wanted to go back to is these sometimes are kids that don’t even know if they’re thirsty Sometimes, some of these kids with interception issues also are the kiddos that might have pica as a secondary diagnosis. 7:31 Um, then the other thing about interception, it’s connected to your vehicle system. 7:36 So, they have a lot of, they can have some issues with self regulation and internally, so that hot cold and those issues. 7:49 Sensory stimulation. 7:51 There is no way of living and breathing in this world without getting some kind of sensory stimulation throughout your day. 8:00 Putting on clothing, whether it’s soft or scratchy, if there’s an issue with a tag on your neck or back active play when you’re playing on the playground or as an adult working out. 8:13 Some of your if you’re doing a cardio class that you’re doing burpees, you’re getting stickler improper receptive and tactile input in just one movement. 8:23 There’s constant music noise voice within your environment, which is auditory changes in position. So if you’re sitting standing, laying, rolling, moving in a car. When you come to the car, breaking, go forward or backward, that’s stupid. 8:41 Input receptive input types and temperatures, a food, that is your tactile and taste. 8:48 Then you also have knowing when to need to go to bathroom that’s your interception. 8:54 So sensory processing disorder. 8:58 This is a term that’s newly coined in the past 10 plus years, maybe going on 15 now. 9:06 Prior to that, it was called sensory integration dysfunction, or dysfunction of sensory integration. 9:13 Um, what is what is it it is when there’s a glitch in the system? 9:19 So when I say a glitch, when I talk to parents to try to describe it, you think about when you’re you have a car and you’re trying to turn it over with the key. 9:31 And it’s not turning over. 9:34 So let’s say it’s a Spark plug spark plug that is the issue because it’s not working. 9:42 The correct way is not put in tight enough. 9:45 Maybe it’s the fuse is gone but something in the system is malfunctioning. 9:53 So that’s why the car is not turning over and you cannot start that engine. 9:57 That is what you want to think about when you think about a sensory processing disorder, you have all the working parts, but there is a glitch within that system. 10:07 So, in other words, the technical part is, the brain cannot register, interpret, or integrate sensory information to produce an organized response. 10:17 So this makes learning an interaction difficult, and interacting doesn’t just mean interacting with other individuals, it means interacting within their own environment. 10:29 So, gene errors, doctor Jane heirs. 10:34 She is the pioneer, the founder of this frame of reference. She called it a neurologic traffic jam that prevents certain parts of the brain from receiving the information needed to interpret the sensory information correctly. 10:50 So if you’re not interpreting the information coming in appropriately or correctly, that output is going to look not to match what the situation was, or there isn’t going to be an outcome. 11:03 So think of it that way. 11:04 So it’s a traffic jam Processing issue, not an integration issue. 11:12 Processing, there’s a glitch in the system. 11:17 About SPG, SPD is a body brain processing of registering, interpreting and integrating sensation. 11:29 If you are completely regulated it goes I noticed so that’s if you are atypical AMENA typical neurologically driven person even if you quote unquote are typically that you can have sensitivities like this over responsiveness to sense stations. 11:49 That makes it difficult to fit in a flexible sensory world, which can be very exhausting. Trump, some individuals in theory. 12:01 Pull back from integrating or engaging in their environment, Then you also have ones that are, to the point that they become so overwhelmed and confused by what is coming into their brain therapy, too bombarded, because they don’t have a gate keeper that’s dropping off some of the sensory information that isn’t needed. 12:23 It’s all coming in, so it’s um, learning their system, so when it’s been burning, this is their system and they don’t know what to focus on. 12:33 They rarely feel safe, because they don’t know what to pay attention to and what to dispose of, then you have the sensory seeking. 12:43 That can be in very inappropriate ways, that can actually cause safety issues. 12:53 I love this little little guy, because it’s a quick insight of some of the issues that can be having. 13:02 You know, like when a kid comes to an OT and a parent starts listing some of the issues that they see, he hates having his hair washed or cut, or brushed. 13:14 He hasn’t had a haircut since he was a baby, he barely gets hair wash maybe once, maybe twice a week. 13:22 Um, He is very sensitive to light, so we have to either wear a hat all the time, keep the lights low, or … wear sunglasses. He’s oversensitive to sounds. We can’t go to the law. We can’t go to the movies we can’t go to parties. 13:39 Um, he chews on everything so you have to like have everything on lockdown and have that person. Individually insight and all types. 13:48 To make sure they’re not putting dangerous things into their mouth. 13:53 Aye. 13:54 They touched too hard, not know a kid that’s constantly tapping, but when they are seeking input, they are the ones that are like spearing you and the stomach for a hug. 14:05 They think they’re just coming for a hug and they don’t realize that it’s too hard, cannot stand or tolerate, tags, or certain kind of clothes, they wear soft things, they never wear jeans. They never wear. 14:19 Aye, dress this freely dresses. 14:22 Um, those kinds of things, kids that walk on their chops. 14:28 So, then we have the breakdown of what are sensory processing classifications. 14:34 There’s three main classifications, you have sensory modulation disorder, you have sensory based motor disorder and you have sensory discrimination disorder. 14:49 So within the ose we have subtitles and subsets. 14:53 Of course, nothing’s ever just those three things. So, underneath sensory modulation, these kiddos these skills are the what if kiddos. 15:02 What if we can get Johnny regulated enough to be able to do this? 15:08 What if we can have the environment this way I can do this? What if Kit? 15:16 He is very dis regulated at most times. 15:21 This is a modulation kit. There’s the three. 15:24 Well, for subsets you have you’re over responsive to input, You have your under responses, then you have your sensory seeking, then you have your regulation disorders. 15:39 So, when you say you’re over responsive, I have a lot of kiddos that are over responsive to sounds and touch but are sensory seeking proper receptive input. 15:57 You can B many different levels within that modulation disorder. It doesn’t have to be. 16:06 He is just over responsive. She is just under responsive. 16:12 He is just sensory seeking. It’s not that way. 16:14 They can interconnect with what levels sensation. They are processing. 16:20 And some are processes over responsive, and some are under responsive. 16:26 Then you have your sensory based motor disorders. 16:30 These are your kiddos that are higher level, they, they know that something’s wrong, they, they could sense that they know that movement is difficult for them. 16:40 So, you have your Praxis. You have your postural ocular disorder. You have your bilateral co-ordination and you have your sonata sensory. 16:49 When you think it’s a medicine. Or you think of a kid that’s a bull in a China shop. 16:54 When you think of dyspraxia, you think a lot more. 16:59 Use the term, but you definitely think more of speech when you think of dyspraxia. 17:05 Like they cannot formulate the way their mouth is supposed to move for the output of the words. 17:13 Posture, postural disorders or pasture, ocular disorders. These are the kiddos that have the kind of the lower level of this subset. 17:25 There are more of the kids that have visual difficulties and pairing it with pastoral system so they kind of are more slouched with their mouth. They usually have open mouth with a Jedi chin and they have difficulty with focus in the learning into their environment. 17:43 Bilateral co-ordination, Kato’s, a lot of times you’ll see, oh, he’s an anti anti district. Now kids are not meant to be using both hands are usually unilaterally using their body because they don’t have a true medline and they can integrate their two sides together. 18:01 Um, your body does want to use one side as a dumb. 18:07 That’s where neurologically, like that’s what your body wants to do. So these kids have a difficulty doing that. 18:14 Um, then you have your sensory discrimination disorder. 18:19 These kiddos I’m not gonna go too much into detail, I’m just going to go quickly over If they have a discrimination disorder, it is a parent because it’s a high level cortex issue of the brain. 18:32 You definitely know if they have vision difficulties. 18:34 It’s, it’s something that is known like, you would definitely know that they have eyeglasses or they also have when they have vision difficulties. 18:45 They have eye teaming difficulties, they might have difficulty with reading and those kind of tracking scanning. 18:53 Here you think about a kiddo that has auditory processing disorder. 18:59 With touch, again, these are things that are going to be apparent like they have lack of smell, they have lack of taste, they have movement and positional difficulties. 19:10 It just, you can definitely tell, it’s not something that you have to point out or investigate, like, modulation and sensory based motor kiddos. 19:22 Behaviors that happen, um, and a lot of these behaviors you see. Kids with autism, ADHD, there’s a lot. I just want you to know that sensory processing. There are kids that are truly just sensory processing. 19:36 But a lot of this sensory processing disorder is linked to many other diagnosis. 19:45 It’s sometimes a precursor to some, not a precursor. 19:50 one of the signs, signs and symptoms within TMS T S and DSM 4 5 I always mess up the letters. I’ll tell you that, now. That’s a little bit of dyslexia. Sorry. 20:05 Um, so, you have your impulsivity and you’re under reactive. You’re overreacting, distractible there, clemency, like your posture ocular kit that I talk to you about before. They’re the ones I can’t sit in, their chair. and they kinda like you sit them in the chair, they fall out. 20:20 Um, kids that are sensitive or Boyden, they’re agitated. They will hit to get out of situations. 20:28 Kids a tantrum, poor frustration tolerance, core peer interaction, emotional outburst successively touching other kids so, understanding sensory based behavior. 20:43 These kids have poorly adapted or challenging behaviors seen in children. 20:49 That may be a result of war, processing, sensory processing. 20:53 You have to be an active investigator of the child’s behavior to see what they get to see them, or what part of the environment is the problem that is causing this disruptive behavior. 21:08 Anyone that has the modulation disorder, or even our kiddos with the century century, motor difficulties will present in psychosocial behavioral ways. Their body is trying to tell you that they need something. 21:25 They’re trying to get a lead or want, and it’s shown in a maladaptive way. 21:31 And that’s the behavior. 21:32 And as you being an investigator, you’re going to say, I saw this kid. 21:39 I’m not really close to Johnny in the line before he broke down into a tantrum. 21:45 Well, Johnny is sensitive. 21:48 two tactile becomes very young guard. 21:52 Doesn’t like sudden movements are expected touch that he might behave, really react when you think it should be a little problem. 22:00 He reacts like, it’s a keynote that just went off knowing these things and understanding that can help set up the situation later that I’m going to use spots the line them up. The lines are no kickers on top of each other and it doesn’t cause any behaviors for kiddos that are sensitive. 22:21 Reasons for behaviorists they one big, big, big thing for especially sensory kids. They are seeking a Specifically they just don’t know how to communicate what they need. 22:33 Because not a lot of times, they can even tell their body isn’t telling them I need to jump in crash. I need to hug somebody, I need to crashing the beanbag. I need to have dark lights. Nobody usually can’t tell it. That’s why they’re seeking it and appropriately. And they don’t know how to communicate it, us as adults are. The ones that are going to help them learn how to use communication in any means necessary to show, feel like this is what I need, like, I need a break, I need this. 23:06 This is a huge reason why the behaviors are happening. 23:10 And the behaviors are happening is a nervous system response to environmental stimuli. 23:19 I want you to know, some times, these environmental responses can become a learned behavior, because if they’re getting something more out of just a sensory need, it can become a learned behavior on top of a century processing problem. 23:39 The emotional impacts that happen with sensory processing disorder, a lot of these kids, especially, especially around Ads 7, eight, they really, really started to show social isolation suffered from low self-esteem, high anxiety, especially our kiddos that are supersensitive early on in life. They definitely show high anxiety. 24:10 They definitely are at high risk for emotional, social, and educational problems, including the ability and ability to make friends or be part of groups per cell concept. Academic failure and being labeled as clumsy. So, think about the kid that’s never picked. 24:31 Gym class on corroborative, disruptive are out of control, later in life or even early on, like a lot of our kids if you see the trend. 24:43 Alright, being diagnosed with generalized anxiety disorder. 24:48 Gosh, where’s my youngest, I think, was 7 or 8 depression, aggression, and other behavioral problems, even later on in life. 25:00 There is a high incidence if he somebody, sensory processing disorders are taken care of or are not appropriately bounds. 25:13 Strategies to help within the situation have led to substance abuse and drug addiction. 25:22 That’s definitely one that hire, a new member. 25:25 Broad spectrum end of it, but it has been late in research. 25:32 So, I love this chart. This chart really helps. 25:36 you see that delineation here, you have your behavior based Meltdown, and you have your sensory based behaviors. Look in the middle. 25:45 Think both present the same. You have your screening or you’re shouting, you’re stopping, you’re swearing, throwing. 25:52 I mean, I don’t know about you, but I’ve gotten some AAC devices thrown at me at times, kicked and punched and happens a pull your hair when they’re agitated. 26:03 Again, the behaviors present the same. 26:07 The big difference here, let’s take the behavior based meltdown. 26:12 It’s driven by a goal. 26:14 They want something big. 26:15 You need, an audience, You take away the audience, it usually ends, or if they get exactly what they want, the behavior tends like that. 26:25 There is no, on Atomic nervous system, site name, literally, can go from 100 to 0. 26:33 No problem. 26:35 Like they didn’t even miss a beat. 26:38 When you have a sensory based behavior, it is driven by something they are reacting to overload or being overwhelmed. 26:48 They don’t care, if anyone’s paying attention to them, you can literally put them in the corner corner, just to be safe and let it be, they’re still going to have that behavior because it has to run out of their system. 27:03 There is no goal. 27:07 So the Meltdown besides getting out that energy and frustration, you will see an anatomic nervous system response and no signs are, if the child turns red if the ears turn red. 27:22 If they start to sweat, if they flagellate, their pupils are dilated, even if the behavior seems like it’s coming. 27:33 It will take up to 45 to 60 minutes for that child to become calm, completely calm, internally, and externally again. 27:45 And that is a nervous system response. 27:49 So to see what the differences are, there are, they present the scene, but you have to look to see what happens during that fever base. 28:04 Then we have our sensory processing intervention. 28:09 You have helping the parents, teachers, or caregivers understand the sensory difficulties that are leading that child’s behaviors and fostering the relationships between the child and significant others. 28:22 So you’re helping them see the child here, really, where they are now, and what sensory systems they need to help them, and try to explain the burbidge to the caregivers, to you, so they can better understand the child, Modifying the environment to fit the child’s needs. 28:44 It’s another huge one, and then also providing direct, and just visualize intervention to meet the child’s needs. 28:54 In other words, nothing is cookie cutter. 28:59 one thing that might help one kid will not help another kid. 29:04 You have to find what is going to help each individual kid. 29:09 So working together as a team, um, something from, she’s actually forgot to put PHD. Lucy Jane Miller is a OT and a PHD in neuroscience. 29:25 She is spearheading so much information and research about Sensory Processing Disorder. 29:32 She has a great book out that is in my references at the end. 29:38 Everyone deserves the best support we have to offer in order to flourish. 29:43 So, even working off of IDA and IEPs and IFSP’s and so on, and so forth, kids need two thrive within least restrictive environments and have the best possibility to strive in any environment with supports, meaning they should not be taken out what can we do to help them within the environment Excel? 30:17 So from there we have how do you using sensory stimulation, to enrich experiences, things that we do every day. 30:26 Think about it, Think about when you, you start to feel tired or, you know, it’s going to be a long day. 30:32 What’s something you could do? 30:34 I know, as me, as an adult, I will exercise in the morning to get myself ready. I need to heavy work. 30:42 Mid-day, I might need a coffee because I’m starting to get tired. 30:47 Right now, I can tell you on tapping my foot, or I’m playing with my ring, or I’m talking with my hands. These are things that I do to get myself through. 30:58 Think about our kids. Their kids, they have other ways that they need to express. They need to move more than we do as adults. 31:04 They will want to go with the playground swing. They’ll want to climb. They’ll make forts and climb over furniture. 31:12 They’ll see, they jump around. 31:17 We can also use weights and compression. I know I, I do better with heavy work. So, again, knowing your own system. 31:24 If you know how you get around in hunger, how you regulate, it’s going to help you better understand the child or adolescents or adult that you’re working with to understand what their needs are. 31:39 Effects of sensory stimulation. 31:41 The effects we have increased or decreased arousal, We have shut down versus hyperactivity, things that you never want to see as a neurological shutdown. 31:52 These kids are to a point that they are in fight or flight, that it’s to the point that they they need to shut down because they feel like they can’t handle anymore. 32:04 Once a kid truly, truly neurologically shuts down, it can take hours for them to be up and running again. 32:14 So we try to avoid that at all costs. And then you of course have those hyperactive kids. He’s just bouncing everywhere he can never said stop. 32:23 Then we have another thing with the effects of sensory stimulation as effects of sleep wake cycles. We have kids that do not sleep. And they’ve never really slept through the night as babies. 32:36 Think about the lack of sleep and what happens to you. 32:38 You have a lack of sleep you become agitate. 32:41 It clustering it so much easier to think about our kids that don’t have any strategies like we do. 32:49 We also have sensory stimulation, for calming effect. 32:53 We have to improve organization. We also have to improve attention, skill development and social interaction. 33:01 If you can have somebody regulate it. 33:04 That means that their arousal system is at that just right level. It’s at that just right level. They have that 10th attention. 33:15 If they have that attention, they have the capability of learning, That’s what we want our kids to be able to do. 33:21 We want the kids or even adults because we can learn throughout our lifespan. We want them at that just right level so they can learn. 33:32 Sensory regulation, it’s, again, it’s the ability to respond or adjust appropriately to sensory stimulation. It is called an adaptive response. Regulation needs to occur in order to attain, maintain, and change one one’s own arousal level to meet the advance of an activity or situation. 33:51 They already talked about what do we do to self regulate? And I gave examples of what I do. 33:55 Knowing what you do is going to help you understand and understand why your kid is doing it Born, again, anyone that you work with, or treating or care for. 34:08 If you can understand yours, you can understand, start to look at their behavior, so why are they doing that? Why? What are they getting out on that? 34:16 When we start to think about what things can help that child, when they’re having a difficult time regulating and meeting that, just re challenge. 34:27 Self regulation is the ultimate goal. 34:30 Um, sensory processing, disorder intervention. 34:34 We want that child to learn how to be accountable and self-aware of their sensory and environmental needs to achieve and succeed within their everyday lives. 34:44 The key is beginning to identify your own emotional state, self-awareness, and helping the child understand their emotional state, so self-awareness, what I mean from that is that, we gotta start to help that kids understand where they are emotionally. 35:03 Um, there’s some strategies that are in the next couple of slides that I’m going to talk about just present quickly. 35:12 That helped kids become self-aware through that self-awareness. 35:18 We start to label with certain names. 35:21 When they become more self-aware, they take accountability of their emotional state. 35:27 What is causing that emotional outplay What do I need if you see where I’m going with that? 35:34 It’s, We started to help them learn As we’re learning them, too, so they have that accountability state, That’s happening, where they’re going to learn strategies to help their own self regulation. 35:51 And the big, big key is, it’s a hard when a caregiver must be aware of their own regulate a state in order to help control child. 36:03 If your child or, again, adolescent, adult, each fan, if they’re all the way up here, this high, they’ll like out of control tantrum. 36:16 If you’re, at their level, coming at them and you’re agitated with five. 36:24 And about the bounce through the roof yourself, because your heart rate has gone up. You’re starting to have a monatomic, the nervous system response, and you’re getting slush. 36:36 How were you going to help them calm? 36:39 How are you going to help them turn it around, if you are as high as they are, out of control? 36:46 So knowing when you need to help you bring you down to adjust rate levels so you can help in that situation. 36:55 So learning your own self regulations, what’s going to help their self regulation? 36:59 I hope that makes sense because again, if it’s like one feeding off the other kids, even if they’re non-verbal, can pick up on other’s energies. 37:11 If your energy is running high, they’re going to pick up on it and they’re already out of control where they feel safe if you’re out of control too because all kids just aren’t when they’re dysregulation, they just anyone wants to feel safe. So they can bring themselves back down to that Calm state. 37:32 Sensory dysregulation, dysregulation dysregulation is kind of not talked about that much, because sometimes, they’re like, Oh, well, he’s just having too much fun. That’s why he’s laughing so hard, and he’s speaking so fast. 37:49 And it’s like, Well, no, this is him, his body trying to tell you he is out of control. He needs help to bring it back down laughing, uncontrollable laughter. Hard fast movements, loud, voice meaning. 38:05 You’re in a library, and they are screaming, they can’t moderate their voice at all, unable to follow directions if you’re just regulate it. Your arousal system is through the roof. 38:17 If your arousal systems through the roof that need your attention is down here, it’s down here. 38:23 You’re not learning, you can’t pay attention. 38:26 If you’re not getting information from your system, the verbiage of following verbal directions, they’re impulsive. 38:35 We’ll assess the saliva. 38:37 So kids might might drool are all of a sudden like Julie lot. Screeching, Heifetz yelling. 38:46 And behavioral strategies. I just wanted to bring this up to you and bring in Tourette’s too. 38:53 With this, the main thing that I tell anyone that I come in contact with: no matter what: make your behavioral strategies as positive as possible. Create that positive environment. 39:09 Create A Environment that you do not shish are tell them no, or stop that. 39:18 Show them other ways of presenting, know, when to ignore it and just keep going and know when to make sure you praise all the good behaviors. 39:30 Um, establishing the simple routines use of a schedule for our kids that are sensitive. 39:36 They need to know what’s coming, They need to know when there’s beginning and end, Um, be consistent. If you say there’s three more, there’s three more, and you stop. 39:45 you simple, specific language, first, then, two more than all done. 39:54 Make your expectations clear. 39:58 Use a timer if need it. 40:00 Then, also, some of our kids do need a motor, sensory motor support, um, to help with transitions. They need to transition from one activity near the other. 40:10 They might need a movement break, knowing these things, being consistent and keeping it positive. So, I have kiddos just for an example, if I advocate on that is self STEMI. 40:21 I’m not. And I know, other bodies excited. And all they can do is this: I’m not gonna say, No, No, no. I’m gonna go, Oh my gosh, Johnny. I see you’re so excited, I’m gonna give pressure into the arms, into the hands and say, Let’s, have we got this? This is awesome. I will never say, Don’t do that. 40:39 So, knowing no kind of terminology, and keeping it positive will go a long way. 40:46 So, again, I said, we’re gonna go quickly through these, because you can look into them. There’s two programs out there right now, there’s the, there’s probably more, but the two that I use are referred to, especially with the practice that I’ve been in the past 20 years. This is what we’ve used. 41:04 The Alert Program, which was originally established, 35 years ago, from to OT’s for 8 to 12 year olds, because cognitively, that is where you can process all three stages. 41:20 Um, but, it has been adapted, and you can use it for 2, 2 years and on, but you just modify it, and then, of course, it could be used through the lifespan to older kiddos. 41:37 The Alert program itself goes on. How does your exit run? 41:41 You have three levels. You have high gesture rate and low. 41:46 Um, when you have your high low and just write. That, just write level is something that you want your kid to be at or ear. 41:56 adolescent to be at, for times of education. Times, of working together as a team ability. 42:05 Didn’t need to have dinner together just right level to go walk into the mall and go to a store when your engines too high. 42:18 It’s, when you’re at the complete extreme. 42:23 It’s like a volcano erupting but in between that, you have the gray areas you see. There’s big gaps, and it’s a big pie piece. 42:32 There are that gray areas that you are in-between gesturing, and to just write in a high that is that excitable stage. 42:42 You’re not to the point that you’re too high that you’re about to explode and like a volcano but you’re at Iraq see it, because kids get excited, everyone gets excited. 42:52 I’m going to This insiders concert, it gets me very excited. 42:57 So, I’m allowed to get excited. It’s knowing when you need to be just right for those other times to focus. 43:04 How do I get my engine back to Jess? Right? 43:07 And that too low. 43:08 Is that sick board? 43:11 Um, sad. 43:13 They’re that they’re there too low. 43:17 Then the next thing is nodes of regulation. Zones of regulation came out in 20 15. 43:24 It pretty much plays Offloads, the Alert Program. 43:28 This one only puts in the that that in-between zone that I told you about that excitable zone they put in the yellow zone. So you have your red, yellow, green. 43:39 Again, green is where you want your kid to be or the person to be for that optimal learning. 43:47 Yellow is where a lot of people function at times, because being silly, being excited, having anxiety, having frustration, having stress, having the weight loss, A lot of people perform there. 43:59 It’s knowing why we need to come back down to green and what, what we, what do we need to get there. 44:05 So, or, or, if we’re under responsive kids that need more input to get them to be alert at blue zone. What do we need to do them in their system to get some degree before they need to participate in something important? 44:20 So these are examples of ways of using zones of regulation. 44:24 A lot of classrooms have used and adapted this and adapted the terminology. 44:30 The big thing with these programs, is all about self regulation. 44:36 It’s helping them become accountable for how they are feeling, and how they are emotionally doing, and how they are showing their output within the system, like what, what are they showing the world. 44:51 So self regulation within these parameters of the two programs, there’s three Strad, three parts of it. You first have to learn the vocabulary to you have to learn the feelings that coincide with the words. So they need to start being self aware and for accepting that adult facilitation. 45:12 Where are they on that barometer of emotion? 45:16 Are they high, low, or just right, or red, yellow, green, blue? 45:21 Then the last part is that they learn strategies to assist in changing the levels of: Regulation. 45:27 What, what, what will read their system up, when they need it, what will slow it down, and what helps them increase their attention in the moment. 45:37 Sometimes kids never independently get to step three. 45:42 It could be a cognitive issue, it could be an age issue, and they can still succeed within those programs with external assistance for step three. 45:55 So quick things about what you can do if you have a child with over responsiveness. 46:02 I try to list a bunch of different things. So, they are in your handouts. But if you have a kid that’s, I’m over responsive, that means they’re hyper responsive. That means they do not like that input. 46:13 Things that you can do is you have for auditory, you can use soft voice. 46:18 You could play sauce, loh music in the background, white noise, wear headphones, play ice by with waiting game still. 46:29 The idea of playing ISI is that you distract them from the input in the environment, meaning buy them, cognitively looking for things, additionally attending at dampens their sensitivity to the sound. You’re telling them to override it by getting them engaged in something else. 46:50 With visual, you can dim the lights you can use natural light instead of Fluorescent lights. Wear baseball, cap. 46:58 Use a screen protector like the visual dimming one for laptops, because sometimes the light of that works help helps. 47:09 Um, proper receptive input, represented input, especially with kids that are over responsive ISO metrics is a good way of helping them. 47:20 ISO metrics is getting something like a 90 position in holding, like the wall set or holding or holding a tray kind of thing working out with weights, chewing gum, giving for while asking for hugs. If you’re if they are allowed, you’re not allowed to give hugs within a school situation, having Beanbag chairs and asking them to be squished in between. 47:46 When pressure garments, a lot of the kids don’t like touch. 47:53 We’ll ask for pressure garments because it’s a passive way that they can get the input without having somebody touch them. 48:00 Wait, I’m gonna say this now because it’s good. 48:03 It’s again for over response, over response of our hyper kids, whatever you use. Wait, this is my soap box. Do not use it for more than 20 to 30 minutes at a time. 48:18 So if you put 10% of that child’s body weight on them, you only let them wear it. for 20 to 30 minutes. 48:26 You set a timer, either your clock. 48:30 I have a, if you have multiple kids in your ear care, have names with kitchen timer’s that you can program. 48:40 Make sure that it, when it goes off, you take that weight off, and you do not wear it again for two hours. Because if you continuously where that weight? 48:49 And you do it, like, say, circle types. 48:54 An hour, I don’t know why, but I’m just saying it. And you let that kid where that’s for that entire time. 49:00 If you continuously do that, that kid become so accustomed to it, that you just gave away one of your strategies, because of body, too accustomed to it, that it doesn’t even work anywhere. 49:12 So, try not to giving fidget toys for tactile kids, having self directed tactile as they can tolerate it. 49:22 I’m so sorry, I have the word tolerate, as they can accept it. Vestibular. 49:27 Being able to rock and the chair taking exercise breaks, reach for the sky, touching their toes. That is a quick way of getting the stability input without taking up a lot of room, or needing a swipe. 49:41 For under responsive, you have those kaos that need more information in their body to be able to register their input in the world, or like them in the world, or them within the environment. 49:56 These are kiddos that need things not to be slow, paced and rhythmic. These are ones that you want that fast, slow, fast, slow. 50:08 They want something not to be predictable, um, using brighter lights for our visual kids that are under responsive, using deep, quick strokes, up pressure for deceptive using a massage, or if they are allotted to be at least massager. 50:28 Some kids cannot use the massage, especially if they’re prone to seizures. 50:33 Using fabrics are materials that they could do like, touch with, because that on their system of the noxious knock sick or kiddos that are over responsive. 50:45 But if they’re unresponsive, they love that light touch. 50:51 And then, things that need to be unexpected frequent, frequently changed to increase arousal. 50:57 They are kids that you constantly have to change things. 51:01 For vestibular, you can have them runs short distances. And a hallway, you can use that. It’s kinda like a disco said. It’s like a little have to flee the ball that they can sit on, and they can still legal. 51:13 You can have aye. 51:16 Animal walks, bouncing, a ball. For oral crunchy. You want, especially if they’re unresponsive, you want some pungent taste with their lunches or hot things for hot sauce, sweet spicy ability to chew gum for short periods of time to help drive their system. And they have to throw it out. 51:37 You can use smell for under responsive with anything like then. under a response, a kid, you want to use things that elicit. 51:44 intentions are small, strong smells like mint citrus, um, then you have your sensory seekers. 51:54 Some of the things overlap, and as the same as you’re under responsive. 51:59 The only thing I can tell you, with the sensory secrets, you want to make sure everything is tight. 52:04 These are the kiddos that you do need the parameters of goal directed activities and tied tech activities because you don’t want to give them too much information. You went to their system to learn how to deal with information in short periods of time and start to accommodate to it, and then their body will start to change. 52:24 Because if you are doing the right kind of input into their system, they will show changes, and become more calm overall, And the seeking part will diminish what smell I’ve used. 52:41 Uh, sweatband, that, I use. 52:45 Essential oils, make sure it’s essential that synthetic, I will put lavender or vanilla and have it in a Baggie and their desk and they can take it out, put it on when they’re having a, A moment of stress. Or, they know they, their body needs to move, they could put it on and use that as a. calm. 53:04 Again, waiting, fidget spinners are huge for these sensory seekers. 53:10 Also, putting a elastic band around the base of their chair, will give them a tactile emperor perceptive while they’re sitting. So they can stay in a seated position but still get a lot of energy out. 53:24 Sensory based motor disorders. A lot of things with these, these are, again, the steering the kids, that know that there’s something not right, but they can’t put their finger on it. 53:34 You have to really help with building self-esteem. You have to have to work on core muscles and strengthening the list, those anti gravity positions like Superman. 53:47 The Ice Cube kinda position, like you’re on your back and you’re trying to hold everything together, weight bearing resistive activities, like wall push ups, yoga positions, anything like that. 54:00 It’s gonna help with them, activities that are, like sign that says or any component of timing and sequencing. So, like, if you think of a component activity for timing and sequencing, think about red light green light. That is something because they have to listen at the same time. 54:16 So, it’s an auditory piece to that is some of the activities that you can do with these sensory based and older kiddos And our discrimination cows. 54:26 Again, these are kiddos that you know that there is something because you can apparently see that there’s something there. So these kids might need visit therapy. They might need FM systems within class. 54:40 They might be kiddos that might do well with an auditory program. 54:47 Also, these are kids that might do well with exposure therapy, is just certain tactile input, oral input, things that are sustaining balance of positioning, things that are same in different games, that’s a good one for visual. 55:04 Um, big thing there tie up. 55:09 Key things to always remember about sensory processing. 55:13 Current research shows a neuroplasticity is ever changing through the lifespan. With that being said, old practice was that once you turn 18, what you got up here is what you have. 55:24 If you get an accident or something else, it’s gone. 55:27 It’s not true. 55:29 Your brain finds a way, If you give it enough input and you have the internal mode, motivation and desire to do certain things and new neural class, new, a new neural pathway will create. 55:46 And, again, it might not be perfect or typical. 55:51 There is ways to enhance that normal plasticity. 55:55 We have to take advantage of it by using our sensory systems and the ways that we can change it is by completing activities with frequency, duration, intensity, and variability. 56:09 Those four things are the way we change any sensory system or processing system throughout your body. And then, also, the need to become an investigator. Oh, one other thing I wanted to tell you about, frequency duration, intensity and variability. 56:26 Yes, it takes on an average, a thousand tries to learn something, to learn it, to become everyday routine, like everyday routine, like knowing for some of my kiddos that knowing how to brush their teeth and knowing what components to get like inside outside, up down tongue. 56:48 It takes about thousand tries. Say they’re doing it wrong and you’re re teaching them how to do something. 56:54 It takes up to 5000 time to learn it, to become everyday practice and become habitual. 57:04 Just so you know, I wanted you to know the numbers, because it makes it apparent of things that you need to do, and why it takes so long, sometimes, for somebody to learn something with kids that have those sensory behavioral behaviors. 57:19 You need to become the investigator. You start to plot out ticket journaled, understand, like, Why is it happening here? Is it a certain time of day? Is it a certain trigger with a certain kid, is it, or a certain environment? 57:34 Is it a certain? 57:36 They know a certain clothing is kinda because they’re going to dance, and they don’t my tights like start plan that out. 57:44 When you have those things, and you come with plotted out. Times, date, when you bring that to a professional, like an OT, we can help you. work through what, what can we do next? 57:58 Knowing all this, because you’re with them longer. What are we going to try to see what’s going to work the best for this child? 58:05 So we make a century program that is going to work and be most beneficial to everyone involved. 58:13 Then remember, again, we’re not cookie cutter. Each child is different, and it will have different needs and just so you know with a sensory system. 58:23 If you change one thing, it might be ever changing just by changing one thing. 58:28 Might not make them portable, integrated in processing fluently. 58:35 It might lead you to the next thing to work on. 58:39 Everyone’s beautiful the way they are and just learning how to help them have that. 58:44 That’s like they can have in the least restrictive environment. 58:50 That’s everything. 58:52 If there’s any questions, definitely loved the answer. 58:56 Pharma’s Felicia, Thank you so so much. 58:59 And I know that we are currently at 8 30 for anyone that needs to log off. We completely understand. We’re going to stay on for a couple of minutes after just to answer a few questions. When you do, if you do need a log off, there will be an exit survey. We would greatly appreciate if you filled this out. This webinar will be archived to our website at WWW dot … dot org, and the webinar blog will be open for the next seven days. We will be having a webinar next month, on Ms. … titled, Stop Making That Sound by doctor … 59:41 on February 15th at 7 30 PM, And for those of you that kinda stay on, we have a couple of questions, and I’m just going to start asking you ready. 59:56 OK, sound, we have, Someone said, I have a student who, when this regulated, pieces, my room scripts and does not process any auditory input. 1:00:10 I could repeat myself 10 times, but he just continues the script, he has so much potential, but I don’t know how, I could help him process input. Do I increase the time I give him to process input? 1:00:22 Do I, This is kind of long. Do I give him some sort of regulatory activity prior to starting my speech therapy session with him? Aside from ASD set aside from ASD, can strip conscripting be a symptom of having a processing disorder? 1:00:40 Then, um, they said Whoo, They said, I don’t know what what. I don’t know the clear antecedent or what his sensory needs are. 1:00:54 So, if a kid is pacing, um, if it’s, I understand. She said she doesn’t understand if it’s a clear antecedent, but usually the pacing is coming from something. It’s either avoiding or seeking. 1:01:11 Finding out that, and trying to figure out how you can, in the most positive way, interrupt that and move them to something else. 1:01:23 Try that slight little body block and say, Oh, hey, you know, and, like, try to bring them back to you, and leave them somewhere else for something that you need. If we know, and we can plot if it’s a certain time of day, or a certain thing, that’s about to happen, that the pacing starts. 1:01:42 Knowing to try to give a little input, or a countdown or something to help them understand what’s coming next is another strategy, So knowing the difference between those two. 1:01:53 Also, uh, things with scripting, things that I’ve tried is that I tried to interrupt in the sense of, ask, if I could pick up what they were scripted like, Oh, OK. It’s a SpongeBob show. 1:02:09 All right, can you tell me something like I tried to engage in it? 1:02:12 And then usually by me trying to engage it usually sometimes has spoken the script that I can get to them. 1:02:20 Um, sometimes I have to let the script run through and then I can alternate through to the next thing. 1:02:29 A lot of times, if I am trying to distract and I know the scripting isn’t going to stop, because there are some kids that are on a constant loop, I will try to do that body block, give some firm input, are their shoulders, or onto their sides, of their arms, and allow them to know that I’m in their space. 1:02:49 And that, OK, we’re gonna move on to this, and then give them a second to process that, because, again, in their head, they’re looping. 1:02:59 So you have to wait for them to register that inflates, because, sometimes, that physical input, we’ll help break some of that. That’s going on, internally, in their brain. 1:03:11 Thank you. 1:03:13 So, our next question is, Can you provide feedback specifically for preschoolers, they didn’t really give an example or anything, OK? Well, preschool, There’s tons of different things you can do. So, like if you think a preschool, you think of one of the major hard things for, most preschoolers are a circle time, circle time. A lot of times what you can do is use spots. 1:03:37 on the floor, You have definitely with kids. They are staying within their own spots. 1:03:43 Using, I’ve used kiddos that have spandex like little cocoon little things that they sit in so that it helps them understand their own body and their own bubbles. 1:03:57 Other things using animal walks or some kind of low motor movement before getting into circle time, To help damping somebody they’re seeking getting out some of that movement prior to sitting and trying to get them to attend. 1:04:13 Um, no kid that young, It’s going to be listed for a long period of time. having movement breaks within circle time. 1:04:22 Having the ability to have digits are things that they can play with, with their hands. 1:04:27 Um, and having ability for each kid taking a turn of participating, so they can be up and moving. 1:04:35 Some quick ones, because I know that in preschool that’s usually one of the big things that I hear, are the most difficult for the children that I see. 1:04:44 Know, and our last question is, what is the best way I lied? We just had someone else, but at another question. I love it, OK, so, second to last question we have: what’s the best way to explain to family members or friends that behavior issues aren’t just bad behaviors? Some people look at Some people look at it as the patient is too lenient or can’t control behavior. 1:05:13 The best thing I can say is educate them Yeah, you can’t, unfortunately. 1:05:23 Help everyone with their pre-conceived notions, but education is the best key to defend against some of them. 1:05:30 Ooh! 1:05:32 I have a lot of friends that do math. 1:05:35 Kids are with ADHD or autism are genetic, other genetic disorders, that education has been key for them to feel more accepted within environments. 1:05:46 Um, but, again, you, you want to be able to be out and about also knowing when to let other things roll off your back. 1:05:54 As a parent, and because you know you’re doing the best you can and letting it be that way. Because you know you’re doing the best you can. 1:06:04 Because I know it’s hard as a parent to do, stuff like that, but all I can say is education, and knowing you’re doing your best, knowing that your child is succeeding and working through a lot of things. 1:06:21 It’s really, really got an important base, and thank you for that. 1:06:25 And so our last question is this person says, I am a speech language pathologist, and I have a student that has a lot of sensory needs, however, we cannot see. 1:06:40 However, we cannot seem to determine what the, and, I’m sorry. However, we cannot seem to determine what input she needs. 1:06:50 We have tried many different ways to provide him with the input he needs. And I even ho treat with the OTA for one of my sessions. 1:07:00 For example, we had him on the swing last week and he seems to be calm when swinging. However, he shows signs of frustration through crying after a period of time but did not want to get off the swing and the ideas. 1:07:17 So if they’re trying to do, if I really, if I’m listening correctly is that they’re pretty much trying to do a session on the swing. 1:07:25 So trying, trying, having at times, and taking the swing down, so having a timed part, having the swing down, do an activity. 1:07:38 Go back to this when I got first and then. 1:07:43 And do it. 1:07:45 At first, it’s going to be a little dance, I call it, especially with mentoring or a therapist. 1:07:51 It’s a little dance you’re going to do. You’re going to do. 1:07:54 All right. 1:07:55 We’re going to do 10 swings stop work, then swain work, Then swing, then, OK, we do an activity. You’re only and it’s a low level activity, because you’re just trying to get the buy in. 1:08:09 Then you do, again, 10 swings. 1:08:12 Then you do that same activity, a same activity, or you. 1:08:16 You do the next part of the activity. 1:08:18 Then you get the 10 swings as he is learning that back and forth. 1:08:23 The next time, or even within that session, if he’s doing well, then you start to do, or you still can have the 10th sweets, but now you have part part one and part two of that activity before we go back, to keep upping the ante as they start to show that they can understand the back and forth. 1:08:41 So is that fine dance of what’s going to work? 1:08:45 They’re that back and forth. 1:08:47 But always giving that back and forth until they don’t need it anymore. 1:08:52 Again, I call it that little dance that you do within a session. 1:08:58 Thank you so so much Miss Sonya and thank you everybody for joining our webinar tonight. So it’s around 8 40. We’re going to close it off now. In any of you have any questions that we weren’t able to get to, our webinar blog is now open. Feel free to go on to our website at WWW dot … dot org and we’ll be right underneath the archived webinar or this archived webinar and Miska Sonya will be able to answer your questions for the next seven days. In addition, there will be an exit survey. Please take a moment to complete it. We would greatly appreciate it. 1:09:42 And, like I said, an archived recording of tonight’s webinar will be posted to our website, and the webinar blog will be right underneath that. Our next presentation will be stopped making that noise presented by doctor Miler Marla Dive Learn on Wednesday, February 15th at 7 30 PM Eastern Standard Time is sense tonight’s webinar. Thank you so, so much, Ms. Hassan, yeah, for your presentation, And thank you to everyone for attending. I hope you all have a wonderful night.


  1. Melissa says:

    Is SPD found outside of Tourette’s?

    • Felicia Castagna, MS, OTR/L says:

      Yes, SPD is found linked to many diagnosis like ADHD, ASD, etc. However, there are children that just have some form of just SPD for treatment. SPD can stand alone as diagnosis; however, it is not recognized in the DSM-V yet.

  2. Julia says:

    Do you believe there are some calming/self regulation techniques that the sensory processing individual can use to avoid a meltdown?

    • NJCTS staff says:

      I definitely believe there are items, when practiced prior to meltdown and as mindfulness training, it can be a crucial tool to assist with avoiding a full meltdown. In my presentation I gave a few examples to assist with this; for example: yoga, breathing technique, imaginary, exercise in course of day, etc. Also, use of the Alert Program and/or Zones of Regulation programs to assist with learning about the child’s own regulation, empathy, and then strategies to help within situations. – Felicia Castagna, MS, OTR/L

  3. LylaMarie says:

    I’ve found that Exposure Therapy greatly helped my child with OCD. Does the same modality suggested for SPD or does it not help to expose child with SPD to certain environments?

    • NJCTS staff says:

      No, exposure is definitely the key. The only difference with SPD is this ideology is also trying to desensitize at the same time. Then coupled with grounding work with the body through activities with proprioceptive and vestibular input at least 30 minutes prior to exposure. – Felicia Castagna, MS, OTR/L