Red Flags for Sensory Processing Disorder

May 21, 2013

What is sensory processing?

Sensory processing refers to how individuals process the information provided by all the sensations coming internally from the body from the environment. These senses work together to give us a sense of the world and our place in it. The brain organizes the information about the different smell, sounds, textures, sights, tastes, and movements that surround us. This organization of sensory information allows us to put meaning to the world around us and gives us a sense of how to respond and behave appropriately. When the organization of sensory information is impaired, it can affect the way in which we live our everyday lives.  Impairments with sensory processing have been found to have a great impact on activities such as play, work, learning, social interactions, and everyday activities.

You might have wondered, “Do I or Does my child/loved one have a sensory processing disorder?” There is an excellent resource for people with sensory processing difficulties at the Sensory Processing Disorder (SPD) Foundation website: http://www.spdfoundation.net/index.html.

They have a checklist (see below) describing symptoms that may fit someone you know with sensory processing difficulties. Please note that this checklist cannot diagnose someone with SPD. It can be help determine if additional testing should be done. When filling out this checklist, think about the individual’s behavior during the past six months. When more than a few symptoms are found in an individual, we recommend that you talk with your doctor/pediatrician or occupational therapist.

Sensory Processing Disorder Checklist

Many of the symptoms listed in the following categories are common to that particular age group.

Infant/ Toddler Checklist:
____ My infant/toddler has problems eating.
____ My infant/toddler refused to go to anyone but me.
____ My infant/toddler has trouble falling asleep or staying asleep
____ My infant/toddler is extremely irritable when I dress him/her; seems to be uncomfortable in clothes.
____ My infant/toddler rarely plays with toys, especially those requiring dexterity.
____ My infant/toddler has difficulty shifting focus from one object/activity to another.
____ My infant/toddler does not notice pain or is slow to respond when hurt.
____ My infant/toddler resists cuddling, arches back away from the person holding him.
____ My infant/toddler cannot calm self by sucking on a pacifier, looking at toys, or listening to my voice.
____ My infant/toddler has a “floppy” body, bumps into things and has poor balance.
____ My infant/toddler does little or no babbling, vocalizing.
____ My infant/toddler is easily startled.
____ My infant/toddler is extremely active and is constantly moving body/limbs or runs endlessly.
____ My infant/toddler seems to be delayed in crawling, standing, walking or running.

 

Pre-School Checklist:
____ My child has difficulty being toilet trained.
____ My child is overly sensitive to stimulation, overreacts to or does not like touch, noise, smells, etc.
____ My child is unaware of being touched/bumped unless done with extreme force/intensity.
____ My child has difficulty learning and/or avoids performing fine motor tasks such as using crayons and fasteners on clothing.
____ My child seems unsure how to move his/her body in space, is clumsy and awkward.
____ My child has difficulty learning new motor tasks.
____ My child is in constant motion.
____ My child gets in everyone else’s space and/or touches everything around him.
____ My child has difficulty making friends (overly aggressive or passive/ withdrawn).
____ My child is intense, demanding or hard to calm and has difficulty with transitions.
____ My child has sudden mood changes and temper tantrums that are unexpected.
____ My child seems weak, slumps when sitting/standing; prefers sedentary activities.
____ It is hard to understand my child’s speech.
____ My child does not seem to understand verbal instructions.

 

School Age:
___ My child is overly sensitive to stimulation, overreacts to or does not like touch, noise, smells, etc.
___ My child is easily distracted in the classroom, often out of his/her seat, fidgety.
___ My child is easily overwhelmed at the playground, during recess and in class.
___ My child is slow to perform tasks.
___ My child has difficulty performing or avoids fine motor tasks such as handwriting.
___ My child appears clumsy and stumbles often, slouches in chair.
___ My child craves rough housing, tackling/wrestling games.
___ My child is slow to learn new activities.
___ My child is in constant motion.
___ My child has difficulty learning new motor tasks and prefers sedentary activities.
___ My child has difficulty making friends (overly aggressive or passive/ withdrawn).
___ My child ïgets stuck’ on tasks and has difficulty changing to another task.
___ My child confuses similar sounding words, misinterprets questions or requests.
___ My child has difficulty reading, especially aloud.
___ My child stumbles over words; speech lacks fluency, and rhythm is hesitant.

 

Adolescent/Adult:
___ I am over-sensitive to environmental stimulation: I do not like being touched.
___ I avoid visually stimulating environments and/or I am sensitive to sounds.
___ I often feel lethargic and slow in starting my day.
___ I often begin new tasks simultaneously and leave many of them uncompleted.
___ I use an inappropriate amount of force when handling objects.
___ I often bump into things or develop bruises that I cannot recall.
___ I have difficulty learning new motor tasks, or sequencing steps of a task.
___ I need physical activities to help me maintain my focus throughout the day.
___ I have difficulty staying focused at work and in meetings.
___ I misinterpret questions and requests, requiring more clarification than usual.
___ I have difficulty reading, especially aloud.
___ My speech lacks fluency, I stumble over words.
___ I must read material several times to absorb the content.
___ I have trouble forming thoughts and ideas in oral presentations.

For more information the SPD Foundation website recommends checking out the SPD Foundation’s Treatment Directory (http://www.spdfoundation.net/directory/index.html) for a professional experienced with treating Sensory Processing Disorder.

 


Living with Dyslexia

June 4, 2012

According to the International Dyslexia Association, dyslexia is characterized by “difficulties with accurate and /or fluent word recognition and by poor spelling and decoding abilities. These difficulties typically result from a deficit in the phonological component of language that is often unexpected in relation to other cognitive abilities and the provision of effective classroom instruction.” (Adopted by the IDA Board of Directors, Nov. 12, 2002) Consequences may include difficulty with reading comprehension, which can limit growth of vocabulary and background knowledge. Recent studies also show that people diagnosed with dyslexia typically process information in a different area of the brain than people who are not dyslexic.

Since the enactment of the Individuals with Disabilities Education Act (IDEA), many students are currently receiving instruction more tailored to their needs. However, adults who are living with dyslexia today may not have received the proper instruction in reading in order to overcome their challenges with written text.

Don’t worry! A wealth of evidence shows that intensive, high quality literacy instruction can help students who are struggling build the skills they need to succeed in high school and beyond (Alliance for Excellent Education, 2006). In other words, it is never too late. Older students with dyslexia, including adults, can benefit from specialized reading and writing instruction, but it is essential for them to find an instructor who is highly trained to successfully teach individuals with dyslexia.

So, reader… while you are busy finding the proper instructor, you can still make improvements to your reading ability with compensatory strategies. These are methods for which you are able to compensate for significant difficulties in a way that would provide you with a more satisfying quality of life. For example, a compensatory strategy for overcoming difficulty with written text can be listening to books on audio recordings.

Other strategies:

Clarann Goldring, Ph.D., is a licensed and practicing psychologist, and maintains a diagnosis of Dyslexia and ADD. Below are some of her “Practical Tips for Success” for adults living with dyslexia: (From http://www.dyslexia-ca.org/pdf/files/clarann%20handout.pdf, 2006)

  1. ACCEPT YOUR LEARNING DIFFERENCE AND ADAPT ACCORDINGLY. The key for unleashing the potential within each person is through a set of specific coping strategies and techniques.

Four components:

1) RECOGNIZING the disability was the key beginning point.  Denial leads to continued failure and moving ahead is impossible.

2) PERSISTENCE – THE NEED TO WORK HARDER THAN OTHERS – Accepting both the negative and the positive.

3) UNDERSTANDING YOUR STRENGTHS AND WEAKNESS – What is my disability and how does it effect my everyday world?

4) ACTION – All the recognition, acceptance and understanding in the world are useless without a conscious decision to work towards a goal.

Understand your Strengths and Weaknesses and Adapt with Compensations

  1. DEAL WITH ANXIETY, OVERWHELM, or PROCRASTINATION
  2. Take a Deep Breath – slow down.
  3. Break it Down into smaller parts.
  4. Make a Plan – organize the activity
  5. Self Talk:

  I am unable to spell but I can create great ideas for a story.

  I am unable to remember the detailed information but 

  I can tape it, write it down and with time I can fully understand it.”

~Admire the fact that you can work through the struggle.

  1. MAKE STRATEGIES FOR MEMORIZING MATERIAL

(use diagrams, cards, tape recorders,  visualization, auditory associations, mnemonics)

  1. If someone gives you information – How do you put it in your long term memory?
  2. Organize the information into concrete usable information.
  3. Multi-sensory – see it, hear it, do it (kinesthetic).

READ IT,   SAY IT,   WALK WITH IT,   BOUNCE WITH IT,   MAKE PICTURES WITH IT

(Note: why do I forget?  I am not interested – not my choice to remember.  For this moment I need to be interested.

Relax – crawl into this material for a moment. Make it a challenge!)

Laughter is another key to happiness. Having a sense of humor about your difficulties may also help you deal with some of the more challenging tasks, when feelings of frustration take over. For a chuckle, please visit: http://www.cartoonstock.com/directory/d/dyslexia.asp (beware – some of them are pretty silly!).

Living with dyslexia doesn’t have to be so hard. If you can have patience and work hard, you will succeed in making improvements to your reading and comprehension abilities. Please visit the resources below for more information about dyslexia, and for access to communities of others successfully living a satisfying life, with dyslexia.

 

References/Resources:

Clarann Goldring, Ph.D., 2006: “Practical Tips for Success”

http://www.dyslexia-ca.org/pdf/files/clarann%20handout.pdf)

International Dyslexia Association:

http://www.interdys.org/FAQWhatIs.htm

Forum and Resource for Individuals with Dyslexia, created by Individuals with Dyslexia: http://www.dyslexia-adults.com/a6.html

Melissa M. McClung, MS, CF-SLP


You Will Not “Zone-out” With This Great Self Regulation Program

April 4, 2012

The Zones of Regulation Curriculum was designed to help children become more successful in school, at home, and in the community by independently controlling maladaptive behaviors through the process of self regulation and emotional control. Self regulation is the ability to be in the best state to successfully engage in a particular activity. When exposed to a frustrating activity, an individual with self regulation difficulties may find coping challenging and will likely demonstrate maladaptive behaviors such as physically escaping the situation or lashing out.

Through the Zones of Regulation program, students will learn how to categorize their emotions and states of alertness into four  color categorized zones.

  1. The Blue Zone: A low state of alertness. For example, when one feels sick, tired, or bored.
  2. The Green Zone: A regulated state of alertness. Characterized when one is focused, calm and content.
  3. The Yellow Zone: A heightened state of alertness. For example, when one experiences feeling of frustration, silliness, or confusion.
  4. The Red Zone: An extremely heightened state of alertness. When one feels intense emotions such as rage, panic, or terror.

The Zones of Regulation curriculum teaches children which zones are expected for given circumstances. For example, right before a championship sports event, it is okay for one’s body to be in the Yellow Zone as a heightened state of alertness may boost athletic performance. In contrast, a heightened state of alertness is not appropriate when one is sitting in math class. If a child is in a zone that does not match the demands of the environment, the Zones curriculum teaches children tools that help them move between zones; this helps a child get their body in a “just right” place to do what is expected of them. A child’s toolbox of self regulation strategies consists of a variety of calming techniques, cognitive strategies, and sensory supports.

The Zones of Regulation curriculum is appropriate for any child, even as young as preschool years, that struggles with self regulation. However, some children with the following conditions frequently have difficulty self regulating: Autism Spectrum Disorder, Attention Deficit Hyperactive Disorder, Oppositional Defiant Disorder, or Anxiety Disorders.

For more information about the Zones of Regulation program, please ask your CSLOT occupational therapist.

-Rosie Commons M.S. OTR/L

References:

Kuypers, L.M. (2011). The Zones of Regulation: A Curriculum Deisgned to Foster Self-Regulation and Emotional Control. San Jose, CA: Think Social Publishing, Inc.


Speech, Language, and Literacy

March 27, 2012

It’s never too soon to start reading with your children! Children begin to learn speech and language skills from the day they are born. As children develop, they learn increasingly complex speech and language skills. During early speech and language development, children are also learning skills that are critical for emergent literacy skills. Emergent literacy begins at birth and typically continues through the pre-school years. It is critical for parents and caregivers to help children develop these emergent literacy skills…

Make reading fun!

  • Make sure both you and your child are having FUN!
  • Read with expression, pitching your voice higher or lower where it’s appropriate or using different voices for different characters.
  • Use puppets to help read and narrate the story.
  • Allow your child to choose the book he/she is interested in.
  • Let your child interrupt to ask questions or make comments.

Play with language!

  • Sing songs (Ex. “Itsy bitsy spider”, “Old McDonald”, or other ones which you know or can create).
  • Tell stories and narratives with your child, especially ones with sequence.
  • Read nursery rhymes and other rhyming books.
    • After a child has become familiar with the rhyme, stop before the last word on the page and let the child say it.
    • As a game, take turns to see how many rhyming words you can think of together: hop, top, bop, mop, stop, drop, and flop.

Improvise!

  • You do not always need to read the words as they appear in the book. You can simply talk about the pictures with your child.

Reading can take place anywhere, anytime!  Integrate reading into daily routines and make reading a daily habit. This is an activity which you and your child can look forward to.

Some ideas …

  • Start and end the day with books
  • Read during snack or after snack
  • Read during transition times
  • Read while waiting for appointments
  • Play books on CD in the car
  • Restaurants

Point out print in your natural environment to your child!

  • Food labels, billboards, words on the computer, names, signs, and more!

Visit your local library!

  • Check out books.
  • Attend a read-aloud with a story teller

Time Together Triangle:

  • There is a balance between you, your child, and the book!
  • Make sure that you:
    • Read to your child: Make a commitment of reading to your child on a regular basis. Keep the routine, it will be something both you and your child will look forward to!
    • Read with your child: Make sure your child is interested in the book, so that you are both engaged.
    • Let your child read to you: Encourage your child to help tell the story, even if he does not know how to read yet.

Remember we do not need to TEACH children all the time, we need to ENRICH their lives!

E –  Encourage

NNuture

RRepeat stories over and over

I –   Involve your kids/Invent games together

CCheer for your kids

HHAVE FUN WITH YOUR KIDS!

-Katey Sellers, M.A., CF-SLP


Social Groups for Older Individuals

February 28, 2012

According to Worrell & Hickson (1991), “there will be an increasing number of older population requiring audiology and speech-language pathology services, and the majority of these clients will be living alone.” Effects of normal aging include age-related impairments of the auditory and vocal systems, word retrieval impairments, language comprehension (including a decrease in literacy skills), and conversational discourse skills. Rave & Kahn (1998) define successful aging as “maintaining physical health, avoiding disease, sustaining good cognitive function, and having engagement with other people and productive activities.” Activities such as socializing helps senior citizens feel competent and improves their self-esteem. Social networks include neighbors, family, and volunteer or social organizations. According to Kastenbaum (1987) a prevention activity is a form of environmental modification to reduce levels of loneliness and to increase social usefulness, while at the same time providing help to maintain and improve older adult coping abilities. Prevention activities can be group therapy that is community centered, or family centered. Communicative benefits of group therapy include: appropriate topic maintenance, rate of speech, number of words per utterance, pitch, and vocal quality. Cognitive benefits of group therapy include psychological support, generalization of communication skills, aiding individuals to cope with feelings of loneliness, depression, and hopelessness as well as increase their sense of worth and belonging (Zarit & Zarit, 2002).  Adult social groups for aging individuals allows for preventative care in a functional and peer-supportive setting.

-Sarah Peters, MA, CF-SLP


ASHA Convention 2011: San Diego, California

January 10, 2012

The 2011 American Speech Language Hearing Association (ASHA) Convention was held at the San Diego Convention Center in San Diego, California, November 17–19, 2011. Many therapists from CSLOT, along with more than 12,000 attendees, attended the convention, where we enjoyed informative classes, caught up with colleagues, and learned new and innovative approaches to speech language pathology!  From classes on voice disorders to brain injuries to augmentative and alternative communication (AAC), attendees had a wide variety of courses to choose from at this year’s convention.

One of the classes featured a panel of researchers who presented their study of late-talking toddlers. The study aimed to discover which therapeutic methods were best for late-talking toddlers. After thousands of studies were examined and scrutinized, it was found that there is no single approach that is best for all children. After taking into consideration family values, it was found that an eclectic approach which combined multiple language stimulation methods was found to best promote expressive language. The researchers presented more than 15 effective language stimulation methods; a few of them are listed below:

  • Expansion: the adult expands on the child’s “baby-like” utterance into a more adult-like form (e.g.:  Child says:  “horse”. Adult says “Yes, that is a horse.”).
  • Self-talk: the adult uses short phrases or sentences to convey your actions to the child (e.g.:  Adult says “I am washing dishes”).
  • Parallel talk: the adult uses a short phrase or sentence to describe what the child is doing.  This technique highlights the action (e.g.:  the child raises a cup to his lips. Adult says:  “You are drinking” or “(Child’s name) is drinking”)
  • Description: the adult uses a word, short phrase, or sentence to describe what the child sees or is playing with.  This technique is object centered (e.g.:  The child picks up a truck.  Adult says:  “a truck” or “It’s a truck” or “a blue truck”).

Further, it was found that environmental arrangement is extremely important. For example, a cluttered play space was shown to be overwhelming and difficult for the child and communication partner (therapist, parent, teacher, etc), to communicate. The child also responded more frequently when patterns and routines had been established within the environment.

Lastly, the power of patience and wait times were emphasized. Rather than giving the child a bombardment of prompts/cues, it is more powerful to listen to the child, watch their response, then add to the interaction. Following the child’s lead is a crucial part of intervention, especially with late-talking toddlers.

-Katey Sellers, M.A., CF-SLP


Smartphones, and Tablets, and Apps Oh My!

November 1, 2011

Mobile devices are in the hands of children and their parents everywhere you look, but what about older adults? If older adults are not yet using mobile devices for making phone calls or texting, there is another reason these devices may have an appeal. Smart phones and tablet computers are now offering a variety of software and applications that can serve as Hearing Assistive Technology (HAT).

Mobile devices are every-user friendly these days, providing icon buttons on the device itself or on each screen that allow users to navigate with ease, if nothing else, back to the “home” screen. Many devices are lightweight and have options to enlarge the screen for easier viewing of pictures or text.

Mobile devices can now be used as portable listening devices with several available apps (and more likely in the making). Apps range in use from amplifying sound or selective frequencies to adjustable frequency response and recorded buffers, which allow conversations to be replayed. Unfortunately, at this time, there is no regulation or warning of maximum output. This puts the user at risk of causing further hearing damage if the device and application are not used appropriately. Ideally, apps should be recommended and monitored by an Audiologist who would be able to make the most appropriate selection and could assist in monitoring the output and safety of the device.

Available apps: EARs, EarTrumpet, Hear, HearingAid, iHearClear, SoundAMP Lite, and UListen-Sound Amplifier.

Other options include visual and telecommunication apps. Visual Apps can convert speech samples to text for when amplification is not enough. Other visual supports on devices, like Skype or Apple’s “Face Time,” provide video of the person talking so the viewer gets visual cues of facial expressions and lip/mouth movements to aid in understanding the auditory message.

It is important to remember that mobile devices being used for the purpose of Hearing Assistive Technology do not replace well-fit hearing aids, but is a possible solution for problems not solved by hearing aids.

For more information on this topic and more detailed information about the listed apps, go to the source: Lesner, S. A.  & Klingler, M. (2011, October 11). Apps With Amps: Mobile Devices, Hearing Assistive Technology, and Older Adults. The ASHA Leader.

 

Lauren Gabrys, MA, CCC-SLP