Introduction: Background on Sensory Processing in Young Children
The human experience is dictated by the body’s senses, as senses are the vehicle through which we are able to see, hear, touch, taste, and smell the world around us. These five senses are visual, auditory, tactile, gustatory, and olfactory respectively (Hyche ; Maertz, 2014). Apart from these traditional five senses, the body also has three additional sensory systems: vestibular, which is involved with movement and balance; interoception, which controls internal regulation responses of the physical state of the body, such and hunger and thirst; and proprioceptive, which is involved with body awareness and motor skills (Hyche ; Maertz, 2014). Sensory processing disorder refers to a problem with sensory integration, or the way in which the nervous system receives and translates information from sensory systems to motor and behavioral responses (LeMond, 2015). Children with sensory processing needs may have problems with any one or combination of their sensory systems; because of this, sensory processing disorders are difficult to diagnose as symptoms vary greatly on a case by case basis (STAR Institute for SPD).
According to Maertz and Hyche (2014), there are three distinct types of sensory disorders: Sensory Modulation Disorder, Sensory Based Motor Disorder, and Sensory Discrimination Disorder. Children with these disorders are frequently misdiagnosed and perceived as troublemakers in class, when in reality they are processing sensory input differently from their peers. This report will focus on Sensory Modulation Disorder, whose hallmark traits include difficulty with touch, movement, and body position (Kranowitz, 2016).
Children with Sensory Modulation Disorder fall into one of three categories: over-responsive, under-responsive, and sensory-seeking. Each of these conditions results in difficulty with sensory integration in distinct ways, and has a profound impact on a child’s ability to function and perform in school. The diagnosis of SMD is controversial and is not always recognized by psychiatrists (Arky, 2018). It is common for people on with autism spectrum disorder (ASD) to experience difficulties with sensory modulation. However, sensory modulation disorder may occur in children with ADHD, OCD, other developmental and learning delays, or even no other diagnosis (Arky, 2018). Over-responsive children are easily overwhelmed by sensory input, which results in a reluctance to participate out of anxiety and fear. This may be perceived by observers as lack of social skills, and often leads to the child having few friends and low self-esteem (Maertz & Hyche, 2014, p. 10). Under-responsiveness to sensory input is “one of the most overlooked sensory differences” (Jordan). Students who are under-responsive may appear passive or lethargic, as it requires a large amount of sensory stimuli to get them to respond (Jordan). In the classroom, these students may take a while to respond to auditory directions; as a result, they may be perceived as indifferent, unmotivated, or even defiant. In addition, these children may not respond to feelings of pain or sickness. This requires close monitoring by teachers to ensure their safety and wellbeing. Children who are under-responsive may lack involvement in academics and social spheres, get easily injured, and suffer from depression or anxiety at feeling left out (Maertz & Hyche, 2014). Finally, sensory-seeking children are always on the lookout for constant sensory stimulation. These students are full of energy; some common symptoms are being overly loud, not able to sit still, or constantly fidgeting or chewing on things around them (Maertz & Hyche, 2014). These children may be perceived as “troublemakers” who are defiant and cannot pay attention. This may have negative impact on a child’s learning and overall school experience.
It is clear that a child’s experience with sensory modulation disorder can have profound impacts on their school experience. Difficulties with sensory processing are manifested in outward behavior, which may be misperceived by parents, teachers, and peers. This can result in academic, social, and emotional difficulties. By educating ourselves as teachers on the assistive technologies summarized below, we will be better able to meet the needs of these students.
Assistive Technologies for Sensory Modulation Disorder
Treatment for children with SMD largely consists of a sensory integration therapy. Sensory integration therapy aims to optimize a child’s level of sensory arousal and regulation through “specific movement activities, restorative body work, and even brushing of the skin (Arky, 2018). Occupational therapists who advocate for SI therapy argue that this exposure rewires the brain to allow adequate sensory processing and responsiveness. Once a child is evaluated by an OT, treatment takes place at a sensory gym which contains a variety of equipment and sensory experiences. Some examples include bouncing on balls, jumping into ball pits, crashing into pillows, and even spinning round and round in a sling (Arky, 2018). This treatment is suited not only for sensory under-responders, but also sensory over-responders and sensory seekers. Beth Arky, a researcher from the Child Mind Institute, references Nancy Peske and OT Lindsay Biel, who co-authored the book Raising a Sensory Smart Child: “A child who is overactive to vestibular input needs to swing and spin to retrain his brain, just as a child who is under responsive to vestibular input does. The difference is that if he’s hypersensitive to movement, he’s more likely to resist it, whereas if he’s hyposensitive, he’s more likely to seek it out,” (Arky, 2018).
Sensory integration therapy can be extended and applied into students’ everyday experiences at school. Children with SMD benefit from receiving increased sensory stimulation on a daily basis (Jordan, n.d.). Some examples of increased visual stimulation are the inclusion of bright colors, high color contrast, and highlighting key information in assignments (Jordan). Providing a oral input and strong flavors at mealtimes, such as crunchy or chewy foods, is also helpful (Jordan, n.d.). Crunchy foods such as pretzels or dry cereal are a good option for snack time. Alternative seating that provides sensory stimulation, such as a bouncy ball or textured inflatable cushion, can help increase student focus and engagement (Biel & Peske, 2018). This allows students to wiggle around while remaining seated on the floor with the rest of the class during circle time.
Students with SMD may benefit from technologies that apply a deep pressure, such as a weighted blanket, vest, or lap pad. Deep pressure has been found to provide a relaxing, calming effect, and helps sensory development in young children (Grandin, 1992). These weighted devices usually consist of 5%-10% of the wearer’s body weight, and activates a sensory response that is like a soothing hug (LeMond, 2015). The additional weight on the body provides the child input from muscles and joints (Maertz & Hyche, 2014). Neurologically, deep pressure causes a spike in the release of dopamine and a decrease in cortisol, all while stimulating a parasympathetic response in the body (Chambers, 2018). These physiological reactions result in feelings of relaxation. Weighted blankets, or lap pads, can help students stay seated during center time, as well as focused while doing work. However, it is important to consult an OT before use to determine the appropriate amount of weight to avoid overstimulation and injury (Maertz & Hyche, 2014). Brushing is another example of deep pressure stimulation. Most OTs who implement the brushing method follow the Wilbarger protocol, which involves applying a soft-bristled brush and joint compressions several times a day (Arky, 2018). Students can be given sensory toys in school to use as brushes to mimic this protocol.
Sensory toys such as fidgets and chewable necklaces are another option that students can use throughout the day at school to enhance focus without disturbing the rest of the class. Depending on the child’s specific needs, they can be given hand, foot, or mouth fidgets. Some examples of fidgest are squeeze balls, hand massagers, velcro strips, or exercise bands tied to desk legs (Maertz & Hyche, 2014). Chewable necklaces are for many different types of children with special needs. For student with stress and anxiety, “Chewing provides proprioceptive input to the jaw that is very calming and organizing” (Lowsky 2015). According to Lowsky, students with any type of stress, including every day stress, being tired, frustrated, or just mad, it could also be stress that has been added up over a period of time. To deal with the stress, children use the chew necklaces/chew toys. This release of stress by the chewing items stems back to the early stages of the child. Mouthing, chewing and sucking are mechanisms for babies to cope with stress. Another reason why student might have the need for chewing is for sensory needs/stimming. “Chewing as a calming mechanism is especially true for children who have Autism and/or sensory processing disorder (SPD)” (Lowsky 2015). Chewing helps these students organize themselves and manage all of the extra sensory information bombarding their systems.
Multisensory learning methods are another way to incorporate sensory integration therapy into the classroom, and does so in a way that is universally beneficial to all students. In exploring strategies to address Sensory Modulation Disorder, it is important to acknowledge the general trends toward multisensory teaching methods in general population classroom. These two topics become inextricable, as strategies that benefits a child with SMD may also have benefits for the rest of the classroom. The human brain is constantly operating in multisensory environments, receiving visual, auditory, tactile, olfactory, and gustatory input. According to Shams and Seitz (2008), multisensory teaching methods tap into the brain’s optimal functioning capacity since they replicate these environments. In this way, some of the assistive technologies that will be discussed have a universal design, as they create positive synergies in the classroom for all students. Incorporating multisensory teaching methods can be accessible and useful across subjects. For example, having students use sand trays to trace letters, phonics patterns, or words can provide tactile input. Another example is putting a plastic screen underneath a student’s paper and have them trace the word using a crayon. The feedback from the plastic screen provides tactile stimulation for students, better consolidating the movement into memory (Vanalst, 2013).
Sensory tables are an additional vehicle through which multisensory learning can be cultivated. Sensory tables are versatile and can be used in variety of ways. They can appear in classrooms as bins on the floor or actual tables. According to Educational Playcare, “‘sensory play’ is crucial to brain development, it helps to build nerve connections in the brain’s pathways.” Sensory tables can be created with many different objects. Some are setup with rice or with water beads. This is so the children are able to get the different feeling of the rice or water beads in their hands. The concept of sensory tables is to explore the childrens 5 senses. They can also be used for lessons. If a teacher is teaching a class of preschoolers about letters, a sensory table could be set up with rice and letters. The students would have to dig in the bin filled with rice in order to find the letters. Sensory tables could also be used for cause and effect. If your sensory table if filled with water and dirt is mixed in, the water would turn into mud. The students are able to explore these concepts through sensory/exploration. “Sensory activities provide children with another meaningful avenue for learning. Sensory tables or several tubs rotated regularly with wondrous sensory materials are worthwhile investments for hours of learning, exploring, and fun. Because children learn best by having “hands on” experiences with materials, sensory experiences are vital to young children’s learning” (Dorrell, n.d.).
While not an example of technology in and of itself, incorporating movement breaks is beneficial for students who have difficulty with sensory modulation. Movement breaks are beneficial not only to students who need vestibular stimulation, but to the rest of the class as well. Research by Kerby showed that incorporating 15 minutes of exercise in class increased cognitive performance, decrease off-task behaviors, and enhanced overall focus (Maertz & Hyche, 2014). Furthermore, sensory play is beneficial as it has been found to build nerve connections in the brain’s pathways, which leads to the child’s ability to complete more complex learning tasks (Educational Playcare, 2016). In addition, sensory play supports language development, cognitive growth, fine and gross motor skills, problem solving skills, and social interaction. This type of play aids in developing and enhancing memory, it is great for calming an anxious or frustrated child, and it helps children learn sensory attributes (hot, cold, sticky, dry) (Educational Playcare 2016).
Medium technology available for sensory processing includes devices that are battery activated. Some devices include noise canceling headphones, specialized listening systems, the Textured Talkable II, and vibrating toys.
Noise canceling headphones are a popular choice for students who have difficulty with sensory modulation. For these students, sensitivity to sound can make everyday activities difficult, painful, uncomfortable, and impossible. The noise canceling headphones are used to mute sounds in noisy or over-stimulating environments (Pacer Center 2015). During school, noisy events may make these students uncomfortable, overwhelmed, and unable to produce work. These headphones are an easy way to mute the “noisy” sounds and enhance focus.
Specialized listening programs focus on the “vestibular-visual-auditory triad” which allows us to understand and function within the three-dimensional space around us (Arky, 2018). Using specialized CDs and headphones, these listening systems exercise muscles in the middle ear. Students can engage with these listening systems while doing crafts, bounding on balls, or doing other activities that engage sensory input (Arky, 2018). One example is Integrated Listening System (iLs), which is a total home program that features music and movement. Through this program, students engage in exercise that work on “hand/eye coordination, balance, attention, and auditory processing abilities” (Curley, 2016).
Another medium tech device useful for these students is called the “Textured Talkable II”. The interface of this device includes two switches for two different messages, and provides the user with a rich tactile experience when they initiate language (Autism Enabled). The device helps children make choices using visual cues. This device is available on websites such as “Autism Enabled” and “Enabling Devices”.
Vibrating toys, such as a vibrating light, are also a great resource for children who have challenges with sensory processing. Vibration is highly stimulating for our proprioceptive sense. Using vibration helps an individual understand where they and their body parts are in a space, thus assisting in coordination and balance (Special Needs Toys).
High technology largely consists of applications which students can access on laptops and iPads, both at school and at home. These apps aim to provide students with a variety of sensory stimulation. Apps available for sensory processing include Heat Pad, BrainWorks, Miracle Modus, Dropophone, and Wa Kingyo Goldfish Pond. Some features of the app Heat Pad include, relaxing background music, pause mode for easy doodling, ability to save creations to camera roll and different inertia settings (Medcalf, 2016). Brainworks is an app that was “developed to provide children with the sensory breaks they need to function their best” (Medcalf, 2016). It has over 130 sensory activities for students to play with. The features of this app include, “Locations”, which provides different activity lists for different locations, “Sensory System Descriptions”, where the child can can describe their feelings at the moment they are at the location they have selected, “Activity Lists”, where there is a extensive visual list of activities, “Timer”, where the caregiver can determine the length of the sensory break, and “Custom Activities”, where they caregiver can add sensory activities to the app customly (Medcalf, 2016). “The Miracle Modus app is a source of hypnotic rainbows and soft bells” (Medcalf, 2016). Features of this app include, watching the pretty lights, and the ability to change or disable sounds, enable or disable modes so you only see your favorites, or re-run the benchmark phase. “Dropophone allows individuals to create their own minimalist melodies” (Medcalf, 2016). Features of Dropophone include, pressing the multi-colored raindrops to trigger notes that loop every six seconds and combining different colored drops and notes to create your own rainy-day melodic backdrops (Medcalf, 2016).
Conclusion: Impact of Sensory Processing in the Classroom
Sensory modulation disorder manifests itself in many different ways due to the involvement of one or more of the eight sensory systems. The variation in symptoms makes it difficult to diagnose and identify in some children. While sensory processing issues are not a learning disorder and oftentimes not an official diagnosis, they can make it hard for children to succeed at school (Child Mind Institute 2018). Children with sensory processing disorders should be given the opportunity try different technologies in order to find a technology that works best for them. When working with a child with a disability that has an impact on their sensory, some no/low technologies could be the answer to help the child improve. Allowing the child to use/try multiple technologies can help find the correct technology for that specific child. These children go into schools and have trouble. By having the available technologies, these students live can be made easier. Giving these children tools and meeting their specific needs, will help them achieve in school and in life.
The assistive technologies outlined in our investigation are a vehicle through which students with sensory processing disorders can function and succeed in school. According to the Child Mind Institute, “There is no medication to treat sensory processing issues, but there are therapies, as well as practical changes you can make at school and home to help your child feel and do better” (Child Mind Institute, 2018). Making “practical changes” could include giving a child a no/low technology tool to help them reach the goal of them feeling and doing better in school and in life. “With support and accommodations from an understanding teacher, and perhaps work with an OT, your child with sensory processing issues can be primed for success in class, on the playground and with friends” (Child Mind Institute, 2018). As a parent, and, or teacher, we want to see our children succeed in school and life. It is through staying vigilant as educators in identifying the needs of our students, as well as educating ourselves on the available assistive technologies, that we can strive to make a lasting impact on the functional capacity of these children.