Tuesday, August 17, 2010

What I learned at the Fragile X Conference, Part 2

You may remember that I wrote a bit about what I learned at the Fragile X Conference about hyperarousal. To me, it seems that hyperarousal and sensory processing are closely linked. If you didn't see what I wrote about it, click HERE.

First of all, what is a sensory diet and what is its purpose? According to Sarah Scharfenaker and Tracy Stackhouse, a sensory diet is an occupational therapy intervention designed to attain and maintain appropriate arousal states throughout the day. The key is to provide sensory imput before hyperarousal occurs. The problem with that is a lot of Fragile X kids have a constant state of hyperarousal.

Different sensory techniques can provide calming of sensory systems for varying lengths of time. Therefore, it is not a good idea to just say, "We'll give Johnny a sensory break every 90 minutes." It is important to observe the child in their environment and watch how long each source of imput provides calming.

Anyone who has a child with Fragile X knows that transistions can be challenging for that child. A sensory diet targets key events in a child's day, provides calming before the event occurs, and helps the child get through the activity or transition to it.

You may have heard of the Wilbarger Protocol from your occupational therapist or another parent of a special needs kid. Sometimes it is referred to as the "Brushing Technique". That's a bit of a misnomer. Wilbarger Protocol provides deep pressure to certain parts of the body followed by proprioceptive imput by giving joint compressions. There is also an effective program by the Wilbargers for oral sensory defensiveness. I am not qualified to explain these in detail and they really require someone who has been trained in its use.

Some sensory activites that are calming are:

weighted vest
ankle weights
bungee cord around legs of chair
fidget toys
bouncing on therapy ball
Sit n Spin
Auditory Training
squishing between beanbag chairs
pushing weighted cart or box
weighing down backpack for child to carry
weighted blanket

Each child will naturally be drawn to certain forms of imput. Another thing that is helpful for kids to learn self-regulation is to provide a sensory trigger board with things like:
Too Noisy
Too bright
Too many questions
Too many people

This helps the child to discern what is causing his sensory discomfort. A good way for kids to gain control over the implementation of their sensory diet is to offer a sensory choice board. This provides visual representation of several sensory activites. The child is allowed to choose what he feels will be most calming to him. If in a classroom, it should be placed in an area where a child can access it to make it easier for him to communicate his need with a teacher or paraprofessional. Of course, it is a great idea for home use as well.

We have never successfully implemented a sensory diet in our home. Not that we've put a lot of effort into it. When school begins, we will get in contact with the boys' Occupational Therapist and try to implement this into their day. I want to carry it through at home and see how this affects their difficulty with certain transitions. I have learned that when they do not receive powerful enough sensory imput, they seek it themselves in less than effective ways. I will see Blake squish himself into a small space, or get under his fitted sheet on his bed. Drew bites his fingers and flaps his hands a lot. I am hopeful that this will improve their state of hyperarousal and make life more pleasant for them.