GL3 Sensory Processing and ASD Flashcards
How would you explain a child’s pattern of behaviour according to Dunn’s Sensory Processing Model?
Dunn’s Model of Sensory Processing assumes that performance problems resulting of inadequate skill development or environmental support. It addresses participation through skill development or changes to task or environment. The key concept of the model is the interaction of differing functions creating 4 basic patterns of sensory processing. These are bystanders, seekers, sensors and avoiders. Once the child’s sensory processing patterns are determined, it will allow an easier explanation and understanding for the parent.
How does sensory processing impact on participation? How does this vary according to patterns of sensory participation? E.g., what impact does being sensory seeking have on participation in self-care or in the classroom as compared with being sensory avoiding?
The impact of sensory processing on participation will vary depending on the individual’s pattern of sensory participation. A ‘bystander’ has a passive response with high threshold meaning that they miss more sensory cues than others. They will seem easy going and can focus even in busy places. They may come across as uninterested, self-absorbed or apathetic which will play an effect on their participation e.g. might not be invited to play as they seem uninterested in the other children.
A ‘seeker’ has a high threshold and an active response meaning they always want more and enjoys a sensory rich environment. They can seem fidgety, excitable and are creating sensation. They have a high ability to generate ideas and responses and notices and enjoys all activity in the environment.
A ‘sensor’ has a passive response with a low threshold meaning they react more quickly and more intensely than others. They notice what is going on and have precise ideas about how to handle situations. They have a high ability to notice, are vigilant, they easily respond to sensory stimuli and notice things others don’t.
An ‘avoider’ has a low threshold with an active response meaning they are more likely to retreat from unfamiliar situations. They want more of the same thing and nothing more. They create routine to keep life peaceful and manageable and are overwhelmed by sensory rich environments.
If a child were identified as more than others for sensory seeking and School Factor 1 on the Sensory Profile2, how might you describe this in a report to the parent and teacher? What type of behaviours would you be expecting to observe in this child? How might these behaviours impact his/her performance and participation?
School factor 1 refers to the student needing external supports to participate in learning. This means they need the teacher’s attention. You would be expecting to observe registration and sensory seeking. This is characterised by high neurological thresholds, with a high ability to focus, engage and generate ideas.
How do intervention strategies for sensory processing challenges differ according to the identified sensory processing pattern, e.g., how are intervention strategies for clients with low registration different to those for clients who are sensory seekers?
Intervention strategies will differ depending on the sensory processing pattern. When designing sensory processing interventions, it is important to identify what the child needs and wants to do (home, school, community). Then, you need to identify their sensory processing patterns. Then, you need to hypothesise how their patterns are supporting or interfering with what they need to do at school, at home and in the community. Finally, you need to design interventions that support occupational participation of the individual i.e. harness strong sensory inputs and reduce challenging sensory inputs. Strategies to support the differing sensory processing patterns include:
- Seekers: incorporate additional sensory input within routine so threshold can be met with activities; select sensory alternatives that are less interfering and socially appropriate
- Avoiders: honour need to limit input, broaden sensory range within selected rituals, avoid or reduce exposure to aversive stimuli
- Sensors: provide calming sensory input within tasks to reduce chances of arousal
- Bystanders: intensify sensory information so thresholds are met and child will notice respond, structure environment/activity to enhance focus on task, set clear boundaries and use salient visual supports
Zoe is 10 years old and in year 5. She loves reading and drawing. Whilst she is happy to engage in tasks her mother and teacher both report that she is very disorganized and struggles to complete tasks required of her within a timely manner. She often fails to complete tasks in class and her mother describes her as a “daydreamer”. A recently completed Sensory Profile 2 and Sensory Profile2 School Companion indicated Zoe’s pattern of sensory processing was typical for sensory seeking and much more than typical for the Registration/Bystander quadrant. Much more than atypical performance was evident for visual and tactile sensory systems, and more than typical in the auditory system in the Sensory Profile 2. Zoe’s teacher reported that she was much more than typical in visual, tactile and auditory sensory systems in the Sensory Profile 2 School Companion. As Zoe does not notice things around her as much as her peers she requires a greater level of support in the classroom and is less engaged in learning than her peers. Using the clinical decision making framework for children with sensory processing challenges developed by Ashburner, et al (2014), identify the supports you could implement to optimise Zoe’s participation. What supports could you implement in relation to mutual information sharing? adapting tasks? etc?
Zoe is much more than typical for the registration quadrant and much more than typical in visual, tactile and auditory systems. Using the clinical decision making framework:
A- Use mutual information sharing and problem solving of issues impacting occupational success of individuals. So collaborate with the parent, get them to share information about sensory processing abilities and issues, and build on their strengths and insights.
As Zoe is typical in sensory seeking but much more than typical in visual, tactile and auditory, it is important to accommodate these patterns of sensory processing. As
As Zoe is low registration, we can structure her environment/activities to enhance focus on task, specifically with auditory, visual and tactile responses.
- Tactile: sit away from distracting children and talkative children
- Visual: provide visual information for her at school
- Auditory: sit her in a quiet part of the classroom
What are the key features of autism spectrum disorder and how they impact on occupational performance in different contexts (e.g. home and school) and stage of development (e.g. for a pre-schooler or adolescent.
- Joint attention – do not orient to social stimuli, shared items, limits capacity to learn through imitation
- Sensory processing – develop strategies to ensure incoming sensory input is predictable
- Difficulty processing speech in noisy environments – may struggle to process instruction or conversation in the presence of noises
- Motor co-ordination – handwriting legibility and speed may be impacted; further limitation on skills required for participation in social play
How might a child with autism spectrum disorder impact on the way in which a family functions?
There is a large impact on family routine and function. A family with a child with ASD can have high structure, it is unpredictable, lack spontaneity and experience difficulty with community social participation. There are high demands to occupy the child and there are many self-care demands (e.g. poor sleep routines and mealtime difficulties).
When information gathering with a child with autism spectrum disorder, what aspects of the condition will need to be taken into consideration when deciding on information gathering tools to be used?
When information gathering with a child with ASD, important aspects to consider are:
- Purpose: diagnosis- to inform intervention, set goals and evaluate outcomes
- Individualised: make it individualised to the child and their needs
- Multifaceted: collaborative multidisciplinary team (may be working with many other health care professionals)
- Unique challenges: each child has individual challenges
- National guidelines: assessment of functioning
A 2 year old child has been referred to you for assessment with a query of a diagnosis of ASD. As part of your information gathering what particular information will you need to address to help inform a diagnosis of ASD?
- Qualitative impairment in social communication and social interaction: deficits in non-verbal communication, language deficits, social emotional reciprocity
- Restricted, repetitive and stereotyped patterns of behaviour, interests and activities: stereotyped/repetitive, inflexibility/routine, restricted interest, sensory hyper/hypo responsiveness
Information provided by you and other professionals supports a diagnosis of ASD for this child. Can you identify the three key strategies used to improve occupational performance across contexts for children with ASD?
3 key strategies to improve occupational performance across a range of contexts:
- Create functional routine for child
- Develop strategies to function within context of sensory processing challenges
- Develop skills for social participation, including self-regulation, social and prosocial skills
