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Sensory Processing Disorder Tag

Your body is always touching SOMETHING. What an interesting thought that most people don’t spend too much time dwelling on. That’s because the brain with a well-regulated tactile sense only briefly makes note of the thing that the body is touching, and then ignores it in favor of more important thoughts and sensations it needs to process. But for a person whose tactile sense is out-of-sync, the textures of certain fabrics or presence of a tag on their clothing may be a source of extreme discomfort and the cause for much distress. Or they may lunge at you for a bear hug because they crave the feeling of deep pressure squeezes. Or they may not seem to notice that their hand is on a hot pan until they have a third degree burn. These are only a few examples, of course. The main point is, our tactile sense helps us determine what we are touching and if the things touching us at every moment of every day are harmful or helpful. An out-of-sync tactile sense may make a person overresponsive to stimuli, underresponsive to stimuli, sensory seeking, or a combination of these, or may make it difficult to determine what the tactile stimulus is or where it is touching.

How does this affect my work as a music therapist? I can start by considering the environment of my treatment space. What is the client’s reaction to the texture of the chair he/she is sitting in? For some of my clients with tactile sensory needs, sitting on a fuzzy pillow that buzzes provides the tactile sensations they need to be aware and in control of their bodies. For other clients, sitting on a rubbery and bumpy cushion serves this same purpose. What is the client’s reaction to the carpet? I have clients who prefer to have their shoes off during sessions. One such client likes having the afore mentioned rubbery cushion under his feet. From which direction is the air conditioning blowing and is it blowing directly on my client? I’ve barely scratched the surface of tactile elements to consider in the environment of the treatment room, but you get the picture.

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What about my choice of instruments I use with my clients? Does the client seem to want to touch textured things? I have many clients who are more engaged in our interventions when they play an instrument like the cabasa (picture below), which allows them to rub their fingers along the bumpy beads. Other ideas of instruments with great sensory feedback are guitar strings, chimes, hand drums, ocean drums, and resonator bells. The cabasa is one of my favorite instruments because it acts as a great massager, providing sensory input to arms, legs, backs, and soles of feet. For clients who are seeking tactile sensory stimulation, instruments like the cabasa can provide this in an appropriate way. Encourage the client to play the cabasa (or other instrument) and use it to provide sensory input independently. This way, the client is learning to self-regulate his/her out-of-sync sensory systems.

 

3317_cabasa_a.jpgOr for clients with an overresponsive tactile sense, choose instruments that don’t have a rough or uneven texture. Then encourage them to explore tactile sensations using the texture and vibrations of various instruments. This could help reduce defensiveness to certain tactile sensations.
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As with all other sensory systems, there are so many things to consider when your child or client has an out-of-sync tactile system. Hopefully the ideas and considerations discussed here have sparked some ideas and increased your awareness of needs related to the tactile sense. Now, I challenge you to stop every now and then and become aware of the sensations on your skin and the things touching your body. Then imagine what it would be like if you could not seem to get enough of or control one of these sensations. How would you fix that?

-Chiara

First of all, what is the vestibular sense? And where is it? Vestibular receptors are found in the inner ear, in the form of tiny hair cells. The vestibular system helps tell us when we’re up or down, moving or still, which direction we’re moving in, and how fast we’re going. When someone’s vestibular sense is out-of-sync, they may crave speed or be overly sensitive to it, they may be able to spin endlessly without getting dizzy or get motion sickness very easily, they may love dangling upside-down or be terrified of it, or they may not be able to tell if the train they are on is moving or if it’s the train next to theirs. An out-of-sync vestibular system, just like any other out-of-sync sense, likely leads to compensatory behaviors. Some of these may be harmful, disruptive, or not socially appropriate. Furthermore, they may interfere with the person’s ability to function smoothly in everyday life.

stock-photo-3791423-small-baby-boy-hanging-upside-down-on-white.jpg           What happens if one of your clients or your child has an out-of-sync vestibular system? They may be underesponsive or overesponsive to vestibular stimuli, or they may seek or crave vestibular stimulation. Any of these forms of sensory processing disorder can cause disturbance and frustration in their everyday functioning. Is the client terrified of moving/being moved? They may have an overesponsive vestibular system. Does the client not notice they are moving? They may have an underesponsive vestibular system. Does the child crave swaying, spinning, or being upside-down? They may be seeking more vestibular stimuli. The challenge arises in the fact that the child’s behaviors are not always so straightforward, and the category of sensory processing disorder under which their symptoms and behaviors fall may not be very clean cut. What I found most challenging is, how do you determine what sensory needs the child has and how to best address them?

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The author of The Out-of-Sync Child, Carol Stock Kranowitz, recommends that parents or caregivers keep a diary of their child’s “troubling times,” noting the behavior, the date and time of day, and the circumstances. Parents and caregivers should also keep a diary of the child’s “terrific times,” again noting the behavior, date and time of day, and circumstances. This may help determine triggers for challenging behaviors and also the things or circumstances that lead to the child feeling in-sync. Matching the out-of-sync trigger with the in-sync antidote, can help parents, caregivers, and therapists determine which category of sensory processing disorder the child’s symptoms fall under, and how to provide the appropriate sensory diet and therapy for the child. I am challenging myself to keep track, in a similar way, of “troubling times” and “terrific times” in my some of my clients who have sensory processing needs, in order to better track cause-effect-solution patterns. In doing so, I hope to understand better what I can do to help their senses feel in-sync.

To better understand sensory processing disorders (SPD), or if you suspect your child, a client, or someone you know may have SPD, I highly recommend reading The Out-of-Sync Child by Carol Stock Kranowitz.

– Chiara

We all know those kiddos – even when they are (miraculously) sitting in their seat for more than 2 minutes at a time, they’re still squirming, sliding down in their chair or moving their body side to side.  They are constantly seeking to interact with their environment.  Or maybe you can relate to leading groups every week and feeling the urge to bring in something new and different for the clients to experience other than instruments.  Lucky for us, the world of Neurologic Music Therapy has an answer in 4 simple letters: MSOT.  Musical Sensory Orientation Training.

Thaut, in Rhythm, Music and the Brain, describes MSOT as follows:

“Musical Sensory Orientation Training (MSOT) is the use of music, presented live or recorded, to stimulate arousal and recovery of wake states and facilitate meaningful responsiveness and orientation to time, place, and person. In more advanced recovery of developmental stages, training would involve active engagement in simple musical exercises to increase vigilance and train basic attention maintenance with emphasis on quantity rather than quality of response (Ogata 1995).”

Let’s all say it together now: MSOT is my friend!  It is so important to ensure that our clients are learning to self-regulate and getting the sensory input that their bodies crave.  Sensory integration is a neurobiological process that refers to the integration and interpretation of sensory stimulation from the environment by the brain.  Individuals with developmental disabilities often have either over- or under- reactive sensory systems, which can mean sensory input from the environment is not being organized properly in the brain.  This makes the sensory experiences we as music therapists provide for them particularly important.  Below are several MSOT strategies I’ve recently been exploring with clients – the possibilities are endless!

  1. Cabasa – I never understood the power of the cabasa until internship.  It is an easy way to take a sensory “break” while keeping the music and instruments going throughout the activity.  For my non-verbal clients I use a simple “I want ____” visual and have them choose a body part (i.e. hands, arms, legs, back) for where they want the cabasa.  You can make up a simple song or chant about where you’re playing the cabasa and use a background loop to free up your hands to provide that input for the client.  You can also use this same format but instead give deep pressure squeezes and simply substitute the lyrics to “I like squeezes on my arms”.

I want visual

2. Therapy Ball – I love using the therapy ball because it’s a great way to incorporate sensory integration into whatever intervention you’re working on (like Bi-lateral drumming).  This targets the the Proprioceptive System – helping our clients understand where their body is in space.

3. Get Creative – Have fun with exploring MSOT strategies!  For adult groups, my co-intern and I have been enjoying bringing in essential oils (stimulating olfactory system), fun themed props for Spring Holidays (tactile), instruments like chimes, cabasa, and drums, bubbles, scarves, and scented squeeze balls.  I hope you’ll find that this brings a fun, novel element to your groups.

Music making (with an instrument) naturally stimulates 3 out of our 5 senses (auditory, tactile, and visual).  If you can add some type of olfactory element, we have 4 out of the 5 covered – a great goal to aim for while session planning.  It’s great to have a variety of MSOT strategies in your tool-belt in order to adapt to what your client needs in the moment – get creative and have fun with it!

-Marissa

We have all seen that wiggly, fidgety child who climbs, touches, bumps into, and jumps onto just about almost anything and everything. The common conclusion that we often come to is that the child is misbehaving and has a surplus of energy. But the truth is that these children may have poor propriocetive sense which adversely effects their awareness of where there bodies are in space and effects their awareness of how fast or slow their bodies are moving. Our sensory processing abilities are supposed to tell us where our bodies are, allowing us to sit up straight and still and to tell us how fast or slow we are moving our bodies so that we can manipulate objects and move around in space without bumping into things. However, children with Sensory Processing Disorder are not being given the sensory information and/or are not able to integrate, modulate, organize and discriminate sensory messages efficiently causing them bounce, wiggle, rock, slide to the floor, and fidget.

There are ways to help these children establish awareness of their bodies which may allow them to listen better, retain information and focus. If you are working with a child who isn’t comfortable in their chair, are sliding off of it or is rocking it on two legs, try giving them an exercise ball to sit on and allow them to bounce while you teach your lesson or facilitate your intervention.  It may seem like they still are unable to pay attention due to their bouncing bodies but check in with them and you may see that they really are paying attention and are able to retain content. This is made possible because the sensory input received from the bouncing tells their bodies where they are, which then clears up the neuro pathways for them to focus on something else other than trying to figure out where their bodies are in space.

A music therapists approach for children in need of sensory input may include creating interventions that involve ample amounts of movement such as rocking, spinning, jumping or pushing.

The Hard Facts:

“Proprioceptive dysfunction is the inefficient processing of sensations perceived through the muscles and skin, as well as the joints.”

The functions of our proprioceptive sense include:

  • Body awareness
  • Motor control
  • Motor planning
  • Regulation of arousal level (aroused or calm)
  • Discrimination of movement in time and space (tells us where our bodies are)

I leave you with this video which provides insight from the perspective of children with SPD and poor proprioception. I share this with hopes that others will think again when they see a wiggly little one.

https://youtu.be/uhsQhGcI0-8?list=PL3opm2WogRKUyk9vStTggyiZQgS26Z0NL

-Kristin