We hope you enjoy this month's edition of Pawprint, Southpaw's newletter filled with informational and practical articles, videos, and product information for all of those involved in sensory therapies.
EMBRACING THE WORLD OF SENSORY THERAPIESPawprint - March 2016
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The AOTA Annual Conference and Expo Is Almost Here!

Come see us in Booth #4219 in Chicago on April 7th - 9th to see new products and old favorites all set up for you to try. Take a few minutes and relax in our Multi-Sensory Tent, take a pass through the Steamroller, or let loose on a swing. You can also get your photo taken with our products to share with your friends back home so they can see the fun they are missing!

Deanna Maciole
Improving Development Is Simple...Just Move!
Deanna Macioce, MS, OTR/L

Movement is important to children for many reasons. We are finding with decreased recess time and outdoor play, and increased sedentary activities, the growth and development of children is affected. From increased difficulty maintaining attention and poor motor control to difficulty with school tasks and poor health and weight control, the lack of gross motor play is having an effect on our children. Overall coordination and use of proper movement patterns are also affected. We tend to find that these children struggle with balance and moving outside their center of gravity. Therefore, there needs to be a greater emphasis on play and movement-based activities, especially for our younger population.
 
It begins as early as infancy, when we encourage children to become "container" children. We find that so much of the baby equipment on the market today brings the entertainment and play to the child. With swings, activity gyms and children seats, there is no reason to encourage movement and exploration. In addition, the amount of time that children of any age spend in front of a screen on any device also plays a role. These items are needed and can be beneficial when used in moderation. However, we find that they are beginning too early, not encouraging children to just move or allowing their bodies to motor plan and navigate in a variety of spaces and against gravity. We are not allowing kids to be kids.
 
Playground equipment is an awesome way to encourage natural play and movement. In addition, it challenges children to improve motor planning and sensory processing skills. These activities strengthen core stability, balance and bilateral coordination. Natural movement during play is essential. From the sensory processing aspect, climbing, swinging and sliding provide proprioceptive and vestibular input. They allow children to put their bodies in a variety of positions and encourage head placement in different planes.
 
In treatment planning, therapists often look for activities that encompass a variety of areas of concern as well as piece together all the sensory systems for overall self-organization. Sometimes natural play is just the ticket. However, not all clinics or treatment places are equipped with a "playground" that can encourage all of that. Therefore, finding different pieces of equipment that encourage play is essential. From scooter boards to swings to tunnels and climbing ladders, play can happen in a variety of ways. Or simply by using a chair to spin or a floor to roll, hop, jump or crawl, movement can easily happen.
 
Southpaw has put a lot of effort into developing the equipment that can help achieve the ultimate treatment experience. With their In-FUN-ity system, children can challenge their bodies to climb, move, transition and motor plan in a variety of ways. This allows individuals to develop a system that fits their needs. In addition, there has been an increased focus on developing a Transition Wall, piecing together various pieces of equipment that encourage natural motor patterns and transitional movements.
 
So, whether it comes through using complex equipment or not, to improve our children's ability to move, focus, attend and use their bodies for coordinated movements...we simply just need them to MOVE!
Swaddle Swing
Swaddle Swing

The Swaddle Swing, brought to us by Catherine Hoyt Drazen OTD, OTR/L, allows you to make a swing anywhere. This unique swing provides vestibular stimulation and helps infants and toddlers with self-regulation and calming. The gentle pressure from the LYCRA� provides a safe, secure environment for the child to experience the movement and comfort of the swing with the soft light coming through the mesh. Can be used by a therapist alone to swing a child, or in cooperation with a parent. A great product for an itinerant or home-based therapist.
Alex Lopiccolo
The Togo - Not Your Ordinary Seating Device
Alexander Lopicollo, COTA/L, CPT, NC
www.sensorydigest.com


The Togo is a combination of a T-stool and spring stool combined to make it the most therapeutic seating device on the market. I like parents to sit on the large Togo while watching their child sit on the small Togo during occupational therapy treatment sessions. A lot of parents have the same response, "Wow! It really makes you work your core but is comfortable at the same time!" Many children love how it bounces while being able to keep their balance due to the weighted bottom, which increases stability. With DIY wooden T-stools, there is no weight at the bottom, which makes it difficult to stabilize your core for a period of time, and the seat is hard and uncomfortable. By being able to engage your core with the subtle bouncing, the Togo helps you keep an optimal alert level for learning and improves engagement with tabletop activities. If you need to turn your body, you are able to twist without falling.

The Togo, which can help improve upright postural alignment, can also help with visual motor and fine motor skills by getting the trunk and neck in better position for the visual system to work appropriately. Children and adults that sit on their feet or are constantly moving may have poor core stability and endurance. The Togo may benefit them by forcing their body to work hard during daily cognitive learning at school and work.

After 6 months of use with patients dropping it frequently, the quality of the product and its durability are amazing, and the therapeutic value is out of this world. In the near future, I see schools, workplaces and homes all using the Togo because it provides therapy by just sitting on it while engaging with purposeful and functional activities.

Moon Ball Swing

Fiber Optic Tunnel

Steamroller Deluxe

Moon Ball Swing
Fiber Optic Tunnel
Steamroller Deluxe

Self-Regulation: What Is It? And What Does Sensory Processing Have To Do With It?
Betty Paris, PT, M.Ed., C/NDT and Carolyn Murray-Slutsky, MS OTR, C/NDT

Self-regulation involves monitoring and controlling one's own feelings, emotions and behavior. It necessitates the ability to block out irrelevant stimuli, control impulses and persist in tasks. Sensory processing is foundational. It is the ability to take in cues from within our body and from the environment, process them accurately, and prioritize what to focus on in order to perform daily activities.

Sensory Modulation Disorder (SMD) and Its Effects on Self-Regulation

Sensory modulation disorder (SMD) refers to difficulty regulating responses to sensory stimulation due to an underlying sensory processing disorder. Three subtypes have been proposed: sensory over-responsive, in which the child responds too much, for too long, or shows a strong response to stimuli of weak intensity; sensory under-responsive, in which the child responds too little, or needs extremely strong stimulation to become aware of the stimulus; and sensory seeking/craving, where the child responds with intense searching for more or stronger stimulation (Miller, Nielsen, Schoen, & Brett-Green, 2009). Self-regulation, attention and arousal are linked to SMD both behaviorally and physiologically. When a child is well-regulated, he adapts to changes in the environment, has a level of arousal and attention appropriate to the task, blocks out irrelevant information, attends to relevant information, and responds appropriately in direct proportion to the input. Behaviorally, sensory modulation thus refers to the observable ability of a child to produce "responses that match the demands and expectations of the environment" (Lane, 2002).

A child with sensory under-responsivity may have difficulty perceiving, processing and attaching meaning to sensory events of daily life. A child with sensory over-responsivity may be overly sensitive to sounds, tastes, smells, touch, movement and even clothing. He or she may appear anxious and fearful, avoiding sensory events or daily life activities. Helping children become better regulated enables them to adapt better to environmental demands; be more tolerant and flexible; willingly engage, process, and learn; have better attention, focus and behavioral regulation; and engage with more purpose. Often, the first step is helping the child move into the calm-alert state, the window of optimal arousal. Looking at the child's arousal levels, we gain insight into the child's modulation. This helps us identify strategies that can move the child into the calm-alert window, a state of better regulation and modulation.

Intervention to Aid Sensory Modulation and Self-Regulation

Help for a child with SMD involves several considerations and types of intervention. Ayres, 1979, posited that modulation is the act of balancing excitatory and inhibitory inputs in the central nervous system (CNS) and responding to only those that are relevant. Sensory cues from the external environment can challenge a child with a sensory processing disorder and impact the child's attention, focus, tolerance and performance. Engineering the environment is an easy start. For the over-responsive child and sensory seeking/craving, you want  to decrease clutter and minimize noise and other distractions to promote attention to salient components within the physical setting and activity (Murray-Slutsky & Paris, 2005, 2014); decrease a child's stress and anxiety; and promote better internal sensory modulation and self-regulation. For all children with SMD, providing structure to the physical space and the tasks, such as well-defined areas for eating, homework and play, is an important first step to aiding sensory modulation and self-regulation. Some may also need a quiet space such as the Cuddle Swing or a tent for their bed.

A next step in aiding the child is inclusion of physical activities and opportunities to meet the sensory needs. Proprioceptive, tactile and vestibular inputs have been identified as helping aid the child in the development of self-regulation, whether in treatment, included in sensory diets, or simply used at school or home. Repetitive, regular-paced rhythmic activities and songs are organizing activities.

Proprioceptive activities are calming and organizing and include climbing activities:
*    Playground equipment
*    Resistive activities
*    Rope ladder
*    Cargo net
*    Wall climbing
*    Climbing through a resistive tunnel

Vestibular activities can be either calming or arousing.  
*    Calming vestibular activities include:
o    Slow rocking in a chair
o    Slow rolling in a barrel

*    Arousing vestibular activities should also be organizing and include:
o    Rhythmic, organized jumping on a trampoline or bounce pad
o    Trapeze Bar
o    Frog Swing
o    Tube Swing

Further steps might include sensory diets. These activities and interventions must be chosen to meet the needs of the individual. The end result of an effective program for a person with SMD should be a more relaxed, contented and focused individual who is able to participate in activities, tolerates change in the environment and in his/her schedule, and is ready to learn and assimilate new information.

* More specific information can be found in the following books by these authors:


Autism Interventions - Exploring the Spectrum of Autism, 2nd Ed.





 Is It Sensory or Is It Behavior?



References


Lane, S. J. (2002). Sensory Modulation. In A. C. Bundy, S. J. Lane, & E. A. Murray (Eds.),  Sensory Integration Theory and Practice (Vol. 2nd, pp. 101-122). Philadelphia: F.A. Davis Company. (Reprinted from: IN FILE).
Miller, L. J., Nielsen, D. M., Schoen, S. A., & Brett-Green, B. (2009). Perspectives on sensory processing disorder: a call for translational research. Frontiers in Integrative Neuroscience, 3(22), 1-12.
Murray-Slutsky, C., & Paris, B. (2005). Is it Sensory or is it Behavior? Austin, Texas: Hammill Institute on Disabilities.
Murray-Slutsky, C., & Paris, B. (2014). Autism Interventions;  Exploring the Spectrum of Autism (2nd). Austin, Texas: Hammill Institute on Disabilities.
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