ASK THE EXPERTS
Sensory Smart School Solutions
byLindseyBiel,OTR/L
Q. My child has sensory issues that interfere with his learning and behavior at school. How can we better meet his sensory needs in this environment?
School can be heaven or just the opposite for a student with sen- sory issues. So much depends on how “sensory smart” the school is: are staff members willing and able to implement sensory diet activities throughout the day? Is the environment reasonably comfortable for a student with sensory issues? Most general edu- cation and many special education programs expect students to sit still, be quiet, and to look and listen carefully – and to tolerate what may be noxious sensory experiences. This can be a major problem for children with autism spectrum disorders.
If a student is anxious about being touched unexpectedly or uncomfortable with how the table, chair, or her clothing feel, she will be preoccupied and not available for learning. If he is over- whelmed by noise on the school bus, playground, or in the cafete- ria, he may act out or tune out. If she has visual difficulties, letters may jiggle on the page and lights may hurt her eyes. One child may learn better if she is able to move constantly, while another child may be so intolerant of vestibular sensations that he focuses on avoiding movement rather than what is being taught. Many children with autism and Asperger’s need to turn off one or more “sensory channels” in order to focus. For example, a child may need to block off his visual sense in order to hear effectively. Such children learn best through a multisensory approach that taps into their most reliable senses.
To make certain that your child’s school environment is one in which he can learn, you’ll need to educate yourself and school staff about your child’s unique sensory challenges. Assuming your child receives sensory-based occupational therapy, the OT should work closely with you, your child, the classroom teacher(s) and any other involved school staff (gym teacher, lunchroom aides, bus driver, and so on) to identify your child’s sensory preferences and intolerances. Obviously, if he can communicate his sensory likes and dislikes, it will be much easier to come up with the right solutions. If he can’t, you’ll need to be patient and creative as you
take a trial and error approach. Quite often, a simple accommo- dation or behavioral strategy can be worked out informally with an understanding teacher. In other cases, a sensory solution may need to be added to your child’s IEP.
Some Sensory Smart School Solutions
A student may have difficulty with the seating arrangement itself. Sitting in badly designed or wrong-sized chairs or on the floor is especially difficult for kids with low muscle tone, poor strength and endurance, decreased body awareness, and those who physi- ologically need to move in order to stay alert and on task. Make sure that when sitting at a desk the child’s feet can be flat on the floor, that her hips are bent at a comfortable angle, and that her elbows can rest on the tabletop. If a child has difficulty filtering out extraneous noise and sights, you may need to change where he is sitting. Some kids can more easily pay attention if they sit close to the teacher. However, if a child is easily distracted by noise, he may end up turning around often to look at who’s mak- ing noise behind him. Also consider distractions from air vents, windows, and the door.
For a child who needs to move a bit, consider an inflated seat cushion like the Disc’O’ Sit, which lets him squirm in his chair or on the floor while remaining seated. A cushion or pillow from home might also do the trick. You can also try a weighted lap pad which gives reassuring sensory input as well as an external cue to stay in his chair. Some students do best on a different type of seat altogether, such as a beanbag chair or ball chair. Vibration can be extremely calming and organizing for some children. The child might be more attentive while sitting on a vibrating pillow, wear- ing a Vibrating Snake or using a Vibramat (a quiet vibrating mat that can be used beneath a chair, for sitting on the floor, under a mattress, etc.). Hand fidgets may improve the child’s concentra- tion and reduce tension. Some good ones are Koosh balls, squishy balls, the Tangle puzzle, and fidget pens. If your child has weak hands, consider a hand-strengthening fidget like the Theraband Hand Exerciser. Deep pressure can make a huge impact on her ability to pay attention. Depending on the student’s preference, a weighted vest, shoulder wrap, fanny pack or other weighted item may be very calming. Another child might prefer the tightness of a pressure vest or snug lycra bicycle shorts and tee-shirts which can be worn beneath other clothing.
14 May – June 2005 Autism ■ Asperger’s Digest
Many kids self-calm and stay on task better when they suck or chew on something. Redirect oral needs away from things like clothing collars and cuffs to accept- able items such as a Chewlery necklace or bracelet, a Chewy Tube, or a chewable Pencil Topper, and provide chewy and crunchy snacks like low-sugar dried fruit, carrot sticks, and hard pretzels. Chewing gum can also be very calming and organizing, but you may have dif- ficulty convincing the school to allow it. These items also help students with speech and eating-related issues by desensitizing and strengthening the jaws and inside and around the mouth.
Auditory issues play a big role at school. If your child has prob- lems with auditory distractibility or processing spoken language, ask an audiologist, SLP, or OT about an FM unit. With this device, the teacher speaks into a transmitter and the receiver sits on the student’s desk or is installed nearby, or the child wears headphones that pick up the signal. The FM unit brings the teacher’s voice to the foreground so the student can’t miss what she is saying. Also, ask the teacher to provide copies of notes instead of just talking, and request written instructions for exams and assignments.
Respect a child’s auditory hypersensitivity by protecting her ears. When a child says certain sounds hurt her ears, they really do hurt! Have the child use noise-blocking headphones, earmuffs or earplugs. If she uses earplugs, make sure they are clean and fit safely. However, don’t let a child wear earplugs all the time because her ears will habituate and they won’t be effective. Save the earplugs for specific situations such as fire drills (which the child should be warned about in advance) and outdoor recess.
Many classroom underachievers have undiagnosed vision prob- lems. A child with diminished visual acuity, impaired binocular- ity, or other visual issues who can’t clearly see the teacher or the board, can’t refocus from the front of the room to her notes, or read what’s on a page will have understandable trouble paying attention. If you suspect the child has a visual acuity or pro- cessing problem, get a comprehensive vision evaluation from a developmental optometrist and ask your OT about modifying printed materials.
Because they are cheap and effective, most schools use fluores- cent lights. Not only does this increase indoor glare, but many kids with visual and auditory hypersensitivity can actually see and hear the flicker. Look into replacing these fluorescents with incandescent or full spectrum lighting or use Cozy Shades, magnetic shades that attach to fluorescent fixtures to soften the light. You can also use a non-fluorescent lamp at eye level to help reduce glare.
Handwriting can be a big problem for lots of reasons. Some people can’t tolerate the feel and noise of using a ballpoint pen on paper on a hard desktop. Use an old-fashioned desk blotter or
simply have her write on several layers of paper. Try a WriteKlip clipboard that moderates the drag of the pen or pencil. If the child has trouble stabilizing the paper with one hand while he writes with the other, he can use a no-skid clipboard or just masking tape that anchors the paper so it doesn’t move while he’s writing. Many children can write more easily if they write on a non-horizontal surface such as various molded pencil grips such
a slantboard or easel. Look into
as The Pencil Grip, which many students find comfortable and helpful in improving their grasp. You can also try different writ- ing instruments such as triangular pencils, the EVO pen, and the mildly vibrating Tran-Quille pen. Some children are more will- ing to write using the vibrating Squiggle Wiggle Writer, although it makes writing wiggly too! Consider the paper as well. There are so many kinds of writing paper used in schools, especially in the early grades. Does the paper have lines that make it obvious where the child is supposed to write? Some children need heavy, high-contrast guidelines. You can provide tactile cues by using paper such as Guide-Write brand that has raised lines a child can feel as well as see.
Resources for all products mentioned:
• www.sensorysmarts.com
• www.integrationscatalog.com; 800-622-0638
• www.earplugstore.com; 918-478-5500
• www.southpawenterprises.com; 800-228-1698 • www.sensorycomfort.com; 888-436-2622
For more information on how to make a classroom more sensory smart, how to advocate for your child at school, strategies to improve learning and organization, and practical tips for han- dling everyday problems such as washing hair, brushing teeth, and picky eating, see Raising a Sensory Smart Child: The Definitive Handbook for Helping Your Child With Sensory Integration Issues, by Lindsey Biel, OTR/L and Nancy Peske.
Look for an excerpt from Raising a Sensory Smart Child in the next issue of the Digest! Lindsey will return as our Expert in the Sept-Oct issue, focusing on sensory strategies and accommoda- tions that can be incorporated into a child’s IEP.
BIO
Lindsey Biel is a pediatric occupational therapist. She works with children ages 0-3 through the New York State early intervention program and with older children in her private practice. She has worked with students in elementary, middle, and high schools through the New York City Department of Education. She can be reached at Lindsey@sensorysmarts.com.
www.autismdigest.com ■ May – June 2005 15
Vibration can be extremely calming and organizing for some children.
As Appeared in the May/June 2005 issue.
www.autismdigest.com
Reprinted with permission of Autism Asperger’s Digest. Distribution via print or electronic means by any other individual or entity prohibited without written permission of publisher.
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