Strategies for Caring for Children with Sensory Integration Issues Script Introduction Welcome to “Strategies for Caring for Children with Sensory Integration Issues.” This 2hour course is part of a series of online trainings designed to help you, as child care providers and directors, gain a better understanding of how to create an inclusive child care environment for preschool and school-age children. According to researchers, approximately 1 in 20 people have sensory processing disorders, and it may be that some of the children in your care are currently dealing with these issues. In this session, we will explore how sensory processing, sensory integration, and sensory processing disorders (abbreviated as SPD) can affect a child’s daily activities and overall development. The purpose of this course is not to diagnose a child with a disorder, but rather to become educated in how to help children with sensory issues. If a child in your program has been diagnosed with a sensory disorder or is suspected of having sensory processing delays, it is important that you work as a caring partner with his parents, Individualized Education Program (IEP) team, physician, and others who have an interest in the child’s well-being. Learning Objectives By the time you complete this course, you should be able to:  Identify and describe the human senses and how they can positively affect children’s emotional and physical development,  Define sensory processing, sensory integration, and sensory disorders and how they affect quality care, and  Identify and explore specific techniques to support children with sensory processing special needs. Defining Inclusion As we begin this course, it is important to understand what we mean by “inclusive child care.” The National Association for the Education of Young Children (NAEYC) and the Division for Early Childhood of the Council for Exceptional Children (DEC) created this joint statement regarding the definition of early childhood inclusion: “Early childhood inclusion embodies the values, policies, and practices that support the right of every infant and young child and his or her family, regardless of ability, to participate in a broad range of activities and contexts as full members of families, communities, and society. The desired results of inclusive experiences for children with and without disabilities and their families include a sense of belonging and membership, positive social relationships and friendships, and development and learning to reach their full potential.” 1

While this definition was crafted with infant, toddler, and preschool programs in mind, the same principles apply in inclusive school-age care programs. In their publication Inclusion in SchoolAge Care: Guidelines for SAC Providers in Caring for Children with Special Needs (2008), the Center for Inclusive Child Care says, “’Inclusion’ is characterized by a feeling of belonging, not by mere proximity…Inclusion is children of all abilities learning, playing, and working together. With successful inclusion, all children are actively involved, physically accessing play and work locations, and have options from which they can choose personally. Inclusion is a process, not a placement. No one person is responsible to make it work; it takes group effort. There is not one perfect way. The inclusion process needs to be tailored to meet the needs of each child as well as the program.” Defining Sensory Processing Terms Imagine having the children in your program sit down so you can read a new book to them. You have been looking forward to introducing this new series to the class – you know the kids will love the interactive activities that go with the book. You begin to read and have the children chant the “chorus” of the book, and you notice that all of them are enjoying the experience with the exception of one child. Instead of chanting with the rest of the children, Sawyer has his hands over his ears and is rocking back and forth. He seems distressed and the other children are noticing it. Your co-teacher stops what she is doing and goes over to Sawyer while you finish the book. Do you have a child like this in your program? Have you noticed that some children are more sensitive to noises, lights, touches, tastes, or movements? Do these things cause unusual or even frustrating reactions? Let’s begin by defining some very important terms related to sensory processing. For example, what exactly is sensory processing and why is it so important? Sensory Processing, or Sensory Integration (the terms are often interchanged), is a neurological, developmental process by which our brains take in sensory input and interpret this information for us to use. We get our sensory input in many different ways, as our senses gather information from the world around us. From the minute we are born we are using our senses to learn. An infant can receive visual input by looking around the room and auditory input by listening to his mom’s or dad’s voice. While we all use our senses to understand the sensory input we receive, how much input a child receives, what kind of input, and how usable the input will depend upon the child’s development. Some other important terms pertaining to sensory input include Visual, Auditory, Gustatory, Olfactory, Tactile, Vestibular, and Proprioceptive. At a young age, we were all taught five main senses; sight, sound, taste, smell and touch. In reality, we have many more senses that help us learn and navigate our world. In this course, we will focus on seven senses that are important for children’s development and learning. The terminology used in research for the traditional five senses are visual (which refers to seeing), auditory (which refers to hearing), gustatory (which 2

refers to tasting), olfactory (which refers to smelling), and tactile (which refers to touching). The vestibular and proprioceptive senses are sometimes called “sensorimotor” senses, because they are senses that help us understand the position and motion of our bodies. Let’s explore each of these senses in greater detail. Understanding the Senses The visual sense, of course, refers to a child’s sight. Visual processing includes the child’s ability not only to see but also discriminate between different sights and successfully respond to those sights within the environment. A child’s auditory sense, or sense of hearing, helps him discriminate sounds and create meaning from those sounds. The gustatory sense (or sense of taste) and the child’s sense of smell (the olfactory sense) help support the child’s ability to perceive, discriminate and respond to different tastes and smells. The senses of taste and smell can help keep a child healthy and safe. For example, a child may refuse to eat food that is too spicy for him, or that smells rancid. The tactile sense, or sense of touch, refers to the child’s ability to recognize the amount of pressure from a touch, as well as temperature, texture, and even pain. Children vary in the amount and type of touch they want. For example, some preschool and school age children may enjoy hugs whereas hugs may make others feel “trapped”, causing them to avoid hugs altogether. The vestibular and proprioceptive senses provide input about our movement. The vestibular sense involves the input we take in through our inner ear. This is the sense of movement. The vestibular sense helps us understand gravity and its effect upon our bodies. The vestibular sense helps us recognize if we are moving or not, the rate in which we are moving, and in what direction we are moving. The vestibular sense helps children develop eye muscle control, visual perception, balance, coordination, and attention span. The proprioceptive sense involves the muscles and joints. This is the sense of position, and it relays information about our body’s position in the environment and how and when the position changes. It helps us decide if we are safe to move and if we feel comfortable in our movement. It helps children become skilled in complex movements and promotes coordination. When our sensory processing system is working correctly, we receive input through each of our senses, it is sent to our brains and interpreted, and then we are able to respond appropriately to keep ourselves healthy, safe, and comfortable. These appropriate responses are also called adaptive responses. Adaptive responses help us function successfully in our environments. When we talk about sensory processing issues, we are referring to issues with receiving, interpreting, or responding to sensory input. If a child has a problem receiving, interpreting, or responding to sensory information, he can be at risk for developmental delays, including problems with motor skills, social skills, and/or cognitive skills (including attention span). These delays could affect his ability to function efficiently within his environment. It is important to keep in mind that all of us have, at one time or another, had sensory processing issues. For example, as we get older we may have a harder time hearing in a crowded area than 3

when we were younger. Moreover, all of us have sensory preferences: some of us like soft, sweet foods, such as a hot brownie, whereas others may prefer a more salty snack that has a lot of crunch. We also all have some level of trouble processing certain stimuli, such as tasting certain flavors or hearing a low voice. This does not necessarily mean we have a sensory processing disorder! Later in this course we will talk in more detail about how sensory processing disorders are diagnosed, but the important thing to remember is that regardless of ability, each child needs an environment that meets his or her sensory needs. By addressing each of the senses, we can work to create a safe and enjoyable learning atmosphere. A Closer Look at Sensory Processing Issues As we’ve already mentioned, sensory processing issues can affect all developmental domains. There are three main patterns of sensory processing problems that you may see in the children in your care. You might notice the child being unusually sensitive to and /or avoiding a particular sensation. This pattern of sensory processing is called over-responsiveness or hypersensitivity. When a child is over-responsive to a certain type of sensory input, she might demonstrate sensory defensiveness. Sensory defensiveness is when a child is defensive to and negatively impacted by stimuli that wouldn’t bother most of us. Think about the scenario at the beginning of the course. The children’s chanting caused Sawyer distress. He was experiencing auditory hypersensitivity, or an over-responsiveness to sounds. In other words, the noise was too much for him. Sawyer became overwhelmed and made his own modifications (covering his ears and rocking) to defend himself from the noise. Under-responsiveness, or hyposensitivity, on the other hand, is a pattern in which a child may be unable to recognize a certain sensation unless it is intense, so he appears to not register that sensory input at the same level as other children. A child showing a pattern of underresponsiveness might seem uninterested in his surroundings. The final pattern is called sensory seeking. A child who is sensory seeking may excessively desire a specific sensation, such as the feeling he gets when he receives a strong bear hug. A child who is sensory seeking may be constantly trying to “relive” a specific sensation. For example, a child who craves touch may be constantly touching everything within his environment – including his peers! Let’s look at some examples of what these patterns of sensory processing problems might look like when they affect each of a child’s senses. 

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Visual processing issues: A child with processing issues related to her sight may be hypersensitive to bright lights and may cover her face constantly. She may seem to have troubling focusing on and looking at objects including numbers, letters, and other visual elements. The opposite may also be true. A child whose sense of sight is underresponsive to light may need bright lights to be able to distinguish between numbers and letters. Auditory processing issues: A child with processing issues related to hearing may have difficulty identifying people’s voices. He may make loud noises constantly (such as yelling or screaming) and may be in perpetual movement when making the noises. Some children with auditory processing challenges may have trouble identifying where a 4

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particular sound is coming from. Others may be irritated by loud or soft noises, depending on whether they are hyper- or hyposensitive to sound. Gustatory processing issues: In the area of taste, or the gustatory sense, a child who is over-responsive may be very selective in the foods she will eat, such as only eating bland foods or one or two specific spices. She might become so anxious at the thought of trying a new food that she gags when it is given to her. She could even fight brushing her teeth or complain about the flavor of the toothpaste. On the other hand, a child who is underresponsive will probably act as if all food tastes the same, prefer foods with strong flavors, want lots of seasoning on every dish, and will probably not notice a difference in taste if food has gone bad. Olfactory processing issues: If a child’s olfactory sense, or sense of smell, is hyper- or hyposensitive, he may be irritated by perfumes, cooking smells, and bathroom smells. He may choose to go to or not go into an area based on the smell. Smells that do not seem to bother others may cause an extreme reaction from him. Conversely, smells that are obnoxious to most people may not affect him. Tactile processing issues: The sense of touch, or the tactile sense, is often the one we think of first when talking about sensory processing issues. For example, a child who is over-responsive to input through her sense of touch may need to have seamless socks or tag-less shirts and pants. She may become irritable and refuse to get dressed, because the textures of her clothing bother her so badly! Another child who has difficulty processing certain textures or temperatures may hate washing her hands or face (or she could love it). Some children with tactile processing problems may avoid touching people and dislike hugs and kisses, and others might actively seek out your touch, depending on whether they are over- or under-responsive to touch. Because some of these behaviors are socially inappropriate, we may perceive some children with tactile processing issues as being socially awkward. Vestibular processing issues: A child with vestibular processing issues, or issues with the sense of movement, may dislike playing on certain playground equipment, particularly if he is hypersensitive to the sensation of movement. He might avoid swings, merry-go-arounds, and slides. Furthermore, he may not want to play games that include movement like the classic games Hokey Pokey or London Bridges. Just like with the other senses, the opposite could also be true. Some children with movement processing issues exhibit sensory-seeking behavior like looking for ways to experience the feeling of falling. Like many other sensory processing issues, this can sometimes be mistaken for challenging behavior, but in fact it is the child’s way of trying to meet his sensory needs. Proprioceptive processing issues: Lastly, if a child has sensory processing issues in the proprioceptive area, or the area of sensing the position of her body, she might prefer to be hugged tightly or “squished”. She may continually ask to play with toys that give a lot of sensory feedback, such as a hammer or a drum. In this case, she is probably underresponsive to input about her body position. She wants to feel that pressure on her joints when the hammer strikes the nail or the drum stick hits the drum. Other children may avoid these same types of activities, because they are over-responsive to this same kind of input. In other words, the feeling of the impact of the hammer on the nail is too strong a sensation, and it makes them uncomfortable.

Sensory Processing Disorder Diagnoses 5

At some point in your career, you may find yourself caring for a child who has been diagnosed with sensory processing disorder. Again, each of us have had difficulty processing information from our senses at one time or another. However, a diagnosis of a sensory processing disorder is based on several factors. These include the frequency of the reactions, the intensity of the reactions, the duration of the reactions, and the negative impact on one’s ability to function efficiently within the world. Parent surveys, clinical assessments, and laboratory protocols are used when diagnosing a child with a sensory processing disorder. Diagnosing SPD is very complex and can be controversial. It should be noted that the main manual used by mental health professionals to diagnose mental disorders, Diagnostic and Statistical Manual of Mental Disorders – 5th Edition (commonly referred to as the DSM-5), does not recognize Sensory Processing Disorder as a stand-alone disorder. The manual does recognize that sensory processing is important, though, and it does note sensory-related symptoms as part of other disorders. Many professionals and parents are working hard to have Sensory Processing Disorder recognized as a stand-alone disorder in later editions of the DSM. What this means for you is that not every child who has a sensory issue will have a diagnosis, and not every child with a diagnosis will have the same needs. It can be tempting, when caring for a child whose sensory needs seem far more specific than her peers, to think the child has a disorder, but it is not your job to diagnose children’s potential disabilities. Instead of focusing on a child’s diagnosis, you ought to focus on each child’s unique, individual needs, regardless of whether or not the child has been identified as having special needs. Possible Causes of Sensory Processing Disorders Obviously defining and recognizing sensory processing disorders are complex processes. Just as the body of knowledge about what SPD is and how to identify it are growing, so is our knowledge about where these sensory issues might come from. There are many possible reasons that a child might process sensory information differently from other children. These include:            

Premature birth, If the child was born premature, Neurological problems, such as cerebral palsy or missing or damaged areas of the brain, Certain genetic disorders, such as Down syndrome, Other genetic traits, Autism Spectrum Disorder, Failure-to-thrive, Feeding disorders, Chronic illnesses, Exposure to drugs (before or after birth), Living in an unsafe environment, Living in a poor learning environment with limited exposure to sensory experiences, or even Poor goodness-of-fit with caregivers.

In some cases, a child shows signs of sensory processing issues even when none of these factors are present, so researchers know they still haven’t figured out the whole story as to what causes sensory processing problems.

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Just like it is not your job to try to diagnose a child, it is not your responsibility to figure out where his sensory processing issues are coming from. Instead, focus your efforts on helping the child learn to regulate, express, and meet his sensory needs. Whether a child has a diagnosis or not, you can help him learn to have some control over meeting his sensory preferences. [Activity: Sensory Processing Checklist] Sensory Processing Issues and Child Care If you find that a child in your care has a tendency to seek or avoid certain types of sensory input, what can you do to meet that child’s needs? Let’s explore some options. Use positive communication. One of the best practices you can utilize when working with children with special needs is positive communication. This means using positive communication with the child AND the child’s parents. By communicating in a constructive manner with both the child and the parents, you can learn the child’s strengths, needs, preferences, and possible reactions to various activities or environments. Find the right cues. Understanding the best way to communicate instructions to a child is vital. You give lots of cues to children throughout the day to direct their behavior. For example, how do you let children know when it’s time to finish an activity and prepare for the next one? Do those strategies work for every child? If you have a child in your care with a sensory processing issue, you might need to ask yourself questions like: Does she respond to a quiet voice? Does she respond to a cue she can hear, such as a bell? Would a touch-based cue, such as touch on her back, let her know what to do next? Later in this course we will talk about how you can document these observations and create a more detailed, written plan to meet the needs of a child with a sensory processing disorder. Anticipate the challenges. Another best practice is to recognize how and why child care may be difficult for a child with sensory processing issues, so you are prepared to plan for the challenges a child might face. First, a new child in your program will have many new expectations placed on him and he may feel pressured. Also, it may be there is too much (or conversely, not enough) stimulation for the child to thrive in the child care setting, based on his sensory needs. Additionally, at home, he may have more control over how to meet his personal needs, but in child care, he probably has to contend with more children and their needs, which may sometimes conflict with his own. Additionally, though your program has consistent rules and routines, a child with sensory issues may still feel that his day is unpredictable and may not be able to selfregulate his emotions or needs within a timely manner. This is probably especially true when he is first enrolled and has not yet gotten acquainted with the new setting. Proactively address the needs. Specifically plan activities to address the child’s sensory needs, as opposed to ignoring them. Some of the ways children express their sensory needs look, to adults, like challenging behavior. If you can find ways to meet the child’s needs, you will spend less time trying to correct unwanted behavior. Here are some ideas of how to proactively meet the needs of children with different types of sensory processing issues: 

If a child has taste processing issues and it is hard for her try new foods, you might look for ways she can help make the snack or meal. Often a child is more apt to try something new if she has been able to have some control over preparing for the experience. You 7

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might also try letting her smell a lemon or peppermint before a meal. Some children are more willing to eat a variety of foods after they have smelled a strong smell like these. For a child who is sensitive to smells, guide him to choose a seat furthest away from a kitchen, restroom, or other area where strong smells might be coming from. If he enjoys them, allow him to use scented materials, such as scented crayons or markers. You can even add scents he finds pleasant to other materials, such as books, blocks, and sensory materials. If a child has trouble processing information through her sense of touch, provide a space that offers a variety of textures and soft, soothing surroundings. Allow her to lie on a mat or blanket, and place pillows over her lower body. Have squeeze balls or play dough for the child to squeeze and play with during times she needs to be quiet and concentrate. For a child who needs support with his movement and/or body positioning senses, you can create a movement area in the child care environment. A movement area is a space where children can do things like: rock in a chair, spin on a toy, or even bounce on a small trampoline. You might encourage children to dance in this area by providing instruments or recorded music. You can even get up and dance with them! You might provide a piece of equipment called a “bounce cushion” that allows the child to subtly bounce while listening to a story or lesson, or have the child lean against a sturdy surface, like a wall or stable bookshelf during circle time. Remember, they are learning through imitation. Older children often like to play dance-based videos games. Just remember, any time you provide “screen time” activities for school-age children, they should be limited to a maximum of two hours per day, should be age-appropriate, and should supplement the learning activities that make up the bulk of your program. If a child is hyper- or hyposensitive to sound, you can allow her to use headphones while listening to music or audiobooks, so she can control the volume to meet her own needs. For some children who are hypersensitive to noise, sound dampening earmuffs or headphones, used without music, can help lessen the noise and enable them to concentrate. Try to incorporate activities that hone children’s listening skills, such as having them listen to nature sounds and try to identify each sound.

Hopefully these proactive steps will help the child enjoy the experience of being in child care with her peers, instead of feeling anxious and stressed. Finding strategies that work for a particular child requires an effort on your part. To find ideas, talk with her parents about what works at home, ask them if anyone else who works with or cares for her has ideas, ask the child herself what might help, and do your own research using the internet or your local library. Sensory Environment for Sara You might have noticed that the list of strategies we just discussed did not address the needs of children with visual processing issues. That’s because we’re going to use the sense of sight to think through a more detailed example of how you can plan for an individual child’s needs. Let’s imagine that you are caring for a child named Sara, who shows some sensory-seeking behavior when it comes to her sight. What are some simple strategies you can use to meet Sara’s visual sensory needs within your program? The first step is to explain exactly what sensory-seeking behavior you are seeing. Document specific instances, then, use your notes to try to understand what Sara’s behavior is telling you. 8

Once you have documented an established pattern of behavior, discuss your observations with Sara’s parents, and work with them to decide how to help her. For example, let’s say you observe Sara constantly standing by the window where direct sunlight can come in. In fact, she seems to struggle with focusing on an activity unless she is near the window. She constantly asks for more lights to be turned on. You can see that her need for bright light is distracting her from learning opportunities. You discuss this with her parents and decide to brainstorm ways you can add more light to your child care environment, such as adding lamps (out of children’s reach, of course), keeping window blinds and curtains open any time the children are present, and giving Sara more control over the lighting by placing “tap lights” on the walls in learning areas that tend to have poorer lighting, so she can turn them on and off as needed, and allowing her to carry a small flashlight that she can use whenever she needs it. You also talk about ways you can increase the color-contrast in your materials, so Sara can discriminate between objects more easily, such as color-coding your unit blocks by size. Sensory Processing Action Plan (or “Sensory Diet”) The process you’ve just completed with Sara and her family will create an informal plan of the strategies you will use to meet Sara’s sensory needs. When this plan is written down and formalized, it is commonly called a sensory action plan or sensory diet. For children with diagnosed disabilities, a version of the sensory diet might be included as part of each child’s Individualized Education Program (or IEP). If that is the case, then you need to work closely with the child’s family, and, when appropriate, members of the team who develop and maintain the IEP in order to support Sara’s existing goals. In some cases, you may even be a part of the IEP team that works together to create a sensory action plan for a particular child. Whether you are creating an informal sensory plan, working with a child’s IEP team to create a formal action plan, or following a prescribed sensory diet laid out for you by the IEP team, it is important to understand the steps that go into developing the plan. A sensory diet is an individualized schedule of sensory activities designed to help a particular child stay focus and learn. It is often created by an occupational therapist, but, like we just mentioned, if the child in your program has not been formally diagnosed but still needs some help with sensory issues, you and the child’s parents can set up a sensory action plan. A sensory diet generally incorporates three types of activities: alerting, organizing, and calming activities.   

Alerting activities are for the under-responsive child. Examples include eating crunchy foods, jumping up and down, or bouncing on a ball, Organizing activities help a child regulate his responses. Examples include allowing the child to chew gum or eat chewy foods, and doing physically challenging work, and Calming activities help decrease overstimulation. Calming activities include rocking or swinging, cuddling, and having the child push up against a hard surface such as a wall with his hands, back, or legs.

A sensory action plan can help a child with sensory processing issues develop in a happy, healthy manner. It gives the child the gift of having appropriate ways to control his stress and anxiety. Believe it or not, we have already addressed all of the components of a sensory diet at 9

one point or another throughout this course. To help you use these tools effectively, we’ll spend the rest of the course looking at the pieces that go into planning a sensory diet or sensory action plan, using our example about Sara as an illustration. The first component every sensory action plan has to have is an identified goal. The need is a goal, often a behavior-based goal, which you want the child to achieve. Like any other goal you set for a child, the goal in a sensory action plan should be specific and measurable. By the time you sit down to create a sensory action plan, you should have taken lots of notes about the child’s behavior that led you to believe she has an unmet sensory need. This behavior is obviously causing challenges for the child (and maybe for you). To help the child function effectively in the child care environment, we want to target this behavior with the sensory plan. In other words, you want to find ways to meet the child’s sensory need so that you can ultimately change this unwanted behavior. Think about Sara’s behavior from the previous example. Sara has a hard time focusing on activities and completing tasks. Not being able to focus on activities and complete tasks is clearly a problem. It interferes with Sara’s ability to learn. This is the behavior we will target with our goal. Remember, a goal should be specific and measurable. In our example, the goal could be stated as something like, “Sara will stay on task for 10 minutes, and will complete tasks she has started more than 40% of the time.” Make sure your goals are realistic with the time, resources, and staff you have available in your program. The entire sensory action plan should be developed cooperatively with the child’s parents, and goals should be mutually agreed upon by the parents, the caregivers who work with the child, the program administrator, and, if applicable, the child’s IEP team. The next step in creating a plan to meet a child’s sensory needs is to figure out what unmet sensory need is leading to the behavior. When you see a child exhibiting a behavior like this, you might have to make some educated guesses about why the behavior is happening. Let’s assume we don’t already know that Sara is distracted because of her need for more light. We might consider many different possibilities. We know that when Sara gets distracted, she tends to stand by the windows. We have documented this behavior many times in our observation notes. Now we need to ask ourselves why this is happening. Is Sara having a hard time focusing because of the noise level in the environment? Is she uncomfortable with the temperature in the room, so she stands by the window to warm up? Is there a strong smell coming from another area of the building that is causing Sara stress, and she’s going toward the window looking for fresh air? Does Sara stand by the window because it is brighter there? To answer these questions, we need to look for a sensory pattern. As you carefully observe a child, consider whether the child is exhibiting any patterns of response to sensory input. Each of us has sensory patterns. For example, before you took your first sip of coffee this morning, did you blow on it, because you prefer it warm rather than very hot? When you got into your car, did you immediately turn on the radio because you prefer the background noise over a quiet drive? Although these behaviors seem inconsequential, they actually are very important. Each behavior is a sensory processing clue. Observing sensory processing patterns can help you meet a child’s sensory needs. Your observations should be purposeful and seek to answer questions like:

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Does the behavior happen at a certain time? How long does the behavior last? What is the intensity of the behavior and can the child regulate that intensity? Does the behavior happen in a certain area of the program environment? Is there a specific person or object that is involved in the behavior? Does there seem to be a specific reason for the behavior? and What sensory needs would make sense, given what you know about the behavior?

With Sara, we put together several different observations to identify her sensory pattern. She prefers to stand by the window. She asks for more lights. She seems to have trouble focusing on tasks when the work area is not adequately lit. When we put these observations together, we can make an educated guess that Sara’s behavior is coming from an unmet need for bright light. The next step in a sensory diet or action plan is to identify and document strengths that can be used to address the sensory need. Recognizing the strengths available to you and the child helps you think about which strategies will be most effective in your circumstances. Strengths are often child-oriented and address a child’s development within other domains. This could mean noting that Sara has strong communication skills and might be able to learn to tell you when something is bothering her, before she gets off task. Strengths can also be caregiver-oriented, such as your comprehension of the importance of sensory processing and your willingness to help Sara with her sensory needs, or your strong partnership with her parents and, if she has one, her IEP team. Finally, strengths could also be environmental. Environmental supports can include licensing regulations and ADA requirements, or materials or equipment that is readily available in your program. The next, and possibly most important, piece of the sensory action plan is to create action steps. Given what you know about the child’s behavior, your observations of her sensory pattern, and your assessment of the strengths and resources you have to work with, what actions or strategies might help you meet the child’s sensory needs?

Let’s go back to our example about Sara. After we identify that Sara’s sensory pattern is telling us she needs more light, we can brainstorm strategies to give her just that. The action steps we came up with in the example were:     

Add lamps to various areas of the child care facility to increase visibility, Keep window blinds and curtains open any time the children are present, Place tap lights on the walls in learning areas that tend to have poorer lighting, so Sara can adjust the level of light to meet her needs, Allow Sara to carry a small flashlight to provide additional light for tasks as needed, and Increase the color-contrast in the materials (such as color-coding unit blocks by size).

The action steps you select should be: 

Individualized – meaning they are based on observations of a specific child, not just general information about children’s development,

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Developmentally appropriate – meaning in addition to being individually appropriate, they are age-appropriate, and culturally appropriate for the child,

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Environmentally appropriate – meaning they are in compliance with all rules, regulations, and laws affecting your program, and are realistic with the resources you have available, and

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Mutually agreed upon by caregivers, parents, and, if applicable, the IEP team.

As you implement the sensory actions from the action plan, you should systematically document the responses you observe in the child’s behavior, emotions, and engagement with the environment. This documentation will help you determine whether or not the strategies you’re using are working. This is sometimes called the review component of a sensory action plan. Together with the child’s parents, other caregivers, and when applicable, his IEP team, you should periodically revisit the sensory action plan and decide whether to continue, change, or stop the application of a particular strategy. Summing It All Up Remember Sawyer, the child in the scenario at the beginning of this course? Sawyer’s story helps remind us that unusual or even problematic behavior may actually give us clues about how to meet a child’s needs. Sawyer’s behavior is a good example to remind child care providers that sensory processing is important to all children, whether or not they have been diagnosed with a disability, and should be addressed in a respectful and intentional manner. It is imperative to offer all children a safe, sensory-appropriate environment that addresses all the senses. Careful observations of the child, communication with the child and the child’s parents, and working collaboratively with the IEP team can help us make a positive impact in a child’s life. By understanding sensory integration, and sensory processing, using a sensory diet when appropriate, and purposefully designing our program activities and environment, we can provide the high quality inclusive childcare that our children so richly deserve! Conclusion In this course, we explored how sensory processing issues can affect the children in your program. We learned to identify and categorize several of the human senses. Sensory processing terminology was defined and we completed activities that allowed you to apply this new knowledge not only to yourself (and your individual needs) but to the children in your care as well. Then we looked at strategies you can use to meet the sensory needs of the children in your care. The key points we would like you “take home” from this course are:   

All children use their senses to process information. This is called sensory processing or sensory integration, While you probably learned about five senses when you were growing up, there are actually many, many senses that humans use. We discussed seven of them in this course, including sight, sound, taste, smell, touch, movement, and body positioning, Children with sensory processing issues can show different patterns. Some may be over responsive (or hypersensitive), some may be under responsive (or hyposensitive), and others may be “sensory seeking.” One child can be over responsive in one area, and under responsive in another, 12

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The diagnosis of sensory processing disorder is complex and controversial. Instead of focusing on a diagnosis, focus on each child’s individual needs and work to meet those needs within your program, There are many different ways to meet a child’s sensory needs. The key is to match your strategies to the child’s sensory pattern, possibly creating a formal sensory action plan (also called a sensory diet), and Finally, it is important to realize that you are not alone in this endeavor. Be sure to work with each child’s parents and if applicable, the IEP team.

Thank you for participation in this course and for your desire to provide a quality care and education for all children!

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References Biel, L. & Peske, N. (2009). Raising a Sensory Smart Child: The Definitive Handbook for Helping Your Child with Sensory Processing Issues. New York, New York: Penguin Books Ganz, J.S, (2008). Sensory Integration Strategies for Parents: SI at Home and School. Prospect, CT: Biographical Publishing Company Kranowitz, C. S. (2005). The Out-of-Sync Child: Recognizing and Coping with Sensory Processing Disorder. New York, New York: Penguin Group Miller, L.J (2014). Sensational Kids: Hope and Help for Children with Sensory Processing Disorder. New York, New York: Penguin Group http://www.naeyc.org/files/naeyc/file/positions/DEC_NAEYC_EC_updatedKS.pdf] http://www.senseablebaby.com/Home_Page.html#The_Development_of_Sensory_Processing_In _Infants http://www.sensory-processing-disorder.com/ http://spdsupport.org/resources/infant-spd-symptoms.shtml http://sensorysmarts.com/practical_solutions.html http://www.ot-mom-learning-activities.com/sensory-integration-activities.html http://www.pbs.org/parents/child-development/sensory-play/developing-and-cultivating-skillsthrough-sensory-play/sensory-play-early-exploration-through-the-senses/

This course was developed and produced by the Texas A&M AgriLife Extension Service of the Texas A&M University System in cooperation with the Texas Department of Family and Protective Services, Child Care Licensing Division, and using funds provided by the Texas Workforce Commission. 14