Creating a person’s (child, student, adolescent, adult) Sensory Profile may be necessary in order to better understand their behavioral disorders and how that relates to their sensory issues… such as being over-sensitive, under-sensitive, passive, and/or balanced. Persons may become less or more extremely sensitive over time, as a result of many of their experiences and/or interactions; or how they discriminate and regulate incoming sensory information. (3 bears… just right).
Mays, et al. (2011) begins with an example of a completed ‘Teacher Observation’ form used to begin a case study.
The example gives the student’s name, the observer’s name, and the date and time length of the observation.
There are 7 choices which the observer may circle to indicate the ‘sensory system(s)’ involved in the behavior they observed at that time. The Sensory Systems are:
- Vestibular (sense of movement)
- Proprioceptive (spatial body awareness)
- Visual (sight)
- Tactile (touch)
- Auditory (hearing)
- Gustatory (taste)
- Olfactory (smell)
Next, the observer rates the intensity of the behavior. Rating on a scale of 1 = not intense, to 5 = very intense.
The part (s) of the body involved are noted.
The number of these behaviors, per minute, are recorded.
The duration time the person is engaged in stereotypy is recorded.
Then, whether or not the person completed the assignment/participated in an activity, during observation time. YES or NO.
There is a place for the observer to include any NOTES for review.
SENSORY OBSERVATION FORM
Student: Bobby S.
Date: 01-12-2012 Observer: Teacher
Observation began: 9:00 am ended: 9:30 am
Sensory system involved(circle):
- Vestibular (movement)
- Proprioceptive (pressure)
- Gustatory (taste)
- Olfactory (smell)
Description of behavior: While sitting in a chair or on the floor, Bobby’s torso bounces up & down, repeatedly, with his bottom leaving & returning to the chair/floor.
Intensity (Rate on a scale of 1 = not intense, to 5 = very intense.) 5 Bobby bounces up & down hard enough that the legs of the chair sometimes come off the floor.
Body part: The part (s) of the body involved are noted. Mostly torso, but his whole body moves.
Number of behaviors: The number of these behaviors, per minute, are recorded. Counted 3 different 1 minute intervals –
30 per min. /33 per min. /27 per min.
Activity & time duration:The duration time the person is engaged in stereotypy is recorded. Bounced 24 of the 30 min. during Circle Time activity.
Activity or task completed? Did the person complete the assignment/participated in an activity, during observation time? YES or NO.
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Adolescents, especially in school, found that difficult, even painful sensory issues made them feel tired, reduced concentration making them feel anxious and causing them to have learning problems.
< My Thoughts > “…previous diagnostic systems neglected the importance of sensory processing…”
At this point and time, it still seems difficult for the layman to discover reliable information regarding Sensory Profiles and Sensory Diets. My attempt to get something solid on paper for everyone to come away with an idea of the best approach seems to be a work in progress. The Occupational Therapists may have the most training in this area, but I’ve heard that Physical Therapists and Speech & Language Therapists have successful programs, too. Smiles.
Mays, et al. (2011) starts us off with what is usually the beginning of the process to determine whether or not the child, or in this case student, needs intervention.
They say that this preliminary observation process becomes crucial before classroom teachers can intervene and decrease or replace self-stimulatory sensory behaviors, so the student may attend to instruction and learn new skills.
< My Thoughts > “…beginning of the process…”
The process from teacher observation and request to final intervention can be a lengthy one. But ‘Teacher Observation’ could be seen as Step One of a formal investigative procedure. With a formal observation eventually leading to a Sensory Profile assessment, which may culminate in the recommendation of a therapist intervention. Perhaps an Occupational
Therapist or Physical Therapist would be the one to evaluate Bobby and design an appropriate replacement behavior which would serve the same function for him. Or, the evaluation determined that Bobby just needed to learn to ask for a ‘break’ when over-stimulated, a Speech & Language Therapist could be called upon to teach that.
As a teacher, my experience has been that there are many factors leading up to the final ‘intervention’ phase. Teachers providing others with documentation of concerns about a student is usually a first step. And, any testing, evaluation, or reevaluation requires the parent’s permission. Also, inquiries about Bobby’s undesirable behavior observed by other teachers and staff will add to the documentation. Document, document, document.
Another important factor is that while he is bouncing in the circle, the learning of others is most likely being interrupted. He may even scare or endanger them physically, due to his erratic chair activity. The effects of his bouncing during ‘Circle Time’ would be expected to disrupt his learning. But, my suspicion is that Bobby’s really not missing a thing as he’s busy bouncing; he’s still learning. Smiles.
Sensory Profiles –
Sensory profiles rely on collecting important data to detect sensory processing abnormalities in individuals with ASD. The goal of a study by Gonthier et al. (2016) was to characterize distinct profiles of sensory dysfunction and understand how that relates to behavioral disorders related to the following systems:
The profiles provide a relatively exhaustive assessment of sensory abnormalities. Participants in the study were split into four clusters:
The authors go on to say that these types of sensory dysfunctions may be at the root of behavioral self-aggression like self-injurious behavior (SIBs).
Conversely, too, under-responsive individuals possibly lack awareness which may explain why they don’t respond to sounds or to spoken language.
< My Thoughts > “…these types of sensory dysfunctions…”
Sonny can suddenly jump up, shove his hand in his mouth and bite down hard. What just happened? Seizure? Air conditioner turned on or shut off? Gas pain? Brain fart? PSTD memory triggered? Who knows? But chances are that he’s biting himself because of some kind of sensory upset. Just saying.
Little, et al. (2016) say that sensory processing is an integral part of how children experience activities that promote learning. Sensory processing can be determined through the use of various ‘Sensory Profile Questionnaires.’ From those inquiries, they can decide which ‘sensory processing patterns’ are unique to a particular person. That is, how quickly that person detects and self-regulates his or her own behavioral or sensory responses.
Continuing, by saying that all individuals have differing thresholds and self-regulation strategies in response to their sensory experiences. Also important to successful intervention would be to uncover the extent to which sensory subtypes – balanced, intense, vigilant, interested, and mellow, present in the general population, as well as in the autism community.
- Balanced sensory profile – explores different sensory stimuli, easily engaging in sensory experiences.
- Intense sensory profile – shows high frequencies of all sensory patterns. May have limited coping & self-regulating strategies to counteract aversive or unfamiliar sensory experiences.
- Vigilant sensory profile – show increased sensitivity & avoidance behaviors. May have hyper-responsiveness.
- Interested sensory profile – may be always seeking out intense sensory stimuli such as movement, tactile, or auditory sensory experiences.
- Mellow sensory profile – doesn’t always register or notice sensory stimuli as quickly as others. Always important to find just the right amount of sensory stimuli so they notice, but don’t become overwhelmed.
< My Thoughts > “…methods and questionnaires…”
There are all sorts of methods and questionnaires for determining a person’s Sensory Profile. There doesn’t seem to be a ‘standard’ for what they should look like, who should fill them out, or who should evaluate them. There are –
Green, et al. (2016) show us a Short Sensory Profile which includes some examples of the following behaviors:
- Tactile sensitivity (7 examples, one of which is… “Reacts emotionally or aggressively to touch.”)
- Taste/smell sensitivity (4 examples, one of which is… “Limits self to particular food textures/temperatures.”)
- Movement sensitivity (3 examples, one of which is… “Becomes anxious/distressed when feet leave the ground.”)
- Under-responsive/seeker sensation (7 examples, one of which is… “Seeks all kinds of movement & strange noises.”)
- Auditory filtering (6 examples, one of which is… “Can’t work when there is background noise.” “Hears, but doesn’t answer to name.”)
- Low energy/weak (6 examples, one of which is… “Poor endurance, tires easily.”)
- Visual auditory sensitivity (5 examples, one of which is… “Holds hands over eyes & ears.”)
Garnett & Attwood, et al. (2013) believe that given the diversity of presenting symptoms in children and adolescents with ASC, clinical settings require valid and reliable measures which profile ASC symptomatology. They feel it is necessary for parents, teachers, and caregivers to be aware of what environmental modifications need to be made, as well as which clinical intervention.
< My Thoughts > “…to be aware of what environmental modifications…”
Knowing your child, and yourself, can help address sensory issues before they become so overwhelming. Consider becoming pro-active, preparing for any changes in routine, weather, people, activity, or anything else that may ‘distress’ them at home, at school, or in the community.
Of course this requires you to be a super sleuth! We know that Sonny will become very upset if we come upon road work or a detour on the way home from the store, that’s a given. But what we didn’t expect was that having a change in the coloring on the carton of his favorite food would create such inconsolable angst.
Stewart, et al. (2016) speak of using a Sensory Profile with individuals who due to being non-verbal may only stare intently at the stressor, expecting someone to understand their need. Many of these persons may have undetected multi-stressory difficulties. Sonny’s stress and anxiety level skyrockets because he can’t yell out and rarely cries. Then the staring could be a seizure or the stress and anxiety could bring one on. Sad.
Van Etten, et al. (2017) characterize unusual sensory behaviors as having higher or lower frequencies. The three categories they mentioned for at-risk infants through teens were –
- Under-responsivity, which refers to indifference or slow response to sensory input.
- Over-responsivity, which refers to exaggerated or prolonged reaction to sensory input.
- Sensation seeking, which refers to intense desire or interest in sensory experiences.
< My Thoughts > “…observational measures…”
While researching for ‘Long Sensory Profiles’ I found this YouTube video by OT Rex titled 5 Pediatric Assessment Overview – BOT2, Peabody, Sensory…(Dec 03, 2017). https://www.youtube.com/watch?v=83mMFUz_Tpk
This is a personal study which was created and posted for informational and study purposes for those interested in some of the Standardized Profile Assessments.
These are my (Sara Luker) notes from the YouTube video…
- PEDS Assessment – Peabody (PDMI-2) Birth – 5 year old participants. Profiles Visual Perception & Motor Integration; including Fine & Gross motor skills.
- BOT-3 Bruininks-Oseretsky – Measures motor proficiency skills in participants from 4 – 21 years of age. Profiles co-ordination, body strength, agility, & manual skills.
- Berry (VMI) – Visual perception, visual & motor integration; culture bias-free and for non-verbal participants from 2 years and older.
- Sensory Processing (SPM) – can also be given by parent, caregiver, or homeschooled; 2 – 5 years & 5 – 12 years. Also measures sensory processing & social participation.
- Sensory Profile 2 – Gives sensory processing patterns , plus impact on functional performance. For toddlers 7-15 months & children from 3-14 years. Can be given by parent, caregiver.
These tests are based on United States Norms and usually given by licensed clinicians and professionals, but some may also be used by those who are homescooling, parents, and carers, as indicated.
Schaaf & Lane (2015) say that Sensory Profiles can help to observe behaviors and to estimate, and predict one’s needs. They also say that sensory feature can change with age and know to be on the watch list for autism. They believe sensory profiles hold promise with those who have a rich history of successful treatment planning; such as Occupational Therapists. These clinicians work overtime at influencing play and living skills, helping with better socialization, as well as other everyday behaviors.
< My Thoughts > “…Sensory Profiles can help…”
Once a Sensory Profile is agreed upon for the individual child, adolescent, or adult, then a Sensory Diet is developed. The following definition has been retrieved from: https://www.sensory-processing-disorder.com/sensory-defensiveness.html
Sensory Diet: This concept is based on the idea that each child requires a certain amount of activity and sensation to be most alert, adaptable, skillful, and calm. By careful planning we can use sensory input to help a child feel safe and organized in thought and movement throughout the whole day.
Note: NEXT BLOG #5J – SENSORY DIET
REFERENCES used here are:
Gonthier, C., Longuepee, L., Bouvard, M. (2016). Sensory Processing in Low-Functioning Adults with Autism Spectrum Disorder: Distinct Sensory Profiles & Their Relationships with Behavioral Dysfunction; Journal of Autism & Developmental Disorders; V46, p3078-3089.
Green, D., Chandler, S., Charman, T., et al. (2016). Brief Report: DSM-5 Sensory Behaviors of Children with and Without an Autism Spectrum Disorder; Journal of Autism & Developmental Disorders; V46, p3597-3606.
Howe, F., Stagg, S. (2016). How Sensory Experiences Affect Adolescents with an Autistic Sprectrum Condition within the Classroom; Journal of Autism & Developmental Disorders; V46, p1656-1668.
Mays, N., Beal-Alvarez, J., Jolivette, K. (2011). Using Movement-Based Sensory Interventions to Address Self-Stimulatory Behaviors in Students with Autism; Teaching Exceptional Children; V43, p46-52.
Schaaf, R. * Lane, A. (2015). Toward a Best-Practice Protocol for Assessment of Sensory Features in ASD; Journal of Autism & Developmental Disorders; V45, p1380-1395.
Stewart, C., Sanchez, S., Grenesko, E. (2016). Sensory Symptoms & Processing of Nonverbal Auditory & Visual Stimuli in Children with Autistic Sprectrum Disorder; Journal of Autism & Developmental Disorders; V46, p1590-1601.
Van Etten, H., Kaur, M., Srinivasan, S., et al. (2017). Increased Prevalence of Unusual Sensory Behaviors in Infants at Risk for, and Teens with, Autism Spectrum Disorder; Journal of Autism & Developmental Disorders; V47, p3481-3445.
< My Thoughts > What I am offering here is a powerful story which may capture in a moment, what it is like to have this experience. (Sensory Profile)
Seeing Ezra: A Mother’s Story of Autism, Unconditional Love, and the Meaning of Normal by Kerry Cohen, eBook 2011 Edition; with < My Thoughts > by Sara Luker
Focused Excerpts from the book (25% indicates location in the Kindle version of the book, instead of page numbers.)
25% She gives me a sensory profile to fill out, the same one I’ve been given twice before, the same one that doesn’t address my son’s particular issue, because like most people, he doesn’t fit into a mold.
But the world of experts is still lagging on this matter, at least when it comes to examining special needs, and especially when it comes to examining special children with needs. No matter. I fill out the form while Ezra jumps into a tub of balls.
< My Thoughts > What I am offering here is a powerful story which may capture in a moment, what it is like to have this experience. (Sensory Profile)
I Am In Here: The Journey of a Child with Autism Who Cannot Speak but Finds Her Voice by Elizabeth M. Bonker & Virginia G. Breen, eBook 2011 Edition; with < My Thoughts > by Sara Luker
Focused Excerpts from the book (2% indicates location in the Kindle version of the book, instead of page numbers.)
2% Elizabeth reminds us of the loneliness that is felt when one is constantly fighting one’s own sensory challenges alone.
20% For many children with autism, stress comes from subtle sensory issues such as sights, sounds, and smells. Years ago, Elizabeth told us about the stress she felt when she saw certain colors and how she found a way to manage that stress.
< My Thoughts > “… stress comes from subtle sensory issues such as sights, sounds, and smells.”
Something stressful comes from smells. Legis, et al. (2013), conducted a study to investigate whether eight children with Autism Spectrum Disorder and eight age-matched children without ASD had the same stress reaction to smells. So as to measure their responses to pleasant and unpleasant odors more accurately, participants’ heart rate, facial expressions, and emotional states were also recorded as odors were introduced. In addition, researchers were looking for any possible ‘triggering of a primary fear response’.
This study brought about a great deal of attention because some thought it might help with early detection of those with autism. CNN (Cable News Network, http://www.cnn.com), a “new study suggests that children with autism might also experience smells differently from children who have typical development.” “… children with autism did not change their breathing in response to being exposed to different aromas.”
Typical children quickly stopped inhaling unpleasant odors, while children with autism did not. “The fact that it does not require a verbal test means that the olfactometer could be used in babies as young as a few months old…” While typical children, of all ages, recoiled at the stench of rotten fish and sour milk, children with autism gave them a more “vigorous sniff.”
20% Elizabeth wrote –
“I like basic colors for basic things. When things get clear I must not see a quiet color like brown. I am looking at yellow because I feel clear, but when I get all confused I have to start looking for my DVD. DVDs can have smooth color effects. They are really noisy in a good way. Not at all confusing. But I get so confused when I hear someone ask me something too direct. I like to see bluish colors when I feel relaxed. I don’t mind it now, but don’t show me brown when I am mad!” This passage helped me realize why she watched so many videos as a youngster.
< My Thoughts > “I like to see bluish colors when I feel relaxed.”
Kendra Cherry, in her recent article “How Much Can the Color…Affect You? (2015) on the website, www.psychology.about.com, agrees with Elizabeth about the colors blue and yellow. “Blue calms the mind; gets rid of nervous tension…” and she even suggests wearing ‘blue-tinted’ sunglasses on stressful days. As for ‘yellow’, she says that this color “energizes; promotes learning (says make notes on yellow Post-its); improves memory and combats the doldrums.” She also cautions that too much yellow for too long can begin to irritate you.
47% As her mother, I’ve come to believe it’s because nature provides an antidote to the sensory overload that senses become hardened to the blaring cacophony of the modern world. A steady diet of car horns, neon lights, television commercials, and nearly constant background music, makes the world truly overwhelming.
Elizabeth writes –
Oh my, how the rain comes down.
Pounding, pounding to the ground.
Some of you might frown
But to me it is profound.
Although nature is scarcely silent, its sounds and rhythms are much more closely aligned with the natural rhythms of our bodies. Long walks seem to calm her spirit. Walks in the rain. Walks where birds in the trees and crickets constantly serenade us with their glorious melodies.
REFERENCES used here are:
Legis, J., Messinger, D., Kermol, E., Marlier, L. (2013). Emotional Responses to Odors in Children with High-Functioning Autism: Autonomic Arousal, Facial Behavior and Self-Report; Journal of Autism Developmental Disorders, V43; p869-879.
< My Thoughts > What I am offering here is a powerful story which may capture in a moment, what it is like to have this experience. (Sensory motor strip)
MIRACLES ARE MADE: A Real-Life Guide to Autism by Lynette Louise, eBook 2011 Edition; with < My Thoughts > by Sara Luker
Focused Excerpts from the book (3% indicates location in the Kindle version of the book, instead of page numbers.)
3% It’s hard to ‘chicken or egg’ the disordered brain.
5% Here are some of the things we do know about autism. It is a disconnect in the brain that mostly affects language and social interactions, so verbal skills and having relationships with the people they come in contact with can be difficult.
Many autistic kids develop coping behaviors – or fixations – that they fall back on in stressful situations…
Unfortunately, those behaviors are so freaking weird that the kids get stared at or laughed at, which they are completely aware of but are unable to put a stop to.
Responding to behavior in a noticeable manner whether it comes from the computer, the sensory system, or the parent is feedback. Brains use feedback to direct their growth patterns.
11% Harmful to the sensory system is the startle response that can sends inaccurate messages about potential danger causing an adrenaline flight or flight response. This literally flips switches, changing the places in our brain and body that are oxygenated and turned on. This body-wide effect causes change to the heart, stomach, and genitals.
14% Feedback itself is built into our very reality. Things like temperature, digestive comfort, and fabric texture are all forms of feedback.
Dar was a smelly, scary mess of a man. That is, until neurofeedback. After that, we could actually watch him learn to calm himself and communicate. The whole thing was happily surprising.
16% The thing about neurofeedback is it simply mirrors life. Every therapy gives feedback. Every sensory integration technique, speech and occupational therapy gives feedback. Every moving, breathing, happening, other thing in your world gives feedback.
31% Sensory disorders manifest as weird behaviors responding to, or not responding to, the stimulation of any or all of our senses. This translates into a lot of children walking around naked or playing with their feces or tasting, touching and smelling everyone and everything that catches their attention.
33% Given that autistic kids often have problems with over-firing of the amygdale and discombobulated sensory systems that act as if they are being attacked when anything around them moves too quickly, relaxing the PTSD hold of the amygdale on Dar’s brain was one of the first things I tried.
38% I often begin by working on the sensory motor strip at the location that is between the two hemispheres. It is believed that this location helps us read brain-wave activity from the deepest regions, possibly even netting some information from the thalamus itself. The thalamus sends sensory information faithfully to the rest of the brain so that processing can take place. Idling when trying to sleep, meditate, or recall memories but is not so useful when trying to pay attention and to listen.
40% My suspicion is that some autistic children live in such a state of cacophonous sensory information that they are driven to control or to block out any sensory information coming their way.
< My Thoughts > “My suspicion is that some autistic children live in such a state of cacophonous sensory information…”
Fuentes, et al. (2010) believe that primary proprioception – the sense of position and movement of the parts of the body, may not contribute to sensorimotor deficits in persons with ASD. But abnormalities may arise at later sensory processing stages.
But, because actively interacting with others plays a crucial role in daily life. They say, examining and understanding the underlying causes of the social, communicative and motor impairments becomes crucial to motor skills and the general ability to successfully interact with the environment.
Given this importance, a Sensory Profile can reveal high neurological threshold scores for movement processing which may be related to proprioceptive hypersensitivity. They go on to say that it is possible associated differences in the cortical organization and integration of information of the brain occurs in some persons with autism; thus explaining inconsistent patterns of motor performance.
46% An unacceptable sensory experience can force the system to vomit up, all over oneself. Parts of the body seem to spin, swirling like in an Alice in Wonderland vortex, unhinging one from the planet of self.
70% Most autistic children are trying to stabilize themselves so you have to help them – if you don’t help them they’ll help themselves, and if they are left to help themselves they are probably going to choose something like repetitious sensory behavior.
REFERENCES used here are:
Fuentes, C., Mostofsky, S., & Bastain, A. (2010). No Proprioceptive Deficits in Autism Despite Movement-Related Sensory and Execution Impairments; Journal of Autism Developmental Disorders, V41; p1352-1361.