The Alert Program (How Does Your Engine Run?) consists of a series of lessons and activities that incorporate sensory integration techniques with cognitive approaches. The program is designed to help children recognize and expand the number of “self-regulation” strategies they use in a variety of tasks and settings. It is important for an occupational therapist with sensory integrative techniques to teach the children, parents, and teachers how to recognize arousal states (levels of alertness) as they relate to attention, learning, and behavior.
“Self-regulation” is the ability to attain, maintain, and change arousal appropriately for a task or situation. Self-regulation involves many neurological connections in the brain. To attend, concentrate, and perform tasks in a manner suitable to the situational demands, one’s nervous system must be in an optimal state of arousal for that particular task.
In the Alert Program, children learn to identify their own level of alertness by using the engine terminology. The child (with the help of an adult at first) will know if their engine level is running high, just right, or low for the activity that they are attempting.
The goal of the Alert Program would be, for example, for a child to recognize that he is in a state of high arousal and to be able to use sensorimotor strategies to calm himself for bedtime.
Source: “How Does Your Engine Run”; Willams, Shellenberger; TherapyWorks, Inc.
Go to www.alertprogram.com for more information.
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Feeding:
Problems with feeding may arise from a variety of causes. When evaluating feeding difficulties, many areas are addressed including postural control, oral motor skills, sensory processing, and environmental factors. Postural control is referred to as a child’s stability throughout his trunk, shoulders, hips, and neck. Postural control provides a stable base for the arms, legs, neck, as well as the jaw and mouth muscles to work from in order to perform their duties. |
Oral motor skills include the ability to manipulate food within the mouth. Just like coordination is required to play sports or for eye-hand coordination, the muscles in and around the mouth must work in a coordinated way to suck, bite, chew, and swallow food. Sensory processing is the ability to use sensory (touch, joint and muscle information, and movement) information for use in activities such as feeding. If a child has difficulty feeling food in the mouth and/or difficulty coordinating the muscles of his mouth, then feeding will likely become an issue. Some children may be hypersensitive to how food feels in their mouth and avoid eating. An occupational therapist will consider how these issues along with environmental factors such as the setting the child is eating in, the utensils or nipple the child uses, and the child-caregiver interaction during feeding to determine the source of feeding difficulty and the action required to improve the development of the child’s feeding skills. |
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Fine Motor and Gross Motor Ability-- A motor skill is an action that involves the movement of muscles in your body. Gross motor skills are larger movements involving the arm, leg, or feet muscles or the entire body — things like crawling, running, and jumping are gross motor skills. Fine motor skills are those smaller actions like picking things up between the thumb and finger, or using the toes to wriggle into sand, or the lips and tongue to taste and feel objects. Gross motor and fine motor skills develop in tandem because many activities depend on the coordination of both kinds of skills. |
Handwriting difficulty may be characterized by the following behaviors:
- seem “tired all the time” because they frequently prop their head on their hands during seatwork in school
- trouble staying between the lines of the paper
- complain of tired hand, fingers, or wrist when writing
- trouble completing writing tasks and keeping up with classmates
- difficulty performing smooth, fluid movements with the pencil
- awkward pencil grasp, or grasp that is too tight or too loose
- avoidance of handwriting or drawing
- illegible writing
- letters are too big or too small
- drawing letters segmentally instead of fluidly
- reversals of letters
Play Skill Development: Children learn through exploring their environment and interacting with the people and items around them. Children who hesitate to explore often have difficulty understanding how to use their body in order to interact with objects such as toys. They may have a limited repertoire of skills such as limiting play to balls or sticks, playing with only familiar toys, or engaging in repetitive play schemes.
Sensory processing difficulties may impact a child’s ability to grade his or her movements to interact appropriately with toys. A child who is underresponsive to sensory information may break toys or crayons because they need more intense information from their skin and muscles to “feel” the toy. A child who is overresponsive to sensory information may avoid playing with toys because the toys may feel threatening to them.
Whatever the reason, difficulty playing with toys impacts a child’s development of fine and gross motor skills, visual perceptual skills, and motor planning skills. These skills provide the foundation for higher learning in order to succeed academically and with daily living activities, such as self-care skills and future career development.
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Self-care skills are important for independence in our daily living. A child begins learning early on how to dress, bathe, brush teeth, and use utensils for feeding. Much of this learning occurs through play and modeling from caregivers. Difficulty with self-care skills often has underlying causes. Foundational skills required for self-care skills include postural control, motor planning skills, visual perceptual skills, and body scheme and awareness to name a few. A child who has difficulty performing self-care skills may take a long time to finish activities, seem like they don’t know where to start, have difficulty orienting their clothing appropriately, or have trouble using tools and utensils. It is important to assess and address these underlying causes in order build the foundational skills necessary to perform self-care skills. |
Sensory integration is the neurological process that organizes sensation from one’s own body and from the environment, making it possible for the body to use that information in order to perform daily activities.
When an individual is so over-sensitive or under-sensitive to things they see, hear, smell, touch, taste, or feel that they cannot function properly in their environment, then dysfunction in sensory integration (DSI) may exist. DSI may be characterized by the behaviors described within each of the following systems. It is important to note that a child may show symptoms in some or all of the sensory systems. An occupational therapist with training in sensory integration will be able to identify sensory integrative deficits and provide the appropriate treatment.
Visual (seeing)
- -Avoids eye contact
- -Has difficulty reading or writing
- -Experiences increased sensitivity to light
- -Frightened by loud noises
- -Has difficulty listening or following directions
- -Is oblivious to noises
- -Avoids getting messy
- -Does not notice when hands or face are messy
- -Irritated by touch
- -Picky eater
- -Picky eater
- -Extreme reactions to strong odors
- -Always “on the go”
- -Avoids playground equipment
- -Spins/rocks self in place
- -Fearful of movement
- -Decreased sense of danger/pain
- -Poor body awareness
- -Rough mannerisms
- -Clumsy
For more information about Dysfunction in Sensory Integration (DSI), visit:
www.spdnetwork.org | www.sinetwork.org | www.sensoryint.com | www.otawatertown.com
Social/Emotional Development:
Most children have a natural drive to interact with other children. However, difficulty or avoidance may have underlying causes that do not involve a shy personality or a loner mentality. Poor sensory processing and poor motor planning skills often impact a child’s ability to interact with other children. A child with poor sensory processing may become overwhelmed by the unpredictable nature of other children and avoid or withdraw from them. Another child may be behind in his or her play skill development and prefer to interact with younger children.
Emotional skills may also be impacted by poor sensory processing or poor motor planning. Children begin learning self-regulation strategies at a young age including sucking on the thumb, carrying a special blanket or toy, or cuddling with a caregiver. A child with sensory processing problems may tantrum or become fearful by what is generally harmless as they perceive the situation as threatening. Caregivers often spend a lot of time trying to comfort their child and avoid anything that may upset the child. A child with motor planning problems may become easily frustrated by what appears to be a simple task. Issues with behavior often develop with difficulty with self-regulation.
Assessment and treatment in the areas of sensory processing and motor planning often help to develop social and emotional skills.
Visual motor processing/integration refers to the ability to use the eyes and hands together (eye-hand coordination). This skill is important for many daily activities and especially with drawing, copying, and handwriting. A child’s academic performance can be significantly impacted by difficulty with visual motor integration.
Articulation therapy refers to what most people think of as speech therapy, and that is correcting how people say their words. Speech develops along a continuum. If your child has difficulty at any stage, a speech pathologist should be consulted.
- 12 – 18 months old
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- uses most vowels and consonants in jargon (sounds like speech, but contains no real words)
- omits final consonants and some initial consonants
- has a few real words, but basically their speech cannot be understood
- 18 – 24 months old
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- using more words than jargon
- can understand approximately 65% of what they say by 24 months old
- starting to say words with beginning and ending sound (for example, “pop”)
- 24 – 30 months old
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- can understand approximately 70% of what they say
- may omit final consonant, substitute one consonant for another, or reduce consonant blends
- 30 – 36 months old
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- continuing to improve intelligibility; now can understand approximately 80% of what they say
- has mastered the consonants p, m, n, w, h
- 36 – 42 months old
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- speech is continuing to become easier for others to understand; sounding more mature
- uses final consonants most of the time
- 42 – 48 months old
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- connected speech is becoming very easy to understand
- has mastered the consonants b, d, k, g, f, y
- 5 years old
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- uses all speech sounds correctly with the possible exceptions of t, v, l, th, j, z, and zh
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Auditory Processing refers to the ability of our brain to process what we hear when our hearing is intact. Children who experience auditory processing disorder will often exhibit some of the following behaviors.
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Earobics is a computer program that is based on 20 years of literacy research. It systematically teaches the critical phonological awareness, listening and introductory phonics skills required for learning to read and spell. The Earobics software provides explicit, comprehensive phonological awareness and auditory processing training for the prevention and remediation of reading and other language-based disabilities.
For more information about Earobics, visit their website www.earobics.com
The Fast ForWord® family of products develops the critical thinking, listening, and reading skills that are necessary for success in the classroom and in everyday life. Based on over 30 years of brain, reading and language research, Scientific Learning’s interactive, adaptive products use patented technology to target the language and reading skills widely recognized as the keys to all learning.
For more information about the Fast ForWord® products visit www.scilearn.com
Friendship Club:
Many children diagnosed with Autism Spectrum Disorder, ADHD, and Asperger’s Syndrome find learning and using social skills to be a very difficult part of living. They do not have the knowledge that most children have of when to say what to whom and how much to say. They must be taught. For the child with ADHD, inattention and impulsivity may interfere with social interactions. For children with Autism or Asperger’s Syndrome, social skill deficits define the condition.
Now in its second year, the Friendship Club at A.C.G. Therapy Center helps children learn these vital life skills. The group of 4-6 children meets two times each week for five weeks. The hour-long sessions are directed by occupational therapists and speech-language pathologists who understand the needs of children with the diagnoses of Autism, ADHD, and Asperger’s Syndrome. The club meetings are designed to provide opportunities for the children to interact with others while learning the “rules” of social behavior and self-regulation.
Language is an organized system of symbols that has meaning and is used for communicating one’s thoughts and ideas with others. Language develops through human interaction and brain development. As children develop language, they learn vocabulary, how to form sentences, and how to use language to interact with others. At A.C.G. Therapy Center, family-centered services are provided by our experienced doctorate and masters’ level speech-language pathologists who evaluate, diagnose, and treat all areas of language.
For more information about language development visit www.asha.org
The Lindamood-Bell Learning Processes (LiPS) program is an approach to teaching reading that is based on development of the sensory-cognitive processes that underlie reading, spelling, visual-motor skills, language comprehension, and critical thinking.
Your child may benefit from this approach to learning how to read, if they have the following characteristics:
- Reading below grade level
- Poor, slow or fatiguing reading
- Reading “steam” for stream, “imagination” for immigration, “claps” for clasp, etc.
- Unorganized and nonspecific writing, and avoidance of writing
- Spelling “gril” for girl, “cret” for correct, “equetment” for equipment, etc.
- Studying spelling words but not remembering them for tests
- Pronouncing “death” for deaf, “flustrated” for frustrated, “pacific” for specific, etc.
- Missing the main idea of a passage and remembering few details
- Difficulty organizing their language, relating information out of sequence or off the topic
- Difficulty in conversation responding relevantly and thinking logically
- Being labeled “poor listener”
- Following only parts of directions
The term oral motor ability relates to the strength, movement and coordination of the muscles and structures of the mouth. Because we use the same muscles for speaking and eating, inability of these muscles and structures to work properly may impact both. Oral motor difficulty may be associated with certain speech disorders (apraxia, dysarthria of speech, etc.) and medical conditions (Down syndrome, cerebral palsy, etc.).
Go to www.cherab.org/information/speechlanguage/oralapraxia.html for more information.
The Picture Exchange Communication System (PECS) is a system for communication that trains individuals to exchange a picture for a desired item or action. Often, children who are unable to speak are unable to express their wants and needs or express their wants and needs in socially unacceptable ways. Using this system, children can be taught to communicate by exchanging a picture for a desired item or action.
For more information and additional links go to:www.childrenwithspecialneeds.com/pecs.html
Stuttering is a communication disorder in which the flow of speech is interrupted. These are considered moments of stuttering and may be characterized by repetitions (mi-mi-mine), prolongations (mmmmine), or inappropriate stopping of the air or voice (no sound) of sounds and syllables. Unusual facial and body movements may also be associated with the effort to speak.
Go to these websites for more information:
www.nsastutter.org/
www.stutteringhelp.org/