Introduction
This book is filled with an abundance of fun, hands-on activities for children. The activities will help reduce symptoms of sensory modulation disorder (SMD), and at the same time induce pleasure. The activities, crafts, poems, recipes and exercises within these pages are intended to bring a big smile to the face of the sensory child and allow her to relax and think—and feel—that “Life is good!”
This book aims to increase the sensory regulation skills of children with SMD and children with autism spectrum disorder (ASD). The book’s four key approaches are to:
1. Educate the sensory systems of children with ASD via a six-month protocol created by Woo & Leon (2015) called Environmental Enrichment. This protocol, detailed and annotated in this book, has been found to be effective in children with ASD. The protocol trains the child’s brain to recognize and utilize multi-sensory environmental input including touch, smell, sound, vision and balance. In one study (Woo, 2015), 21 percent of children who completed the protocol shed ASD symptoms to the degree that they lost their ASD label (although they retained enough symptoms to still be on the spectrum.) Other children who did not lose their label still made significant gains in reducing the severity of autism.
2. Desensitize the child with SMD and ASD to noxious environmental input. Several specific desensitization techniques are covered in the book, with examples in the areas of sound, touch, taste and smell sensitivities. There is also a general discussion of desensitization that will help the reader to adapt these techniques to other areas.
3. Immerse the child in pleasant sensory input. The book provides fun, sensory-based activities that give him the sensory input he needs. At the same time, the child is taught skills that are useful for establishing sensory-based hobbies through engagement with the sensory aspects of a variety of materials such as clay, yarns, metal and music. Activities include several long projects that can be completed over several weeks, as well as multi-sensory projects.
4. Regulate the child through intensive exercise. The book contains fun, yet strenuous movement activities designed by Jasmine Ma and appropriately named FUNtervals. Instructions for creating your own FUNtervals are also given.
Why is an enrichment program important? Studies indicate that between five to sixteen percent of all children have significant problems processing sensory input, to the degree that they qualify for a diagnosis of SMD. That percentage compares to that of children diagnosed with attention deficit hyperactivity disorder (ADHD), yet SMD doesn’t receive the same attention because children with SMD tend to be better behaved and have better functional skills in the classroom.
SMD symptoms include a combination of oversensitivity to sensory input, undersensitivity to sensory input, and may also produce cravings for certain sensations. The symptoms vary with the child. Children with SMD struggle to keep body, mind (attention) and emotions self-regulated. For a sensitive child, the symptoms can be acute and very disturbing. Environmental sounds, physical touch, and internal sensation such as pain and temperature register acutely in the brain and can sometimes provoke a fight-flight response. The opposite is true for the undersensitive child who misses out on some of the pleasures in life and is at higher risk for injury. Pain expert and fibromyalgia researcher, Dr. Dan Clauw, compares sensory sensitivity in the brain to a sound system in which the amps are turned up too loud. Similarly, we can think of undersensitivity as amps that are turned down too low. It goes without saying, a child with these symptoms is often an unhappy child—and perhaps quite cranky, too. Fortunately, as that child gets older, she slowly learns to live with the amps turned up or down. And around the age of eight, her abstract reasoning skills emerge and she is able to develop coping strategies. She knows when and where not to pick battles about the things that irritate. She also tends to suffer in silence when she has no control over her environment.
While we don’t have a cure for the symptoms that plague children with SMD, there’s much we can do to reduce symptoms and help children live with them. In fact, life with SMD is not all bad. The person who is oversensitive to noise, for example, is also very sensitive to music and might experience a wonderful sense of joy from listening to it. The person who craves sensation might find a career as a cook, artist or mechanic. And the person with undersensitivity might become laid-back and more immune to life’s stressors.
The premise of this book is that the sensory child can learn to put suffering aside and be happy and well-regulated. To that end, this book provides techniques to help desensitize the child to touch, taste and sound, and to give the child who craves sensory input activities that immerse him in pleasant sensory sensation, helping him to be at ease.
This book also provides techniques to improve sensory functionality of children with ASD. Lane (2014) found that 62 percent of children with ASD have moderate-to-severe sensory processing problems. Ten percent of these children have sensitivity to body sensation, including issues with posture and core strength; 40 percent have extreme taste and smell sensitivities; and 12 percent have overall sensory dysfunction. As well, most children with ASD have difficulty processing speech, especially when competing background noises are present. They also crave touching things. Sensory symptoms in a child with ASD can be so severe as to compromise basic sensory function. For example, a child may have extraordinarily sensitive touch, or poor registration of temperature or pain.
Sensory symptoms can interact with and exacerbate symptoms of autism such as poor joint-attention and poor attention to environmental cues, resulting in the child fixating on objects such as fans and clocks and not performing work in the classroom. For children with autism, poor attention to the environment might also cause a fight-flight reaction when something unexpected happens. Their poor verbal skills make it difficult for them to let others know their displeasure with bright lights, loud noises, or someone touching them. Poor verbal skills also limit their ability to assume functional control in those situations. This, in turn, may lead to behavioral overreactions. Adults may then inadvertently address the behavior, leading to unsatisfactory outcomes, rather than the underlying sensory factors.
To improve such a child’s ability to process environmental input, we must first build a foundation for him by training his brain to recognize basic sensory input such as: this is warm; this is cool; this is hot; this is cold. A program for building that foundation exists, and it has been found to be quite effective for children with autism, helping them to shed symptoms of autism and improve sensory processing and verbal reception skills. The program, Environmental Enrichment, is detailed in this book. The program is an excellent first step in educating the senses. Again, it does not resolve all symptoms of SMD, but improves them. Children doing the program will also benefit from the techniques mentioned earlier, namely desensitization and immersion in sensory activities (Woo, 2013, 2015).
Sections and Chapters
The book comprises three sections that cover these topics: 1) information for the therapist, teacher and parent regarding sensory modulation and tips for working with children with SMD, 2) a complete implementation guide for the Environmental Enrichment protocol (for children with ASD), and 3) fun techniques for helping children work through symptoms of SMD. Below is an outline of those sections and the chapters within them.
The first section covers the basics of doing sensory-based interventions with children, including children with autism.
Chapter 1 provides foundational information about the senses, including how to screen for SMD, the types of problems that can occur, and general techniques for working with children with SMD.
Chapter 2 discusses the ten core elements for providing good interactive training to a child. The elements were identified by leading sensory experts as being especially effective for children with SMD or the overarching disorder, Sensory Processing Disorder. They are also helpful in guiding interventions for all children.
The second section is devoted to providing the Environmental Enrichment protocol to children of all ages with autism.
Chapter 3 provides background about the Environmental Enrichment program. Two variations are offered, a short version with 15 enrichment exercises, and a long version with 34 enrichment exercises. The two versions are individually described, and compared and contrasted. Instructions for performing the protocols are included in this chapter.
Chapter 4 details each of the 34 enrichment activities along with the materials list. In addition to Woo and Leon’s protocol outline, there are activity instructions, photo illustrations and graded (both easier and harder) alternate activities designed by the author.
Chapter 5 contains additional foundation activities in the areas of speech, movement and emotions that can be done alongside the Environmental Enrichment program.
The third section covers the topic of sensory enrichment for children with and without autism.
Chapters 6 – 9 contain activities for touch desensitization and touch immersion; taste desensitization and scent immersion; sound desensitization and sound immersion; and visual immersion, respectively. The underlying goal is to regulate the child and to introduce him to the pleasures that can be had from his sensory systems. Each topic area begins with simple activities that teach basic sensory skills and craft skills. Activities become more complex and can involve long projects, such as making a 20-inch monkey from yarn and a multi-sensory sensory indoor planter.
Chapter 10 contains several intense movement activities, and it spells out how to create others. Included are several FUNtervals, the story-based high-intensity interval training routines that were developed by kinesiologist Jasmine Ma (2013, 2015).
Chapter 11 contains instructions for longer, more complex sensory immersion activities described in chapters 6-9.