SUNSHINE COAST KIDS THERAPY
Improving learning and developmental outcomes
Backed by extensive experience and training, Sunshine Coast Kids Therapy offers a range of therapeutic approaches, techniques and programmes. Every child's needs are different -here is just a flavour of possible interventions.
THE ASTRONAUT PROGRAM
The Astronaut Program is a therapy tool which uses sound, specific movement and eye exercises to support children who struggle to integrate their auditory, vestibular and visual systems. Numerous studies support the premise of this programme, that vestibular activation can boost functional performance.
The vestibular system helps us with spatial orientation, balance, coordinated movements, eye muscle control, core postural muscle functioning, visual perception and attention/listening. The functioning and integration of the three systems provides a stable mental image from which to move and engage with objects and people, even when we are in motion.
Children who benefit from this programme typically experience prior difficulty with some or many of the following:
Reading (fluency, accuracy, speed)
Handwriting (formation/reversals/spacing/organisation on the page) and copying
Motor coordination for skills such as crawling, walking and more refined motor skills
Over-active and disorganised behaviour
Under-active and passive behaviour
Fear of swinging and climbing at the playground, riding on escalator, a dislike of movement based activity (may appear very passive and lacking motivation to play/learn/engage socially)
Timing and coordination needed in sports and recreational activities e.g. kicking/catching ball
It is provided as one part of clinic based therapy and the child may also be asked to engage in aspects of the programme for short bursts regularly at home (explicit instruction to caregiver is given for accuracy.)
INTERVENTIONS FOR SELF-REGULATION and SOCIAL COMMUNICATION/INTERACTION
Sunshine Coast Kids Therapy uses a range of programmes designed to foster self-regulation and social communication (self-control, attention, impulse and emotional control, getting along with adults and peers) by addressing three critical components: sensory processing, executive functioning and emotional regulation.
Children are taught skills such as: an emotion vocabulary so as to be better able to communicate how they feel, reading other people's non-verbal communication, understanding how their behaviours may be perceived by others and how they might impact on others, insight into events that may trigger their less desirable behaviours, thinking strategies such as learning to match the size of their reaction to the size of the problem, insight into negative and positive self-talk and how these can be used to self-regulate. Your child will be taught what they can do for themselves to reach the “just right” level of neurological arousal/alertness, so that they are at their optimal place when learning, making friends or having dinner with family (calm and grounded)
Therapy draws together cognitive-behavioural, sensory integrative and social thinking concepts.
SENSORY INTEGRATION APPROACH
It is believed that over 80 percent of the nervous system is involved in processing or organising sensory input and many children displaying functional/performance or behaviour difficulties have an underlying sensory processing difficulty.
The SI based therapy approach provides opportunities (through active engagement in play) for varied sensory experiences, which include tactile, vestibular and proprioceptive, with the aim of remediating underlying impairments. It challenges postural, ocular, vestibular, oral and /or bilateral motor control. It assists the child to attain and maintain appropriate levels of alertness through an emphasis on proprioception and deep pressure input.
The activities are selected so as to provide the ‘just right challenge’ (neither too difficult nor too easy) to evoke adaptive responses and success in doing all or part of the challenge.
It is based on the principles supported by neuroscience that neuroplasticity of the central nervous system can be changed by active engagement in sensory rich activities (little change occurs when something is done to you) which is meaningful to the child, purposeful and goal-directed and in which the child has had some say in choosing.
Intervention is aimed at enhancing:
ability to participate in meaningful and satisfying daily occupations
ability to engage with others
ability to expand play, come up with new ideas, be engaged and motivated
self-regulation, emotional stability and organisation of behaviour
academic skills and self-care skills
Handwriting intervention sessions are designed by the therapist to meet the specific handwriting deficits of the child. They may focus on perceptual-motor skills training, cognitive strategies, improvement of neuro-muscular components, sensory-motor training or tackling specific issues such as reversals, letter formation or spacing.
All ages and levels of difficulty are catered for, from those with letter formation struggles to slow writers who may struggle to produce the expected volume or to generate ideas or plans for written pieces of work.
A number of well-regarded multi-sensory programmes are available for use at the clinic, as well as a range of specialist remedial handwriting materials.
Handwriting interventions are designed to complement teaching strategies and approaches used in the classroom. Advice is given on biomechanical, ergonomic and environmental factors which are impacting on the child’s handwriting. Advice on aids/equipment and alternatives to handwriting is given if appropriate.
As writing is a higher level cortical process which is reliant on effective sensory processing, it is not uncommon that the OT will use sensory integration methods and modalities as a bottom-up approach to tackling handwriting challenges (from the grass roots up), where this is indicated, in addition to the above mentioned approaches.
Handwriting sessions are fun, goal-directed and very effective.
This is an evidence based auditory intervention that uses the sound patterns inherent in music for therapeutic purposes. The music has been modulated and filtered (electronically altered/processed using an alternating high and low pass filter, creating a significant contrast between the upper and lower end of the frequencies) to activate certain harmonics for their effect on the nervous system.
There are two modes of delivery:
1. The child listens to microchips containing music which are played using a small MP3 player attached to specialist headphones specifically designed for this programme (loaned to you by the OT).
2. The parent downloads the TL app and rents the music on a fortnightly basis. Again, the music is played through specialist headphones.
Either way, the music is prescribed by the Occupational Therapist for each individual child, depending on their specific presenting difficulties.
The Sounds Headphones can be purchased from www.sensorytools.net.
This programme was adapted from the works of Dr Alfred Tomatis, Dr Guy Berard and Dr Ingo Steinbach (initial pioneers of auditory interventions) and was integrated into a Sensory Processing model by Sheila Frick, an American Occupational Therapist.
Therapeutic Listening can assist the development of:
Sustained attention and greater ability to follow instruction
Ability to filter auditory information and to attend to what is relevant auditory stimuli
Improved performance in noisy environments such as classrooms
Calmer and more organized behaviour
Better postural control, coordination of movements, spatial awareness and motor planning
Oral and tactile sensory sensitivities
Fine motor control and handwriting (through improvements in timing, directionality, discrimination and spatial abilities)
Oral motor/articulation and communication improvements (e.g. initiation of sound play and speech; greater range of nonverbal communication; better ‘timing’ in conversation; greater emotional and verbal expression)
Phonological awareness, reading and spelling skills
Enhanced interaction with peers and engagement with the world
Greater emotional and verbal skills, greater range of facial expressions and eye contact, improved pragmatic use of language
Improved sleep and wake cycles; improvements in toilet training/bed wetting
On what basis does it work?
The function of the ear is to feel and hear sounds and movement through the vestibular-cochlear system.
Auditory information from the Therapeutic Listening music stimulates both the vestibular and the auditory portions of the vestibular-cochlear system, as well as the middle ear muscles that support our ability to attend to goings on in our environment and to organise auditory data.
The vestibular end of the canal processes the lower frequency vibration (movement) and has a strong impact on:
arousal and alertness levels
muscle tone and posture
coordination and motor planning
The cochlear end processes the higher frequency vibration (sound) and has a strong impact on:
processing of higher frequency sound such as speech
discrimination of background/foreground sounds
auditory discrimination (understanding speech sounds) especially in complex environments such as the classroom
How does it work in practice?
It is important to use the specific headphones made for this programme as poorer quality headphones (as might be used for everyday music listening) will negate the therapeutic benefits of the music. This is because:
The Therapeutic Listening headphones pick up the higher and the lower frequencies to capture the full spectrum of sound
The impedance slows down the sound so that it is extremely clear and sharp
The child listens twice a day for 20-30 minutes, whilst actively involved in almost any activity. For example, a child may listen whilst engaging in a core development or respiratory activity from her home programme (as prescribed by the Occupational Therapist), whilst walking the dog or during meal time.
The listening volume is low which means that the child can listen (even in the classroom) and still be aware of the goings on around him. At times the ears need to ‘reach for’ the sound due to the way the music is recorded.
It is important that the programme is used with regular guidance and monitoring from a trained therapist, as the selection of music is highly individualised (unlike other listening programmes) and requires background training in sensory integration.
The child is seen by the therapist every 2 weeks for a review (when a new chip is provided or recommended, the choice of which is based on parental/child feedback and changes that are seen). For children who are attending weekly therapy, the review and music change will happen as part of this appointment, every second week.
Research suggests that the optimum listening time is over five to six months. However, for some children a ‘boost’ is all that is needed and results are seen much sooner. Conversely, others continue to listen for much longer as part of an ongoing sensory diet/therapeutic management programme.
For more information, a summary of the existing research evidence and an explanatory short video please visit the Therapeutic Listening website: www.vitallinks.net
Treatment of sensory processing challenges is based on the notion that functional abilities and emotional/behavioural regulation can be strongly influenced by the amount and type of sensory input that the child is regularly exposed to.
A ‘Sensory Diet’ of daily activities is a very effective way to improve sensory processing difficulties, particularly:
Regulation of arousal levels (e.g. a ‘hyperactive’ child with fleeting attention or an under-aroused child who does not seem to register what is going on around him- both of whom are likely to have trouble with on-task behaviour)
Influencing over-sensitivities to certain sensory information (likely to be struggling with meltdowns and /or anxiety)
The clinic uses specialist software to create pictorial and engaging programmes of activities which are highly individualised so that they meet your child’s specific sensory needs.
A Sensory Diet is often likened to taking vitamins or medications: taking them every now and then is not expected to help but taking them daily/regularly is likely to make a big difference. Sensory Diets work best when they are fully integrated into the daily life of the child on a long term basis and become part of his/her ‘lifestyle’. The clinic will provide the tools for you to be able to do just this.
THE WILBARGER DEEP PRESSURE and PROPRIOCEPTIVE TECHNIQUE
The DPPT is a specific method of treating sensory over-responsiveness and regulation/modulation (over-activity or under-activity) difficulties through the use of deep pressure brushing with a specific brush (which is provided by the therapist).
It capitalises on the therapeutic use of the three most important and largest sensory systems- the tactile sense, the proprioceptive sense and the vestibular sense. These three systems, when working properly, are extremely important in neural organization, and are at the core of neurological sensory integration.
Deep pressure is systematically applied by brushing individual parts of the body in a specific way. Brushing is always followed by joint compressions which provide proprioceptive sensory input, and are therefore calming and organising.
There is usually a Sensory Diet in place as a companion to the DPPT, that is, a programme of daily activities which the child does at home/school for short bursts of time and that include vestibular, proprioceptive and specific tactile activities (as prescribed by the Occupational Therapist).
Through the tactile and proprioceptive sensory systems, deep pressure is offered which is calming because it influences the release of both serotonin and dopamine in the brain. These are the ‘happy’ neurotransmitters which help to keep us regulated. Research suggests that these last in the system 90 minutes- 2 hours. If the brushing occurs frequently throughout the day, as the protocol stipulates, then these happy and calming brain chemicals are in the bloodstream consistently and this state becomes the norm for the child. In turn, any existing sensory defensiveness and related anxiety is reduced.
The Center Of Development And Pediatric Therapies in the US (http://developmental-delay.com) say: ‘Proprioceptive input is the best source of sensory input to help keep a good balance of serotonin in the brain which helps regulate all other brain chemistry and keep a neutral and relaxed learning state. Proprioceptive input is the best type of input to help with sensory modulation and regulation disorders.’
The protocol has been widely used in the US, UK and Australia since the 1960s. It used to be called The Wilbarger Protocol (known by some as ‘the Brushing Programme’ or the ‘Therapressure programme’).
INTERVENTIONS FOR DYSLEXIA and STRUGGLING READERS
As part of a wider therapy programme, the clinic uses a range of highly regarded and widely used programmes to address reading, writing and spelling challenges faced by children with dyslexia and other struggling readers. These are structured phonics based multi-sensory programmes which are extremely helpful for children with or without a diagnosis.
As this is not a tutoring service, such programmes are not used by themselves but are used as an adjunct to and in conjunction with therapy for weaknesses in underlying mechanisms- to expand, consolidate and maximise learning. Typically, therapy addresses these underlying mechanisms first, for example ocular-motor control, visual perception, visual memory, vestibular processing, working memory, auditory processing or other. This may then be followed by phonological and phonemic awareness work.
COGNITIVE ORIENTATION TO DAILY OCCUPATIONAL PERFORMANCE
The Co-op approach was developed for children and young people who experience difficulty learning to perform new motor-based skills. It is a performance based problem-solving approach which enables skill acquisition through a process of strategy use and guided discovery.
Any number of motor based skills can be successfully ‘taught’ using this approach, for example handwriting, catching or kicking a ball, cutting with scissors, tying shoe laces, cutting food with cutlery, skipping rope.