Sensory issues are a common characteristic in children with dup15q. Parents frequently report their child with dup15q experiences sensory modulation disorders. These sensory modulation disorders disrupt the affected child’s ability to achieve and maintain an optimal range of arousal and to adapt to challenges in daily life. These disorders are often manifested by an over-responsiveness or under-responsiveness to sensory input or fluctuations in response to sensory input.
In her research study Molecular Investigations of Chromosome 15q Duplications in Autism, Dr. Carolyn Schanen asked parents to report on the sensory behavior of their affected children. Approximately half of the kids had some degree of sensitivity to sound and about 65% of them had other sensory aversions at some point in time.
Physicians may order the following evaluations to help better diagnose and treat the individual.
Referral to occupational therapy to evaluate for any sensory processing concerns. There is not one evaluation or test that can tell definitively if an individual has a sensory processing disorder. Many of the assessments used will rely on clinical observation and parent questionnaires to help guide treatment.
Sensory Modulation Disorders
Most individuals with sensory modulation disorders have a combination of both sensory defensiveness and sensory dormancy, depending on the event, circumstance, type of sensory stimuli present, and familiarity with the environment.
Sensory defensiveness is a constellation of symptoms that are a result of defensive reactions to environmental stimuli, across one or more sensory modalities. It is an over reaction of our normal protective senses.
Individuals with sensory dormancy are, generally speaking, under-responsive to sensory input or lacking sensation and awareness and display an inability to orientate to relevant sensory stimuli. Decreased sensory awareness usually results in deficits in motor planning (dyspraxia) and in motor control.
The overall effect is an inability within the individual to adapt to changing environmental demands or situations. This affects the ability to attend and behave appropriately and interferes with learning.
Treatment Strategies to Promote Improved Sensory Modulation:
Activities and strategies for providing proprioceptive input and increasing body awareness:
- Compression vests and shorts to provide maintained deep pressure and to increase body awareness.
- Ankle/wrist weights for added resistance and to increase body awareness.
- Weighted vest, weighted blanket to provide calming and body awareness.
- Pushing/pulling activities such as furniture moving, carrying books, tug of war.
- Passively applied deep pressure through squishing games, resisted creeping and rolling games.
- Controlled jumping and falling games.
- Stair climbing.
- General core strengthening activities to improve muscle tone through trunk.
Activities that provide vestibular stimulation and increase body awareness (without the use of suspended equipment):
- Mini trampoline jumping
- Hammock swinging
- Rolling, spinning
- Bouncing on large ball
- Jumping and controlled falling
- Scooter board games in sitting and lying
Strategies for improving regulation and attention (to be used under the direction of a trained professional)
- Wilbarger brushing program. This program consists of brushing followed by joint compression to reduce sensory hypersensitivity.
- Therapeutic Listening and other listening therapies can easily be incorporated into a sensory diet/home program to improve regulation, posture and auditory processing.
- Provide a small get-away area made from an appliance box or collapsible cube. Provide quilts and pillows. This or something like it can be used as a “get away” area when a individual needs to re-group.
A Word about Sensory Diets….
Sensory diets provide the individual with the needed sensory input at regular intervals throughout the day to meet their sensory needs. It is optimal when these diets can be implemented in both the home and school setting. When developing a sensory diet the following systems should be examined: touch, vestibular, propricepitve, visual, auditory, smell, taste, body position and movement. In addition, consider the possible impact of allergies, GI issues, sleep patterns and nutrition. Therapists are encouraged to work with both families and school staff to help caregivers and educators learn how to implement a sensory diet. Ideally therapists can provide frequent and ongoing monitoring and adjustments of the individuals’s sensory diet as needed. The critical features of a sensory diet include:
- Sensory activities that meet the sensory needs of the individual.
- Easy to fit into daily routines.
- Are manageable for family and individual.
- Are effective in reducing undesirable behavior and/or increasing desirable behavior.
- Need to be changed and adapted as the individual’s sensory needs change.