7 x 10
Appendix
Common classroom modifications for sensory modulation disorder (SMD): Rationale and effect on adaptive response
Rationale and effect on adaptive response
| Strategy | Rationale | Benefit and effect on adaptive response |
|---|---|---|
| Dynamic cushion | Wedge-shaped: allows child-generated minor movement in linear front to back plane (some bounce) | Increases proprioception and thus arousal; suits degree of movement to child; enhances attention; extends work endurance; outlet for sensory-seeking behavior; use on floor to delineate child's space, increasing comfort in group(placing child at periphery can be more tolerable to overresponsive child); increases intensity of sensation |
| Disc-shaped: allows child-generated variable movement in all planes; heavy work to postural core; can be used on chair or floor | ||
| Rocking chair; glider | Child-generated, rhythmic, linear movement | Child adjusts movement intensity to calm or alert; enhances attention; extends work endurance during quiet times(silent reading); delineates space; provides respite when child needs a break |
| Cube chair; booster seat; armchair | Provides tactile boundaries around child's body | Provides constant, predictable pressure touch for calming(especially if padded); delineates space on floor; increases duration of sensation |
| Small inner tube | “Cradles”child when seated on floor | Provides constant, predictable pressure touch for calming; child-generated movement as tolerated; delineates space on floor; provides respite |
| Therapy ball | Can be used as alternative to desk chair; provides child-generated movement in multiple planes; can be used for universal support to whole class.Variations for floor: inflated“animal seat,”inflated stool,bolster,peanut-shaped ball | Rock for calming; bounce for alerting; extends work endurance and attention to task; outlet for sensory-seeking behavior; adjusts intensity frequency,duration |
Environmental Modifications
| Strategy | Rationale | Benefit and effect on adaptive response |
|---|---|---|
| Modify walls | Limit decorations and/or hangings to include at least one“neutral”wall; paint with calming colors(blues and/or greens) | Calms visual environment;removes distraction;enhances attention;prevents gradual escalation of arousal |
| Modify lighting | Turn fluorescent lights down on sunny day;include lamplight;use“daylight”bulbs or full spectrum lighting | Reduces harsh light;calms visual environment;enhances attention;may increase work duration;prevents gradual escalation of arousal;flashing lights may be intolerable to overresponsive child |
| Modify sound | Provide background music to suit needs of student;provide movement break;provide rhythm;provide warnings of loud sound(fire drill) | Provides calming or alerting auditory sensationCalming:quiet,nature sounds;beat-per-second rhythms;predictable;moderation of teacher voice;“silent clapping” |
Wearables
| Strategy | Rationale | Benefit and effect on adaptive response |
|---|---|---|
| Weighted vest, shoulder“snake”or lap pad; weighted backpack | Increases proprioception and deep pressure touch | Calms and/or organizes for self-regulation; increases attention and adaptive response; limits sensory-seeking behavior; weighted back-pack can be worn during transition times between classrooms to organize the overresponsive or sensory-seeking child; regulates intensity, duration |
| Spandex or Lycra clothing; bike shorts; pressure vests | Increases deep pressure touch | Calms and/or organizes for self-regulation; regulates intensity, duration |
| “Body sock”or Lycra wrap | Increases deep pressure touch；“heavy”(resistive) work | Calms and/or organizes for self-regulation; respite activity; can be incorporated into classroom movement games; social engagement |
| Hooded sweat-shirt; soft, worn, or all-cotton clothing; seamless socks; tags removed | Increases warm and/or tolerable touch; hood allows for occasional“escape” | Calms and/or organizes for self-regulation; eliminates sources of nonhabituating tactile sensation that can distract the overresponsive child and escalate behavior |
| Headphones | Provide soothing or alerting sound or no sound; filter or eliminate ambient sound via general noise reduction | Calms, alerts, or organizes for self-regulation; provides respite from multiple sound environments of classroom; increases attention to task; may improve test taking; eliminates source of nonhabituating auditory sensation |
Routine
| Strategy | Rationale | Benefit and effect on adaptive response |
|---|---|---|
| Early arrival or dismissal | Enables packing or unpacking before group arrives | Reduces likelihood of unwanted physical contact or“chaotic” movement; enables selective attention to arrival and/or dismissal routine; provides a better start and end to the day |
| Movement breaks | Embed regularly into daily routine and learning activities; allow extra as needed | Excellent for self-regulation of all children; enhances learning via the movement-learning link |
| Special assignments | Additional movement breaks (bring attendance to office; hand out or collect papers; stack books; erase board; carry materials bin while walking in line; be door holder, note taker, stopwatch manager) | Creates embedded proprioception and movement for self-regulation; provides respite; provides outlet for sensory-seeking behavior; provides protection from unwanted sensation; promotes self-esteem and confidence |
| Daily schedule | Predictable or novel, depending on child's needs | Predictable for overresponsive child; novelty for underresponsive or sensory-seeking child |
| Visual schedule | Aids predictability of daily events and transitions | Reduces anticipatory anxiety and hypervigilance; facilitates work duration when breaks are known |
Benefit and effect
Strategy | Rationale | on adaptive response
Timers Aid predictability of work session or end of break Reduces anticipatory anxiety; facilitates work duration or end of break
Visual timer for child who processes best through visual channel.