“How Does Your Engine Run?” ‘The Alert Program for Self-Regulation jary Sue Williams and Sherry Shellenberger fancy Drees, OTR/L, Occupational Therapist ‘The Primary focus is to help children lea to monitor, maintain and change their level of alertness so that its appropriate to a situation or task. ‘There are eight key concepis used in the Alert Program, We are going to go over them today. They are: ‘Occupational Therapy ‘Sensory Integration ‘Arousal Theory ‘Arousal states or “Engine Levels” Protective Responses of the Autonomic Nervous System Inhibition and Its Relationship to Proprioceptive Input ‘Sensorimotor Preferences “Detective Work” 1. Occupational Therapy ‘A. Occupational Thetapy “isa health profession concemed with improving a person’s ‘occupational performance. In a pediatric setting the occupational therapist deals with children whose occupation are usually players, preschoolers, or students. (Therapy is) ‘based on knowledge of neurology, kinesiology, development, medical diagnosis, and current research.” (From a Parent's Guide to Understanding Sensory Integration, 1991 sil) B. OT's are trained t treat clients holistically addressing their cognitive, emotional, and physical needs through functional, actvity-based treatment,Page 2 2, Sensory Integration A, “Play isthe work ef children. Through play, children learn about themselves and the World around them. When all that they see, hea, and feel make sense to them, _pincess of sensory integration occurs.” (From Sensory Integration International's poster, Children at Work, Ayres Clinic 1991) 3. Arousal Theory A, AROUSAL can be considered a state ofthe nervous system, describing how alert one feels. To attend, concentrate, and perform tasks in a manner suitable tothe situational demands, one's neivous system must be in an optimal sate of arousal for that particular task. (From the Leader's Guide, page 1-5) B, SELF-REGULATION is the ability to attain, maintain, and change arousal appropriately for aask or situation. When difficulties in self-regulation occur, the individoal will have twouble changing the degree of alertness they fel, which in tum ‘will compromise optimal functioning. (From the Leader's Guide, page 1-5) (©. HABITUATION isa decrease in response to repeated stamulation..'his process of habituation i important for adaption tothe envieonment...Not only is this important for survival, but itis oe of the processes that impacts leaming and memory.” D. WE HABITUATE MOST QUICKLY WHEN THE STIMULUS IS: 1) Familiar 2) Weak 3) Very brief or long in duration 4) Presented in quick successionPage 3 E, WE ARE MOSTINTERESTED IN OBJECTS, PEOPLE, EVENTS, AND TASKS ‘THAT PROVIDE: Novelty Complexity Conflict Surprise Uncertainty ‘And that are presented for moderate durations F. “These types of stimuli, if they are distinctive and unique in elation to what we already ‘know and ean process, cause us not only to orient, but to remain interested in leaning. ‘The more novel, complex, and interesting the stimuli are, the longer it takes to habituate to them” From Neuroscience Foundstions of Human Performance, DeGangi & Porges, Chapter 5 4. Arousal States and Engine Levels 5. Protective Responses f the Autonomic Nervous System A. Wilbarger's Chat ~ Sensory defenseiventss, 1, Wibarger, 1991.) B. Note: poor recovery from sensory events.Page 4 6. Inhibition and Its Relationship to Proprioceptive Input A. Brain Picture B. Proprioception is tie information gathered from muscles and joints. Propriaceptive inpatis defined as heavy work to muscles and joins . Some examples of proprioceptive input are pushing and pulling games, lifting and carrying heavy objects, wrestling, playing football, moving furniture, biking, hoeing in the garden, taking out the trash and “tug of war”. More subtle ways pushing hands together, standing and pushing against a desk with hands and arms, stretching, doing a chair push up, manipulating stiff put. D. The same proprioc=ptive input can have both calming and alerting effets, soit can be used on engines either too high or too low. Unlike other sensory inputs, proprioceptive input is rarely ovestoading 1o a nervous system. 7. Sensorimotor Preferences A. Sensory-Motor Preference Checklist, BB. Itis important to know your preferences, but remember they are not universal 8. Detective Work A. The Alert Program provides a framework in which adults can observe and try to determine the purpose behind the student’s sensorimotor behaviors B, Through detective work, adults may assist students in finding appropriate strategies that are tolerable to alSENSORY-MOTOR PREFERENCE CHECKLIST (FOR ADULTS) DIRECTIONS: Ths chek was developed to help adults recognize wha statues thei ow nervous systems employ to atin an ppropriste tt of lene. Mak the eas below tht you use to increase (1) orto decrease (L) your sate of alertness. You might mak bth (74) on some ems, Others yon might nota al ‘PUTSOMETHING IN YOUR MOUTH (ORAL MOTOR INPUT: ink a milesake sack om ard ead “crunch ar euckon ic pieces Tongue in cheek movements “chew "on pei /en chew on coffe swizale sticks “tae sow deep beats “soc, ik bite on your lips or the nie ‘of your cheeks donk catonaed dea -eatacold popsicle ‘MOVE (VESTIBULAR /PROPRIOCEPTIVE INPUT): “rock narcking chit “shift or “squire” inacbair “push cic back 08 2 ees “serbie exercise “isometries weights rock ovn body ligly rab then floor roll ek and head slowly ‘TOUCH CTACTILE INPUT: ‘vi on hai move keys or coins in pocket with your hind “cool shower sam bath receive a massage peta dog oreat rum fingers or pencil on table LOOK (VISUAL INPUT: open window shades afer &horag movin a clnsrom svat place “sate fis ak yah sunset uni sath “ol ad water (©1984 Therapy Woks. In. This page may bere for intracton! se tow gum -erunch 0 nuts / pete his “bie on mal cutie eat popcorn ut up vegetables eatchips nd a spicy dp “smoke cignenes shew on Paton, sweat sings collars nhs while you week ik ote / ea cafes) “trinknotcoeo or waem i voter -siwith crossed eps and bounce ne sighty ron on “ide bk pte, eet oot dance sap pei pea yd work sch shake body pars “other Fidget withthe following pope ips eal als “peel pen -aving or eckace pone cord while aking ‘ut ges ner mouth, ye, nose ‘ow do you eat din ging ‘arescentightng “sunlight through bedroom window when sleeping rode colored om 1"clered desk” when needing to concentleLISTEN AUDITORY INPUT: How do you reset ison to Chasis! Mae torah on achlldoard sistent Hard Rock squeak” ofa mechanical pent steno oters “har” fe siren workin “quiet” om “waking to an unusual noise worn oi" roam dog brkng (almost constantly) -sng oak to sl QUESTIONS TO PONDER 1 Review this Sensory Motor Preference Checklist. Think shout what ou do in a mal ale nner to mntain an speopite let evel hata child with ess matwe nervous sytem may nod to doin lager more intense wa. 2 Notice which ype of emery input ae comforting in your nervous system and which yes of vensory input bother your merous sytem, Ae your items hstered in a ers category of sneoy ipa? 3. Consider bow often (frequency), how bng (ration), how mach Gens, and with what shyt (fst, slow, uneven or ees) you use these ints to change your sta of alertness, 4 When you ae needing to concentrate your work spice, what sensory input do you prefer to work most fen? 8) Whit do you put in or around your mouth? (Example: food drink, gue.) 1) What do you prefer to touch? (Example: clothing, exture of hi, fidgeting with objects, ete.) 6) Whattypes of movement do you we? (Example: rockin chi or movement bea to stetch or wall et) 1) What are your visual preferences? (Example: natural ihting from window, use ofa lamp, eighty colored walls. Are you sn"in” person working bes with our desk clesed aff oan “out” person whose desk pled high with papers ee) ©) What auditory inpat do you use (Example o you listen to music wile you work? Iso, wha typeof bet? Do you lik to ‘al to youself or others and woekat he same tine? Do you prefers quiet environment et) (© 1992, Therapy Works Ine. |AS6-How dou youre rn” (©1994 Trap Wonks Je. Ts ae maybe erode for isto,