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Book: Montessori Strategies for Children with Learning Differences

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Book: Montessori Strategies for Children with Learning Differences

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by Joyce S. Pickering with Sylvia O. Richardson

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Article: Montessori Practical Life Activities for Sensory Processing Disorder

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Article: Montessori Practical Life Activities for Sensory Processing Disorder

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This is a four part series highlighting Sensory Processing Disorder ...
Montessori Education for Children with Sensory Processing Disorder
https://montessoritraining.blogspot.com/2010/04/montessori-education-sensory-processing.html
Observing Sensory Processing Disorder in the Montessori Classroom
https://montessoritraining.blogspot.com/2010/05/montessori-education-sensory-processing.html
Montessori Sensorial Activities and Materials for Sensory Processing Disorder
https://montessoritraining.blogspot.com/2010/05/montessori-education-sensorial.html
Montessori Practical Life Activities for Sensory Processing Disorder
https://montessoritraining.blogspot.com/2010/05/montessori-education-practical-life.html

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ADHD is a neurobiological disorder that interferes with a person's capacity to complete tasks and regulate activity. Inhibition control - the ability to filter out extraneous information - can also be impaired. Because the minds of children with ADHD are bombarded with sensory input that they are unable to inhibit, they absorb it all.

There are 3 types of ADHD ...

INATTENTIVE

normal or above average intellectual ability

can sit still

erratic attention, focus, concentration

difficulty finishing a task

easily distracted

tendency to lose things

daydreams

hops from task to task

disorganized

trouble following instructions

forgetful

HYPERACTIVE / IMPULSIVE

normal or above average intellectual ability

hard to be still

noticeable from birth

fidgets

may interrupt others frequently or speak at inappropriate times

hard to wait their turn

COMBINED

experience traits of both inattentive and hyperactive ADHD

(Montessori Strategies for Children with Learning Differences)

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How to Meet the Needs of Children with ADHD in a Montessori Environment

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How to Meet the Needs of Children with ADHD in a Montessori Environment

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Limiting Choices
Children with ADHD may be overwhelmed with the number of choices available in a Montessori environment.  They may have difficulty choosing work and working productively. A guide may help with this by limiting choices to one area or even just one shelf at a time to help the child focus.
Developing attention
To help children with ADHD develop their attention, guides should model a still posture, talk slowly, maintain eye contact, and at times gently touch the child's shoulder. During the lesson, the guide may say the child's name or say "look" to improve focus.
Checking in
A child with ADHD may benefit from showing the guide their completed work before restoring it to the shelf. The teacher can remind the child how to restore their work if necessary, then ask what the child would like to work on next.

The goal in offering these supports is to help the child to make choices, focus on work, complete a work, and restore the work to its place. As the child develops in these areas, the guide offers less support until the child is able to complete a work cycle independently.

(Montessori Strategies for Children with Learning Differences)

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During the Silence game, children practice inhibition of movement and sound. This requires a great degree of self-control for the young child. Because children with ADHD have difficultly with inhibition control, this is a great exercise to help them to improve focus and develop that control.
The Silence game also helps the children to develop body control and awareness, to develop auditory skills, and to develop attention.

(Montessori Strategies for Children with Learning Differences)

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On my role as a model for my students ...

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On my role as a model for my students ...

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It is important that I notice and reflect on the way that I speak, react, and move around the classroom because my demeanor sets the tone for the classroom.
If I am to help children with ADHD develop focus, attentiveness, calm, etc; I must model these attributes.

My voice should be calm and my words intentional.
I should get at the child's level and make eye contact as I speak to them.
I must move about the classroom gracefully.
When children have outbursts or exhibit inappropriate behavior, I have to remain calm when speaking with them and ensure that I am treating them with dignity and respect.
I must closely and purposefully observe children exhibiting signs of ADHD and modify my interactions with them to meet their needs in necessary areas as they develop the independence.

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The first step in helping a child with ADHD or a Sensory Processing Disorder is observation - to  to identify symptoms of ADHD or to pinpoint the sense that they are either avoiding or seeking. I can then plan and offer supports and sensorial experiences within the classroom to meet their needs.

I find it interesting that children with Sensory Processing Disorders are often suspected of having ADHD.

Both children seeking sensory experiences and children with ADHD may have difficulty sitting still and may engage in rough play. However, children with a Sensory seeking disorder will often calm or focus when given sensorial input.
Sensory Processing Disorder is a condition in which a child has difficulty receiving and responding to sensorial input.

Because many of the symptoms to both ADHD and Sensorial Processing Disorder are similar or overlap, it is essential to observe the child to determine which, if any, of these disorder the child may be experiencing.

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(The Ultimate Guide to Sensory Processing Disorder)

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Sensory Modulation Disorder
"difficulty regulating responses to stimuli"

Sensory Over-responsive: very sensitive to sensory stimuli, exhibits sensory defensiveness, avoids sensory sensations

Sensory Under-responsive: takes a lot of stimuli to get a response, difficulty regulating force of movements, difficultly with body awareness, high pain tolerance

Sensory Craving: seeks sensory stimulation - touching, mouthing, moving, crashing, jumping

Sensory Discrimination Disorder
"difficulty interpreting specific qualities of sensation"
Can affect one or multiple senses

Sensory-based Motor Disorder

Postural Disorder: decreased muscle strength, balance, control, and posture

Dyspraxia: "Child knows purpose of task but cannot organize motor actions"

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Article: The Ultimate Guide to Sensory Processing Disorder

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Article: The Ultimate Guide to Sensory Processing Disorder

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https://harkla.co/blogs/special-needs/sensory-processing-disorder?utm_source=pinterest&utm_medium=social

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Did you know that there are actually 8 sensory systems in your body, not just 5?

Our bodies take information in through sensory systems:

1. Auditory - sound/hearing

2. Visual - sight

3. Olfactory - smell

4. Gustatory - taste

5. Tactile - touch

6. Vestibular- movement

7. Proprioception - input from muscles and joints

8. Interoception - internal sensors indicating physiological conditions

Sensory Integration is the process your central nervous system goes through when it takes information in from your body's 8 senses, processes that information, and then responds accordingly.

What is Sensory Processing Disorder (SPD)?

When one's central nervous system has difficulty processing any of this sensory information, the body's responses are atypical and can be observed in motor, language, or behavioral skill difficulties. Occupational therapists diagnose these atypicalities as Sensory Processing Disorder or SPD.

When we talk about Sensory Processing Dysfunction (SPD), occupational therapists diagnose 3 subtypes of SPD:

Sensory Modulation Disorder

Sensory-Based Motor Disorder

Sensory Discrimination Disorder

It is likely that people with sensory processing dysfunction demonstrate a combination of symptoms from the subtypes, however, a trained OT will know how to address the different deficit areas in Sensory Integration Therapy.

If you're a parent struggling to understand how your child's sensory system works, what it all means for your everyday life, and how to help, we've tried to outline some of the basics to help you make "sense" of it all! And, since OTs often use visuals to help with SPD kids, we've put together a visual of SPD just for you!

1) Sensory Modulation Disorder (SMD)

The STAR Institute defines Sensory Modulation Disorder as "difficulty regulating responses to sensory stimuli." The magnitude of these sensory processing difficulties affects key areas of daily functioning and, for many children, it affects their ability to purposefully interact and engage because their arousal level and level of alertness is affected!

Sensory Modulation Disorder is further split into 3 categories or types based on those atypical responses: Over-Responsive, Under-Responsive, and Craving/Seeking.

SMD Over-Responsive Type - (SMD-SOR)

Child has a low threshold for sensory stimuli - meaning, it doesn't take much for them to be overwhelmed, overstimulated, irritated, or avoidant. This child is very sensitive to sensory stimuli. Play, exploration, safety, and comfort are all affected because of this over-responsivity to sensory input. Sensory defensiveness is seen in any or all sensory systems. Child avoids or becomes irritated by sensations (fight, fright, flight response). SMD is seen to affect social, emotional, and behavioral areas.

SMD Under-Responsive Type - (SMD-SUR)

Child has a high threshold for sensory stimuli - meaning, it takes a lot of sensory input to get him to respond as compared to the typical person Child does not attend or respond to sensory stimuli in his environment Can appear passive, quiet, or disengaged Child may appear clumsy, have difficulty with body awareness, have a high pain tolerance/no pain response, difficulty understanding temperature gradations (hot/cold) Difficulty regulating the force or volume of movements.

SMD Sensory Craver (SMD-SC)

The child often looks disorganized as they seek more sensation. Child seeks constant stimulation, an intensity of input - jumping, crashing, bouncing, touching, moving, mouthing...however he can get the sensory input he's seeking! Unsafe, extreme sensory seeking behaviors Happiest in busy, stimulating environments.

A child with SMD-SC can be referred to as a "Sensory Seeker".

2) Sensory Discrimination Disorder (SDD)

Close your eyes, put your hand in your pocket or handbag, and feel around for your keys. Did you find them or did you touch upon that old gum wrapper? How do you know what's what? How do you know how far and in what direction to reach, how to pull your hand out, or what material you were touching?

Better yet, how do you know what is your car key versus your house key without opening your eyes? Now put on a pair of gloves and try again.

Were you as successful in finding what you needed without using a secondary sense of vision? It's unlikely!

You may not realize it, but every day you use a combination of discrimination senses to help you navigate your world - in this case, you just used your proprioceptive and tactile discrimination senses to help you find what you needed without your eyes!

Sensory Discrimination Disorder can happen in any of the eight sensory systems. Here are some characteristics or common observations with SDD:

Difficulty interpreting or giving meaning to the specific qualities of sensation. Trouble detecting similarities and differences among sensory stimuli. Difficulties in daily routines and activities. Difficulties with motor planning. May be awkward with gross and fine motor skills. May appear inattentive to people and objects in their environments.

3) Sensory-Based Motor Disorder (SBMD)

Sensory-Based Motor Disorders are manifested by difficulties with balance, motor coordination, and motor tasks. There are two subtypes of SBMD: postural disorder and dyspraxia.

SBMD Postural Disorder

Low muscle tone, decreased balance, decreased motor control; bilateral movements, ocular motor control, oral motor. Child's decreased muscle strength affects postural control (sitting, standing with balance) in order to do higher-level skills with control.

SBMD Dyspraxia/Motor Planning

Child appears clumsy or awkward. Child knows the purpose of the task but cannot organize motor actions to solve the motor problem - planning, sequencing, problem-solving. Prefers familiar activities (novel activities require too much motor planning). Frustrated easily. Gross motor delays may be more evident than language or fine motor delays.

What is a Typical Sensory Processing Disorder Treatment?

If you believe your child may have sensory issues, then the best place to start is with your pediatrician. They'll typically refer you to an Occupational Therapist (OT) to work on ways to improve your child's sensory responses, to get them in "just the right" state.

Once you're working with an OT, they'll typically start working with you to implement a Sensory Diet.

What Is a Sensory Diet?

A sensory diet is a treatment plan filled with sensory activities that are tailored to your child's specific needs. The idea is to get the body and brain into a "just right" state of arousal.

Children with sensory processing challenges typically need more input than they receive on a daily basis, which is why we see "behaviors". These children are oftentimes labeled as the "naughty" or "bad" kids.

A Sensory Diet is designed to give the child the input they need, at different times throughout the day for specific activities -- school, homework, meal time, and bedtime. The idea is to incorporate these different physical and sensory activities into the daily routine, throughout the day.

They need to be fun and motivating to the child -- so the child doesn't refuse but instead feels HAPPY and CONFIDENT. We want the child to recognize how great they feel when they are regulated and how beneficial these activities are for them.

If you want to dive deeper into Sensory Diets, we wrote The Ultimate Guide to Sensory Diets - Activities, Templates, and More.

Think you're ready to implement a sensory diet at home? Or are you an OT or COTA looking to expand your sensory diet tool box?

Learn more about our Sensory Diet Digital Course!

Takeaways and Tips

There's a lot to know about the ins and outs of sensory processing. This guide is not meant to diagnose your child's sensory processing disorder, it is intended to help you begin an informed conversation with your occupational therapist about some of the sensory behaviors that are causing you to seek professional guidance.

Be sure to reference the STAR Institute Website for more information on sensory processing and check back with Harkla for more information to advise you in Sensory Integration Therapy!

If you found this article useful, you may like our other articles about Sensory Processing Disorder:
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The Ultimate Guide to Sensory Processing Disorder

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This guide will help you understand Sensory Processing Disorder, also known as sensory modulation disorder, so you can figure out what to look for and how to approach therapy with an informed background. Learn the types of sensory disorders to better understand what help your child needs.

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A sensory diet is an action plan with activities to target the specific sensorial system affected. These activities give children the sensorial experience that they are seeking. These are often created by Occupational Therapists. Montessori guides should work with therapists be advised on implementation of these plans in the classroom.

This article offers many suggestions to support each sensory system. https://harkla.co/blogs/special-needs/sensory-diets

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Quote on Sensory Modulation Disorder: Over-responsivity

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Quote on Sensory Modulation Disorder: Over-responsivity

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"Imagine the sound of nails running down a chalkboard. You know that feeling you get in your spine? Goosebumps. Maybe your shoulders elevate and you can’t tolerate it for more than a second before you get up and walk away. That’s a good representation of how individuals feel with SPD and sensory processing challenges. That’s why we say empathize!"

(The Ultimate Guide to Sensory Diets)

~ I got the chills just reading about nails on the chalkboard. This analogy really helps me to understand what children with this disorder may be feeling and/or sensing.

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Article: The Ultimate Guide to Sensory Diets

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Article: The Ultimate Guide to Sensory Diets

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https://harkla.co/blogs/special-needs/sensory-diets

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The term "sensory" is all the rage right now on social media and in the classroom. But what does that even mean? Does it apply to you or your child?

What do you need to know about sensory diets to help your child thrive across all environments?

Let's Talk about Sensory Processing Disorder

Are you the person chewing gum or fidgeting with a pen during a meeting at work? Do you ever take a walk or drink coffee to stay alert and make it through the afternoon? Maybe you bounce your feet under the table or have a serious commitment to working out?

When you do these things, you're providing your body with the sensory input it needs to remain focused and attentive throughout the day.
Who would have thought?
It's our natural instinct to regulate and do what we need in order to feel most alert and focused.

For children with sensory processing challenges, they might need more oral input than just chewing gum. They might seem like they're bouncing off the walls. They might refuse to touch "normal" things that could get their hands or face messy. Without exposure to the input they need or refuse, they will likely struggle to demonstrate expected behavior, remain alert, and keep their bodies organized and in control. They might become overstimulated and hide from sensory input as well.

According to the Star Institute, "Sensory Processing Disorder (SPD) exists when sensory signals are either not detected or don't get organized into appropriate responses."

We like to think of these signals as roads throughout the body. When there's a lot of traffic, maybe a traffic jam, and the cars aren't able to efficiently drive where they need to be, it causes quite a conundrum!

Unfortunately, SPD is not a recognized diagnosis in the DSM-5 ... yet! We are hopeful that one day it will be. However, it's important to note that anyone can have sensory processing challenges without an official diagnosis.

If you'd like to learn more about Sensory Processing Disorder, we wrote a longer post breaking it down: The Ultimate Guide to Sensory Processing Disorder

How can you help a child with sensory processing challenges?

The first tool to help children struggling with sensory processing is empathy. Recognizing and understanding that what they're feeling is REAL. They need to feel validated and heard, and they need to know that you're there to help them.

Imagine the sound of nails running down a chalkboard. You know that feeling you get in your spine? Goosebumps. Maybe your shoulders elevate and you can't tolerate it for more than a second before you get up and walk away.

That's a good representation of how individuals feel with SPD and sensory processing challenges. That's why we say empathize!

But we have to remember, EVERYONE has a sensory system and we all process those messages uniquely to our own nervous system!

We like to say, "Put your sensory goggles on!" There are sensory experiences to be aware of in every moment of every day. When you start to see the world with your Sensory Goggles on, you will appreciate the sensory system so much more!

Some people can tolerate other people chewing nearby. Others have to leave the room. Some people can tolerate pumpkin guts touching their hands when carving a pumpkin, others will gag. There's a difference between having some sensory quirks and having true SPD.

Sensory processing challenges will affect each person differently. When a person is "diagnosed' with SPD (remember, SPD isn't a true diagnosis, but more of a description of the person's needs), they often don't recognize or understand the sensory input they need to regulate their body and mind. When a person simply has a sensory quirk or some sensory processing challenges, it likely won't impact their ability to function on a daily basis. They can give their body what they need, such as chewing gum or fidgeting with a pen, like we talked about earlier.

When the sensory challenges significantly impact the person's ability to get through daily tasks, such as getting dressed, eating meals, going to the bathroom, or brushing their teeth, it becomes an issue that needs to be addressed.

When Occupational Therapy Comes into Play

An Occupational Therapist (OT) and an Occupational Therapy Assistant (OTA) will evaluate your child's sensory system and create a treatment plan for the child receiving services. Based on a variety of standardized tests, clinical observations, and rapport building, a sensory diet can be created for the child.

So you've heard the term "sensory diet". But what the heck does that even mean?!

What is a Sensory Diet?

A sensory diet has nothing to do with food!

A Sensory Diet is a treatment plan full of sensory activities which tailored to the child so they receive the specific sensory input they need. The idea is to get the body and brain into a "just right" state of arousal.

If you're familiar with The Zones of Regulation, this would mean being in the Green Zone. Check out The Zones of Regulation! If you use the Alert Program, this would mean being in the Just Right section.

Children with sensory processing challenges typically need more input than they receive on a daily basis, which is why we see "behaviors". These children are oftentimes labeled as the "naughty" or "bad" kids.

A Sensory Diet is designed to give the child the input they need, at different times throughout the day for specific activities -- school, homework, meal time, and bedtime. The idea is to incorporate these different physical and sensory activities into the daily routine, throughout the day.

They need to be fun and motivating to the child -- so the child doesn't refuse but instead feels HAPPY and CONFIDENT. We want the child to recognize how great they feel when they are regulated and how beneficial these activities are for them.

Frequency is important to help the child's sensory system maintain that "just right" state while also not getting overloaded.

Intensity of various activities depends on the child and how much input their body needs.

Sensory Diet activities should:

Be goal directed

Incorporate specific "stops" and "starts"

Incorporate a variety of sensory input including movement and heavy work

Incorporate other senses such as touch, taste, scent, hearing

Be choice based - allow the child to choose preferred sensory tasks

Utilize a visual tool or schedule

The OT and/or OTA can help design a sensory diet specific to the child.

Creating a sensory diet for your child

Children with high arousal levels may need lots of proprioceptive based activities. Proprioceptive input is calming to the sensory and nervous system. Things that involve pushing, pulling, or "heavy work" are considered good proprioceptive input.

Children with low arousal levels may need lots of vestibular based activities. Vestibular input is alerting to the sensory and nervous system. Things that involve swinging, jumping, spinning or running are great vestibular input.

By the age of 10, children can do well with 10-minute breaks about every 2 hours. This means completing a sensory diet routine every 2-3 hours.

Keep track of how the child's affect changes. Are they more focused? More dysregulated? This will help the OT/OTA determine if changes need to be made to the Sensory Diet.

Younger children and those with cognitive impairments may need input more frequently. Sensory Seekers typically need longer breaks- sensory diets with a longer duration- than Over-Responders or Under-Responders.

For more information on the subtypes of Sensory Modulation, check out this podcast episode!

Here's a list of some of our favorite Sensory Diet Activities for each sensory system!

Proprioceptive Input:

Animal walks (bear crawl, seal walk, lizard crawl, frog hopping, etc)

Wheelbarrow walking

Pushing/pulling a laundry basket full of books or toys around the room

Climbing a rock wall

Steamrolling with a therapy ball or cushion

Wearing wrist or ankle weights

Vibration

Weighted blankets

Weighted vests

Vestibular Input:

Jumping on a trampoline

Rolling down a grassy hill

Somersaulting

Tactile Input:

Sensory bins full of a variety of textures (shredded paper, corn, pudding, etc)

Messy play

Vibration

Slime or putty

Auditory Input:
Oral Input:

Chewing gum

Blowing-through-a-straw games

Bubble mountain

Drinking smoothies through a straw

A variety of food flavors- sour, sweet, spicy

Olfactory Input:
Visual Input:

Wearing sunglasses or a baseball cap

Spinning Tops

Eye Spy games

Sand Timers

Games like Spot it

Here's a list of some of our favorite products we use during sensory diets:

For more in-depth information on sensory diets, make sure to check out our podcast and our Sensory Diet Crash Course.

These books are also a must read. They are full of helpful information and activity ideas:

The Out of Sync Child

The Out of Sync Child Has Fun

Helpful Sensory Diet Resources and Tools

Creating Sensory Diet Cards

We love using the Brainworks Sensory Diet creator tool to make specific Sensory Diets for our clients. Simply drag and drop the sensory diet picture card, print, laminate, add velcro dots, and you have yourself a sensory diet! They also have pre-packaged and printed resources to use as well! Here's a free webinar to help get you started!

Sensory Diet Checklist

Keep in mind, your child can have severe adverse reactions to sensory activities without knowing what their sensory needs are. Here's a simple sensory diet checklist you can fill out to learn more about their unique sensory preferences... and yours too!

Sensory Challenges Quiz

Unsure if your child has sensory challenges or not?

We created this Sensory Challenge Quiz to see if your child may have sensory challenges which a sensory diet may help with!

Sensory Diet Digital Course

If you're really ready to dive deep on Sensory Diets then our sensory diet course is a great place to start.

We run you through the different types of sensory inputs and how to tell which one your child needs right now. This is the best way to start implementing a personalized sensory diet at home for your child.

Or, if you're an OT, COTA, or educator looking to expand your sensory toolbox, this course is very helpful for that!

Click here to learn more about the Sensory Diet Course!

Want to Dive Deeper? Listen to Our Podcast Episode on Sensory Diets

Listen & Subscribe on Your Platform of Choice:

Closing Thoughts

Make sure you're working to reach your child's sensory threshold! If they're jumping off the walls and seem out of control, give them a structured activity that gives them that same input, rather than implementing an activity to try to calm them down.

Their sensory system is telling them that they need more input, more jumping, running, crashing, etc. Once you've provided the sensory input and met their threshold, then you can implement more of the 'just right' or 'calm down' activities to regulate their system.

There's no one size fits all approach to sensory diets. It takes consistency and patience to identify if a protocol is working or not. We suggest trying one sensory diet consistently for 2 weeks before modifying it or giving up completely.

Before you start implementing a sensory diet, we HIGHLY recommend consulting with an Occupational Therapist, like we discussed earlier. If your child's sensory challenges are impeding their ability to get through daily tasks, they could benefit from the resources an OT has to share with you.

If you've had success with using a sensory diet to meet your child's needs, we'd love to hear about it!
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Related Sensory Articles on Harkla

If you found this article useful, you may like our other articles about Sensory Processing Disorder:
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The Ultimate Guide to Sensory Diets - Activities, Templates, and More

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Sensory Diets can help kids with sensory processing challenges and SPD. A Sensory Diet is designed to give the child sensory input at different times throughout the day through specific sensory activities. Read this article to learn everything you need to know about sensory diets!

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Many of these resources refer to the book "The Out-of-Sync Child" by Carol Kranowitz. This book explains the challenges of living with Sensory Processing Disorder and offers non-medical ideas for treatment of Sensory Processing Disorder.
I plan to order this book for further research. After reading this book, I would like to create observation forms to be used to intentionally observe for Sensory Processing Disorder and track reactions to adaptions and interventions.

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Both children with Sensorial Processing Disorders and children with ADHD benefit from routines and order.
The Sensorial lessons each follow a very precise and specific routine or procedure. They are carefully ordered on the shelves and beautifully displayed.
Because each of the Sensorial materials isolates one specific sense at a time, a child will not be overwhelmed when completing these lessons. As the children work through these materials, their senses become more and more refined.

(Montessori Sensorial Activities and Material for Sensory Processing Disorder)

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Practical Life Suggestions for Sensory Processing Disorder - Propioceptive Sense

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Practical Life Suggestions for Sensory Processing Disorder - Propioceptive Sense

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The Proprioceptive Sense have difficulty with muscle and joint processing. They struggle to know their "position in space". The following Practical Life activities may help these children to increase attention and refine this sense.

Proprioceptive Processing tasks

transferring buckets of water

transferring jars of sand

filling a wheelbarrow with mulch

moving furniture

scrubbing

pounding / hammering

wall push-ups

rock wall climbing

jump rope

(Montessori Practical Life Activities for Sensory Processing Disorder)

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Quote on the Montessori Environment and Children with ADHD

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Quote on the Montessori Environment and Children with ADHD

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"A Montessori classroom, combined with the needed supports, can provide these challenging children a less restrictive educational environment where they can learn through movement and where they have the freedom to develop self-regulation skills so they can optimize their own working and intrinsic love of learning."

(Helping Children with Attentional Challenges)

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Article: Helping Children with Attentional Challenges

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Article: Helping Children with Attentional Challenges

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https://files.eric.ed.gov/fulltext/EJ1144538.pdf

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"The way of attracting attention is the great preoccupation of all those who educate because one does not receive anything within, if one does not fix the attention upon something. There are means of attracting attention and means of holding it. These are two different things. To attract attention, some stimulus is necessary; to hold it, on the other hand, an intellectual stimulus is necessary, something (on which) the intelligence may work."

(The California Lectures of Maria Montessori)

~ In traditional school, attention is attracted by the teacher and attempted to be held by offering rewards or punishment for sitting still and quiet.
In a Montessori environment, the materials themselves attract the attention of the child. After the guide, shows the child how to use the material, the child's attention becomes fixed on the use of the material. In essence, the material itself attracts and hold the child's attention because the intelligence is at work as the child manipulates the material. This attraction draws the children with ADHD and hold them there. Gradually they are able to hold this attention for longer and longer periods of time.

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Book: The California Lectures of Maria Montessori

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Book: The California Lectures of Maria Montessori

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11% of children ages 4-17 have been diagnosed with ADHD
5-16% of children show signs of a Sensory Processing Disorder
40% of children with ADHD have a Sensory Processing Disorder as well.

~ This year I will have 36 students. Based on these statistics, 4 of my students would have ADHD and 2-6 of them would have a Sensory Processing Disorder.

Common behaviors of both ADHD & Sensory Processing Disorder

impulsiveness

touching of others

frequent movement

distracted

difficulty following multi-step directions

ADHD

impulse behavior regardless of sensorial input

craves novelty and activity, not related to specific sensory input

attention held when presented with constant novelty

does not become more calm or organized with intense sensory input

takes turns or waits for cognitive input rather than sensory

Sensory Processing Disorder

becomes disregulated when provided sensorial novelty

sensory disregulation often occurs at certain time of day or during certain activities

attention held when provided sensory inputs

behaviors are not resolved with ADHD medication

(Is it Sensory Processing Disorder or ADHD?)

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Article: Is it Sensory Processing Disorder or ADHD?

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Article: Is it Sensory Processing Disorder or ADHD?

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https://sensoryhealth.org/node/1114

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There's a good chance you have met a child who matches the following description: impulsive, inappropriate touching of others, inappropriate and frequent movement, distractible, unaware when spoken to, difficulty following multi-step directions. When you met this child, you may have been quick to label them. Here's the question though, what label did you use?

The behaviors listed above are common presentations of both ADHD and Sensory Processing Disorder (SPD). It is easy to see how a child can be mislabeled with one when they may actually be dealing with the other. Even more confusing, they may be dealing with both. They are, in fact, two separate disorders. There are certainly commonalities between the two, but there are distinct differences as well. Before looking at that, it is important to know who we are talking about.

ADHD is now a part of our pop-culture. Characters in TV, books and movies have ADHD and it is part of their story-line. Stop any person on the street and ask them about ADHD and they are likely to say they know someone who has an ADHD diagnosis. On the other hand, SPD does not garner the same recognition as ADHD. Ask that same person on the street about SPD and they may not know what you are talking. Is that because ADHD is more common than SPD? According to the Center for Disease Control (https://www.cdc.gov/ncbddd/adhd/data.html), 11% of children aged 4-17 years in the United States have been diagnosed with ADHD. Statistically, if you put 100 children in a room, eleven of them will have been diagnosed with ADHD. The Center for Disease Control does not keep statistics on SPD. Fortunately, we have research that gives us an idea of how common it is. Studies indicate that 5% to 16% of children exhibit symptoms of SPD (Ahn, Miller et. al., 2004; Ben-Sasoon, Carter et. al., 2009). In that same room of 100 children, five to sixteen of them will have SPD, potentially outnumbering the children identified with ADHD. Equally important is that many of these kids have both disorders. A national stratified sample of children suggests that 40% of children with ADHD also have SPD (Ahn, Miller et. al., 2004). Back in our room of 100 children, four of the eleven ADHD identified children will ALSO have SPD.

So now we know. SPD is statistically a big issue. Bigger, possibly, than ADHD. But the original question remains, what is the difference? On passing glance, it would be easy to say there isn't any, but that would be wrong. Let's use the perspectives of cause and treatment to help explain the some of the differences between the two.

Causes: In very simple terms, ADHD and SPD are both disorders that impact the brain. Both disorders show strong signs of being largely hereditary, but pre-natal, peri-natal and environmental factors have been linked to each disorder. In ADHD, current understanding points to problems with neurotransmitters (not enough dopamine and norepinephrine) and structural abnormalities in the front part of the brain (the seat of judgment and executive functions). This directly impacts the ability to attend, focus, plan, and persist with mental challenges.

The causes of SPD are very different. Recent brain imaging research has demonstrated that children with SPD have abnormal white matter structure in the posterior (rear) part of the brain. White matter is responsible for carrying electrical impulses (information) from one part of the brain to another - it's like the highway system of the brain. The posterior parts of the brain have been identified as where sensory integration occurs. For someone with SPD, the white matter in the posterior part of the brain is not effectively carrying electrical impulses. Important information about the physical world is not being processed correctly as a result. The brain with SPD is using incorrect or partial information as a basis for how it interacts in the environment. The resulting behaviors and responses are maladaptive.

Treatment: It is not surprising that since ADHD and SPD cause very different issues in the brain, the approaches to treating them are also very different. Studies have shown that medication and behavioral management are the most effective formS of treatment for ADHD. Medication is helpful with balancing out the insufficiencies in neurotransmitters. Behavioral management addresses the deficits in executive functioning by teaching skills for the person to learn. This is a "top-down" approach. Physicians and mental health providers who specialize in ADHD typically are the primary providers.

There is currently no medication that addresses the underlying components of SPD. Instead, SPD treatment relies heavily on a "bottom-up approach to improving the impacted neurological systems. Active participation of a person in a structured, sensory-rich environment by a trained occupational therapist provides them with specific, graded sensory inputs presented in meaningful and supportive activities. This kind of sensory processing therapy facilitates improved and efficient neurological responses, eventually leading to overall improved processing in the brain. Additionally, sensory strategies and sensory lifestyle components are used to support the person outside of the treatment session. Sensory-trained Occupational Therapists are typically the primary providers of this type of treatment.

A question OTs are often asked is, "How can you tell the difference between ADHD and SPD?" It's a fair question, given how the presentations of the disorders can look a lot alike. If the person is given ADHD medication and the behaviors improve dramatically, then it is clear that the issues were related to an ADHD presentation. If medication is not an option, or is not a preferred treatment, then we can look at other clinical observations.

ADHD is a more likely diagnosis if a person:

Cannot stop impulsive behavior regardless of sensory input.

Craves novelty and activity that is not necessarily related to specific sensations.

Does not become more organized after receiving intense sensory input.

Waits or takes turns better with cognitive rather than sensory inputs.

Calms or improves attention when presented with constant novelty.

SPD is a more likely diagnosis if a person:

Calms or focuses when provided sensory inputs.

Becomes more dysregulated when provided novelty related to sensory input.

Dysregulation issues seem to follow pattern (occur at a particular time of day, or during particular activities).

Sensory sensitivities and/or craving behaviors do not seem to resolve with ADHD medication.

The tricky part is when a person has both. These are people who still demonstrate significant, functional issues after receiving specific treatment (either for ADHD alone, or for SPD alone). Remember, studies suggest that up to 40% of children who have ADHD also have SPD. In these cases, a collaborative team approach that involves the physician, OT and mental health provider is most effective.

ADHD and SPD may look similar at passing glance, but it is important to remember that they are two different disorders. They have different causes, effect different areas of the brain by different mechanisms, and have different evidence-based treatments. Understanding and sharing the differences between ADHD and SPD helps ensure that anyone suffering from one or both of these disorders gets the proper care they deserve.

If you are looking for SPD treatment for yourself or your child fill out a child or adult intake form now to be treated at STAR Institute Treatment Center or search our Treatment Directory to find services in your area.

STAR Institute for SPD needs your help to raise $30,000 in the month of October.

Donations go to SPD awareness, treatment, and research.

Mim Ochsenbein, MSW, OTR/L has been a practicing pediatric occupational therapist for over 20 years. She has received advanced training in sensory processing (STAR Institute Intensive Mentorships, SIPT certification), listening therapy (Therapeutic Listening), feeding therapy (SOS) and infant massage (CIMI). Mim received her MSW in 2012. Her work with children and youth has occurred in a variety of settings including early intervention, school based, clinic based, mental health and private practice. In her role as STAR Insitute's Director of Education, Mim creates and teaches STAR Institute trainings, oversees SPD University, and provides educational programming and resources for clients and families.

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Is It Sensory Processing Disorder or ADHD?

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There's a good chance you have met a child who matches the following description: impulsive, inappropriate touching of others, inappropriate and frequent movement, distractible, unaware when spoken to, difficulty following multi-step directions. When you met this child, you may have been quick to label them. Here's the question though, what label did you use?

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"Children want to learn from other children. If we support children working together, all children benefit. The child that needs help is the obvious benefactor, but let’s not forget that working with someone helps to solidify your knowledge and provides social and emotional growth opportunities."

(Foundations for Montessori Inclusion)

~ Inclusion benefits everyone in the classroom. I had a student suspected of having ADHD transfer to my classroom from another classroom. He was 6 when he came into our room mid-year. When he did have behavioral issues, the other students were quick to forgive. One told him "I don't like when you ..., but I know you're a really nice boy and I really want to be your friend." They included him in games at recess and when he looked upset would go over and ask him to join them in a work. Eventually his outbursts stopped. I don't think that he had ADHD, I think his need at that time was acceptance. In his previous classroom, he was labeled as "the naughty kid" and was frequently sent to the office. The students in my room instinctively recognized this, maybe even subconsciously and gave him the support he needed at the time.

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Article: Foundations for Montessori Inclusion

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Article: Foundations for Montessori Inclusion

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https://www.montessoripublic.org/2019/10/foundations-for-montessori-inclusion/

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The storied Hellbrügge program comes to the U.S. at last

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Move from integration to inclusion: Integration welcomes atypical developing children. Inclusion prepares the environment to meet everyone's needs.

Specialists must work together: This includes therapists, pediatricians, guides, and parents.

Assessment requires a deep understanding of development: Our observations as guides should be supplemented with knowledge & observations by specialists.

Montessori materials are versatile developmental tools: Our presentation can be adapted to meet the needs of atypical developing children.

Early intervention is key: When you notice something atypical, observe. Try individualized interventions. If they are not successful, meet with parents and bring in appropriate specialists.

Schools must plan for classroom makeup: Ideally, there should be less than 25% of atypically developing children in a classroom.

Children want to learn from other children: Peer to peer learning solidifies knowledge and provides opportunities for social and emotional growth.

(Foundations for Montessori Inclusion)

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Article: Sensory Processing Disorder & its Natural Fix

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Article: Sensory Processing Disorder & its Natural Fix

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https://childhoodbynature.com/sensory-processing-disorder-its-natural-fix/

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Some experts state that some kids experience Sensory Processing Disorders because they don't move around like kids used to, especially outdoors.  “I view nature as the ultimate sensory experience for all children and a necessary form of prevention for sensory dysfunction.” (Angela Hanscom, a pediatric OT)
Children should have the opportunity to play in puddles, climb, walk barefoot, and build forts outdoors. "The outdoors naturally challenges a child senses with the many sounds, smells, textures, temperatures, and colors it offers."

(Sensory Processing Disorder & its Natural Fix)

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On bringing nature into the classroom ...

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On bringing nature into the classroom ...

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Many children do not spend much time in nature. This summer, I taught summer school. Each Friday, we went to a different nature area to hike, explore, picnic, and play. This was the highlight of the kids' week! We were able to do this because we had small class sizes. I have been brainstorming ways to bring nature into our classroom this coming school year. Here are some ideas I came up with so far ...

planting

create a mini rock garden

flower dissecting

rock scrubbing

nature journaling

flower pressing

seed sorting

chairs under the windows so students can observe the outdoors (our windows are at adult height)

sorting seashells

We already have many plants, a tortoise, aquarium with freshwater fish, and an aquarium full of snails.

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Because the Silence game helps children develop focus, I looked up variations of the Silence game and plan to offer it more frequently.

close eyes and open when they hear their name

listen to what we hear in the silence and share at the end of the game

create an individualized silence mat where children can practice making silence on their own

make silence with a stethoscope and listen to our heart

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This project really gave me a great appreciation for the Sensorial materials. These materials are not regularly on the shelf in Lower Elementary. It is imperative that child spend as much time as possible manipulating these materials and experimenting with extensions. These materials were developed to heighten the development of children's senses. Because each material isolates one sense at a time, children are really able to refine and develop each of their senses.