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Coffee and Chat | Sensory Integration, ARFID and Travel

FREE| Wednesday 2 March 7.30 pm GMT

Book Here: https://www.eventbrite.co.uk/e/2022-asi-wise-coffee-chat-talking-ayres-sensory-integration-registration-238213722657

Dr Yana Wengel is an associate professor at Hainan University. Yana takes a critical approach to tourism studies; her interests include volunteer tourism, tourism in developing economies and nature-based tourism. Her dissertation examined the social construction of host-guest experiences in volunteer farm tourism. Her current projects are focused on nature-based tourism and leisure and travel experiences of patients with an eating disorder. Yana is interested in creative methodologies for data collection and stakeholder engagement. She is a co-founder of the LEGO® SERIOUS PLAY® research community.

Publications: https://orcid.org/0000-0002-8131-4137  

LinkedIn: www.linkedin.com/in/yanawengel

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PANDAS and PANS Sensory Integration and Processing Challenges

a displeased girl screaming in anger

PANDAS and PANS Sensory Integration and Processing Difficulties

Sensory Systems:
Vestibular processing deficits, often low PRN
Poor postural control especially antigravity extension
Can slouch, slump – extension against gravity is tricky and tiring
Likes to move and not stop/fidgeting
Can have low levels of alertness when not moving
Scared of the dark without visual input to support spatial understanding
Altered spatial awareness
Poor grading of force
May appear ‘low toned’ – but normal Beighton Scale
Poor self-awareness – spatial; position in space and body awareness
ARFID and picky eating | often poor tactile registration and poor modulation
Super sensitive to some tastes
Altered temperature perception
Delayed cues re ill, nauseous, hungry, full or needing toilet
Hyper-responsivity to some textures and light touch eg certain fabrics/textures
May dislike light touch; skin, hair, tooth and nail care can be tricky
Dislike being touched or held when not on own terms
Slow or under-responsivity to pain,
Hyper-responsivity in far senses; smell, vision and hearing

The dyspraxic patterns seen can include;
Often bumping into things and people
Difficulty playing with manipulating tools and toys
Difficulty learning new/novel movement/motor skills
Fine motor co-ordination difficulties e.g., handwriting, bilateral co-ordination, poor tool use
Speech praxis difficulties include stutter, slurred words, poor pronunciation and timing
Ideation, planning and execution can all be affected.

Emotion Regulation
Rage
Anger
Irritability
Poor frustration tolerance
Difficulties with co and self-regulation
Poor self-awareness – emotional lability is common
Tearful one moment, raging the next 0-100 in 3 seconds

Executive Function
Poor processing speed
Multi-tasking is hard
Poor timing and sequencing
Poor concentration and focus
Slow to perform tasks
? observed difficulties with language processing
? observed difficulties with more complex and abstract problem solving that is age-appropriate

Fatigues easily and needs lots of reset time
May go ‘off legs’
Looks like have regressed

May need much parental encouragement and support
Lose resilience to trying new things
Low self-esteem

Older children
Self-loathing and disgust at self
Extreme fear and losing control of agency over the world
Awareness of personality change and burden on parents and siblings

[list developed by Kath Smith OT 2014 – 2021]

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The Teenage Brain – a great new resource

Looking forward to following this new organisation, who appear to have some amazing resources from my first drop onto their website today.

https://www.ourteenbrains.org/

From their Founder…

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Summer fun ideas for challenging Tweenies and Teens

Here are some great hand-eye coordination activities for clients across the lifespan – some are especially good for teens! Try these with tweenies and teens with difficulties with sensory-motor coordination, to get them off devices and outdoors over the summer.

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Neuroscience and Sleep

Submitted by guest blogger Ruth OT

Before I trained to be an occupational therapist, I studied neuroscience to masters by research level. It is so helpful in my work to have that underpinning knowledge of some of the things going on in the brain and how these affect behaviour. However, I don’t miss growing neurons in petri dishes and counting them.
Our kids are not great sleepers, to understate it considerably. We have had more sleep advice than anyone has any business accessing. It’s been variably effective. In the UK, there are several charities who offer sleep advice for children with special needs (Cerebra and Scope to name but 2), alongside advice from our children’s centres and child and adolescent mental health services (CAMHS). They’ve all been helpful, they’ve all prioritised the importance of a good consistent bedtime routine, on minimising distractions from sleep and on knowing your child’s sleep patterns. We have filled in more sleep diaries that you can shake a stick at (incidentally, this is the most effective way to make sure your child actually sleeps I have found! It’s amazing how well they sleep when you’re filling in a sleep diary to prove they never sleep).
I have promised myself I will stop reading sleep advice because I only get frustrated when we still don’t sleep, but here are some things we have found helpful (some nights at least!) and a little bit of the neuroscience of why.

Melatonin
One of our children along with many autistic people I know is taking melatonin at bedtime. The doctor tells us frequently that this is expensive, and we’d prefer to avoid medication as much as we can on general principle, so it’s worth knowing a bit about what melatonin does and how to boost it without medication.
Melatonin is a substance which the brain makes from the neurotransmitter serotonin, mostly in the pineal gland. The pineal gland is a tiny gland right in the middle of the brain and close to the visual centres of the brain. It starts making serotonin into melatonin when the light reduces, stimulating sleep onset. I don’t know whether my kids’ pineal glands are less efficient converters of serotonin to melatonin or whether their brains are less sensitive to the melatonin produced, but I just need some sleep so here are some ways we try to boost melatonin production.

Light and Screens
If melatonin is made when the light dims, it stands to reason that emphasising that light change is important, so we make sure they get lots and lots of daylight when we want them to be awake, and none when we want them to be asleep. This is not always easy in Northern England and involves a lot of getting wet and muddiness. We play outside every day we possibly can. When we can’t, we are lucky enough to have a big conservatory which we use as a playroom, and we have daylight effect lightbulbs in key rooms of the house which we use in daytime then switch to lamps in the evening. We have found that physical activity in the day can help with sleep, but if it’s all indoors such as soft play centres and swimming pools, it’s nothing like as effective as a walk outside no matter how wet the walk may be!
We have a no screens after the evening meal rule when sleep is particularly tough. Focusing visually on an (often bluish) glowing screen will inhibit melatonin production if you’re struggling to sleep, turn the technology off, it really does help.
We have blackout blinds behind blackout curtains and we close the doors of all the rooms that don’t have that every night (actually in our child who takes melatonin’s bedroom, we’ve made wooden boards which fit exactly into the window area over the Velcro blackout blind. Yes, I am serious…).

Serotonin
If melatonin is made from serotonin, it also stands to reason that it’s a good plan to have a lot of serotonin available to be converted. A large proportion of the antidepressants available have their effect by increasing the amount of free serotonin in the brain, this may explain some of why depression can affect sleep patterns. If you think mental health difficulties may be influencing sleep patterns, please talk to your doctor about this. It can be a vicious cycle that poor sleep exacerbates depression and depression then makes sleep more difficult, it is important to break that cycle.

Food
There are certain foods which contain tryptophan which the brain then makes into serotonin. I know some parents who swear by these in evenings, these include cherries, nuts, seeds, tofu, cheese, red meat, chicken, turkey (you know how we all fall asleep after Christmas dinner?), fish, oats, beans, lentils, and eggs. Just be aware that strong flavours and smells can be very alerting and so be less helpful than you’d think. Also, many of these can be allergens.

Movement
It’s also good to know that serotonin and melatonin levels rise with proprioceptive activity (movement against resistance, which helps the person to understand their own body more clearly), so including (not too vigorous) movement against resistance as part of the bedtime routine can really help- moving against the water in a warm bath, followed by squeezing yourself in a soft towel would be one example, or carrying a good sized box of bedtime stories up the stairs to bed. Movement of the head can also stimulate serotonin release in the brain and help sleep, just avoid spinning and sudden changes in speed or direction as these will counteract the effects.
Doing all of this does not mean you will get a good night’s sleep (I think we got about 2 hours last night!), but it might just improve your chances.