ASA's 37th National Conference on Autism Spectrum Disorders (July 13-15, 2006)
|Friday, July 14, 2006: 1:45 PM-3:00 PM|
|#2101- Illuminating the Connection Between Sensory Integration Treatment and Improvements in Language Comprehension|
|This presentation will illuminate the connection between sensory integration (SI) principles and language learning. Particular attention will be paid to how SI treatment can lead to gains in language comprehension that may not be achieved through speech therapy, alone. Amidst a backdrop of research, participants will be provided with specific “sensory-based” techniques that can aid language learning. Finally, parents and professionals will be given specific strategies for incorporating these therapeutic approaches into a child’s educational plan.|
|Presenters:|| - Jennifer Twachtman-Reilly is a speech-language pathologist specializing in autism at the Connecticut Children’s Medical Center. She is the Associate Editor of Autism Spectrum Quarterly (www.ASQuarterly.com), and serves on ASA’s Panel of Professional Advisors. She is a published author and frequent workshop presenter with experience in school, clinic, and hospital settings
- Patrecia Zebrowski, M.S. OTR/L is an occupational therapist who specializes in sensory integration treatment for children with ASD. She has practiced in pediatrics for the past 17 years primarily at Sargent Rehabilitation Center in Rhode Island. She has provided multiple presentations for Sargent's "Link to Learning" parent education series, parent advisory groups, and private and public schools. In addition she was a contributor of intervention tips to the 2005 SOULS Calendar.
Among children on the autism spectrum, difficulties in the areas of language comprehension and expression have been well documented in research literature (Just, Cherkassky, Keller, & Minshew, 2004; Kjelgaard, & Tager-Flusberg, 2001; Minshew, Goldstein, & Siegel, 1995; Minshew, Meyer, & Goldstein, 2002). This knowledge has translated to practice in the form of language-based educational programming and, in some programs, to the provision of more extensive speech therapy than had previously been offered. While speech therapy has been getting some much-needed respect, however, other important components of the child's treatment program are sometimes de-emphasized to the point where they are provided to an inadequate degree. For example, many parents report difficulties with securing funding for and/or an adequate degree of occupational therapy to address sensory processing disorders that impact daily functioning and development. Given the complex nature of ASD (Courchesne, 2004; Minshew, Goldstein, & Siegel, 1997), neglecting even one component of treatment can have a negative impact on the child's gains in other areas. While intervention using a sensory integration framework does not set out to address language and communication difficulties, marked improvements are often seen in these areas.
For years the connection between sensory integration intervention and gains in the speech and language domain has been nebulous and unclear. While many parents report improvements in language expression, how and why these gains may occur has been a mystery to many. In an attempt to tap into the child's elusive language reserves, many speech-language pathologists and occupational therapists have advocated the use of co-treatment therapy sessions where both professionals work alongside one another to maximize gains in their respective areas of expertise. Indeed, this collaboration has been the subject of many conference presentations across the country.
Despite the success of co-treatment sessions, often, the very professionals involved are hard-pressed to truly describe why the “whole” of co-treatment can lead to greater gains than the sum of its individual therapeutic parts. Those who do attempt to unravel the mystery often cite the benefits of sensory integration treatment to expressive language and/or the physical aspects of speech production. For example, some parents and professionals have reported that a child may speak more when engaged in a particular type of movement. While speech production gains should not be minimized, the benefits of sensory integration intervention to language comprehension go far beyond the oft-cited observation that “he talks more when he's in the swing.”
The goals of this presentation are twofold: First, the connection between sensory integration principles and language learning will be clarified. Particular attention will be paid to gains that can be achieved in language comprehension since this is an area that has been addressed less frequently in both the research literature and conference presentations. The second goal is to provide participants with specific “sensory-based” techniques that can aid language learning, and give parents and professionals strategies for incorporating these therapeutic approaches into a child's educational plan. The presentation will be divided into 3 parts:
Part 1: ¨ Brief, research supported, description of how children learn various components of language, including nouns, verbs, and concepts. ¨ Brief description of the pattern of strengths and needs of children with ASD in learning these language components
Part 2: ¨ Description of the prerequisite skills that are necessary for language learning, for example: o Attention to learning experiences o Calm demeanor / motivation to learn o Social connection to the instructor to ensure that word is connected with experience ¨ Description of the types of therapeutic approaches (e.g. experiential learning); and specific experiences that are necessary to achieve learning of the language components described in Part 1.
Part 3: Description of how sensory integration intervention directly contributes to the learning of these skills: ¨ Provides a therapeutic environment that is often motivating for children and, therefore, conducive to the teaching of basic language skills. ¨ Provides the child with the direct experiences necessary for concept and verb learning. ¨ Improvements in sensory processing allow the child to experience their world more accurately. This allows the child to: o Register sensation in order to notice, determine relevancy, and respond to the information from the environment. o Develop an accurate understanding of language concepts by attaching meaning to experiences (e.g. pain, “hurts”) o Learn the words that connect with these experiences. ¨ Improvements in arousal regulation help the child to benefit from learning experiences far beyond the therapy room o Increases attention in individual and group learning experiences in the classroom or other environments where distractions are more numerous. o Provides strategies to initiate and sustain engagement and social interaction
The presentation will conclude with a brief discussion of strategies for including sensory integration treatment and its components into the child's IEP, as it is here that light can be shed on individual differences in sensory processing, and corresponding treatment protocols can be established.
In conclusion, the importance of establishing an environment that is both conducive to learning and supportive of the child's inner drive to learn cannot be underemphasized. It is additionally important that “best practices” in the treatment of individuals with ASD incorporate the latest research findings into their approaches. The work of Minshew, et al (1994) and its follow-up studies (e.g. Just, et al., 2004; Minshew, Meyer, & Goldstein, 2002; Minshew, et al., 1997), have established that individuals with ASD demonstrate strengths in procedural skills (e.g. rule learning, formal language, simple memory), and weaknesses in declarative skills (e.g. concept development, complex language & memory). This complex pattern of strengths and needs dictates the necessity of a multi-pronged treatment approach that incorporates many components, of which this presentation addresses only a few. An intensive focus on both comprehension skills and the establishment of meaningful interactions is not a primary component in many intervention protocols, if it is included at all. Thus, it is believed that the information contained in this presentation will enhance the overall outcomes for children on the autism spectrum.
· Participants will be able to describe how children learn nouns, verbs, and concepts, and the pattern of strengths and needs seen in children with ASD.
· Participants will be able to describe the one therapeutic approach that facilitates the learning of concepts and verbs.
· Participants will be able to describe how improvements in sensory processing lead to improvements in language comprehension.
· Participants will be able to describe how improvements in arousal regulation help the child to benefit from therapeutic experiences beyond the therapy room.
· Participants will be able to list 3 possible sensory-based strategies that assist attention, engagement, and comprehension.