Sensory Integration Education

We spoke with Children's Occupational Therapist and SI Practitioner Charlotte Anastasi of OT Play and NHS Speech Language Therapist and Advanced SI Practitioner Kirsty Mansfield to discuss ideas for sensory strategies for supporting deaf children. First, let’s look at sensory integration and sensory processing differences within the deaf population.

Sensory integration is the way our brains take in, process, and respond to sensory information from the environment and also from within our own bodies. Everyone's way of processing sensory information is different. But sometimes sensory processing differences can make it hard for a person to handle sensory information, understand it, and react appropriately. Sensory integration differences can affect how we spend our time and what we feel able to do on a day-to-day basis.

Do Deaf Children Experience Sensory Processing Differences?

Deaf children may be more likely to have sensory integration difficulties in addition to experiencing auditory (sound) input differently than the hearing population. Some research shows that over 70 per cent of deaf children experience sensory integration difficulties (Bharadwaj, 2009). Another study (Alkhamra, 2020) found that children with cochlear implants and hearing aids are susceptible to auditory processing disorders. The same study found higher risks of balance, multisensory processing, social-emotional, and fine motor challenges in children with cochlear implants. 

So it's important for families and professionals to be able to recognise when deaf children’s behaviour may have an underlying sensory need contributing to it. And to have practical sensory strategies to use to help support the child’s sensory needs in the moment. 

Sensory Strategies for Supporting Deaf Children

OT Charlotte Anastasi has a rich experience of working with D/deaf children and young people and is qualified as a Sensory Integration Practitioner. SLT Kirsty Mansfield has a long NHS career working with D/deaf patients and is qualified as an Advanced Sensory Integration Practitioner. Both are passionate about promoting independence and inclusion for D/deaf young people. 

We asked Charlotte and Kirsty for some simple sensory strategies for supporting deaf children. 

Charlotte: “Deaf children, and in particular British Sign Language (BSL) users, are visual learners and as the parents, teachers and professionals who support them, we need to promote this skill and use visual resources all the time. This may include photos, symbols, video resources or demonstrations. For example, showing how to make a sandwich or referring to a picture guide of different exercises that may help with sensory regulation.” 

Charlotte: “In the brain, the hearing system is very closely situated to our balance system. Depending on the cause of a person’s Deafness, this may mean that their balance system is affected. Did you know, the balance system not only affects movement but many other daily activities too, including posture, spatial awareness, ability to use both sides of the body together? We can support balance skills by offering students more movement opportunities every day! Get off the bus one stop early and complete a brisk walk, do a 7-minute online kids’ workout a few times a week, get the children to help with laundry or take a visit to the park. Any way in which you can increase your child’s level of movement will help to develop balance, posture and spatial awareness which is likely to have a positive impact on using both sides of the body together - this is crucial for BSL users and all children for tasks such as using cutlery, scissors and handwriting.”

Charlotte: “I use this sensory breaks poster all the time with Deaf students. It suggests ideas for movement and we find these equipment-free strategies are super helpful for our students. There is a range of calming and alerting exercises that can be used at any time of time to help with sensory regulation.”

Regulation refers to the ways that we all manage our energy states and emotions so that we feel in just the right state (whether that’s calm or energised) to do the tasks that we need or want to do. 

^{Image: Sensory Breaks Poster from OT Play}

Kirsty: "With many of the children I work with as a speech therapist, we have a focus on supporting self-regulation as well as attention and listening skills to access communication. What I use in sessions and recommend depends on the child’s presentation and age etcetera, but I often stress to parents and teachers the need to separate the idea of ‘good sitting’ from being automatically linked with ‘good listening’. 

“A deaf child may need to move to help them pay attention if they have vestibular (balance) difficulties or other sensory needs. The below Whole Body Listening poster is quite helpful for talking through with parents what their child in particular needs.”

^{Image: Download this Whole Body Listening Poster for free from everydayregulation.com}

Kirsty: “For preschool and younger children we combine singing and movement. Combining actions with singing is great for both language and the vestibular and proprioceptive (body movement and position) systems. For example, actions for ‘Baby Shark’ and ‘Wind the Bobbin Up’ are great for tapping coordination of both sides of the body and meeting at or crossing the midline. Songs like ‘The Grand Old Duke of York’ get children marching and moving around – a good stomp can help the proprioceptive system.”

Kirsty: “I ask school staff to incorporate proprioceptive activities into the daily routine, for example, pushing and holding the corridor and classroom doors, carrying and handing out books etc. I also use similar strategies in therapy sessions, for example, getting the child to push the chairs and desks into place before starting. I allow the child to decide on how they can best attend that day – sitting on the edge of the chair squashed into the desk, standing up and moving from one leg to another, lying on the floor, bouncing on a yoga ball etc. I incorporate movement into sessions when needed, e.g. placing items just out of reach so they have to stretch for them etc.”

Thanks to Charlotte and Kirsty for these ideas!

We’d also suggest considering making changes in your child’s environment to better suit their particular sensory needs and preferences. This can include adjusting lighting and background noise and adding items that can provide sensory input, such as weighted soft toys, chewable sensory toys, fidget toys, a yoga ball, etc - the contents will be specific to your child. If your child works with an SI-trained occupational therapist or speech and language therapist, they will be able to suggest sensory strategies uniquely tailored to your child's needs and interests.

References

_{Alkhamra, R. A., & Abu-Dahab, S. M. N. (2020). Sensory processing disorders in children with hearing impairment: Implications for multidisciplinary approach and early intervention. International Journal of Pediatric Otorhinolaryngology, 136, 110154. https://doi.org/10.1016/j.ijporl.2020.110154}

_{Bharadwaj, S. V., Daniel, L. D. & Matzke, P. L. (2009). Sensory-Processing Disorder in Children With Cochlear Implants. American Journal of Occupational Therapy 63(2). https://doi.org/10.5014/ajot.63.2.208}