University of Edinburgh
 

Sensory Rooms and Cerebral Visual Impairment (CVI)

Presented on Friday, 6th November 2015 by Suzanne Little, Specialist Teacher, Scope's Meldreth Manor School, Hertfordshire

Case studies and Multisensory approaches

Colour tents and multisensory rooms with individual planning.

Child 'T'

Child 'T'> Quadriplegic Spastic Cerebral Palsy> CVI >Brain Shunt> Epilepsy

Balint Syndrome

Simultagnosia: Seeing one thing at a time - Difficulty fixing on an object of interest - Optic Ataxia: Defective visually guided reaching

Educational experience

FIRST SCHOOL: No sensory Programme, No visual assessment - Distress, shouting, screaming - Exclusion, time in school corridor, Removed from school play etc. - No Individualised routine or planning - Negative comments to parents of unresponsive and disruptive behaviour. / CURRENT: Multidisciplinary assessment, Ongoing evaluation, Visual/sensory programme - Ability to calm, engage, maintain and develop - Inclusion, Individualised learning programme - Habilitation approach, child centred and integrated therapy - Video and photographic evidence to share achievements

A Section of a Multidisciplinary Assessment

Sample of assessment report: Assessment Summary; Progress; Development aims and targets; Strategies for learning (Headings)

  • Prior to the tent environment T was visually unaware
  • First time in a colour tent, an immediate response
  • Bright fluorescent colour tent opens the door to a new found visual awareness.
  • Orange has a positive effect in ‘opening’ visual awareness
  • ‘Joy’ and beginning to gaze around at the space
  • Looking up and to the side with the orange colour
  • Concentration span increased to visual awareness and attention and remained even with a change of colour.

Before and after tent activity - developments

Strategies: For Ease
Sensory and Communication skills:
T may require a movement activity or change of position for calmness prior to a specific activity that requires her sensory awareness and attention.

Activity of one thing at a time:
Colour tent:
To develop T’s sensory awareness and attention with time to engage at her own pace without distraction
To develop expression of preference of colour from a choice of two tents, one at a time with time to process information, by facial expression, vocalisations and/or clapping for more.

After Tent activity: sensory engagement in interaction with others and her close environment through the use of intensive interaction

Colour and light tent: calming activity
Multisensory room or sensory colour and light tent in classroom area preferences working with one activity at a time to enable concentration and focus

One stimulus which surrounds a child

Sensory assessment levels:
Awareness, attention, location, recognition and understanding
When at ease T is working at developing her sensory skills of awareness and attention.
One sense stimulus.
Colour and light tents
T can locate projector wheel colour effects which are gentle and slow moving light patterns in the dark and light contrast of the multisensory area of the classroom. This environment is distraction free and uncluttered, which appears to enable her use of vision as she gazes around at the colour movement for seconds at a time. The materials are hung in a tentlike manner within 20-30cms from her vision and the projector positioned to avoid glare.

Colour tent.
T has responded in using her limited vision within colour tents:
T can gaze at colour and move her head to gaze when within a colour tent. When well this tent appears to enable her to use her visual awareness and attention for several minutes at a time. It cuts out extraneous sounds and envelopes her with a tent of one bright colour and creates a calm space for focused attention without sensory overload.

Simultanagnosisa

  • Is the inability to recognise more than one object at a time.

One stimulus at a time

  • When touching toys T became disinterested in colour tent

Observing and monitoring the use of space, time and stimulus

  • Developments within and without the tent.
  • Calmness
  • Increased interaction with vocalisations and claps for more
  • A sensory individualised learning programme

Combination of sensory stimuli

  • Sounds one at a time with changes of pitch and tone
  • Tent and music

A new development of visual awareness and attention with light and colour

Combination of sensory stimuli introduced one at a time.

Multisensory activities

Reaching out tactile awareness:
Frame with tactile stimuli to involve use of touch connected to a sound and movement reward. Intensive interaction with Tac Pac.
Sound activities one at a time:

  • Hello session and name
  • Musical instruments
  • Music therapy
  • Chants
  • Rhymes
  • Rhymic poems

Beat that and sound activities to encourage vocalisations and switch use for communication and cause and effect work.

Sensory Preferences: T prefers sensory stimulus one at a time.

Light reflection: multisensory room
Reflective materials: visual auditory and tactile experiences with space blankets

Sound and touch:
Listening and reaching out skills for switch work
T is motivated by the sound of her name being sung with high and low pitch and tone slowly and emphasised. Use of 1,2,3 prior to an intensive interaction activity such as finding through touch to press the switch to say hello.
1,2,3 is an important sound cue for T before beginning an activity.

Individualised programme

  • Sensory programme
  • Building upon ‘can do’.
  • Design of learning environments
  • Monitoring and evaluation

Building upon calmness from tents for sensory integration engagement

Tac Pac for music and movement
Musical instruments and music choices of two familiar tracks.
Sound environment activities, songs, rhymes beginning with the 1,2,3 anticipation cue.

Movement activities: swings, sensory walks finding preferences of smells, listening for bird song and other sounds one at a time, feeling different movement sensations from bumpy and smooth ground etc, water bed, floor exploration of exploring favourite familiar objects of touch, vibration and sound.

Pressure work with balls and texture exploration.

Ultraviolet light area: for choices and expressing preferences of colour and involvement on art

Child 'S'

Child 'S'> Quadriplegic Spastic Cerebral Palsy> CVI > Difficulty with head control> Epilepsy

Balint Syndrome may not exhibit each aspect

Simultagnosia: Seeing one thing at a time - Difficulty fixing on an object of interest - Optic Ataxia: Defective visually guided reaching

  • S motivated to lift his head
  • Orange was his favourite colour
  • S happy with his choice of colour
  • S engaged with his head up, but with one thing at a time attention away from the tent, to interaction with sound and touch.
  • S fixing his visual attention
  • Simultanagnosia, one thing at a time. S has difficulty fixing and reaching to this object but he is motivated and pleased to do so.
  • Some difficulty with removing fixation of gaze
  • S increased using his visual attention in different visual stimulus environments.
  • A visual and sound stimulus. Visual and auditory awareness with better head control.
  • A sound activity with involvement of listening one thing a time, sensory awareness and attention.

Types of tents

types of tents

Frame

frame

Frame with light and colour projection

Frame with light and colour projection

Hanging frame

Hanging frame

Hanging frame with material

Hanging frame with material

Reflection

“The brain, like a computer, processes in time (the speed of the processor), and space (the amount of RAM) must not be exceeded because the communicator has wasted their own time, and the receiver has not learned anything.”

Professor Gordon Dutton