by Katherine Stimpson, Early Intervention Service Coordinator, Mecklenburg CDSA
The sound of a ticking clock, chalk squeaking on a chalkboard, and food that has a texture that makes your body squirm. We all have sensory processing differences that set us apart from one another. As early intervention providers, we are tasked with supporting families in understanding their child’s self-regulation abilities and sensory differences. In addition, we want to think about how to best support families to address these questions as we discuss with families the impact on their daily routines. This is a tall order, but the conversation at the May Table Talk Wednesday event helped enhance how we look at supporting families with these priorities. The discussion was facilitated by Cheryl Medlin, COTA, Milestone Therapy Morgan Gatwood, Service Coordinator, CDSA. Below, are a few of the big questions posed to the group, and the conversation that followed.
How do you navigate the conversation about sensory concerns with the family?
The word sensory can have different meanings for each family we work with. Many service coordinators shared that initial referral to the Program sometimes contained sensory concerns, and they used that information to start the conversation with the family. This is a great opportunity to ask reflective questions to gather information and understand what the family knows about sensory processing. A challenge shared by multiple providers was when families hear the word sensory, they immediately think Autism. The group talked about appropriate times to share information with families about sensory differences. This part of the conversation focused on asking parents’ permission to share information (i.e. I have some information about sensory processing; would you like me to share it?) One suggestion made by a participant was when speaking to a family she explains that we all have sensory processing differences, and she feels if parents understand how they process sensory input themselves, they can better understand the sensory needs of their child. An occupational therapist shared that the conversation about sensory concerns has typically already been started when she enters the IFSP team. She focuses on helping the family understand how their child is processing information within the context of the family’s daily routine and activities.
How do you identify family routines?
The group discussed how the Initial Child Assessment (learning about the child and family routines) helps identify routines that may be challenging or a priority for the family. Here are some of the reflective questions used when identifying routines with families (this example focuses on a meal time routine):
• What would you like the routine to look like?
• Where is Sarah in the house when she is eating?
• Who is feeding Johnny?
• Tell me about what other meals look like?
• What have you tried?
• What has worked?
• How is sensory processing for Johnny impacting meal time?
• How would you like meal time to look?
• What do you think meal times will look like outside of the home?
The group agreed that it is important to ask additional questions about the routine to make sure we are not making assumptions! Questions help individualize the routine to the child and family. By identifying a specific routine, we are able to support parents in reflecting on the sensory processing needs of their child and make appropriate accommodations to help the routine match the family’s priorities.
Along with asking strong reflective questions, the group stressed the importance of OBSERVING THE ROUTINE! The group shared that during the observation they will often talk about what they see and ask parents how that compares to what the family is typically seeing during the routine/activity. They will also talk about other situations where the family has seen a similar behavior or response. Observing the routine allows for additional questions, intentional modeling, and problem solving with the family. It also supports a strong joint plan for the next session which helps keep the routine focused on the family’s priorities.
What if I see a sensory concern but the family’s priorities are elsewhere? Help!
We have discussed how to talk about sensory processing concerns with the families when they initiate the conversation, but what about when you as the professional may have a concern, but it has not been identified as a priority by the family? One provider stated sometimes she has to “table” her concerns for a while. The sensory concern has to be important and relevant to the family! Another service coordinator shared that she has started the conversation about sensory concerns with the family by saying: “My responsibility is to give you as much information as I can. You can use the information however you like, and I am here to support you either way”. This allowed her to provide honest feedback to the family about her concerns. She always followed up the information share by saying: “How do you feel about what I just shared with you?”. Remember, it is important to always ask the family’s permission prior to sharing information!
It was agreed upon that there is no perfect approach to discussing sensory processing differences within family routines when working with children and families. Individualizing the discussion to the family and focusing on routines and family priorities helps guide the conversation. Additionally, routines change all the time, so remember to keep the conversation about sensory processing going with the family while enjoying the journey!