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Sensory Modulation/ De-escalation Room

Sensory Modulation/De-escalation Room for teenagers in Residental Foster Care
by

Michelle Dougherty

on 24 November 2015

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Transcript of Sensory Modulation/ De-escalation Room


Tranquility Island
Sensory Modulation De-escalation Room

Strive to promote growth and change
While genuine change always happens WITHIN an individual child; committed, well trained professionals can
teach
and
support
the youth immensely in learning and internalizing new behaviors.

PSR vs. MSDR
Casa Pacifica MSDR
Benefits
Spend less time in program

Often left triggered and very little is learned.

The message is “ I am alone” and I have to figure this out by myself.

Seclusion ISOLATES
MSDR ENGAGES
Sensory rooms engage both the
staff and the kids physically and cognitively.

It teaches positive/pro-social skills over time

The message is "Adults can and want to help me at my worst time, I have choices on how to deal with my history and emotions"


Blending of Theories
1. Proactively to prevent a crisis situation

2. Responsively after a crisis to de-escalate and problem solve

3. Sensory Modulation- Self Regulation

Awareness of the different strategies we use to self-organize in order to functionally engage in meaningful life activities
Ways to use the room
The MSDR is an effective intervention at any stage except during the height of a crisis!
Gross Motor > Fine motor > Cognitive > Problem solving
Use caution not to trigger the
stress center (amygdala
) so that learning can occur (hippocampus). Engage gross motor skills (cerebellum), then transition to fine motor skills (motor cortext) and then to cognitive skills (frontal lobe).
Recognizing Early Warning Signs
Do you know your clients low level cues?
How do you normally respond to them?
Do you think your response affects escalation?
Start making mental notes of early warning signs to better prepare yourself for when to intervene to prevent further escalation
Access to the room
Notify designated staff. Michelle and Jenn G have key to room, school stafff, and supervisors
Never to be used as a consequence for behavior
Clients never to be left alone(the room is designed for one on one interaction)
Encourage taking off shoes (not required)
Clients NOT allowed in equipment closet

As long as it takes for youth to begin de-escalating
Average session lasts about 22 minutes
Ideal one staff to one client
Goal is to be open 24/7
Those kids who struggle everyday might need 10-15 minutes daily
Ex: transition after school, before bed, middle of night..

Duration of intervention
Resources
Gross Motor ( Cerebellum)
Bolster Swing
Taco Swing
Hanging Nest
Lycra Sock
Medicine Balls
Exercise Balls
Ring Toss
Fine Motor (Cerebellum/Somatosensory Cortex)
Bopp it
Jenga
Play Dough
Theraputty
Kinetic Sand

Cognitive ( Frontal Lobe)
Scrabble
Checkers
Connect Four
Card Game
Find –It
Maze Ball
WordSearch..

Sensory/Touch
(Somatosensory Cortex)
Weighted Blanket
Weighted lap animals
Pea Pod
Bin of Beans
Bean Bag Chairs
Vibrating Massagers

Gross Motor
Fine Motor
Cognitive
Sensory
Initial Evaluation and Assessment
Sensory Cards per referral
Documentation log
Code List for Interventions
Alternatives
Arts and Craft
Coloring Pages
Football
Puzzles
Walking
Yoga/Stretches
Drum
Journaling
Board Games
Legos etc.
Sports
ANY WELLNESS ACTIVITY!!!
The room is always to be used
BEFORE
and
AFTER
a crisis.
NEVER During!
Remember!
Ayers, J. (1986) A parents guide to understanding sensory integration. Torrence, CA: Sensory Integration International .

Casa Pacifica Center for Children and Families.(2010) Multi-Sensory De-Escalation. www.casapacifica.org/training


Champange, T. (2006) Creating Sensory Rooms; Environmental enhancements for acute inpatient mental health settings. Mental Health Special Interest Section Quarterly, 29(4), 1-4.

Champagne, T. & N. Stromberg (2004). Sensory approaches in inpatient psychiatric settings: innovative alternatives to seclusion and restraining. Journal of Psychological Nursing, 42(9), 1-8.

Davis, M., Eshelman, E. R., & McKay, M. (2000). The relaxation and stress reduction workbook (5th ed.). Oakland, CA, USA: New Harbinger Publications

Gosper, J. Neville, L. Sebille, J. (2013) Risk Management: Re thinking Escalation and Crisis. NSW Australia.

Kranowitz, C. (1998) The out of sync child: Recognizing and coping with sensory integration dysfunction. Ney York, NY: Perigree.

National Executive Training Institute (NETI). (2005). Training curriculum for
reduction of seclusion and restraint. Draft curriculum manual. Alexandria, VA:
National Association of State Mental Health Program Directors (NASMHPD),
National Technical Assistance Center for State Mental Health Planning (NTAC)”

Perry, B, D., & Szalavitz (2006). The boy who was raised as a dog. Cambridge: Basic Books

Tiffin, P. & Kaplan, C. (2004). Dangerous Children:
Assessment and Management of Risk. Child and Adolescent Mental Health, 9 (2), 56-64.

Willis, T. J. & LaVigna G. W. (1994).
Challenging Behavior: Reactive Strategies and Emerg
ency Management within a non-aversive Framework Los Angeles, IABA.
References
Use your Resources!
Feel Free to Ask Questions

I will be here for support and to help whenever needed!!
Remember the room is a safe place for clients.
Create a environment in which internal behavioral control is
valued
,

taught
and
rewarded
.
Proactive
Responsive
Do not use during height of crisis !!
Casa Pacifica, 2010
Adapted from Casa Pacifica, 2010
Adaptad from Casa Pacifica, 2010
(Gosper,J.,Neville,L.,Sebille, J. 2013)

Three Most Important things to Remember:
The Room is to be used BEFORE and AFTER a crisis. NEVER during!
The room is designed for one on one staff to client
ENGAGEMENT
You must sign in/out of the room using the documentation log after every session
Applied Brain Research
The room is designed for one on one staff to client
ENGAGEMENT
You must sign in/out of the room using the documentation log after every session
Limbic System/Stress and Memory
-Amygdala
-Hippocampus
V
V
Pre Frontal Cortex
Problem Solving and Critical Thinking
Creates a safe space
Facilitates the therapeutic alliance
Increase ability to self-nurture
Increase resilience
Increase self-esteem and body image
Increase ability to engage in meaningful life roles
Increase ability to engage in social activities
Increase ability to cope with triggers

Cerebellum
Gross Motor
Primary Somatosory/Motor Corte
x
Fine Motor
Sensory Modulation/ Calming Exercises/ Relaxation Groups
Mindfulness/ Soothing exercises
Progressive relaxation exercises
Deep breathing
Distress tolerance exercises
Sensorimotor activities
Stretching and Isometric exercises
Using therapy balls
Application of varied deep pressure/ touch activities
Imagery
Music
Calm vs Alert
smell
taste
vision
auditory
touch
propreception
vestibular
Calming
:Vanilla scents, lavender scents, lotion, and aromatherapy machines
Alerting
:
strong perfume, citrus lemon or mint scents
Alerting:
fire ball candies, sour jelly beans, spicy foods, hot salsa, spicy foods
Calming:
Chocolate, hot tea, soup
Smell Sensations
Taste Sensations
Visual Sensations
Calming
:
Serene murals, pastel colors, watching fish in a aquarium, soft lighting, lava lights, bubble and fiber optic lights
Alerting
:
Modern art, bright colors, music videos
Auditory Sensations
Calming
:
nature sounds, soft music,ocean or waterfall sounds, meditation sounds
Alerting:
Loud and quick paced rock music, noise in the units, fire alarms
Touch Sensations
Calming (deep pressure)
:
Using a weighted blanket or shawl, sitting in a bean bag chair, squeezing a stress ball
Alerting (light touch
):
Tickling, fiddling with koosh ball, bug crawling on you
Propreoceptive Sensations
Alerting
: jogging, step aerobics, isometric exercises, jumping jacks
Calming
:
Weight lifting, yoga, bean bag tapping, walking, heavy lifting, deep tissue massage, and foam roll
definition
: perception of joint and body movement and how much force we are using
Vestibular Sensation
definition
: the inner ear contains receptors that act as internal compass and signal changes in head position and motion (Moore, 2005)
Alerting
: Spinning quickly, moving all around on therapy exercise ball
Calming
: Rocking in a rocking chair/glider, swinging gently, hammocks, slow head roles, taco swing
use designated ipod only

What music calms you?
What music alerts you?
Do you listen to the same music going to bed as you do on a run?
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