FAB Strategies

Sensory-Motor Strategies to Improve Self-Control

Sensory-motor strategies are often motivating for children and adolescents, providing therapists with a useful modality for improving self-control.  DBT www.linehaninstitute.org and CBT intervention http://apt.rcpsych.org/content/7/3/224.full can improve self-control in children and adolescents, but are often ineffective for youngsters who have significant cognitive deficits and/or a very limited attention span. Sensory-motor strategies offer a motivating and effective component of comprehensive mental health treatment to improve self-control in young people with complex behavioral, developmental, and sensory processing challenges.   
Inappropriate behavior involves a lack of functional inhibitory motor control.  Behavioral problems result from inadequate inhibitory control of arm movements (e.g., punching, slapping, scratching) or mouth movements (e.g., spitting, biting, threatening, screaming, swearing). Actively helping children learn motor self-control is an effective intervention for aggressive youngsters with behavior, developmental, and sensory processing challenges. Sensory-motor strategies promote the development of overall inhibitory control, behavior, and social skills. Since inappropriate behavior involves movement, graded activities requiring increasing levels of inhibitory control can be reinforced to improve self-control.  These activities include: Simon says, red light, giant steps freeze dance, freeze shake, play plan, play review, and turn taking during sensory-motor games. www.fabstrategies.com  www.challengingbehavior.org
Self-control can also be facilitated through new learning of developmentally sequenced bilateral movements.  Research suggests that learning new bilateral sequential skills (e.g., drumming and piano) promotes neurological connectivity (e.g., between cortical and midbrain emotional centers as well as across the corpus callosum coordinating the brain hemispheres) involved in self-control skills.  Neurological connectivity impacting self-control can be significantly compromised in youngsters with Pervasive Developmental Disorders and/or an early trauma history.  For this reason sensory-motor activities involving sequential bilateral movement appear clinically useful in promoting inhibitory control and communicating feelings.
Sequential bilateral activities include: ball bouncing activities, bean bag pass, obstacle courses, and mindfulness movement. Sequential bilateral activities can be integrated with the verbal expression of feelings and coping strategies using a game format.  Sequential bilateral movement activities are clinically useful to promote learning and social development in students with behavioral, developmental and sensory processing challenges. www.braingym.org www.movementbasedlearning.com
In addition, clinical experience utilizing the sensory processing frame of reference suggests that slow sequential movement activities involving deep pressure input through the joints help calm children and adolescents with behavioral, developmental, and sensory processing challenges.  While some therapists question the efficacy of sensory-motor intervention the benefits of exercise on the development of physical and mental health has been repeatedly demonstrated.  Further, exercise clearly has less potential contraindications when compared to the alternative of prescription medications to reduce hyperactivity and anxiety.
Sensory-motor activities can be embedded in regular classroom activities through movement brakes, music activities, brakes to get a drink at the water fountain, and school jobs (e.g., moving desks, moving mats, passing out books, delivering supplies around the school).  Children and adolescents can be taught to independently use tasks combining slow linear movement with deep pressure coping strategies (wall pushups, isometric exercises, therapy ball activities, theraband arm exercises, theraplast hand exercises) to maintain a quiet alert state when they initially notice they are becoming anxious.  In addition, children can participate in after school activities involving aerobic exercise (e.g., walks, biking, scooter, swimming, basketball, soccer, dancing and structured playground activities).  Sensory-motor strategies offer an effective component of a comprehensive intervention program to improve self-control and functional behavior.
References:
Bengtsson, S.L., Nagy, Z., Skare, S., Forsman, L., Forssberg, H., Ullen, F. (2005).  Extensive piano practicing has regionally specific effects on white matter development.  Nature Neuroscience, 8, 1148-1150.
Hillman, C. H., Pontifex, M. B., Raine, L. B., Castelli, D. M., Hall, E. E., Kramer, A. F. (2009).  The effect of acute treadmill walking on cognitive control and academic achievement in preadolescent children.  Neuroscience, 159(3), 1044-1054.
Riggs, N.R., Greenberg, M.T., Kusche, C.A., Pentz, M.A. (2006).  The mediational role of neurocognition in the behavioral outcomes of a social-emotional prevention program in elementary school students: Effects of the PATHS curriculum.   Prevention Science, 7(1), 91-102.
Smith, S.A., Press, B., Koenig, K.P., Kinnealey, M. (2005).  Effects of sensory integration intervention on self-stimulating and self-injurious behaviours.  American Journal of Occupational Therapy, 59, 418-425.
Sun, F.T., Miller, L.M., Rao,  A.A., Esposito, M.D. (2007).  Functional connectivity of cortical networks involved in bimanual motor sequence learning.  Cerebral Cortex, 17(5), 1227-1234.

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