Teaching Sensory Modulation Improves Behavior

Many children and adolescents with sensory modulation, Autism Spectrum, behavioral, and/or mental health challenges are under-responsive and/or over-responsive to sensory stimulation.  Difficulty maintaining a calm alert state can negatively impact behavioral, mental health, and learning skills.  The FAB energy modulation strategy teaches clients to identify their arousal level before it becomes problematic and use coping strategies to manage it.  While independently managing their arousal level is challenging for children and adolescents practicing this through the FAB energy modulation strategy teaches that self-control is their responsibility.
Children and adolescents with behavioral and sensory modulation disorders often state, “I suddenly feel bad in my skin, then explode when someone tells me no or orders me to do something”.  To manage their energy levels clients must learn to identify their arousal level and notice when it begins becoming uncomfortable and problematic. The FAB energy level strategy involves kids regularly describing their energy level verbally and/or using visual supports such as the energy meter, anger meter, or spazo-meter
 

The FAB energy level strategy involves rating their energy as low (e.g., “feeling numb and sleepy”), medium (e.g., “calm and alert), or high (“hyper and wired”).  Youngsters are also encouraged to notice whether their energy level feels comfortable or uncomfortable.
By repeatedly modeling and discussing energy levels throughout the day clients gradually become aware of them.  Adapted from the ARC “Attachment, Self-Regulation, and Competency” model for children and adolescents with trauma challenges <www.traumacenter.org> The FAB energy level strategy also helps youngsters with sensory modulation, mental health, and behavioral challenges.  The FAB energy level strategy can be embedded in the school routine before and after low structure and stressful activities (e.g., school lunch room, recess, physical education class, therapy sessions).  If a student identifies his energy level as uncomfortably high after physical education class or recess I urge school staff to send him to occupational therapy for individualized energy modulation strategies (e.g., pushups, mindfulness tasks).  Once the child rates his energy as medium and comfortable he is rewarded and returned to class.
The FAB energy level strategy also encourages youngsters to identify their triggers and coping strategies through drawings or using the FABTrigger & CopingForms  On each page clients select their 3 most problematic environmental triggers, body triggers, and effective coping strategies.  Youngsters can color and paste pictures of their trigger and coping strategies to post in areas where they often experience behavioral problems related to sensory modulation difficulties (e.g., preschool nap area, first grade writing area, math corner).

The final aspect of the FAB energy modulation strategy is embedding individualized strategies that effectively manage their energy levels into their daily routine.  Practice with coping strategies can begin in the sensory calming area where the environment can be easily managed.  Deep pressure activities with slow linear movement (e.g., going through a Steam Roller Deluxe, wheel barrow walking on hands over a therapy ball, moving mats) are frequently helpful for modulating energy levels.  Daily cardiovascular (e.g., an hour walk, half-hour jog), relaxation (e.g., 30 minute meditation, mindfulness, or yoga activities) and heavy work (lawn mowing, weight lifting, swimming) activities often help clients maintain a quiet alert state.
Rather than prescribing a specific sensory diet individualized FAB Strategies are suggested to provide options for maintaining self-regulation embedded in the daily routine. Strategies for maintaining a quiet alert state can be independently developed by the child or adolescent using the FAB Energy Modulation Wheel  
or developed as a home program with his therapist and teachers using the FAB STRATEGIES form. The SensoryLifestyle is a great new approach I was introduced to by occupational therapists in discussions on my blog that conveys the lifelong management of arousal levels that is often needed.  While teaching children and adolescents to manage their arousal level can be a long and challenging process, it is ultimately affective for promoting functional behavior and learning.
References:
Ayres, A. J. (2005). Sensory integration and the child: 25^th Anniversary Edition.  Los Angeles, CA: Western Psychological Services.
Dunn, W., Cox, J., Foster, L., Mische-Lawson, L. & Tanquary, J. (2012).  Impact of a contextual intervention on child participation and parent competence among children with autism spectrum disorders: A pretest-posttest repeated-measure design.  American Journal of Occupational Therapy, 66(5), 520-528.
Flook, L., Smalley, S., Kitil, M., Galla, B., Kaiser-Greenland, S., Locke, J., Ishijima, E., Kasari, C. (2010).  Effects of mindful awareness practices on executive functions in elementary school children.  Journal of Applied School Psychology, 26(1), 70-95.
Rodger, S. & Brandenburg, J. (2009).  Cognitive orientation to (daily) occupational performance (CO-OP) with children with Asperger’s syndrome who have motor-based occupational performance goals.  Australian Occupational Therapy Journal, 56(1), 41-50.