The pressure principal


Using a body awareness programme to aid relaxation and promote learning for children with ASD

Our school, like many other special schools, has a cohort of complex pupils with autistic spectrum disorders (ASD), many of whom are working at a pre-verbal level with difficulties of cooperation and compliance. Over time, we have developed personalised learning strategies using elements of various well-known techniques and social skills interventions. Our pupils also benefit from a timetable incorporating many opportunities for additional physical activities, including weekly horse riding, rebound exercises and adapted cycling. Last year, school staff revisited sensory integration, following INSET and the formation of a small working party with a remit to develop relevant programmes for indentified pupils.

Some of our pupils demonstrate classic hyper or hyposensitivity to sensory input. For example, Isaac is a typical hypersensitive child with poor awareness of his body parts; he struggles with getting dressed and weight bearing and on many occasions he withdraws from activities which include touch. Josh also has poor awareness of his body but is hyposensitive; this manifests in sensory seeking behaviours which include banging objects when walking, deliberately crashing and breaking equipment, obsessive jumping, and sucking and chewing items. Emily is a typically sensory-seeking child. She is easily distractible and most of her day is focussed on an intense search for more or stronger stimuli, which unfortunately for staff and children, includes biting and scratching.

Research has shown that all these pupils have difficulties with regulating their senses appropriately, including proprioceptive and vestibular difficulties (problems with how experiences of movement and gravity are processed). These, in turn, affect the children’s learning and behaviour, which inevitably impact on the school and the families concerned. While staff at our school do have an understanding of the effects of sensory integration difficulties, and have benefited from general training and individual programmes produced by our occupational therapist and physiotherapist, there was general agreement amongst staff that more could be done to help pupils with these difficulties.

It can be a challenge for schools such as ours to ensure that therapeutic programmes are not only timetabled with sufficient regularly and appropriate staffing, but also that the activities are age appropriate, motivating and meaningful for our pupils. It was with these challenges in mind that a group of interested staff – teachers, teaching assistants and a physiotherapist – explored new ways of combining aspects of sensory integration with a physical activity, music and communication programme.

Some of us had worked in discrete autistic provision previously and recalled the positive impact of a body awareness programme (no longer produced) which put musical accompaniment to fine and gross motor activities. We decided that we would develop our own updated version – a CD with a photographic cue sheet and 14 different activities – using more contemporary musical cues with sung directions (so staff and children could participate) and including some aspects of sensory integration, in particular deep pressure. This use of deep pressure – using hands and small balls – promotes increased body awareness and, most importantly, provides increased proprioceptive feedback, which we have found to be very calming for many of our pupils.

Partnership work is included throughout the programme, incorporating relationship play work, where pupils work closely with a member of staff with opportunities to rock back-to-back, building up a sense of trust and increased awareness of their body moving in space. In time, some children also progressed to working with each other.

The musical phrasing was designed to incorporate elements of intensive interaction (when pupils could control the pace and nature of movement which is then imitated by staff). The deliberate and slow nature of the programme provides opportunities for staff to closely observe their pupils’ reactions, however imperceptible they may be. Some children look intently into their partners eyes to indicate their enjoyment of an action; they may move their partner’s hands during the relaxation session to convey a need for physical proximity or, alternatively, they may adjust their backs to show readiness for firm pressure.

Staff were clear that the optimum duration of this programme should be about 20 minutes, with an opportunity for vigorous physical activity – bouncing balls – to introduce children to the activity and aid transition to the programme. A composer was commissioned to work closely with school staff; the dynamics and timbre of each musical cue were considered carefully and lively and calming pieces were interspersed throughout the programme. Lyrics were also of immense importance. Care was taken to ensure that there was plenty of repetition, to aid pupil recall, and that the words were as simple as possible. In addition, there were unaccompanied excerpts so that pupils could indicate their preferences regarding extending the recommended actions.

This programme now takes place four times a week for a discrete group of youngsters with ASD. However, identified children from other classes also come along and take part in these sessions. Our classroom now accommodates 11 children and partners working together on the programme; all that is required is a small mat (yoga type is ideal) and a small squashy or weighted ball. Pupils throughout school have benefitted from our Listen and Move programme, including older teenagers with mental health difficulties and degenerative conditions and some youngsters with Down syndrome who need to develop turn taking skills. The programme was also piloted with parents and the feedback from families has been very positive.

Careful recording takes place after each session, noting pupil responses. All children have responded positively to this programme, impacting on their behaviour in all settings. Initially, some of us were unsure that our more challenging children would be able to sustain concentration for the duration of the session; however, it has been with these children that we have seen our most remarkable results. To observe a highly distractible and anxious child, who struggles to attend to adult-directed activities, suddenly calming, stilling and anticipating the sequence of movements in the programme is remarkable. At the end of the session, which concludes with a relaxation session when partner and pupil lie side by side, all children are calm, happy and, most importantly, more ready to learn and participate.

Further information

Barbara Bradbury is Deputy Headteacher at the Loyne Specialist School, Lancaster:

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