Area for sensorial integration
The Multi-sensorial and Relaxation Classroom forms part of the educational answer to pupils with important disabilities. The educational intervention endeavours that the individual emits adapted answers (continual visual fixation, vocalizations, muscular tone regulation ...) after receiving two or more sensorial stimulations.
This space has been designed with a special consideration to light and sound, and contains specific objects and materials which fashion the atmosphere necessary to help development. The musical water bed, the columns of bubbles, the luminous fibre beam, the vibrating massage mattress, the tactile panel, the light and sound panel, the ultraviolet light, the ball of mirrors, the oil projector and the ball pool furnish a classroom which transmits that indefinable sensation of languor which is interwoven with certain states of relaxation.
1- THE BEGINNING OF THE MULTISENSORY ROOM
In 2002, a Multisensory and Relaxation Room was set up at the Special Education School Gloria Fuertes in Andorra (Teruel). The room measurements are 6,20 x 5,53 m; Its light and sound have been carefully designed, which combined with specific materials and equipment create a space that help to re-encounter intense, primitive and holistic sensations with a high emotional contents, that generate adapted responses. Some of these special equipment are the musical water bed, bubble columns, bundles of luminous fibres, a vibromassage matters, panels activated by touch, light and sound, ultraviolet light, a ball of mirrors, an oil projector, a pool full of balls and sound box.
This room is specially designed for pupils with various degrees of disability, but especially for the most severe. Its main purpose is to facilitate their physical and psychological wellbeing as a way to the re-encounter with themselves and the world.
The needs of special communication and interaction with the surroundings make necessary the introduction of Augmentative and Alternative Communication Systems in order to help the communicative intention.
Some features of these pupils are:
- Difficulties to interact, to receive and transmit information, to process it and project it.
- The need to communicate and interact make necessary the use of specific stimulations, mainly through the body, which they are apply by various therapies.
- In the majority of cases, pupils need one to one interventions; these limits
the number of pupils in the sensory room.
These students' needs, together with the design of this new space and its specific equipment created a new area within the School Curriculum, the Sensory Integration and Development Area.
2- OUR MODEL: BASIS AND METHODOLOGIES
Sensations form the main source of our knowledge, of the outside world and of our own organism. Sensory Integration is the organization of sensations for our own use.
According to J. Ayres (2005):
- "Is an unconscious process of the brain (occurs without us thinking about it, like breathing).
- Organizes information detected by one's senses (taste, sight, hearing, touch, smell, movement, gravity, and position).
- Gives meaning to what is experienced by sifting through all the information and selecting what to focus on (such as listening to a teacher and ignoring the noise of outside traffic).
- Allows us to act or respond to the situation we are experiencing in a purposeful manner (know as an adaptive response).
- Forms the underlying foundation for academic learning and social behaviour".
Research clearly identifies sensory integration problems in children with development and learning difficulties. Different studies show, in the American Society, that sensory integration dysfunction is common in more than 70% in learning disability children at schools. Possibly, although unknown, in the Spanish society this figure is similar. It is very likely that an important percentage of school failure cases hide an underlying sensory integration dysfunction. Generally speaking, we also find this type of problem in any degree of intellectual disability.
In the following, we are going to describe some general features of the two major methods on which we built the structure of our intervention: Jean Ayres´ Sensory Integration Therapy and Andreas Froehlich's Basal Stimulation. In addiction to these two methods, the accumulated experience of the Gloria Fuertes School professionals on psychomotor work, has been another important contribution.
Ayres describes four "levels" of the sensory integration process. At the first level, Tactile stimulation indicates that touch sensations from every bit of skin come together for several types of use: one to help the child suck and eat, another to form a mother-infant bond. Touching and being touched have a very important influence on the infant and on the rest of his life. Vestibular and Proprioceptive stimulation together in the child leads to well-organized eye movements, posture, physical balance, muscle tone, and gravitational security.
The second level is reached when the three basic senses are integrated into a body percept, coordination of the two sides of the body, motor planning, activity level, attention span, and emotional stability.
At the third level of sensory integration, auditory and visual sensations enter the process, and at the fourth everything comes together to form the functions of a whole brain.
None of these functions develops at just one age. The child works at each level of sensory integration throughout childhood.
The theory and methodology of Andreas Fröhlich, are mainly explained in the "Stimulation for the development of very deficient children" (Fröhlich and Haupt, 1982), "The basal stimulation" (Fröhlich, 1993) and "Basal Stimulation. Das Konzept" (Fröhlich, 1998), his most recent work, which in many aspects is quite similar to his previous one.
The basal stimulation is not a method, neither a technique. It intends to be a concept, in other words, a logical approach to the problems and difficulties of very dependent persons. This concept signifies that it is not a defined formulated and established therapy, but essential and fundamental reflexions that we always need to consider and adapt. In the centre of this concept we find the person with his physical reality, which takes us towards a personal search when the intelligence and all communication possibilities seem deficient. Each one of us must find a way to communicate with the child, adolescent and complex disability adult, using sensitivity and respect. (Fröhlich, 1998, 12).
The German author introduces the basal stimulation concept as the beginning of the process of reciprocal action of perception-motricity-perception. He defines it as basal because the stimulus, on one hand, does not demand any kind of knowledge and previous experience to be assimilated, and on the other hand, because they are the base of the highest perception. Also, he understands Stimulation as the child's exposure to certain stimuli which at first they are semipasive and whose quantity, type and duration are established by the teacher o therapist.
Equally, in the basal care, he distinguished the day to day stimulation and the specialised stimulation. Within the later, the basic stimulations, which are the foundations of perceptive organisation, comprise: vestibular stimulation and somatic stimulation. The primary body experience includes touch stimulation and vibratory stimulation; the motor experience contains the experience of micro-movements, mobilisation and various postures to enhance wellbeing. Finally, he deals with the stimulation of communication.
The accumulated experience of the Gloria Fuertes School professionals highlights the importance of the actions and movements to improve certain cognitive skills. The importance of the vestibular stimuli to organise the sensory integration in people with different types of disability, has encouraged us to design a specific space: the Psychomotricity Room, with its appropriate devices to implement this stimulation easily and effectively. We have also tackled experimental research and the curricular design in the areas of Psychomotor Therapy and Physical and Psychomotor Education since the year 1993.
3- EQUIPMENT AND ITS USES IN THE MULTISENSORY ROOM
Here there are some suggestions for equipment and its use:
- The musical water bed is the central element for the pupils with the most severe difficulties. Working possibilities: postures, tactile stimulation, propioception (modulated pressures) vibratory stimulation (sound through water), use of relaxation methods (especially those related to Jacobson, with adaptations), balance work.
- It combines well with the four colour light, the ball of mirrors, the oils projector and the columns.
- The child should wear few clothes and not foot ware.
- Either music or his/her own sounds/words can be felt through the water.
- The vibro-massage mattress . In option 0, with duration of three minutes, it is adequate for all pupils.
- It combines well with black light, the four colour light and the ball of mirrors.
- Make sure the child's feet are fixed to the support.
- In certain pupils a wedge under their knees is advisable.
- While the program is working, the teacher should be at the side, being able to work on visual exercises. We should not forget that one of the aims is to achieve physical relaxation and mental alertness.
- Once the programme has ended, the teacher should perform pressures throughout the body, especially on the legs; and to finish off, 2 or 3 minutes of immobility.
- The bubble columns should be use with no other light device.
- The teacher may go on the stand with the pupil to play with colours, visual games.
- Different body parts can be brought to touch the column, to be able to feel its vibration.
- Point out to the child his reflexion on the mirrors.
- The tactile panel can be use from the floor, raising the child on to the soft seat, positioning him on our knees or directly from the wheel chair. The ergonomic seat can also be used, placing it next to the panel, so that the child can reach to play with it.
- The sound box transforms the music sounds or the human voice into vibration. It combines well with the four coloured light and the ball of mirrors (with/without movement).
- The child can feel the vibratory stimulus either by leaning different parts of his body directly on its surface, or by sitting on a device (wheel chair, wooden chair,.)-
- You could work with the vibration on - off concept, by asking for more vibration with different communication signals (vocal sounds, smiles, body language,.), bimodal sign language and oral language.
- Using a microphone enables you to work on the imitation of vocalizations, words and sounds.
- This device, because of vibratory characteristics, is especially indicated for working on auditory stimulation with hearing disable children.
Micro skills related to tactile-movement stimulation should be worked on as well: defensive reactions, tactile sensitisation y desensitisation, hand activation and hand grip.
- The light and sound panel should be used without any other light element at the same time.
- It is difficult to use it with children with severe and profound disability, although it may be tried out with some of them, so that they can discover the pleasure of being the cause. For this pupils, the panel would activate automatically through various types of music and light.
- The medium or slight disable children, perhaps with some other added difficulties, benefit most from this apparatus.
- There is mode where speech and sound trigger screen colour; it is sensitive to sound intensity and duration. Very useful in Speech Therapy.
- The pool full of balls has got enough room for one or two children and the teacher.
- The child should move or be moved until his body is completely covered by balls. Experiment with the contrast of moving and not moving.
- You may want to massage the child's body with lots of balls, or perhaps just use only one of them for his/her face or other specific part of his body.
- Looking for the bottom of pool or searching for a bright object can be another possible game.
- The bundle of luminous fibres should be used with no other light device.
- Playing can be done with one single fibre, with several of them, or with the whole bundle. In children with visual difficulties, it is useful to bring the fibres close to their eyes to produce contrast.
- Other possibilities are: stretch them until they cover most of the child's body; make arm bands, bracelets, necklaces; place them under the clothes; draw figures in the air; play to imitate what the child does, or the other way around.
- You can work either on a hard surface (carpet) or on a soft one (water mattress).