OT On-Hand Attention & Focus

The ability to attend focus on school tasks plays a significant role in student success.

There is a lot of literature on what causes poor attention, and as much, if not more, on strategies and techniques to help a student focus on the task at hand. Strategies commonly recommended by OTs are usually based on sensory integration theory, also known as sensory processing. Our understanding and application of sensory integration theory and practice, first researched by OT Dr. Jean Ayres in the 1950s, continues to grow and develop.

Keys to Success

• discover a student's individual sensory needs to enhance his classroom functioning
• modify the environment and routine to match student's needs
• acknowledge small amounts of change

Everyday Opportunities

• try animal or silly walks to move between centres, activities or sessions
• stretch during work sessions, for example during a printing session
• use of fidget tools during instructions
• vary your voice (volume, speed, rhythm and pitch) to match the classroom or a student's needs.

What is Sensory Processing?

Sensory processing is the term used to describe how the brain takes, interprets, and acts on sensory information.

Hearing, touch, smell, sight and taste are the best known of our senses. The brain also takes in information about vestibular and proprioception.

• Tactile: This information about light /deep touch and temperature comes from the skin, body and mouth (oral)
• Proprioception: This information about deep touch, pressure and movement comes from joints and muscles.
• Vestibular: This information is about movement and position in space and comes from vestibular organs in the inner ear.

Sensory Thresholds

Every individual has a threshold for different sensory information.

Responses to sensory information can be either motoric (run, stop, hide or change action) or emotional (fear, anger, sadness, happiness). Of course, the resulting action then feeds back to the brain as more sensory information. Individuals can, at times, either over-respond or under-respond.

Every individual has a threshold for different sensory information. Thresholds are like a cup – some are quite empty and the individual needs to add to the cup. Other cups are just filled to the brim and are waiting to spill over. Over time, some individuals require less sensory input to reach their threshold.

Continuing with the cup analogy, those with low thresholds are just on the point of spilling over and just the slightest bit of information can send them over the edge and they appear to be over-responding. As a result these people will avoid certain sensations in an attempt to avoid "spilling over". For example, some students will cover their ears on hearing the school buzzer or walk along the wall during gym class to remove themselves from the noise and action.

Similarly, others with high thresholds tend to engage in activities to get more of the sensation they need to add to the cup. In class, this is the student who fidgets and squirms when seated, drops things, or bumps into other students. This last action especially can be misinterpreted by other students as "picking a fight" and by adults as misbehaving.

Filtering

The brain also has a filtering function which enables it to process the most salient information required at any one time.

For example, if the phone rang and the fire alarm went off at the same time, you are more likely to attend to the latter, and then think about answering the phone. Students in school must be able to attend and listen to the teacher while simultaneously filtering out sounds from the hallway. Some students' filters may not work that well – so they are constantly attending to all the sensory information, and consequently cannot focus on the task at hand.

What do you do…

• What sensory information (hallway sounds, students talking or laughing, the noisy photocopier) are you blocking out while reading this material?
• How would you respond (listen or ignore) if an overhead announcement was made?
• What would you do differently if the fire alarm went off just now (get up and follow the fire procedure)?

How is Sensory Processing Related to Attention and Focus?

Individuals are able to use different sensations to alert or calm themselves in order to meet the alertness level needed for a particular activity. This is called self-regulation.

The appropriate alertness level depends on the activity and on each individual's unique threshold. For example, some people need background music to fall asleep, while others need complete silence. The result is that an individual is constantly regulating sensory input in order to balance their alertness level to the activity, whether it be studying, sleeping or interacting with others.

Most adults manage their sensory environments without even thinking about it. For example, they have an ability to avoid distressing sensory situations or environments. Children on the other hand, are still learning about their own sensory systems and may not know how to express what they are experiencing or feeling. They also may not always have the option to avoid a particular situation or environment. A student who has difficulty focusing in a busy, noisy environment still has to participate in a loud, rambunctious gym class.

What do you do to…

• go to sleep?
• wake up in the morning?
• concentrate while reading?
• calm yourself if angry?

Which sensory systems are involved in order to manage these tasks? Are they alerting or calming?

Behaviour Versus Sensory Issues

Adults play a central role in helping children discover how to manage their sensory environments.

As mentioned earlier, it is not unusual for an individual to under or over-respond to certain situations. This does not affect their daily functioning or performance. However, a breakdown in one or more stages of processing or with one or more of the sensory systems, can affect a student's functioning at home, school and community.

It is not always easy to tell the difference between a student with behavioural problems and one trying manage his sensory environment and needs.

• Did a student hide in the cloakroom to escape from following through with a task (behaviour) or to reduce the visual and auditory effects of a busy classroom (sensory)?
• Did the student clown around at the desk to get attention (behaviour) or engage in alerting movements to help alertness level (sensory)?
• Did the student deliberately bump into other students to annoy peers (behaviour) or does he need touch input to meet his threshold (sensory)?

Levels of Alertness

Adults use sensory input every moment to regulate their level of alertness in order to focus on a task. These sensory activities can be alerting or calming – depending on the task and individual.

It is helpful if the teacher can discover with the student which sensory system to access for a particular activity. Try a variety of sensory strategies to see what works best for a particular student.

• Adult Use of Sensory Strategies - Examples:
  • chewing at the end of a pen while writing (tactile: proprioception);
  • snacking while prepping (tactile, taste: crunchy and salty);
  • shifting position in a chair while attending a workshop (proprioceptive, vestibular);
  • opening the car window while driving (tactile: wind, cold temperature)
• Calming: After an exciting gym class, turn down the lights and do deep breathing exercises to get the students ready for a spelling test.
• Alerting: If you notice the students become restless while doing a worksheet, have them stand up and march to an action song.
• Leveling: They are calming for some, and alerting for others and are, therefore, easier to use with a group of students. Leveling activities involve proprioception, or "heavy work": (chewing gum, drinking from a sports bottle through a straw or using fidget tools like pencil toppers, koosh balls, manipulatives or putty).

Strategies

The following sensory strategies can be used in the classroom.

• Monitor the class and/or students to see when they need these strategies the most.
• Remember that there is a novelty phase when introducing sensory strategies, especially the fidget tools.
• Students will need to practice a particular strategy before the effects of it can be seen.
• Do not be discouraged if it does not work right away or if changes are small.
• Keep in mind that individual student needs can vary.
• An OT can help you to find specific strategies for individual students or classroom organization.

Alerting:

• Bright lights and bright colours
• Fast music
• Voice: hight pitch, fast, loud
• Light touch
• Cold temperature
• Handling manipulatives ("fidget tools")
• Action songs
• Chair ball
• Move 'n' Sit® Cushion

Calming:

• Reduce visual distracters (cave, den, carrels)
• Use of a visor
• Clear desktop
• "white" or neutral background noise such as a fan, or calm music
• Tennis balls on the legs of chairs
• Linear movement (rocking chair)
• Deep breathing exercises

Leveling:

• Vary brightness or dimness using lamps or shades in different pars of the room
• Simple instructions
• Drink through a straw or sports bottle
• Chew gum
• Fidget tools

Rules for Fidget Tools:

• Explain to the class the purpose of a fidget tool. It is to help students focus on their work.
• If it does not help, then the student does not need it.
• If it is misused, the fidget tool is taken away. It can be returned when the student is ready to use it appropriately.