Wednesday, August 31, 2011 at 10:07AM

Why Assessment?

Assessment, a word to strike a degree of apathy into the heart of any one linked to education or any other target driven field of support, where the use of assessment has been done to death. Hang on though take some time to have a quick browse at this blog as there are some really important reasons why we should be considering assessment in terms of multi-sensory work.
There are two obvious reasons for assessment. One is to ensure that what we are doing is of some use to the student. We need to ensure the person we are working with is making progress so we need to provide activities that challenge but are also not beyond the individual’s capabilities.  Secondly we need  ensure that what we are doing is not actually causing those we work with any harm. It is this second aspect that I want to discuss, firstly by considering how we could actually cause harm in our sensory work.
In general terms there are three levels of response to sensory stimulation. The majority of us present with an average response, we are well tuned to sensory stimulus and only react adversely when the stimuli is presented at extreme levels, too loud, too bright or too heavy, say in the case of touch. For a smaller proportion of the population hyposensitivity and hypersensitivity presents problems. People who have additional needs are far more likely to present with ‘hypo’ or ‘hyper’ sensitivity issues than the general population and so it is extremely likely that at some point you will be working with someone with a different sensitivity pattern.
So what does ‘Hyposensitivity’ and ‘Hypersensitivity’ actually mean. The term ‘Hyposensitivity’ is used to describe the state where an individual needs much more of any particular stimulus before they will sense it. This can be in some circumstances very dangerous particularly if they are hyposensitive to touch. The condition makes them insensitive to pain and means that they can hurt themselves without being aware. Such an individual may tolerate heat to the point at which the skin may burn before reacting. ‘Hypersensitivity’ is the opposite, where a relatively small amount of the stimulus is required and normal levels of sound, light or touch can become painful. Many autistic individuals display with either and sometimes both sensitivities. Often the challenging behaviour exhibited by a child with autism has a direct correlation to a sensory stimulus that other children would not be aware of. I have worked with many such children who find the noise levels in an early years classroom setting so noisy as to cause anxiety. The build up of anxiety can create sufficient stress that it leads to aggressive behaviour a manifestation of the fight or flight scenario. Many parents of children with autism, ADHD or other similar neurologically based additional needs report such difficulties when out shopping, often in supermarkets overloaded with sensory stimuli.
So we will be working with individuals who are hyper or hypo sensitive but a greater problem is that it is very likely that the majority of adults they come into contact with will have no knowledge of their sensory needs.
It is necessary then to understand or assess the individual’s threshold for sensory experiences. The most common process in schools and centres is the logging of incidents and seeing a pattern over time. This, however, means that we are placing that individual on a regular basis in a situation where they become anxious on a regular basis. Far better surely that where we suspect a sensory problem some form of assessment is carried out initially. Where vision or hearing issues are suspected it may be possible to turn to services for visual impairment or hearing impairment for specialist help. If you do go down this route ask if possible for a functional assessment not just an acuity test. If such support is not available then initial sensory sessions can easily be structured as an assessment. A multi-sensory room if you have access to one is the ideal place to conduct such an assessment owing to the control over the range of sensory stimuli.
Consider exploring the individual’s response to light at varying levels, do they seek it out or do they avoid it. Start with simple torches, easy to handle, easy to control, consider using other safe sources such as fibre optic lights. If such light levels cause no problems move to stronger light sources such as rotating projectors, pin spots. The assessment is always seeking to identify the same aspects; the minimum level to elicit a response and those situations where the individual tries to avoid the stimuli. You may wish to consider the impact of different colours, moving light, flickering light.
A similar process should be undertaken for the other senses, touch, consider the pressure needed to elicit a response. Some individuals may really try to avoid any physical contact with other people; others may really enjoy this form of contact. Different materials can create different responses and not always the typical response we would expect. Some people may react adversely to soft fluffy sensations and may prefer rough coarser sensations from hard resistant materials.
Sound too needs careful assessment both for volume but also for the type of music. I personally could never relax to the sound of panpipes nor would I find crashing waves and the trumpeting of whales particularly conducive to relaxation. So if the whole purpose in the sensory room is to calm down an agitated individual their personal preferences are extremely important. Sound volume and sound frequency to is of importance.
Don’t forget that for many of us we can make our own personal decision about the level of stimuli we expose ourselves to, either by communicating to others that it is too loud, too bright, too hard or by simply walking away. For many of our clients this is not an option and their communication may come through their behaviour either switching off or getting angry.