The extent of the sensory environment used in the treatment and rehabilitation of children with disabilities expands to include all groups and stages of treatment for them to work on stimulating their senses and increase their awareness and other problems. This study focuses on a fundamental question which is to what extent could sensory environment be used in the treatment and rehabilitation of children with disabilities in rehabilitation centers?
Spatial limits of the study
A case study was conducted on the Sanad Association for People with Special Needs in the city of Nablus. Since the start, two sensory rooms were implemented; to hold special sessions for children, the rehabilitation treatment was an integrated program in the association from the beginning.
The association was established in 2012 in the city of Nablus to provide distinguished services to children with disabilities. By a group of enthusiastic mothers, many of whom have disabled children, believe in the importance of enhancing the abilities and self-concepts of disabled children so that they can lead more productive and meaningful lives.
The association aims to raise awareness of the importance of early detection and intervention and the importance of accepting the child’s condition as a necessary first step in identifying and applying appropriate adaptation. Developing the physical and social capacities of children with disabilities to increase their independence and participation in life. Supporting parents of children with disabilities, training them and providing them with the necessary skills to enhance abilities and care for their children.
The association contains 75 children, 22 of whom are females and 53 males, ranging from 2-14 years old. The groups of children in the association focus on those who suffer from autism, cerebral palsy, hearing problems, motor disabilities, psychological problems, and behavioral disorders such as hyperactivity and attention deficit hyperactivity disorder.
Tools of the study
In conducting this study, the research team relied on the semi-structured interview tool conducted with the professional specialist within the association, Nidal Hannoun. Where she worked for 3 years in the Sanad Association up to now.
The interview included (17) quantitative and qualitative questions and sub-questions according to their type, which allows the research team to delve into details other than the previously prepared questions, focusing on the same topic.
It was found through the interview which was conducted with the professional Nidal Hanwan that the sensory room is widely used in the treatment and rehabilitation of children with special needs to include a wide range of therapeutic aspects for them.
The interview focused her questions on several axes:
The first axis: the components of the sensory environment in the association and its role
The center contains two sensory rooms, each with some sensory tools. The first room is equipped with an interactive floor, infinity mirror, bubble tubes, sensory box, and lighting table, while the second room contains fibers optics, tactile panel, the interactive table, the sensory box, the ball pool, and the interactive steps.
She explained that each of these tools has a special role and results that are achieved through their use, according to the nature of the child being worked with, the category to which he belongs, and the treatment stage the child has reached.
The second axis: the nature of the sessions within the sensory environment of the center
The duration of the session inside the sensory room is 40 minutes, and then the mother is seated for 5 minutes. But in light of the Coved-19 pandemic, the session duration has been reduced to 30 minutes and the mother setting for 5 minutes.
The specialist emphasized that each case has its specificity in the session. Children who suffer from sensory disturbances use the interactive floor to develop a sense of the feet and the tactile panel to develop hand touch. As for children who suffer from problems with vestibular sense, the spiral swing is used by means of spiral swings or side swings in an attempt to achieve random movements to stimulate the vestibular sense, raise the nervous sense, increase the child’s neurotransmission, and increase his attention and focus. Therefore depends on the nature of the existing situation and the goals that are being worked on with the cases. Thus, it depends on the nature of the existing case and the goals being worked on with the cases.
For example, in the session that is held with children with cognitive issues, the focus is on the program for cognitive skills such as matching, classification, distinction and games that focus on harmony in movement between fingers and eyes through the sensory box and its content. For any child who suffers from higher cognitive problems the sensory box system is mainly used with them, and many satisfactory results have been achieved through its use for many children. This helped this is the inclusion of the content of the sensory box within levels that are determined and chosen according to the condition of the child with whom the session is held, which helped the children’s development significantly while graduating in these levels. Other sensory tools are also used in the room, such as a lighted table, for example, which helps children match and learn shapes and colors In in an interactive and fun way.
As for the child who suffers from sensory problems, we start the session with him/her by getting close to them and getting to know their feelings and temperament, then starting the session with them through the swing, and later working on the cognitive entertainment side with them through the contents of the sensory box such as music, and interactive games. After making sure that the child is integrated into the session and feels comfortable, working on the sensory aspect starts with them. The child takes off his/her shoes and begins with him the exercises of walking on the interactive floor with the help of the specialist until the child accepts walking on it alone, which is often after the third treatment session with the interactive floor. The textures to which the child is affected and the extent of development in his condition are observed through his acceptance of walking on the floor each time the session is held.
The third axis: the role of sensory tools in the treatment and rehabilitation of children within the association
The specialist explained that sensory tools have uncountable benefits for children, and she gave examples of sensory tools benefits in improving children’s pronunciation. Some of the sensory tools in the room helped children to speak, especially for children in the “language explosion phase” of two and a half years of age. Within less than a month of using the sensory environment, the children became able to speak normally without any problems. In these cases, the children have linguistic competence, but they never speak, but the sensory room and its environment help them with “language explosion” to a large extent.
Bubble tubes have greatly helped with pronunciation as well. Many non-speaking children, after continuous sessions using bubble tubes, begin to speak, where their pronunciation is initially random, and then continue with other remedial methods to develop the child-directed speech process.
During 2020, 4 cases of children were treated using this method and the children are now fluent. They are currently being graduated from the association because they have mastered all sensory and language skills.
The infinity mirror in the room helped the children to speak by sitting in front of it and seeing their image on it in an infinite way. The children are trained with it to master the skill of directed speech by directing the speech to themselves using the mirror. Many children when they start the process of using the infinity mirror, appear as if they see themselves for the first time in the mirror.
She emphasized that the sensory environment has a significant impact on the mood of children, not only in their development during the treatment journey. As the sensory room is an environment for psychological discharge and sensory stimulation at the same time. Many children have some behavioral problems, but as they enter the sensory room and keep going with the sessions, they obtain a significant improvement in the behavioral aspect.
Also, children who suffer from sensory problems with touch, or a certain sensitivity to tastes, show signs of relief and come out of it with a completely different mood. The sensory room is a place to discharge negative energy in children.
The fourth axis: the methodology that is used for treatment with the sensory environment
The methodology of learning by playing with children is followed. It seems that the child is only playing, but all that the children play with is part of preparations and plans to achieve goals that were previously determined. She explained that based on the experience of all specialists over the years, the best way for children to respond and develop in their condition was to learn by playing, especially using the sensory environment tools and the sensory box, which are tools that encourage children to respond to and focus all their senses with.
Fifth Axis: Determining the needs of children and setting individual goals
The first step when the child enters the center is to undergo a comprehensive medical examination and obtain a medical report for them to evaluate their condition organically, to ensure the safety of the child’s inputs and outputs, and the classification of the children’s condition is primarily and essential from the doctor. After that, an evaluation session is held for the child in the presence of occupational, physical and speech therapists to implement a case study in cooperation with the mother of the child.
Then each specialist sets the goals that they will work with the child to achieve, and the professional supervisor inside the center makes sure of the goals that have been set so that they are measurable as well as achievable. The duration of the plan was developed in 3 months, after which the child’s condition and response to treatment will be evaluated with the specialist, and then the plan will be developed after the third month according to the child’s condition that he has reached.
For example, if there is a goal to develop the child in terms of colors, coordination is made between specialists to work on this goal. The speech pathologist works with them in terms of pronunciation in a linguistically correct way, and the educational specialist works with them to distinguish sounds perceptually. She works with them in the same field and goal to achieve. She also stressed that there is no specific period for achieving the set goals because this depends on the child’s response with specialists and the cooperation of parents with the specialist in following up the child inside the home.
The sixth axis: the categories most responsive to sensory tools
The specialist, Nidal, confirmed that each category responds differently from the other categories through the sensory environment treatment journey. In addition to the difference in the devices and tools that are used with each category, and the extent of the desired benefit from using the device. She stressed that, based on the assessment of all children in the association, all those with whom the sensory environment was used developed and improved their health and psychological condition.
For example, autistic children are the group that suffers the most from sensory problems, as they are the group that benefits the most from the tactile panel and the interactive floor in the sensory room.
For autistic children, the tactile panel, interactive floor, bubble tubes, and infinity mirror are used colors in addition to the sensory box, which plays a major role in developing visual communication among autistic children, as the response and development rate for autistic children is more than 70% of what they were before using sensory tools.
As for children with Down’s syndrome, for example, they suffer more from cognitive problems. The sensory box is used with them to develop their cognitive skills, in addition to the use of the lighted table, which plays a major role in increasing children’s cognitive skills, learning shapes and colors and drawing with sand on the surface of the table.
The seventh axis: How to measure the effect of using the sensory environment in treatment and rehabilitation
During the interview, the specialist explained that the impact of using sensory tools with children in the sessions is measured by comparing skills before undergoing the sessions in the sensory room and after receiving the sessions, in addition to the fact that video clips of some children are filmed before and after starting the treatment in order to compare these clips and measure the effect that was obtained. The feedback from the children’s parents while continuing the treatment indicates the amount of development that their children are getting.
The eighth axis: Practical models of improving children while continuing to use the sensory environment.
The child Ahmed is a 12-year-old child with autism, who spent two and a half years of treatment in the association. He used to get 3 sessions a week in the center inside the sensory room. He is a very intelligent child, but he suffers from great sensory problems and high sensitivity to sounds to the point that he refuses to eat because the sound of chewing food disturbs him and causes him great tension and distraction.
After several sessions in the sensory room using the tactile panel and the interactive floor and training him on friction and jumping on different textures, he was completely cured of this problem by exposing him more than once to these textures, especially the rough ones, to work on the neurotransmitter to reduce his sensitivity to sounds and friction In addition to using the box. Sensory education teaches the child about different types of food and how to eat them through the educational games inside.
Moreover, he was suffering from a sensory problem in his limbs, as they remain in a state of great convulsion, so physiotherapy sessions were conducted for the child inside the sensory room to stimulate his delicate limbs by means of the tactile panel and the interactive floor. He obtained an estimated benefit of 70% over what it was before.
The ninth axis: Parents’ experience with the sensory environment
The specialist also mentioned that the association also focuses on some recreational activities for the parents in order to psychologically relieve them, as some sessions were carried out inside the sensory room of the mothers with the aim of psychological emptying for them, and the reactions from them were very positive and they requested that it be repeated and implemented periodically for them.
- The scope of the use of the sensory environment in treatment and rehabilitation extends to a very wide range with all categories of children with special needs.
- The response rate of autistic children to sensory tools is more than 70% of what they were before using the sensory environment.
- The sensory box plays a major role in developing children’s perceptual and sensory skills through the interactive and educational content in it.
- The use of the sensory room is not only limited to treating and rehabilitating children but also includes psychological discharge for their parents.
- Sensory tools help children with speech, especially if they are combined with them early in treatment.
This study examined the extent to which the sensory environment is used in the treatment and rehabilitation of children with disabilities and its role in the development of their response to treatment, through an interview conducted with the professional specialist in the Sanad Association for Special Needs, Nidal Hanoun.
The study reached several results, the most important of which was that the sensory environment is not limited to the extent of its usefulness to children of all groups and helps them develop their sensory and perceptual response.