Sensory Issues in Chromosome 15q Duplication Syndrome

Sensory issues are a common characteristic in children with dup15q. In the current research study Molecular Investigations of Chromosome 15q Duplications in Autism, Dr. Carolyn Schanen asked parents to report on the sensory behavior of their affected children. Approximately half of the kids had some degree of sensitivity to sound and about 65% of them had other sensory aversions at some point in time.¹

Parents frequently report their child with dup15q experiences sensory modulation disorders. These sensory modulation disorders disrupt the affected child’s ability to achieve and maintain an optimal range of arousal and to adapt to challenges in daily life. These disorders are often manifested by an over-responsiveness or under-responsiveness to sensory input or fluctuations in response to sensory input.

Sensory Modulation Disorders
Most children with Sensory Modulation Disorders have a combination of both sensory defensiveness and sensory dormancy, depending on the event, circumstance, type of sensory stimuli present and familiarity with the environment.

Sensory defensiveness is a constellation of symptoms that are a result of defensive reactions to environmental stimuli, across one or more sensory modalities. It is an over reaction of our normal protective senses.

Children with sensory dormancy are, generally speaking, under-responsive to sensory input or lacking sensation and awareness, and display an inability to orientate to relevant sensory stimuli. Decreased sensory awareness usually results in deficits in motor planning (dyspraxia) and in motor control.

The overall effect is an inability within the child to adapt to changing environmental demands or situations. This affects the ability to attend and behave appropriately and interferes with learning.

Strategies to promote better sensory modulation
Activities and strategies for providing proprioceptive input and increasing body awareness

• Compression vests and shorts to provide maintained deep pressure and to increase body awareness.
• Ankle/wrist weights for added resistance and to increase body awareness.
• Weighted vest, weighted blanket to provide calming and body awareness.
• Pushing/pulling activities such as furniture moving, carrying books, tug of war.
• Passively applied deep pressure through squishing games, resisted creeping and rolling games.
• Controlled jumping and falling games.
• Stair climbing.
• General core strengthening activities to improve muscle tone through trunk.
  

Activities that provide vestibular stimulation and increase body awareness (without the use of suspended equipment):

• Mini trampoline jumping
• Running
• Hammock swinging
• Rolling, spinning
• Bouncing on large ball
• Jumping and controlled falling
• Scooter board games in sitting and lying
  

Strategies for improving regulation and attention (to be used under the direction of a trained professional)

• Wilbarger brushing program. This program consists of brushing followed by joint compression to reduce sensory hypersensitivity.
• Therapeutic Listening and other listening therapies can easily be incorporated into a sensory diet/home program to improve regulation, posture and auditory processing.
• Provide a small get-away area made from an appliance box or collapsible cube. Provide quilts and pillows. This or something like it can be used as a “get away” area when a child needs to re-group.

A word about Sensory Diets….
Sensory diets provide the child with the needed sensory input at regular intervals throughout the day to meet their sensory needs. It is optimal when these diets can be implemented in both the home and school setting. When developing a sensory diet the following systems should be examined: touch, vestibular, propricepitve, visual, auditory, smell, taste, body position and movement. In addition, consider the possible impact of allergies, GI issues, sleep patterns and nutrition. Therapists are encouraged to work with both families and school staff to help caregivers and educators learn how to implement a sensory diet. Ideally therapists can provide frequent and ongoing monitoring and adjustments of the child's sensory diet as needed. The critical features of a sensory diet include:

• Sensory activities that meet the sensory needs of the child.
• Easy to fit into daily routines.
• Are manageable for family and child.
• Are effective in reducing undesirable behavior and/or increasing desirable behavior.
• Need to be changed and adapted as the child’s sensory needs change.

Resources

1. Schanen, C., Cleary, N.: Research Update Molecular Investigations of Duplications of Chromosome 15 in Autism, Published in MIRROR Newsletter, Fall 2006.

Information provided by Debra J. Denniger, OTR/L, BCP, Clinic Director for Physiotherapy Associates/Rainbow Center in Aurora, IL. Based on a presentation given at the 2005 International Conference on Isodicentric 15 and Related Disorders.

Last updated August 20, 2006