Sensory Learning Kit Study Group #4 This video is posted online with the following chapter markers: Chapter 1. Introduction - Welcome from moderators Scott Baltisberger and Sara Kitchen. Chapter 2. Arousal State Profile - Discussion about conducting the Arousal State Profile. Chapter 3. Sensory Response Record - Discussion on conducting the Sensory Response Record. Chapter 4. Appetite Aversion List - Very brief review of the Appetite Aversion List Chapter 5. Closing Comments - Closing comments. Sensory Learning Kit Study Group #4 Transcript [ Music ] [ Start slide: ] [ End slide: ] [ Start slide: ] [ End slide: ] Chapter 1. Introduction Scott: Welcome to the fourth in our series about the Sensory Learning Kit. This is Scott Baltisberger and also here is Sara Kitchen, TSBVI Outreach consultants. We are here to lead a discussion with you guys about using Millie Smith's Sensory Learning Kit, to perform Learning Media Assessments on some of those kids who ‑‑ for whom more typical Learning Media Assessments may not give us the information we need. So, this past month we were working on the Arousal State Profile and I just thought we just might have a little discussion about that before we start talking about the next section. So I just want to know if anybody has any questions or any comments about this portion of the Sensory Learning Kit, or if maybe you have, just would like share your experience in doing it. I did have a poll to bring up about what kinds of comments or questions you might have. So why don't we go to that poll. Chapter 2. Arousal State Profile [ Start slide: ] Scott: There we go. You guys can just take a little bit of time and see if any of these things are issues for you or you had questions about that. [ End slide: ] So if you are not sure how to describe the arousal sates, I guess that is one thing that kind of occurred to me. Like what -- I mean, for us it is different because we are not as familiar with the students, I think as a lot of the TVIs are, talking about what constitutes, you know, active alert as opposed to quiet alert. You know, one man's quiet alert might be another one's active alert. Sara: Yes. Scott: For some kids. Sara: Or another one's over-stimulated or under-stimulated. Scott: Correct. It doesn't look like anybody else had that issue though looking at the current poll... Sara: A lot of people said that the student was in extended states for most of the observation period. Oh, that is interesting. Scott: Yeah. So the results do say that about 60 percent of the people were not sure how to describe the arousal states, or 50 percent now. A few said they weren't sure how long to spend on the observation period. And some said there was not enough time available for sufficient observation and 100 percent say that the student was in extended states for most of the observation period. Sara: Now, I wonder what the other is. Scott: Hmm. Sara: Maybe somebody could clarify what they meant. Scott: Yeah, that one person. [ Laughter ] Sara: We know you are out there. Participant: Okay. Hi, this is Tracy. Scott & Sara: Hi Tracy. Tracy: Hi. What happened was -- I went three days in a row but the first two days I went, the teacher was absent. And so that really did create an issue as far as what the student was doing for the time period while I was there. So that is why I put 'other.' Scott: Right. Yeah, that -- I think that -- we had the same issue, because we were trying to do some of ours in the last couple of weeks, and the student was actually out and had an accident and was out for a week. Sara: Yeah, we first scheduled it. Scott: And then with all the Christmas. One day Santa Claus was -- came to the school and some other things happened. Sara: And there was a sub for the teachers one of the days we went. It's just hit and miss with some of those things. Scott: There was a sub. And so I think, you know, you need to -- you know, some people talked about their -- not how long to spend or not having enough time and you know Millie said you need to have -- everyone needs to agree it is a typical example of their day. So I think a teacher not being there, that would certainly lead to things being different. Sara: It can. It can. Scott: It is very possible. Sara: I don't that it really did in our situation. Scott: No, because I think that our student is with the one teaching assistant quite a bit. Sara: Yeah. Yeah. Scott: Anyway, thanks, Tracy. And I noticed, yeah, I think the students in the extended states for most of the observation period, that is 100 percent, everybody had that experience. Sara: What kind of extended states did you see? Were they like on the sleepy side or were they more on the over -- or just what did you -- Kate: Sleeping is one response. That is certainly something I have often seen a lot. Sara: We had some of that and we just stopped observing when we got to there. Kate: Arousal issues due to meds, sleeping. You know the one thing that I noticed a lot with these kids is the whole issue of them going to sleep because of the noise level and activity level in the classroom, you know. And that one is a real problem. Sara: Yeah, yeah. Kate: It truly is. Sara: Overly stimulated. Or under sometimes when they are not allowed to mo-... Not necessarily not allowed move but not able to move and the staff isn't really understanding how to help. You know, how that can really help with alertness, you know and how especially if you have limited movement, and you know, in order to emphasize any movement the child makes. What a really nice thing that the staff does with the student, and it is a PPCD class, isn't it? Scott: Yeah. PPCD. Sara: It's PPCD, and they -- the kids are able to get out of their chairs frequently, and this child spend a lot of time out of her chair because she really likes rolling around and kicking and moving and so she -- so she is able... to practice a lot of those things that she needs to do. Scott: Right. But she was also, I mean, we were just talking about that before we started, you know, she was actually in extended states for a significant portion. Sara: Right. And way more than, you know, just like -- I guess Scott did the math and I just, you know, have my memory of -- I think you did one more observation than I did too. Scott: Right. Sara: So in my memory, I think of her as somebody who is very active and very alert most of the time. But then when it comes down to it, there are a lot of time she actually spends, you know, crying or sleeping, you know, because she has to -- she has a hard time regulating her own system, I think. Scott: Right. Sara: And has to depend on other people to get... her system -- her needs met like she needs frequent access to water and food. Very frequent. More frequent than many. Kind of like a really young infant. So that was interesting. I didn't really think about the fact that -- I mean, she seems so, she's not one of those kids where you just go in and she is just asleep, but the percentage was like, what? How much of the time? Scott: I think 60 percent she was alert. Sara: Yeah. Scott: Which maybe -- Sara: That is pretty good. Scott: May be a lot, if you think about it. Sara: It might have been higher if we hadn't just stopped observing when she went to sleep. Scott: Right. And that is... at the end of the Arousal State Profile you are supposed to arrive at a percentage. I didn't realize that when I was looking through it. You're supposed to write a percentage? I kind of thought, "What are we going to use this information for?" Sara: Uh‑huh. Scott: Really it is just that kind of idea. Like, oh, you know, because your perception may not match -- always match what reality is. A way of looking at the student and how much time and maybe... maybe use that in the future about increasing those states. Sara: Yeah, because if you do it again -- if you do it again and you see that the child is more -- is spending more time active alert or just quiet alert, then that can be considered progress. For sure. Scott: Uh‑huh. So anyway. Let's move on. Okay. Scott: Thanks for participating in the poll, everybody. [ Start slide: ] Scott: We got another one. We are just talking about the right amount of time for doing all these. And so, looking at this poll, which most close describes the observation period that you are able to use? So, a single observation on a single day? A single observation periods on multiple days? Or multiple observations on a single day? Or multiple observations on more than one day? [ End slide: ] Scott: Looks like most people are single observations on more than one day, which is what we did. You know, and going back again, Millie originally, in the [ Inaudible ], she talks about three days of observations. And... and she said -- that's very difficult to do. Sara: Three whole days. Scott: Uh‑huh. Yeah, three entire days. Yeah: I mean that would be great. That would be wonderful. Sara: I wonder, did anybody get someone else to do this? Like I know that Millie had talked about getting a paraprofessional or a teacher to do this. Scott: Right. Sara: We did it ourselves. I guess that could be another poll. I'm wondering if you guys -- if anybody did do that? Scott: Did anybody out there, if you could maybe reply on the chat or call in. If you... if you had someone besides yourself take the data? Do the observations? Sara: I mean, I guess it was kind of iffy trying to figure exactly what we wanted to do, you know. It would have been another step to try the describe to someone else what to do. Kate: It would seem like you have to do a certain amount of training of what, you know, what you are looking for before observation could be done. Sara: Right. Kate: Though it would be nice, if, in school districts where they have a lot of kids and regularly have a lot of these kids, they could do some in‑service so that a team of people were sort of trained to do observations and that observation may be able to be divided up somewhat among different individuals, so you could get kind of three days worth in a continuous run. Scott: Right. Yeah. Sara: That kind of observation is important to do anyway on a regular basis, I think. Scott: Yeah, it is. Kate: Brenda says I would rely on the classroom staff to help since I am an itinerant. And that, again, I think that's great way to go when you are an itinerant, but it does require to you do some training with your staff ahead of time, so they're adept at using the instrument, knowing what to look for. Scott: Uh‑huh. Sara: Definitely. Scott: And describing those states, I think is really important. I mean, you know, to me, our student seemed to kind of go in between the quiet and the active. So, again there is kind of hard to say, was this an active? To me, what constitutes active is they're engaged with whatever they are doing; whereas quiet is more observing? Is that generally how you look at it? Sara: I think so. And I also looked at their actual level of activity. Because, you know, if you think of it in a sensory way, you know, it's like, yes, quiet alert is like, "What's happening around me?" Active alert might be like, "I'm looking and I am also moving and moving my arms and kicking my legs," and so that's kind of how I differentiated for this student, at least, between active -- quiet alert and active alert. Scott: Right. Kate: And I know with Renee, I don't know whether you are on here today but -- Sara: Somebody on there. Kate: But one thing I know with the group of kids that Renee has had in the past, a lot of those kids who were very medically fragile, you know, you're looking at things like differences in breathing rates and stuff like that. And, you know, that's where it gets I think a little tricky to know how to peg some of those levels of alertness, but I do know that, like, one of the kids that I saw, happen to see with Renee -- oh, a number of years ago now -- she said that when he had come into their program, you know, he really just slept all the time, and they really did a drastic change to the environment, just so sort of dampened it down and put some things in there, like vibration and some lights that were interesting to him or whatever. And were able to really adjust his ability to be actively alert, and to tolerate a whole day where he wasn't sleeping all day long. And, so, I think with a kid like that, when you are trying to do one of these, you know, what's active alert for them may be that they are just not asleep, even though they are not really doing anything much, you know, they're at least not asleep. But over time that would, probably, you'd have to shift it and I wonder if y'all have had, or if anybody out there has had a situation like that and maybe Renee, you especially, since I know you do get a lot of kids that have some of those challenges, how do you address that? Because to me it would be that those active alert states don't look exactly the same on every kid. Sara: I would think that you might see more quiet alert, because I think of active alert as kind of on the road to partial participation. So either, you know, you are there with us or maybe you are not. Kate: Yeah. Sara: It might be almost easier to tell sometimes, you know, as long as you're tuned in. If it is breathing rate, you know, if somebody's eyes are open and they look the same, but not with you, you'd have to just know: when are you with me, when you are not with me. Scott: And you know, for the purposes of the SLK, when you're counting, you're counting both alert states. Sara: Right, and they're all the same. Scott: They don't really -- there's no real need to differentiate as far as the data you're taking at this point. Sara: Right. And later on you, you might want to differentiate between those two, because... because active alert could be, you know, better in some situations and quiet alert in some, but I think of active alert as more of an observation and active alert is more of an interacting with the environment. Kate: Engaged, yeah. [ Start slide: ] Scott: So next we're going to be looking at the Sensory Response Record and the Appetite/Aversion List. So those are the two things we'd like to try to get done before our next meeting. [ End slide: ] And once again, we'll see how that goes everybody. I know we've got the holidays coming up and then being back the first few weeks after Christmas may be a little bit crazy as well. Sara: Might be a little bit of an adjustment. Kate: Might be able to get an appetite aversion list very easily right after Christmas. [ Laughter ] Sara: Like sugar. Kate: Don't like school. [ Laughter ] Scott: Well, but my point is that this study group is run by you guys so don't stress out over it. If you're not able to get to it, let's just talk about that, because we need to make sure everybody kind of stays on the same page and that we get good information, and we don't get caught up in discussion group kind of being the -- our schedule as sort of running everything. Really needs to run on what -- how we are able to get through it. Sara: It is our schedule, meaning all of us. Not just -- Scott: Not just me. Sara: Not just Scott. Not like usual. [ Laughter ] Scott: Not like usual. Sara: If you wanted him want him to stay in that alert state, you got to go on his schedule. Scott: Hmm. Anyway. Sara: I'm just trying to apply the information. Scott: Okay. So Anyway, so we're going to look at those two things. So we're going to take that information and once we get those two things done we can move on to the long anticipated Levels and Strategies Guide. Sara: Woo hoo! Because we like strategies. Scott: And that will be -- that will probably be an extended several meetings talking about that. Because that's really where your -- Sara: That's where you're setting up routines. Scott: That is where your instruction comes into play. Sara: First you gotta get those likes and dislikes. And this kind of reminds me of... you know, when you ask -- when you're first meeting a child and you are talking to people who know the child and like, "Oh, well, what is, you know, little Henry like?" And they say, you know, the people who know him, "Well, he doesn't like anything." And they say, "He likes everything." Scott: Yeah. Sara: You know. That's... that is really when you need to find out more. And I think that this kind of assessment, or Every Move Counts, are both really good in finding out more, doing those probes so you know, like, you look at a certain sensory channel that the child maybe responds to and we're really, you know, we're really good at looking at sensory channels. I mean, we're a lot more -- we're a lot more tuned into that than a lot of people are, as Teachers of the Visually Impaired, because we're always kind of seeing, okay, how are they learning stuff? How are they getting information? And so I think this is where we find out the information, and the only way we can do that is by providing those experiences. If he isn't getting those experiences, then they're not going to be able to respond. Scott: Right. Yeah. That's the really wonderful thing about this is that we do get -- you do kind of delve deeper into that, and get, like, an actual document, you know, that you can show. Like, "Oh no, they do like some things, and this is what it is." Or you know, "They don't really like everything." They just -- there just maybe someone who is, you know, real mellow kid, not that prone to complaining about things, but there are things they don't like. I mean, I don't think I really know anybody that doesn't -- that likes everything. Kate: Certainly not me. [ Laughter ] Sara: Kate does not like everything. There are things that Kate does not like. [ Laughter ] Chapter 3. Sensory Response Record Scott: So. Yeah, the Sensory Response Record. [ Start slide: ] So, before you begin, these are the questions you have got to ask. You know, when and where are you going to do it? How long will it last -- the entire session? How long will the presentation of each item last? What'll be the time between? What will be the items used? So, let me bring up the form. [ End slide: ] You had a comment, Sara? Sara: Oh, yeah, I'm sorry. When I did this before, I remember I did this on Matthew, the student we saw at [ Inaudible ] Scott: Oh, really? Sara: And I... I kind of -- during my observation period I kind of made a note about what his strong likes were. Because I already knew about those things, and I did not test those things because I didn't want to spend a whole lot of time. I did bring one of those things along as a transitional object, so he could have that and if he got real anxious, and I brought a couple things along for him to take little breaks in between. But he was a very active kid, more on the active alert, kind of, over -- you know, more easily going up into that high up, high energy extended state than the down low one. Scott: Right. Sara: But thinking about bringing something, a favored object, if you're going to remove the child from their classroom, I think is a good thing. And I also think removing the child from the classroom depends on the kid, but -- and the classroom, really. If the classroom is a noisy environment or you can't really be -- you might not be getting a very good read on the auditory sensory channel. So... Scott: True. True. And that's, you know, and that's where it comes into play. [ Start slide: ] If you look at the -- on the form, you know, the first thing you decide about here is the date and time, the place, the presenter. It's just, you may be doing it multiple times in the classroom, or whatever the setting is. But number two, that kind of gets into that idea of, you know, how long should your session be? Because everyone said their kids were in extended states for long periods of time. [ End slide: ] 100 percent of the people said that. So really thinking about... how... how much time should you really be in there trying to do this to get an accurate read on what their response is, as opposed to just making it over-stimulated, in general. We -- because our student, we noticed in looking at the, what was it, the... what was it, the... ASP... that she was in alert states for about 60 percent of the time, but that really translated to about ten to 15 minutes chunks where she was really kind of able to do things and attend. Sara: That is when they have morning circle. That's when she was the most alert. Scott: She is very alert during morning circle. Sara: After she eats and then also right after she -- oops... Right after she eats and then gets changed, she's good during morning circle and then needs to do all that stuff again. A lot of that stuff again. Scott: Right. Right. Sara: So yeah, 15 minutes, we might take a break. We might interrupt -- I don't know if they'll let us do it during morning circle. Scott: Well we might have to do it on multiple days, I think, but, I think, if we look at doing 15 minute sessions, maybe we can get in two of those in a morning. If you do that over, you know, like, three different days, we might get that information in. Sara: Yeah. Scott: But I was really thinking, that really did seem to be a pattern with her. And... so that's just looking at the length of session again, and I think a lot of that's probably going to be a factor with most of these kids. I think it's going to be a real important factor to take into account because once you're overstim -- you know, completely overwhelmed or tired or whatever, you know, you are not going to be responding to... Sara: Not to new stuff. Scott: Uh‑uh. Kate: Michelle asked a question, she said, "Would there ever be a time you could record the students you're referring.... referring to, or sharing with us, and go through this with a video?" Sara: We don't have -- we don't have -- I would love to do that. We don't have video permission at this time. Though I do think there is -- the student I had did with the Sensory Response Record, that's what I did about seven years ago. I think that is an archived TETN. Of course it's a TETN and it was one of first ones I did. It was when we were still in that cafeteria, and it's not very good quality, but you should be able to see some of the stuff as it goes along. Kate: It sure would be nice if some of you out there, as you go about doing it, if you could record some of yours. Maybe we could pull together some, and get permission for to us use it. Maybe pull some things together for this webinar to take a look at, as a group. I don't know how doable that is, but I do think that, you know, it does help to see it. And I know Millie has done training has shown some clips, but I don't think she has necessarily of the assessment piece of it. Scott: Yeah, I think it would be real helpful, and we would really like to get permission for our student, because I agree. Sara: We may be able to get permission, you know, it got sent home last week sometime. We may be able to, but... and we're hoping to. But yeah, it is really nice to be able to see what it is that people are talking about. Definitely. Kate: Well, if any of you can... volunteer to maybe use your iPhone or use an iPad, and get some video footage, we can create a place in dropbox, or whatever, for people to share it and to get a permission form so that we can share it with the group. Sara: Yeah, we can post a -- we can send you the permission forms. Scott can send the group, right? The permission forms, we have them in Spanish and in English. We could look at, if you have video permission, we could look at them during the Sensory Learning Kit study group, too. And we've been recording this series so we wouldn't to not record one, I suppose. Kate: No. We would not be able to do that. We need permission. Sara: You know, we could also just, if you wanted to share your video but not to have it on the web, if your student, you know, if your parent doesn't want it on the web, then we could find another way to share it and just have a conversation. Kate: Yeah, you could go into a protected Google docs and just look at it before the event or pull it up during the thing and watch it, not record it. Sara: Yeah. So there's a lot of ways that we can figure out how to look at your student, if you have a particular student or hopefully we can get permission to share our student. But... yeah... our student is less of an enigma, I think, than some of the kids, like some of the medically fragile kids you were talking about. I mean, she has more typical responses. You know, you can really tell when she is in her states -- in her various states. So she is more obvious. I think she'd be easier... to decode than some, and another student we were looking at who we didn't get permission to even look at his record, so we haven't gone forward with him. He would be a really good example of somebody who is very hard to read, other than when he is in extended -- you know, he's in certain extended states on the high side you can definitely tell. But when he's anywhere else other than that, it's kind of hard the tell where he is at. Kate: Well, and Tracy volunteered that she has been recording her students, and she will check with the parents to see about giving permission, so that would be great. So that would be great, Tracy, it really would. Scott: Great. Yeah, that would be nice. Sara: If we could use that. Kate: We'll shoot the permission form to you today. Scott: Uh‑huh. We will. That would be great. So yeah, I mean, in looking at that, I mean the other part on this number two of the Sensory Response Record, you know, item number two, there's the length of the session, but then there's the duration of the presentation, and the time and between presentations. So you are looking at, you know, how long do you present each item, and then how long in between each item do you wait? Sara: So you have to have a palette cleanser in between. Scott: Yeah. Sara: So you're not getting the response from the previous item. Scott: Right. Yeah. It is like... it's like a big taste of ginger in between each item on the sushi tray. Because really, think about it, you do kind of make sure you are not getting some sort of vestigial response... and it needs to be the same amount of time that you -- the same duration that you present it. So because you know think about it, that can completely skew things if you weren't doing that. And think of human nature, our tendency is, you know, to push it a little bit. Right? Sara: Hurry through... Scott: : Either hurry through it or... you know, "I know... I know he likes this!" Kate: Only give him one more second. [ Laughter ] Scott: So I think it's real important to keep that in mind and adhere to that, as much as you can. That's why you really should be doing this with a couple of people. You know, somebody to record and someone to time it, and somebody to do the actual presentations. Kate: Yeah, I was going to say, it's -- that 's a lot to keep up with if you are the only person involved going to do it. It seems like way too much. Scott: Uh‑huh. Kate: Especially to keep track of the time and everything. Scott: Yeah, I think it's very, very difficult. Sara: And if you, are, you know, if you don't want to take, you know, you can video yourself just for that purpose of record keeping, and then go back and use the video to determine what the child's responses were and how long, you know, each thing was done. You know, I mean recording -- Scott: That is an option. Sara: Yeah. Scott: So I am not -- but I just had a question. I mean, how do you decide the duration? I mean how -- what would you -- I mean -- what would be... Kate: Where do you start, yeah? Scott: Yeah, like how do you -- I mean, 30 seconds? Kate: Well, I would think, you know, one of first steps we talked about was the interviews, and I would think you would want to start with some -- you know, if you have some idea from the parents or the teachers, what they think the response time is or how long -- Sara: Yeah, I think the duration of presentation is mostly based on how long it takes the child to respond or notice. Kate: The first time? Sara: Because if a child is having a hard time, like, you know, sometimes we have a hard time differentiating ourselves from our environment. In order to discriminate between this and that and me, you know, it's like, it takes a lot longer for some people than for others. And so, if you look at just how long it takes the child to respond to something they like, you know, during any sort of observation or something they don't like, you know, that would be, I would think, you know, you would give them that amount of time plus a little bit longer... to make sure what they're responding to that. Scott: You're saying, given the amount of time that you see them responding to a known preferred item plus another... Sara: Plus another, I don't know a minute? That's a long time. Kate: A minute's a long time. Sara: I don't know, and also depends on how much the child is interested in exploring the object. You know, if the child really takes up -- takes it up and interested, I hate to take it away immediately. Scott: Yeah, but you have to. Sara: Well, [ Laughter ] I -- I don't -- when I did that with Matthew, I ‑‑ you know, there were certain things that he just took, you know. And he -- there were some things that he, like, I wasn't really sure. I thought maybe he was rejecting it, but, you know, like, I brought in a different ‑‑ Sensory Learning Kit has an ice pack. I brought in also something warm and so what I did was make one of those socks out of rice -- fill a sock with rice and warm it up in the microwave, it kind of has a good smell, it smells like, kind of has a vanilla-ish, the sweet smell of rice. And then, so he took that, and he kept -- he picked it up and then he dropped it on the floor, but if I would've taken that as a dislike and moved on, you know, because he would -- he went right back to it. If I would have taken it away, he went back and picked it up and... he liked ‑‑ there were so many things he liked about it. He liked the weight of it. He liked -- I think he liked the temperature, he liked the smell. He put it up to his mouth and his face, and liked the sound of it plopping on the floor because it made an interesting sound. Now that's a child who had a lot of motor abilities. But, you know, with somebody else it might be, you hold it up to them and they turn their head towards it a little bit. You know, and if that's their positive response, then you leave it there a little while and maybe take it away, put it back. See if they want more of it, you know. But I think it really depends on the kid. I think it's so kid specific, and if you're reading the child, you know, that's going to tell you the duration, and I think you'd have a general idea of the duration in, you know, in mind, but you're probably going to adjust as you go. Kate: What are some of the other people doing that have been ‑‑ how are you guys looking at this? Any feedback from the folks out in the... Sara: In the real world? Kate: In the real world? Kate: You can press star six if you don't want to type. Scott: Okay. To me that's an interesting part of the discussion is how figuring out how long that presentation duration should be. Sara: So that's not -- we didn't really answer it, I guess. Scott: Well, no, I don't think there is an answer, Sara. I don't think there is an answer, but you know, there is a discussion or a way of thinking about it which you expressed quite eloquently. Thank you. Sara: You are welcome. Scott: Okay. So after you've done that, after you decided, you know, how long you will take, you know, the Appetite Item Menu. [ Slide start: ] So, what Millie says is you need have to have at least four items for each of the sensory channels. [ Slide end: ] Sara: Oh, wait, we have a comment from Brenda that says EMC gives short times, ten to fifteen seconds per stimulus. Sara: Every Move Counts Scott: Ah. Sara: And is that -- Brenda, is that the -- is that EMC or is that the EMC3 or are they the same? In that way? I do remember Jane Corston saying something about if a child doesn't respond within about five seconds, then they're probably not responding to it. Oh, it's the original. Okay. I don't remember whether she changed that time period -- presentation period. But I do remember her saying something about this five second rule -- and that might have been -- no, that might have been something really different. Kate: We'll have to check and see. Sara: There is definitely a five second rule in Every Move Counts, and I think it -- oh, no, if you want the child to make an association between what you are doing and their behavior, you have to respond well within five seconds, I think. That's -- I'm sorry, that's a totally different thing. But... I would think ten to fifteen seconds would be a long enough time to present and then you might have to wait a little while after that to see if there's a response. I'm not sure. Scott: Yes, it doesn't -- For some kids -- Sara: I would think that if it depends -- if it's a distance sense, too, a longer presentation period might be more because you -- it's harder to notice distance senses, I think. Scott: Hmm. Sara: Or if they don't have -- Kate: It would be hard to tell, If you took a lot longer than that if they were responding to that stimulus or something else that you just weren't aware of. Sara: Unless you really noticed a pattern, like... like you know, you presented this light box and then 30 seconds later they started to move over that way. I mean, I don't usually think it's that... huge amount of time for most kids, even for slow responders. If it's not a huge response we're looking for. If it's is not a huge amount of coordination, you know, if they're just moving towards or moving away. Kate: Or stilling.... Sara: Yeah, so we are not asking the kids to do anything that is really hard to do. We are just asking them to, you know, show some sort of response and, you know, and we're just reading it, so we're making it as easy as possible for them. So that should be enough time. Scott: Ten or 15 seconds? Sara: I would think so. Scott: Yeah, if you are talking about a reac... a sensory reaction. It's not really a cognitive function. We're just looking at, you know, what instinct... instinctively attracts them. So yeah. Okay. Sara: Thanks, Brenda. Scott: Thank you, Brenda. [ Start slide: ] Scott: So anyway, moving on to the appetite, you need at least four items for each of the sensory channels. So that is, you know, at least 24 items in all. [ End slide: ] And, you know, Millie has a list. There's a list in the appendix at the back of the book, which has about 52 different items that you can use. Those are some of her suggestions. Sara: And some of those are actually in the kit, and some of them are not. Like she doesn't have a hammock swing in there. I know that's one of them that's in there. And, you know, like, I used that hot sock; I thought could I bring it in, because I knew it was okay to bring in something else, and I thought it was interesting that there was something for cold, but not something for warm. Scott: Yeah. Sara: That's just an idea if you are interested in that. The student hasn't had a whole lot of experience with that. Scott: Yeah. You know some items hit more than one channel as well. Sara: Really. Yeah. So you have to kind of look to see what the child is responding to. Are they responding to all those areas or what is the most -- the sensory channel that they're using the most to respond to that item? [ Start slide: ] You know, "What is it about that that they like?" Kate: And how do you know if -- I mean, I could see if you're looking at gustatory, you know, if it's actually the their mouth, you know they are responding to that, but olfactory is one that to me seems somewhat tricky to tell. [ End slide: ] Sara: It just depends. I mean, sometimes you get a strong response, and sometimes... they'll like -- somebody might gag if they smell a certain smell or they might, you know, startle or... Scott: Just alert. Sara: Yeah. And smells are tricky, too, because I think there are certain smells that can have such strong responses and, so, that would be -- if there's a smell that you... that you found, you know, through your interview, that the child really, you know, really makes the child sick or something, you know, that might be a good -- or if there are types of smells that they like, or don't like, you know, that that would be something to think about. Kate: I guess go back to the interview... Sara: If you already know and the child -- especially if the child is really fragile. Kate: Brenda says, "I have had students gag." [ Laughter ] Sara: Yeah. [ Start slide: ] Scott: Okay. So, once you've got all your items chosen, you need to decide what types -- the response modes, what constitutes a positive response, what constitutes a negative response, and what constitutes distress. [ End slide: ] So, again, when you look at -- when you do to code this, you're going to be saying, you know, they had a positive response or they had a negative response. Sara: You know, I think Every Move Counts is also a really good resource for looking at signals because it's got a lot of just reflex signals that could cause -- that could, you know, signal -- nervousness, anxiety or stress. Like... I didn't realize that sometimes yawning is a signal of stress. So you know, just going and looking at that -- before I was reading Every Move Counts, there's -- but there's a section on that. And I think in both the old one and the Every Move Counts: Clicks and Chats, that is on that kind of -- those real basic reflex kinds of responses that may -- that your child may be using. Scott: Uh‑huh. Sara: So... maybe we can bring that to the next -- Scott: That would be a good resource to bring in to talk about, I think. Kate: Absolutely. [ Start slide: ] Scott: So looking at modifications -- Millie mentions about those kids who, if you're going to do gustatory with them, they may, because they might start salivating, so you may have to look at positioning, for that, in order to make sure you don't have problems. [ End slide: ] So again it may be -- because I've run into kids that, you know, that can't -- don't eat, but there are ways to present gustatory information without actually eating. Kate: I know that, Lilli in Active Learning, would do things like if a kid liked sweet stuff, she would make like rock candy on a string, where the kid could suck on it but not get it off of that string. And I thought that was a kind of clever way and then also I've seen people put things in cheese cloth so that the student could maybe chew on it but not necessarily get the stuff into their -- swallow it very well. Scott: They actually make -- there is a thing that is made for that express purpose, and I can't remember the name of it. Kate: Probably [ Inaudible ] would know, for sure. Scott: They would. They would. Okay. So, that just takes us to the actual record itself. [ Slide start: ] So again this is where you're going to put in all the information. You've got the -- you know, you've got the item... and... the channel. You know, that's going to be the... the visual, gustatory, olfactory. You have got the appetite aversion. That's going to be a plus or minus, whether they were attracted to it or whether they were not -- not attracted to it. The amount of delay that there might be between your presentation and the response, and the intensity level; it's on a level of one, two and three, you know, with one being the least intense and three being the most intense. Kate: In terms of their response. Scott: In terms of their response. [ End slide: ] So really there will be a lot of information on here, about not just about what they like and they don't like but also kind of the way they respond. And the response is these last four columns, only one of those is doing to be marked. [ Start slide: ] Okay. So, there will be no situation where all four of those or more than one of those will be marked. So Sara, did you find the -- Sara: I didn't find the thing on yawning, but I did find reflexive responses, a list of protective responses and I think what these are is a -- not necessarily a positive response. [ End slide: ] And those are, extending the extremities, startle response, blink response, gag and grimace. So... that might not be a smile. Might be a grimace. So really pay attention to that. I'm not finding exactly what I wanted to, but another thing that this brings up is, you know, making sure not to wear perfume during the assessment, because that could skew the results. And not to talk a whole lot. Scott: Yeah, we're almost -- maybe -- I mean, I think -- we're running out of time. So probably, let's try to remember to bring that next time and look through it and put some of that information out. Because it'll probably be real helpful, I mean, I'm thinking we may need to talk about this... Sara: Some more... Scott: A little bit more, just because when all this is happening -- when... Sara: We could do a poll and ask. [ Laughter ] Scott: Interesting you should ask that, Sara. Kate: Do we have another poll? Scott: We do! [ Start slide: ] Chapter 4. Appetite Aversion List So the only other part -- there's also the Appetite Aversion List which you do after you've done the Sensory Response Record, and that's just listing the items. [ End slide: ] So, have you looked at it? Just how -- level of comfort with the SRR and the AAL. Yes, I have looked at it, I'm fine. Yes, I have looked at it, but I'm not sure. Nope, I haven't even looked at it yet. Laughter ] Kate: I know how this year has gone, for me. Sara: So, for those that are not sure about administering it, is that because you haven't done it before? Kate: Yes. There's one person saying yes. Sara: OK. Scott: OK. Kate: Yes. Sara: Yeah, I think that you're going to find that it's not -- it's not super hard to do and you won't be -- I don't think that it'll be so daunting once you've done it. Chapter 5. Closing Comments Scott: Yeah. Yeah. Well, let's just, I think we'll -- I think we'll -- we'll probably be talking a lot about this a lot more at our next session, so that's cool. Sara: It's four o'clock. Scott: It's four o'clock. [ Music ] [ Start slide: ] Sara: Thank you, guys. Scott: Thank you. Kate: Happy holidays. Scott: Bye‑bye. [ End slide: ]