TITLE: Sensengage: Sensory engagement for people with severe and profound intellectual

disabilities.

Author Details:

Andy Smidt is a lecturer at The University of Sydney. Andy is interested in lifelong disability,
communication and empowering the voice of people with a disability through qualitative research.

Sheridan Forster is private practitioner and lecturer at Latrobe University and RMIT. Sheridan is
interested in everyday engagement of people who have severe and profound ID.

Sinead Quinlan and Lauren Yuile are honours students at the University of Sydney. They will be
using Sensengage in their honours project in 2018.

Presenter Requirements:

No additional requirements

Target Audience

Intermediate/Advanced level

Evidence areas

 
 Research Methods or Theories

Content Focus Areas: AACcess emerging technologies: innovative tools, resources and techniques
that advance the field of AAC.

Declaration of Interest Statement 
 The authors disclose they have no financial or other interest in

 objects or entities mentioned in this paper 


People with PIMD typically rely on others for all activities and interactions, and function within a
smaller social network relying on family members and paid staff for interaction. Interaction includes
sensitive responsiveness, joint attention, co-regulation and an emotional component(Hostyn &
Maes, 2009). Partners need interactive strategies and a clear sense of their own role and knowledge
of the communication of the person they are supporting. People with PIMD frequently lack
interaction and meaningful relationships and have less positive staff affection and contact. They
may be offered fewer stimulating activities and staff may find it difficult to offer meaningful
engagement. Staff may find it difficult to feel connected and responsive to their client’s needs.

Numerous researchers have investigated sensory based therapy with people with self-stimulating
behaviours (Bunning, 1998) to improve engagement . Sensory based interventions for people with
PIMD facilitate interaction and engagement including multi-sensory environments (MSE), music,
sensory stimulations, and Intensive Interaction. Smith, Press, Koenig, and Kinnealey (2005) trialled
an intervention based on active participation of the individual, where sensations were applied that
were individual to the person and required an adaptive response. This differs from other sensory
integration approaches in that the sensations are individualised and the sensations were varied
according to the responses of the person. Although communication was mentioned by Smith et al.
(2005) , it was not the focus of the intervention. Clearly there is interest in using sensory programs
to increase engagement and interaction but to date the results of these programs are not conclusive
and are mostly based on small scale studies providing limited evidence of their efficacy.

It is unsurprising that carers of people with PIMD wish to be able to provide a positive environment
for people supported. Given the limited repertoire of skills that people with PIMD have, and their
frequent lack of engagement and alertness, it may be difficult and disheartening to work with people
at this level. Interaction between people with PIMD and their partners has the potential to increase
the happiness of the person with PIMD (Lancioni, Singh, O'Reilly, Oliva, & Basili, 2005).

For people who are not yet intentional communicators, one approach is to assign meaning to
behaviours that can be considered is that of potential communicative acts (PCA) (Sigafoos et al.,
2000). Prelinguistic behaviours (including reaching, leading, gestures, facial expression, eye gaze and
body movements) may serve the function of requesting or rejecting.

Sensengage provides a specific, individualised program of sensory stimulations to a person with

PIMD building on the concept of attunement (Forster & Iacono, 2014) to facilitate ongoing
interaction between the person and their communication partner. Once attunement has been
established between communication partners, the aim of Sensengage is to enable the person to
request to continue the interaction by using PCAs (Sigafoos et al., 2000). Building on the work of
Bunning (1998) we use sensory stimulations which are individualised to the person, to create an
engagement bubble where the dyad is connected by and with a sensory stimulus. If the
communication partner withdraws the stimulus and effectively breaks the bubble, the client can use
their behaviours to request continuation of the interaction. This is the very beginning of requesting
for more (Sigafoos et al., 2000)

This presentation will present a rationale for the development of this approach and present
preliminary results of a trial of this intervention with school aged children.

Bunning, K. (1998). To engage or not to engage? Affecting the interactions of learning disabled
adults. International Journal of Language and Communication Disorders, 33(Suppl.), 386-
391. doi:10.3109/13682829809179456
Forster, S. L., & Iacono, T. (2014). The nature of affect attunement used by disability support workers
interacting with adults with profound intellectual and multiple disabilities. J Intellect Disabil
Res, 58(12), 1105-1120. doi:10.1111/jir.12103
Hostyn, I., & Maes, B. (2009). Interaction between persons with profound intellectual and multiple
disabilities and their partners: a literature review. J Intellect Dev Disabil, 34(4), 296-312.
doi:10.3109/13668250903285648
Lancioni, G. E., Singh, N. N., O'Reilly, M. F., Oliva, D., & Basili, G. (2005). An overview of research on
increasing indices of happiness of people with severe/profound intellectual and multiple
disabilities. Disabil Rehabil, 27(3), 83-93. doi:10.1080/09638280400007406
Sigafoos, J., Woodyatt, G., Keen, D., Tait, K., Tucker, M., Roberts-Pennell, D., & Pittendreigh, N.
(2000). Identifying potential communicative acts in children with developmental and
physical disabilities. Communication Disorders Quarterly, 21(2), 77-86.
Smith, S. A., Press, B., Koenig, K. P., & Kinnealey, M. (2005). Effects of sensory integration
intervention on self-stimulating and self-injurious behaviors. American Journal of
Occupational Therapy, 59(4), 418-425.