the 7 senses and hand-under-hand prompting

The 7 Senses and

Hand-Under-Hand

PromptingKrista Lewis

Office of Developmental Programs, Special Populations Unit

12/17/2018 1

What are the 7 senses?

• Sight

• Smell

• Taste

• Hearing

• Touch

• Vestibular

• Proprioceptive

12/17/2018 2

(7 Senses Foundation, 2013)

Sight or Vision

• Focus

• Detects images

• Visual perception

– Visual-motor coordination

– Figure-ground perception

– Form constancy

– Position in space

– Perception of spatial relations

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Smell or Olfaction

• Ability to detect scent

• Begins in the nose with many receptors

• Interconnection with memory and

language

• Linked to taste and appetite

• Alerts us to danger

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Taste or Gustation

• Detect the taste of a substance

• Received through taste buds

– Sweet

– Bitter

– Sour

– Salty

– Umami

• Well developed at birth and diminishes

with age

• Can be decreased

• Alerts us to danger

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Hearing or Audition

• Detecting vibrations

• Auditory system differentiates between:

– Localization

– Differentiation

– Interpretation

– Memorizing

• Aspects of a hearing loss diagnosis

– Unilateral (one ear) or bilateral (both ears)

– Type of loss

• Conductive, sensorineural, mixed

– Degree of loss

• Mild, moderate, severe, profound

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Types of Hearing Loss

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Ear CanalBones Cochlea

Auditory

Nerve

https://www.google.com/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=2ahUKEwjqvIO71MXeAhWKUt8KHSYPDvEQjRx6BAgBEAU&url=https://lynnthaler.com/tag/implant/&psig=AOvVaw0xZrVQoHxQNheP0Thb7Sm6&ust=1541796163913937

Degrees of Hearing Loss

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• Degree of loss– Mild

– Moderate

– Severe

– Profound

• High and low

frequencies

• Loud and soft

sounds

Touch or Somatosensory

• Throughout all major parts of the body

• Sensory receptors are triggered

• Passive touch experiences

– Happen to us

– Surfaces we come in contact with

• Active touch experiences

– Choose to explore

– Add to our knowledge of the world

• Main avenue for communication for

deaf-blind individuals

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(Alsop & SKI-HI Institute, 2002)

Vestibular System

• Helps maintains posture and balance

• Helps us locate body parts

• Develops and maintains muscle tone

• Supports eye movement

– Steady focus on objects even as the position

of our body changes

• Relates to vision, hearing, memory,

attention, postural control, coordination,

feeding skills, and sociability

• Located in the three semi-circular canals

in the inner ear

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(Brown, 2007)

(Scoggin, 2018)Cochlea

Semi-

Circular

Canals

Proprioceptive System

• Tells us about the position of the body

and limbs

• Knowing their position without looking

or touching

• Located in our muscles and joints and

sends information to the brain

• Does not require vision

• Impacts fine motor skills, spatial and

body awareness, and applied force

• Seek proprioceptive input

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(Scoggin, 2018)

Imagine…

• Paper bag full of something squishy and cold – No warning that it’s going to happen

– No explanation of what it is

– No explanation of why they’re doing this

• How would it make you feel?

• Our eyes are how we access our world

• For others, it’s their sense of touch

• When we use hand-over-hand, it is as if someone

walked up to you and poked your eye, without

warning or explanation.

1212/17/2018


Sensory Overload or Overstimulation

• Our individuals face a constant loss of control

• How do they access their world?– Any senses not fully functioning?

– Consider how they navigate, communicate, and complete tasks

• Sensory overload

• Allow them to move at their speed

• Build trust and rapport

– Hand-under-hand prompting

• Example: Incredibly complex task

– Consider how hard their bodies are working to do this

1312/17/2018

Internal Factors

– How the individual feels

physically and emotionally

– Medical conditions and

medications

– If the individual is sick or in

pain

– How much sleep the

individual had

– How the individual’s

visual/auditory/tactile abilities

impact learning

– If the individual has sensory

processing difficulties

External Factors

– Lighting

– Sound, background noise

– Smells

– Movement of and around the

individual

– Number of people in the space

– Tactual input

– Physical supports (positioning

and equipment)

– Clutter: visual, physical,

auditory, or tactile

Internal and External Factors

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• Consider the individual’s internal and external factors

(Scoggin, 2018)

Supportive Strategies

• Support the individual’s availability for communicating

and learning

– Use the individual’s preferences (likes/dislikes)

– Use the individual’s strongest sensory channel

– Active participation

– Anticipation

– Implement wait time for the individual to process

– Amount and pace of input

– Imitating the individual

– Mutual tactile attention

– Following the individual’s lead

– Best communication partner

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(Scoggin, 2018)

Mutual Tactile Attention

• Tactile equivalent of pointing

• Gives meaning to what is happening with the individual

• Importance:

– Joint attention

– Sharing an experience

– Exploring with more confidence

– Shows an interest in what the individual is doing in a way that makes

sense to them

– Provides a foundation for conversational turn-taking

• Allows them to move at their own pace

• Follows the lead of the individual

• Slide your hand next to the individual’s hand while they are

exploring an item or working on an activity and become engaged

in what they are doing

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(Project SALUTE, n.d.)

What do

you see in

this

picture?

12/17/2018 17

Hand-Over-Hand

• Forcing individuals to touch

new/unfamiliar items and

textures

• Intrusive and disrespectful

• Requires them to complete

tasks unnaturally and rushed

• Is insensitive to their timing

and how they process

information

• Doesn’t give them an option in

participating (passive recipient)

• Can cause stress and distrust

Hand-Under-Hand

• Gives individuals a sense of

control

• Respecting individuals’ hands

• When comfortable, individuals

can explore independently

• Allows them to move at their

own pace

• Individuals can be an active

participant

• Connects you with the

individual

• Allows you to do it WITH them,

not TO them

Hand-Over-Hand vs. Hand-Under-Hand

12/17/201818

Why is it Important?

• “There is a large group of neurons [within the hands] that have the

ability to perceive many different sensations”

• Learned through the sense of touch:

– What certain textures/objects are and what they do

– Concepts

– Spatial awareness

– Speed

– Textures

– Movement

– Amount of pressure and force

• Provides individuals with access to the ways we use our hands to

learn about the world

• Provides opportunities for individuals to expressively communicate

by reaching for another’s hand when they desire communication

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(Foley & Matlin, 2016)

(Snow, 2017)

(Washington Sensory Disabilities Services, 2012)

Meet Cecilia

• Diagnosis of deaf-blind

and CHARGE

• Uses what visual and

auditory access she has

well

• Struggles to coordinate

senses simultaneously

– looking and eating

• Tactilely defensive

– Very sensitive to any

unknown texture on her

hands and needs time to

warm up to new textures

12/17/2018 20

What Does it Look Like?

• You be the skill and they’ll be the

movement

• Slide your hand under theirs

• You preform the activity while the

individual’s hand rests on top of

yours

– Feel what is being done

– Hesitant of new objects or activities

– Feeling movements

• Helps the individual learn the task

in a way that respects their timing

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(Fields, 2014)


When you:

cut it for me,

write it for me,

open it for me,

set it up for me,

draw it for me, or

find it for me,

All I learn is:

that you do it better than me

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-Unknown

Take a look!

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Example

• Eating food:

– Sit on the person’s dominant side so you can use their

dominant hand to eat

❖ If you’re using their right hand, use your right hand too

– Place your other hand on the individual’s shoulder to help

them feel more secure

– If they have accessible hearing, explain to them what you’re

doing, where your hand will be going, and what they’ll be

eating

– Place your hand under the person’s hand respectively and

gently

– Move the utensil into the individual’s mouth (you will be holding

the utensil and spooning the food directly into their mouth)

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(Snow, 2017)

Other Opportunities

• Personal hygiene

– Dressing or brushing teeth

• Medication

• Washing dishes/laundry

• Grocery shopping

• Paying bills

• Making choices

• Completing activities

– Puzzles

– Reading

– Writing

– Controlling a tv remote

– Playing games

• Community activities

• Assistive technology

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Think about the aspects of

an individual’s day that

happen consistently and

find ways to make

communication a priority

during those times

Take Away Thoughts

• What we would consider “simple tasks” may be difficult for our individuals

– Think about all the senses coordinating when they’re working correctly,

let alone when they’re impacted

• How do our individuals access their world?

• Show an interest in what the individual enjoys in a way that makes sense to

them

• Do things WITH them, not TO them

– We make them passive when we do things for the individual

• Give them the patience and consideration you would want someone to give

you

• Think about what the individual experiences regularly and help them

become an active participant during those times

• Communication is always the goal. Look for ways to communicate about

things that are important to our individuals in a way that is meaningful and

respectful to them.

12/17/2018 26

“It’s not about what was; it’s

about what can be. You did the

best you could with what you

knew, but come tomorrow you

have new skills.”–TeepaSnow

Do better now that you know better!

12/17/2018 27

Thank you!

Questions?

Krista Lewis, Communication Support Professional

[email protected]

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mailto:[email protected]

Citations:

• 7 Senses Foundation. (2013). What are the 7 Senses? Retrieved from

http://www.7senses.org.au/what-are-the-7-senses/

• Alsop, L., & SKI-HI Institute. (2002). Understanding deafblindness: Issues, perspectives, and

strategies. North Logan, UT: Home Oriented Program Essentials. p. 37-64

• Brown, D. (2007). The Vestibular Sense. Dbl Review, 17-22. Retrieved from

http://files.cadbs.org/200000353-9f7fca079e/2_vestibular_dbrown.pdf

• Fields, C. (2014). Hand-Under-Hand Prompting. Retrieved from

https://www.unr.edu/ndsip/tipsheets/60-hand-underhand%20prompting.pdf

• Foley, H., Matlin, M. (2016). Chapter 12: Skin senses. In Sensation and Perception (12.6-12.18).

Psychology Press.

• Project SALUTE. (n.d.). Mutual Tactile Attention. Retrieved from

http://www.projectsalute.net/Learned/Learnedhtml/MutualTactile.html

• Scoggin, K. (2018). Senses, Availability for Learning Behavior, and

Communication: They are all Connected! [PowerPoint slides].

• Snow, T. (2017). Positive Approach to Care. Retrieved from

https://www.hcanj.org/files/2013/10/Teepa-Snows-Positive-Approach-to

Care-Part-1-and-2.pdf

• Washington Sensory Disabilities Services. (2012). Hand Under Hand.

Retrieved from https://www.wsdsonline.org/hand-under-hand/

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the 7 senses and hand-under-hand prompting

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