How do you know when you are being effective with an individual in a MSE/Snoezelen Room?
First and foremost, you must be a keen observer and quiet listener. Don’t interfere with the process of letting the sensory components of the equipment communicate with the individual. In other words be sure that for example they can experience the quiet, hear their own thoughts as they are washed in sensation from the gestalt of the room. You want them to hear the bubble tubes, watch the visuals effects, hear the music, and touch the fiber optics (or whatever, item they choose). Remember “NO THERAPIST-INTERRUPTIST! Follow your MSE Protocol for turning on your room consistently. Remember choice is empowering. But, on the other hand you are ultimately running the experience for the individual and you must go slowly starting out where the person is at. (Person Centered Approach)Meaning you have done your homework and identified the person’s sensory diet (encompassing their preferred sensory processing style) prior to going into the MSE. Remember you are utilizing information from their unique Life Experiences/Personal Preferences and their unique way of sensory processing. The experience is about and for them and through them; anything less is not treatment or respectful.
The first order of business is to consider their brain arousal level *1 and then decide if it needs to come down or be brought up. If you want to think of this as level of excitement; go ahead but, be careful and go slowly. Remember the rules for changing arousal and keep these active in your mind. All components in the MSE can or should be adjustable and afford you the opportunity to change the arousal continuum. You must begin with matching their level of arousal. Once you have changed someone’s arousal level either from too lethargic or from too active (distracted by their own inability to change their own arousal level, self-regulation) you will observe their baseline level of engagement or focus. Observe their behavior; change in activity level, (Changes in movement speed for example) their observation level (they will look around and notice other sensory equipment or people); their head position and body language will change especially facial expressions and their eyes. Next, look for the signs of relaxation; changes in muscle tone, which will change how they are sitting or lying down and watch the hands, as often a clenched or fisted hand will start to open up. You will often see deep sighs or yawns; watch their breathing. If the individual has abilities to speak or produce noises or sounds you may see spontaneous speech, words, noises or even singing. Often this is accompanied with some sign of pleasure; especially smiles.
Now you need to determine more changes in what you utilize in the MSE based again on the individuals own sensory diet/personal preferences. What this means is you utilize both the music and visual components (the 250 optikinetics solar projector and accessories) to maintain novelty to continue to produce pleasure, joy, wonder and maintain optimal level of arousal. This is accomplished by producing musical beats, rhythms and tempos that speak to the individual’s patterns of sensory processing and Life’s pleasurable experience (meaningful history) through the auditory system and utilizing vibroacoustic equipment (which is tactile) for feedback. This is done while simultaneously using the abstract visual components of the projector to produce visual effects that surround the person that they will follow visually and move their head and neck to watch; “The Show” as I put it. What you now will observe is a continuance of pleasure (engagement with the sensory components) and the emergence of signs of the music taking effect: taping of a body part to the rhythms, beats or someone whom all of a sudden will want to dance. (Each Diagnostic group will have reactions based on their capabilities) This is now the time for you to engage them; blending in with the music and reinforcing the rhythms and beats; take their lead and help increase the input. For example, model using the bubble tube switch to make the colors match the beats, rhythms and tempos of the music; as they make contact with you; engage them back, quietly. Don’t over whelm them. Move into their space slowly and observe their response, if they start to lean back or show signs of how close they want you in, respect it, watch the eye contact, and maintain being quiet and offer a hand or item to hold. (This is a good time to offer a fidget, based on their sensory diet that can be taken with them; it builds an association with the MSE and will pair you with that association. They will respond if it is their choice. If they begin to talk to you, speak back softly. This is the time to use your good judgment, clinical or teaching skills on knowing how much to engage and for how long. If you see any stress responses back off and try again later or next time. Remember the first number of times in the room you want to be consistent; build a predictable safe environment and trust in you.
This Multi-Sensory Dynamic Systems Technique is based on the knowledge of complex science, our human systems dynamics and truly using empathy, self-restraint and good sound clinical reasoning from your Professional Expertise; no matter what your profession.
Brain Arousal* in a continuum of low to high, would be defined as: more Motorically active, more alert to Sensory stimuli of all sorts, more reactive Emotionally (MSE) Other states of arousal will influence one another; dampening or increasing the other state on top of the generalized arousal state causing an emergence of one focus Reference: Donald W. Pfaff, PhD, Rockefeller University
Written By: LMessbauer 10/6/11©