Joyful Activities Are a Team-Approach: Meeting Goals with Adults Who Have Sensory Processing Challenges

By Dr. Janice Ryan, OT, HSDP

Joyful activities are increasingly incorporated into services for people with intellectual and developmental disabilities, as their benefits to human well-being are widely recognized globally. Research has shown that joyful activities calm anxious nervous systems and elevate depressed moods by activating the parasympathetic nervous system. This has become a team-approach for treating people with sensory processing challenges at Orange Grove Center (OGC) in Chattanooga, TN.

I am a Sensory Services Program Design Professional currently working at OGC. I would like to share a story from OGC’s current service program’s sensory initiatives. This is a sensory story told to me by one of OGC’s Music Navigators named Ellen Poole.

OGC Music Navigators serve people with a wide range of abilities and well-diagnosed intellectual and developmental challenges. Ellen’s story was about her joyful work with a 32-year-old woman served in the OGC Outpatient Mental Health Department who has the primary diagnosis of autism. Initially, it is important to discuss the diagnosis of autism and the sensory processing challenges that are commonly associated with this condition.

Research consistently shows that 90% of people with autism have sensory processing challenges that can cause poor emotional self-regulation. Ellen’s story paints the picture of an adult living with the life compromising effects of what autism experts now call sensory noise. It is also the story of how music can be used to reduce the influence of that sensory noise and empower people with autism to achieve new goals during adult years. For this story, we will give Ellen’s adult music student the fictitious name of Olivia.

“After Olivia broke the ice by reading her own poetry to a large OGC audience, Ellen offered to give Olivia private voice lessons.”

Ellen began working with Olivia right after she entered the OGC outpatient services program in 2022. Olivia reported what she described as traumatic experiences and was cautious about who she trusted at OGC during that first year. Olivia’s traumatic experiences had sapped her of confidence for developing the independence that she now wanted.

Ellen’s original goal for Olivia was simply to increase her confidence. Ellen only worked with Olivia during music class at first. Due to auditory hypersensitivity, Olivia’s reaction to music class was inconsistent. This was because other students or musical instruments often made loud and unpredictable noises that were uncomfortable for her to hear.

From speaking with Olivia and her classroom teacher, I know that Ellen was always flexible and understanding with her entire class. Sometimes Ellen went to their classroom so they would have a comfortable and familiar environment to enjoy music. During those days, she sometimes began class with a mindfulness meditation activity called visual imagery. From visualizing herself walking through a deep forest and listening to slow rhythmic music, Olivia developed the ability to calm herself.

As Olivia got better at this form of emotional self-regulation, Ellen increased her confidence-building challenges by using karaoke with her favorite songs. “Open Mic. Poetry Reading” in front of class members was used to build Olivia’s confidence for public speaking. This opportunity was used by her classroom teacher to motivate Olivia to write her own poetry which she later read out loud to a large OGC audience.

Ellen could see that any form of excitement, whether happy or sad, tended to increase Olivia’s pressured speech. Olivia had a strong desire to overcome her habit of stuttering, repeating words, and apologizing for her own communication patterns. She developed a coping strategy called Relaxation Breathing and practiced this often in the OGC Outpatient Multisensory Environment (MSE). Olivia learned to use slow finger-tapping to reduce the speed of her pressured speech and began practicing her solos in the relaxing outpatient MSE.

After Olivia broke the ice by reading her own poetry to a large OGC audience, Ellen offered to give Olivia private voice lessons. This is when Olivia’s confidence began to soar. Ellen insightfully described Olivia’s first attempts to sing in front of an audience as, “the anxious feeling of taking up too much space in the room.” That was over a year ago and Olivia is now practicing for her third all-school musical show solo performance.

Ellen arrived to share this sensory story yesterday with obvious excitement. For Olivia, the sensory noise that goes with autism sometimes looks and feels like depression and that was the way she arrived at her most recent voice lesson. Ellen said she was in a “down place.” Sometimes Olivia’s sensory noise looks and feels like anxiety. Ellen also said Olivia had arrived for that voice lesson in a “deep anxiety pit.”

Ellen used her close, supportive relationship with Olivia as an added therapeutic intervention as she prepared her for her upcoming solo performance. Ellen delegated to Olivia the responsibility of deciding her ability for the day's practice and just focused on them having fun. By the time, this private voice lesson was over, Ellen and Olivia were laughing together. Then Ellen got a pleasant surprise.

Two OGC friends came into the music room and Ellen left it up to Olivia whether she would sing in front of this small impromptu audience. For the very first time, Olivia asked Ellen to “let” her sing for this friendly audience. Ellen said, Olivia “nailed it.” She sang the song perfectly and then told Ellen that it must be true that “laughter really is the best medicine.”

Ellen summed her story up by saying, Olivia never “trips over words” or stutters when she sings. When her brain is focused on the rhythm of a favorite song, she stays with the beat of the music and self-regulates her heartbeat for staying calm and focused. For the next OGC musical show planned for this summer, Ellen wants to increase the tempo of Olivia’s song to add a new challenge.

Ellen already knows the sensory intervention she plans to try first to help Olivia learn to cope with the challenge of faster music. Rather than keeping the rhythm of the song by using finger tapping, Olivia will be using the heavy work movement of marching to self-regulate her emotions. This OGC Music Navigator story is just one example of the way Orange Grove Center in Chattanooga, TN uses joyful activities to calm anxious nervous systems and elevate depressed moods for meeting life goals in adults with autism.

About the Author

Janice Ryan, OTD, HSDP is a Doctor of Occupational Therapy and the owner of a sensory-based program design company that develops innovative service solutions for dually diagnosed persons with intellectual disabilities and mental illness. She works closely with international organizations such as Human Systems Dynamics Institute (https://www.hsdinstitute.org/index.html) to promote new paradigm strategies for better serving the psychosocial needs of the individuals, couples, and families receiving service… as well as the hardworking professionals and staff who serve them. She knows her work has just begun and real change will come when IDD service organizations have learned to avoid using traditional approaches to leadership, management, and daily operations that no longer work in today’s nationally integrated and constantly changing service ecosystem.