Written by Philip Wade – Complementary Services Occupational Therapist at Inspire Malta

The concept of the multi-sensory room (MSR) was first developed by Jan Hulsegge and Ad Verheul at the De Hartenberg Institute in the Netherlands in the 1970’s. They created a room to be used by people with disabilities where the senses are stimulated through the use of lighting effects, colour, sound, music, scents and textures.

Before understanding the benefits of the MSR, it is important to have an understanding of our 7 senses (yes, 7!), sensory processing and sensory processing disorder. While most of us know of the 5 main senses; sight (vision), smell (olfaction), taste (gestation), hearing (audition) and touch (somatosensory) there are a further 2 senses which contribute to our understanding of the world; vestibular and proprioception. The vestibular system explains the perception of one’s body in relation to movement, balance and gravity. This system gives our brain messages about our body movements and head position. A fully functioning vestibular system ensures you know if you are lying down or sitting up, and it will help you move up and down stairs. Proprioception is the sense which lets us know where our body parts are, where we are positioned in space, how to create movements and how much strength and effort to put into such movements. Proprioception is the sense which allows us to be able to clap our hands whilst our eyes are closed, or to use a pencil with the correct amount of pressure.

Sensory processing is the way in which the brain receives messages from the 7 senses and turns them into appropriate behavioural and physical responses. Whether we are biting into a sandwich, riding a bicycle or reading a book, in order to complete the activity successfully our brain must process the sensations correctly.

Sensory processing disorder (SPD) is when an individual’s sensory signals do not get organised into appropriate responses. Therefore, a person with SPD can find many everyday activities a challenge to perform. This can cause clumsiness, behavioural problems, anxiety, depression, underachievement, social isolation and many other issues if not addressed and treated properly. Research by The Sensory Processing Disorder Scientific Work Group in 2009 estimates that 1 in every 6 children experiences sensory symptoms which have a significant impact on their daily life activities.

At Inspire’s Therapy & Leisure Centre in Marsascala there are three state-of-the-art multi-sensory rooms, which make up the MSR suite. The soft room, dark room and white room each provide a unique, specifically-designed environment which enable people with a disability to enjoy a wide range of sensory experiences.

The MSR is used by individuals of all ages, with a range of conditions. The service is frequented by clients within Inspire’s programmes, by members of the public, individuals from day care centres, and schoolchildren who attend Inspire’s Winter Programme. Each MSR client is assessed by an occupational therapist and recommendations are given as to which rooms and activities will be of most benefit to the client according to their individual needs.

Inspire’s MSRis an ideal environment for therapists, tutors, LSAs and parents to address specific sensory issues which are affecting the individual’s functioning. For example, a child with a defensiveness to tactile sensory input (touch) could be encouraged to explore the different textures of the tactile wall in the dark room in order to build up their tolerance of tactile sensations. An individual with issues with their vestibular system could benefit from a range of activities in the soft room, such as an obstacle course (to encourage balance) or the board swing (to enhance the messages given to their brain about gravity and movement). An individual with proprioception processing issues could benefit from using the ball pool, as the sensation of being in there gives their brain information about their position in space. The trampoline is also a great way to provide proprioceptive input, as the individual must exert the correct movement and strength to bounce.

It is not just clients with autism that benefit from using the MSR and it is not just sensory issues which are addressed in the MSR, but a multitude of physical, cognitive and communication areas can also be tackled. It is also important to note that the rooms are accessible to all, regardless of mobility issues. Inspire prides itself in inclusion, and the MSR is a great example of this in practice. For example, a wheelchair user is able to spend time on the water bed in the white room, offering them the opportunity to relax out of their wheelchair. An individual who uses a walking frame can access the dark room to use the large floor keyboard which makes musical sounds when it is stepped on. An individual who is unable to communicate verbally can make decisions about which activities they prefer because there is an accessible visual flash card for every piece of equipment within the 3 rooms.

Other way in which the rooms can be used to promote, enhance and encourage specific skills include: working on cognitive skills such as numeracy, colour-recognition and sequencing by asking an individual to repeat a pattern by changing the colour of the bubble tubes using the control pad. Working on imaginative play (the ball pool could be the sea, and the child has to dive to the bottom to retrieve the treasure). Working on colour-recognition and numeracy skills by asking a child to count how many soft blocks and identify their colours while building a house with them. Gross motor skills can be encouraged through obstacle courses, jumping, hopping, throwing and catching games in the soft room. Fine motor skills can be encouraged in the dark room by encouraging the individual to press the buttons of the control panel for the infinity tunnel or bubble tubes. Behavioural issues can be addressed in the white room, a calm and relaxing space where clients are encouraged to be quiet and peaceful.

Inspire’s MSR gained accreditation from the UK’s National Autistic Society (NAS) in 2013. Following a thorough inspection of the service and interviews with professionals working there, NAS confirmed that the MSR meets their very strict and specific standards for services provided to individuals with autism.

An average of 450 sessions per month are carried out within the MSR, sometimes one-to-one and sometimes in small groups (depending on the goals of the session).

The MSR service is overseen by an occupational therapist, who is on hand to provide guidance and advice. For more information contact Philip Wade (Complementary Services Occupational Therapist) on 21636526 or Philip.wade@inspire.org.mt

OTHER PERSONAL EXPERIENCES

Jack is a 6 year old boy with autism, he is very shy and does not initiate interaction with his peers at school. He has been attending sessions at Inspire’s MSR with his LSA as part of the Winter Programme. The OT has helped Jack begin to socialise with his classmates through the gradual introduction of group activities in MSR sessions. Team treasure hunts in the dark room, and competitive obstacle courses in the soft room have helped Jack to develop his social interaction skills in a fun and playful way.

Andrew is a 25 year old man with cerebral palsy who attends one of Inspire’s programmes and uses the MSR service at least once a week. Andrew enjoys the dark room, where he can control the colours of the lights. Although Andrew is having fun changing the colours, his OT is using this activity as a way to promote and enhance numerous physical and cognitive skills, such as fine-motor skills, colour-recognition, memory, sequencing and turn-taking. At the end of his session Andrew always looks forward to chilling out on the waterbed in the white room. This gives him valuable time out of his wheelchair, which not only provides relaxation, freedom of movement and reduces the risk of pressure sores, but is also a great way to provide gentle vestibular sensory input.