Concerned About Unconventional Mental Health Interventions?

Concerned About Unconventional Mental Health Interventions?
Alternative Psychotherapies: Evaluating Unconventional Mental Health Treatments

Wednesday, September 24, 2014

Sensory Rooms and Gift Horses

Most people have heard the admonition “not to look a gift horse in the mouth” – in other words, not to query or criticize anything we are given for free. Well, it seems that an organization has provided to some Russian orphanages a small stable of gift horses in the form of “sensory rooms” (http://psypress.ru/psynews/d8484.shtml). Most Russians are not examining the value of these gifts carefully, so I will do it for them.

What are sensory rooms? They are rooms full of equipment that provides sensory stimulation through flashing lights, changing colors, and so on. Google the term and you will find that you can buy one on line for more than $20,000, and it will include the following: an infinity tube, a bubble tube, a LED fiber optic cascade, a projector wireless, color changer, and other bits including a bean bag chair. I don’t know what all those things do exactly, but they are said to change your room into a Multi-Sensory Environment (their caps).

What are sensory rooms for, and why would anyone want to have them? Basically, they are the same kind of thing as “snoezelen” (see http://childmyths.blogspot.com/2011/03/ja-das-ist-ein-snoezelen-bank-or-theres.html). These activity rooms were originally created in the ‘70s for fun, by graduate students in the Netherlands, and I would speculate were planned to make recreational drugs even more recreational. More recently, they have been used with dementia patients and with autistic children--  but without any evidentiary support for the helpfulness of this practice.

Now, the Russian orphanage managers and their donors are assuming that young children in institutional care will benefit in some way from periodic sessions in the sensory room. Once again, there is no empirical evidence to support this idea, so perhaps it would be a good idea to ask where anyone got this notion.

The basic belief behind sensory rooms (and similar treatment) is that human personality and intelligence are shaped by the impact of sensory experience—that infants are “blank slates” whose development and eventual characteristics derive from the sensory experiences they have had. This idea dates back to the French philosophe Condillac, who at the time of the French Revolution put this suggestion forward as relevant to creating good citizens in the post-revolutionary world. J.M.G. Itard, an admirer of Condillac, used this approach as he attempted (unsuccessfully) to work with the “wild boy of Aveyron”, an apparently feral, language-less boy who was about 12 when “caught”. Itard used a variety of sensory stimuli such as massage and the production of different sounds in his efforts to produce in the “wild boy” more normal levels of ability, which of course Itard assumed to develop in most people as a result of the sensory experiences of which the “wild boy” had been deprived. Similar approaches were taken later in the 19th century as American educators tried to work with blind and deaf children. (This was the reason for the famous scene in the life of Helen Keller, when Annie Sullivan pumped water over her hand.) Some children responded well to social interaction and stimulation, but more generally it appeared that whatever the source of their cognitive and sensory limitations, they could not be cured just by additional sensory experience.

But--  here we are today, with sensory rooms for sale, and in use in institutions like the Russian orphanages, from which children often emerge with poor cognitive abilities and possibly with emotional disorders as well. If there is no evidence that sensory rooms provide effective treatment, why are people spending resources for them,  that might be used more helpfully in other ways? No doubt some of this is the “trailing edge” of Condillac’s thinking, but I believe there are some other misunderstandings at work here.

A primary problem with regard to the sensory room practice has to do with the confusion between social stimulation and sensory stimulation. Genuine deprivation of sensory stimulation in early life has been shown to result in later cognitive weaknesses in animals, and Jerome Bruner in the 1950s generalized this finding to human beings. Because some (but not all) aspects of sensory development are guided by sensory experience, it’s true that problems like poor depth perception can result from a lack of sensory experience. However, in the 1970s, Jerome Kagan, studying Mayan infants who were reared for the first year in darkened huts, found that although the children seemed cognitively slow at a year of age, they recovered over the next several years as they became involved with a stimulating outside environment.

In any case, children in institutions are not deprived of sensory stimulation, as has been done experimentally with animals and as has occurred for cultural reasons in some human situations. Institutional infants have plenty of illumination and things to look at, including other children, adult caregivers, windows, doors, and so on. (This may not seem like an interesting view to adults, but it is quite enough to support the growth of cortical sensory areas.) Institutions tend to be  noisy, with talk by caregivers and older children, crying of babies, and so on. There are also smells, tastes, and the experience of physical handling.  But just having these experiences--  or the experience of the sensory room--  is not enough to encourage good cognitive or emotional development in the very young.

What is missing, then? Institutional children are often deprived of social stimulation, for example of infant-directed speech with a pitch and tempo of interest to infants, or of the smiling, interested gaze of a caregiver. (Of course, these experiences may also be missing in foster homes or even in poorly-functioning families.) Social stimulation at its best encourages cognitive development by helping to guide infant attention to important sensory events and by regulating or buffering sensory experiences that may be overwhelming for an infant. But there is more to it than that.  A well-trained and engaged caregiver does not just speak in an infant-directed way—he or she changes the voice in an effort to get the infant’s attention, or softens speech if the infant seems over-stimulated by it. Such a caregiver smiles and gazes at a baby, but if the baby averts his or her gaze, the caregiver waits until the baby looks back before making other efforts to interact. Good caregivers recognize that in order for a baby to learn from sensory stimulation, the sensory experience must be neither too intense nor too weak, neither too rapid in tempo nor too slow.  They also realize that for infants and toddlers, much of their most important sensory experience occurs during care routines like feeding and diapering, and that these routines can provide an essential ”curriculum” for teaching young children.

In sum, sensory stimulation is not useful for early development unless adult caregivers actively engage in shaping the infant’s sensory world in ways that foster attention and learning. Unless caregivers are doing this job in sensory rooms, any stimulating properties the rooms have may simply overwhelm young children and minimize any learning effects that they might conceivably have.

Could the money contributed for the purchase of sensory rooms have been better spent? Yes, but to do so would involve ongoing commitment of dedicated amounts over a period of years. Real advantages for young children’s development do not come from “one shot” solutions like the gift of a sensory room, but they are a matter of hiring and training excellent and sufficient staff.  Help of especial importance is given by increasing staff salaries and living conditions so that turnover of employees is reduced and a stable social environment is provided. Without stability, caregivers cannot get to know the children, and unless they know the children well and read their communications of interest or aversion, the caregivers cannot buffer sensory experiences to provide the best levels of stimulation.  

Throughout human history, and all over the world, most babies have not had environments that looked or sounded interesting to adults, but they developed and learned well because they had plenty of social stimulation by engaged caregivers who modulated sensory experiences to suit the children’s needs. Living arrangements that fail to provide this help will not support good development whether they are orphanages with sensory rooms, foster homes, or the children’s biological families.




2 comments:

  1. Some of the 1-2 year-old children in orphanages elements have autism. It disappears after a while apparently in the process of maturation and interactions with adults and peers. Maybe it's not even autism but temporary apathy and indifference. Maybe sensory rooms are not useless? Sometimes this is a strong incentive for the child and the possibility of his interest. Replace the communication between an adult and a child can not be ...... but some shake and a strong shock sensor may be useful for some kids. Flashing lights and overdrive bad effect on vision. All this colorful splendor can not be held useful and informative information for the child but may be sometimes necessary touch shock for some children?

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    1. I wouldn't want to say that this is impossible, but the evidence seems to be that it doesn't work that way.

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