The Multisensory Handbook: A Guide for Children and Adults with Sensory Learning Disabilities

I began reading ‘The Multisensory Handbook’ whilst travelling to a rural school to visit three children who were blind who each have significant cognitive disabilities. For many years I have been working with these children, their families, teachers and the school community to increase their orientation and mobility (O&M) skills. Through this collaboration we have been able to develop a joint program to develop their mobility, cognitive, and communication skills. With this program in mind, it was with interest that I skimmed through this book and noted two things – the emphasis on a ‘unified’ approach to supporting people with challenging sensory needs and the importance of fully understanding sensory development when designing appropriate intervention strategies. It is these two points that make this book valuable reading for all professionals supporting people with sensory impairments.

This book is divided into two sections. The first section focuses on understanding sensory development and defining multisensory stimulation. The second section explores the unified approach to assessment and designing appropriate environments.

In the first couple of chapters there is an overview of the important concepts used in the book and a brief introduction to the anatomy and physiological aspects of human sense development. By having an understanding of the concepts that underpin sensory stimulation, such as sense organs, perception, sensory processing, sensory thresholds, and multisensory stimulation, it is easier to understand how our senses link our brains to our environment. As an Orientation and Mobility instructor the quote ‘…the more multisensory the stimulation, the more likely it will be perceived in more accurate, valid and dependable ways’ (p. 7) challenged me to look at the emphasis I place on the different forms of sensory information available to the children who are blind or have low vision, forcing me to ask whether or not I place too much emphasis on the senses that are dominant for me, in vision and hearing.

The next few chapters look at the idea of pleasurable sensory experiences and how designing multisensory programs can lead to relevant and meaningful success for participants, working towards changing a situation of learned helplessness to learned optimism. The concept of predictive coding is defined as the brain using prediction and anticipation to interpret the sensory information coming in and therefore guiding perception of that sensory experience. This chapter provides the basis for understanding that development of sense learning and therefore understanding sense-learning difficulties.

Chapter 6 provides an interesting breakdown of various considerations for the design of a multisensory space. This includes describing 17 different multisensory ‘design prototypes’. Whilst reading I was able to recognise many of these designs that are commonly used in specialist schools, including the ‘white’ room, wet areas, and social areas. This section clarifies many of the ideas behind the use and design of a multisensory environment and provides any practitioner with much food for thought.

The second part to the book, titled ‘A unified approach,’ focuses on how the ‘participant, the practitioner, and the environment are all indispensable’ (p.79) and stresses the need for all to work together, with the specialisations of the practitioners being secondary to the participant’s multisensory development.

In these chapters the author provides detail on how to conduct a multisensory assessment, with templates to guide practitioners through the assessment of five key multisensory areas – the participants well-being, stereotypy, engagement, interoception, and exteroception. From an orientation and mobility practitioner perspective, I feel these templates provide appropriate information to guide me through the process as well as highlighting the need to assess using various approaches, in a variety of settings and including all key stakeholders.

The final few chapters look at the considerations that need to be addressed before starting the process of designing a multisensory environment. After the detailed templates in the previous assessment chapter, I was looking for further step-by-step information on designing a multisensory environment but for good reasons the author only provides examples and suggestions. He reminds us that each participant is an individual, therefore it is not possible to provide specific ‘how to’ recipes for practitioners to follow.

Throughout the book the author employs a particularly useful strategy of reviewing and linking ideas from previous chapters with new information in subsequent chapters. This spiralling of information helps the reader review the important concepts and provides links to new the concepts. This spiralling of information throughout the book echoes the purpose of the book, that as practitioners we need to design appropriate programs to build on new experiences, linking new information with a spiralling effect to aid sense learning.

Whilst not the major focus of the book, Chapter 7 engages in an intriguing discussion about ‘establishing a caring relationship’. It challenges any practitioner to give much thought to the relationships we establish with the participants we work with. The author reminds us that this relationship requires a genuine interest, an open mind and a recognition of assumptions we may hold about our clients. It is particularly pleasing to see this addressed in a book written for practitioners. Often the philosophical reasons for doing what we do in a ‘caring’ profession are not written about. By including this chapter the author is acknowledging that not everyone in a ‘caring’ profession demonstrates high expectations for their client group they work with nor do they honestly believe that this group are capable of learning or have the potential for more independence. The author notes ‘establishing a caring relationship is much more complicated than it initially appears. This is because it involves considerable preparation and requires a very substantial skill set’ (p. 81).

Reading this book made me think that in training courses, such as those for orientation and mobility practitioners, there is a need for greater understanding of sensory development. This book is a good starting point as the author provides the background knowledge in the area of sense anatomy and development. This book is therefore useful for both new and experienced practitioners.

It was also encouraging to see the promotion of a ‘unified approach’ to working with people who have challenging sensory needs. I have found this approach particularly helpful in the rural program mentioned earlier. This program has only worked because the orientation and mobility instructor, physiotherapists, speech therapist, music teacher, class teachers, and families have all provided input and contributed to the running and success of the program.

In summary, this book has definitely contributed to my understanding of sense learning and development and how to design a multisensory program. I am reminded to think in greater depth about how I can assist the children I work with to understand their environment and to help them to make use of multisensory information in order to facilitate the development of more accurate, valid, and dependable interpretations of the environment.