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This diploma thesis is focused on Snoezelen as special educational support for children with autistic spectrum disorder. Snoezelen can be understood as a way of relaxation, spending free time, pedagogical action or comprehensive therapy. It can be practiced in different facilities and it brings profit to general public with different impairment. Autistic spectrum disorder is one of diagnoses in which therapists decide to use the effect of Snoezelen. There are some researches focusing on quantitative detection of the circumstances associated with Snoezelen. This is why this thesis is dedicated to a qualitative study of the use of Snoezelen in a special pedagogical institution. This Thesis aims to analyse literary sources to comprehensively characterize problems of autistic spectrum disorders and to outline the principles, benefits and requirements of Snoezelen. Subsequently, using a qualitative survey, describe coherently the way in which Snoezelen is practiced to children with autistic spectrum in a particular special pedagogical institution, evaluate this way and recommend possible improvements. KEYWORDS Autistic spectrum disorder, autism, Snoezelen, sensory stimulation, multisensory room

La present tesi doctoral ha estat plantejada amb l'objectiu general de poder valorar l'efecte de l'estimulació multisensorial en les persones amb greu discapacitat intel·lectual. En particular, aquest objectiu se centra en analitzar l'efecte que pot tenir el fet de participar en un programa snoezelen en persones amb greu discapacitat intel·lectual.Esmentar que el treball empíric es desenvolupa en un espai snoezelen. Aquests són espais especialment dissenyats per a poder proporcionar estimulació sensorial a diferents nivells a persones amb greus afectacions. Aquests espais es van crear als anys setanta a Holanda i, la paraula snoezelen és una contracció de dues paraules holandeses "dozzelen" i "snufelen", que significarien quelcom semblant a dormitar o relaxar-se i olorar. En definitiva, és un espai agradable a la persona i que li ha de produir sensacions de benestar emocional i relaxació, entre altres. Destacar com a novetat d'aquest treball el fet d'haver dissenyat un instrument per a poder mesurar objectivament l'efecte que sobre l'estat de la persona provoca el fet d'haver participat en una sessió d'estimulació en un espai snoezelen. I, alhora un software que analitza les valoracions i en treu resultats.La investigació ha estat dissenyada per obtenir dades que ens confirmin o rebutgen la hipòtesi general plantejada que ha estat la següent: "El fet de participar en un espai snoezelen contribueix a augmentar la qualitat de vida de les persones amb greu discapacitat intel·lectual". Per a comprovar aquesta hipòtesi la investigació empírica s'ha plantejat de la següent manera. En primer lloc, s'ha elaborat després d'un llarg procés, un full de valoració de l'efecte de les sessions snoezelen en les persones amb discapacitat intel·lectual greu. Aquest full de valoració de les sessions analitza variables de resposta conductual per part del subjecte (conductes disruptives, nivell de motivació, nivell d'activitat, benestar emocional i nivell de relaxació) en tres moments diferents (en començar la sessió snoezelen, en finalitzar-la i mitja hora després). El fet d'analitzar les variables esmentades comparant els seus valors en els diferents moments establerts, ens ha de permetre veure l'efecte de la sessió snoezelen i també si aquest efecte dura o no en el temps. A banda d'aquestes variables s'han analitzat també respostes del subjecte com puguin ser somriures, fixació visual i vocalitzacions de plaer o displaer. Aquestes respostes ens han d'indicar si la persona gaudeix o no de la sessió i si presenta o no respostes de conducta adaptades durant les sessions. Hem valorat important també, analitzar una variable psicofisiològica com és la freqüència cardíaca de la persona, en començar i en acabar la sessió; aquesta serà una dada clarament objectiva a l'hora de poder valorar l'efecte de la sessió snoezelen en l'estat del subjecte.S'han analitzat un total de mil sis-cents divuit fulls de valoració de les sessions i amb aquest full s'ha realitzat un estudi estadístic emprant la prova no paramètrica de Wilcoxon. Amb aquest estudi analitzem de manera detallada la significació o no en el valor de les variables analitzades en els tres moments diferents en què hi ha dades. A més s'analitza també per a cadascun dels individus de la mostra, com cada variable augmenta o disminueix segons sigui en començar la sessió , en acabar-la o mitja hora després.Després d'analitzar i discutir amb detall tots els resultats, podem dir que, de manera molt clara es confirmaria la hipòtesi que plantegem. És a dir, el fet de participar en una sessió snoezelen augmenta la qualitat de vida de les persones amb greu discapacitat intel·lectual. Si considerem que una millora en el nivell de les variables analitzades després de participar en una sessió snoezelen, ha d'implicar una millora en la qualitat de vida, és molt clar el fet que sobretot la variable benestar emocional i nivell de relaxació augmenten de manera significativa després de dur a terme les sessions snoezelen en el 100% dels casos. / The main goal of the thesis is to assess the effect of multisensory stimulation on adult people with profound mental disabilities. The work includes an in-depth review of the scientific literature concerning the effects of multisensory stimulation and an experimental study with 23 individuals. The literature review showed that there is little work aiming to quantify the effects of multisensory stimulation in a systematic and objective way. The experimental work was carried out in a Snoezelen room, where stimuli can be programmed and controlled. This is a space specifically designed to produce basic multisensory stimulation to disabled people, through vestibular, tactile, visual, auditory, olfactory and other sensations, in order to increase the quality of life (defined through several quantifiable variables).A new methodology to quantify the effect of the Snoezelen sessions on individuals has been developed by defining and measuring several variables before and after the session. The general hypothesis is that the participation of profound mentally disabled people in Snoezelen sessions increases his quality of life. This global variable is measured through several response behavioural variables such as disruptive behaviour, motivation level, activity level, emotional wellbeing and relaxation level. Other measured variables were heart rate, smiles, visual attention and pleasure vocalizations. These variables were measured before starting the session, at the end of it and 30 minutes after. A total of 1618 individual sessions were analyzed in order to determine statistically significant differences in the measured variables using the non-parametric Wilcoxon test.Results showed a significant increase of the quality of life of most of the individuals after the Snoezelen sessions. The variables related to emotional wellbeing and relaxation level increased significantly in a major portion of individuals, and the effect lasted at least 30 minutes after the sessions. The disruptive behaviour decreased significantly in 65 % of individuals 30 minutes after the sessions; the motivation level increase significantly in 69% of individuals; the activity level changed significantly (increased or decreased) in 43% of individuals; the emotional wellbeing increased significantly in 87% of individuals; the relaxation level increased significantly in 74% of individuals. In three particular individuals a significant amount of sessions (up to 30%) resulted in negative or non-significant effects. These cases are related to the cyclical behavioural alteration of the individuals, so they were less sensitive to stimuli during some periods.The results of this work stress the importance of developing and improving quantitative methods to asses the effect of multisensory stimulation, using a significant number of individuals and sessions. The correct definition of quantitative variables and the determination of the effect of the observer on the results of the sessions are two aspects to be improved in future works in order to obtain more conclusive results.

This master's thesis is focused on the Snoezelen concept used for patients with physical or multiple disabilities. The Snoezelen concept can be applied as a therapy, an auxiliary educational method or possibility to spend free time in various facilities like schools, school facilities, rehabilitation centers or retirement homes. For that reason, Snoezelen concept can be used by many clients and professionals. However, it is mostly used for patients with mental deficiency; that is reflected in the majority of researches. Therefore, patients with physical and combined deficiency were chosen for purpose of this Master's thesis as this issue has not been yet examined enough. The Master's thesis aim is to gather relevant information of the Snoezelen concept and to make quantitative research with a questionnaire that determines rate of using the concept, awareness level and attitude of clients with physical and multiple disabilities, their representatives and professionals. From these data, a summary is created for that issue. A very low awareness level was found in clients with physical and multiple disabilities, their representatives and professionals. Therefore an information leaflet was created and is provided at the end of the Master's thesis. Powered by TCPDF (www.tcpdf.org)

Barn med diagnosen intellektuell funktionsnedsättning, ADHD och autism kan uppleva en minskad delaktighet i sociala relationer och i samhället. Dessa diagnoser kan medföra symtom som kan ha en negativ påverkan på utförandet i vardagliga aktiviteter. Studier visar att ett symtom som påverkar aktivitetsutförandet hos dessa barn är den sensoriska bearbetningen av stimuli i barnets omgivning. Syftet med detta examensarbete var att beskriva hur sinnesrum kan användas som åtgärd hos barn med intellektuella funktionsnedsättningar, ADHD och/eller autism för ökad delaktighet i deras aktivitetsutförande. Examensarbetet var en Scoping Review där 20 artiklar och kapitel från en bok har inkluderats. Inklusionskriterier för artiklarna var studier om barn upp till 18 år, diagnostiserade med ADHD och autism samt användning av sinnesrum och sensorisk bearbetning vid ADHD och autism. Artiklarna skulle antingen vara kvantitativa-, kvalitativa- eller systematiska litteraturstudier. I de systematiska litteraturstudierna granskades dess referenslistor för att utesluta att en artikel inte redan blivit granskad. Artiklarna skulle vara skrivna på svenska eller engelska publicerade mellan 2005 och maj 2018, finnas tillgängliga i fulltext samt vara peer reviewed. Resultatet beskriver hur sinnesrum kan användas som en sensorisk integrationsåtgärd för examensarbetets målgrupp och dess effekter samt hur sinnesrummet erbjuder olika slags stimuli som ska tillfredsställa barnets sensoriska behov, vilket kan bidra till en positiv effekt genom ökat aktivitetsutförande och delaktighet. Slutsatsen är att sinnesrum är en sensorisk integrationsåtgärd som kan användas som åtgärd av arbetsterapeuter och kan erbjudas till barn med ADHD och autism som ger positiva effekter på deras delaktighet i aktivitetsutförandet. / Children diagnosed with intellectual disability, ADHD och autism may experience that they have a reduced participation in their social network and the community. These diagnoses have symptoms that may have negative impact on the performance in the daily activities. According to studies, one of the symptoms that has an impact on the occupational performance for these children is the sensory processing of the stimuli in the child’s environment. The purpose of this bachelor thesis was to describe how a multisensory room can be used as an intervention for children with intellectual disabilities, ADHD and/or autism to increase participation. The bachelor thesis was a Scoping Review where 20 articles and chapters from a book was included. Inclusion criteria for the articles was studies about children to the age of 18 years, diagnosed with ADHD and/-or autism, use of a multisensory room and sensory processing in children with ADHD and autism. The articles could be a quantitative-, qualitative-, or systematic review studies. The reference lists of the systematic reviews studies were reviewed to exclude that an article wasn't already reviewed. The articles would be written in Swedish or English, published between 2005 and May 2018, would be available in full text and peer reviewed, The results describes how a multisensory room can be used as an intervention for the population of the bachelor thesis, the effects and how the multisensory room offers different stimuli that can satisfy the child’s sensory needs. This can contribute to a positive effect by increasing the occupational performance and participation. The conclusion is that occupational therapists can use multisensory rooms as an intervention and it can be offered to children with ADHD and autism and it shows a positive effect on their participation in their occupational performance.

Background: Dementia is a degenerative neurological disorder that afflicts a growing proportion of the global population. Complementary alternative medicine (CAM) modalities are under investigation for their therapeutic value in the management of dementia. Purpose: Nursing care of dementia sufferers can include managing agitation and negative behaviors; this study investigates staff appraisal of the Multi-Sensory Stimulation Environment (MSSE) as an intervention for these nursing challenges. Methods: A purposive sample of nursing staff employed in residential care for dementia patients were recruited 10 weeks after the initiation of an open-access MSSE at the facility to complete a confidential self-administered questionnaire. Results: 79% of potential participants returned completed surveys for a total sample of n = 23. 70% of survey respondents felt that residents were utilizing the MSSE "Somewhat Frequently" or "Very Frequently." 77% of the staff felt the MSSE should continue in use at the facility or continue with some alterations. The sample suggested that the MSSE is helpful for mood, specifically anger, sadness, anxiety, and restlessness, but not for boredom. Higher-scoring items in favor of the MSSE intervention included confusion, perseverating, wandering, and interpersonal conflict. Conclusion: Several components of agitation and negative behavior in the dementia population appear to be improved with the use of an MSSE according to this sample. Further research is needed to support the results of this sample and to explore more detailed recommendations regarding the use of MSSE in dementia care.

La stimulation multisensorielle (SMS; Snoezelen) utilisée avec des personnes atteintes d’un trouble neurocognitif majeur (TNC) est une intervention non pharmacologique qui vise la stimulation sensorielle ainsi que la relaxation corporelle pour favoriser le bien-être du patient. Cette recherche comporte deux études. La première étude, de nature qualitative, examine comment les salles de stimulation multisensorielle sont utilisées avec des patients atteints d’un TNC dû à la maladie d’Alzheimer (TNC-MA) dans quelques résidences pour personnes âgées de la région d’Ottawa. Les entrevues ont été menées avec huit intervenantes provenant de neuf résidences. Quatre idées fortes ont émergé des entrevues: 1) Snoezelen est utile pour réduire plusieurs symptômes comportementaux et psychologiques (SCPD) dans le TNC-MA, 2) son utilisation présente des défis logistiques, 3) il y a une grande variabilité dans son utilisation, et 4) il s’agit d’une approche humaniste, centrée sur la personne. La deuxième étude s’adresse à l’utilité clinique de l’intervention. Un protocole à cas unique a été utilisé, avec ligne de base multiple, phase d’intervention et posttest (A1-B-A2), afin d’examiner l’effet de la SMS sur les SCPD les plus prévalents (agitation, apathie, et humeur dépressive), sur le niveau de retentissement des SCPD sur le personnel soignant, et aussi sur la fréquence d’administration de médicaments psychotropes chez des participants institutionnalisés atteints d’un TNC-MA de modéré à sévère. Sept résidents d’un centre de soins de longue durée ont participé. Les effets sur l’apathie, l’agitation, l’humeur dépressive et le retentissement ont été évalués à l’aide de l’Inventaire neuropsychiatrique, version équipe soignante (NPI-ES). La prescription des médicaments a été documentée par la chercheuse principale. Les résultats démontrent que la SMS réduit l’agitation chez les patients et atténue le retentissement sur le personnel soignant. La SMS pourrait aussi réduire l’apathie chez certains participants. Il n’y a pas d’effet notable sur les médicaments prescrits. Toutefois, les résultats modestes ne permettent pas de recommander cette forme d’intervention auprès des personnes institutionnalisées atteintes d’un TNC-MA, en l’état actuel des connaissances, considérant les investissements en ressources qu’elle implique. En bref, cette recherche contribue au développement des connaissances sur l'utilité clinique d’une forme d’intervention multisensorielle, non pharmacologique, dans les soins d’un TNC-MA.

Title of the diploma thesis: Use of promotive therapy and stimulation in hospice care Aim of the thesis: Possible use of promotive therapy and stimulation in therapy of patients in hospice care is discussed in this diploma thesis. The aim of thesis is to compare use these therapies in hospice facilities that provide accommodation for clients or in home hospice care in the Czech Republic and the Slovak Republic and to analyze way of its use in praxis. For purpose of this thesis following promotive therapies and stimulation were selected: music therapy, art therapy, bibliotherapy, basal stimulation and concept Snoezelen. Methods of work: Quantitative and qualitative investigation was used for research. Quantitative investigation in form of questionnaires provided to hospice facilities with accommodation for clients was utilized as a method for data acquisition. Observation of practical promotive therapies processes in hospice facilities with accommodation for clients was included in methodology of qualitative investigation. Results: Research deals with death and dying which is still quite often taboo theme in our conditions. This fact is perceptible in results of research investigation. It was revealed that offer of promotive therapies, which are provided professionally and defined in advance, is not...

The thesis deals with the creation of Snoezelen room, its characteristics and properties. He is more closely involved with the creation of snoezelen for pupils with mental and combined disabilities who are trained in special primary schools. The work describes the target group, defines the snoezelen method and describes its origin and development in our country and abroad. The main goal of the thesis is to explain to the reader how the rooms are created and what it is necessary to know before deciding to launch the snoezelen room. This information was used mainly by special teachers who operate snoezelena in facilities where they work in schools. The thesis also touches on the topic of education at special schools, methods of working with these pupils and describes types of expressive therapies, therapies, basal stimulation and sensory stimulation. The thesis also reflects the Snoezelen-MSE qualification course in theory and practice, which was the main source. The output of the thesis is a proposed room model, description of equipment and activities that are suitable for working with disadvantaged pupils.

This diploma thesis is focused on leisure activities for children with moderate and severe mental retardation. The theoretical framework demonstrates the degrees of mental retardation, and in addition, integration and inclusion issues in education are discussed. This part of the diploma thesis acquaints with potential leisure centres and presents various forms of leisure activities for children with moderate and severe mental retardation. The practical application part identifies specific leisure activity options and in a collaboration with leisure centres it provides a comprehensive overview of leisure activities for children with moderate and severe mental retardation in Kolin and Nymburk region. It also captures parental interest in these leisure activities.