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Snoezelen multi-sensory environment: An overview of research and practical implications

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Abstract

The Snoezelen multisensory environment (MSE) is a specially designed setting developed for individuals with disabilities. The popularity of the Snoezelen MSE has grown in schools, recreation centers, and hospitals over the last 20 years. The purpose of this article is to provide an overview of the Snoezelen MSE by providing a description of the environment and discussing research on it within the context of evidence-based practices and offering recommendations for research and practice.

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... 4,7,10 As an example, the multisensory stimulation (MSS) environment known as Snoezelen was developed in the 1970s in the Netherlands. [9][10][11] It was initially developed as a therapy for young people with learning difficulties, 12 but since the beginning of the 1990s, it was introduced in the care of people with dementia. 9,10 This technique is applied in a darkened and comfortable room, where all senses are stimulated using aromatherapy, water columns of different colors, fiber-optic cables and tactile objects, among others. ...
... 9,10,12,17 Balancing the pace of sensory-stimulation or sensory-calming activities is necessary for all people, but particularly elderly people. [9][10][11][12] Multisensory stimulation aims to stimulate the primary senses to achieve a balance between sensory-stimulating and sensory-calming activities. 9,11,18 Therefore, the professional works one-on-one with patients to stimulate different senses, such as visual, auditory, proprioceptive and olfactory, through a variety of sensory activities, such as different types of food, clothes, tactile objects, light and music. ...
... [9][10][11][12] Multisensory stimulation aims to stimulate the primary senses to achieve a balance between sensory-stimulating and sensory-calming activities. 9,11,18 Therefore, the professional works one-on-one with patients to stimulate different senses, such as visual, auditory, proprioceptive and olfactory, through a variety of sensory activities, such as different types of food, clothes, tactile objects, light and music. 11,15 Furthermore, MSS is one of the interventions that can be applied at any stage of major NCD (dementia), including the severe or very severe stage. ...
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Review question/objective: This review aims to identify and synthesize the effectiveness of multisensory stimulation in managing neuropsychiatric symptoms in older adults with major neurocognitive disorder.More specifically, this review focuses on the following questions: what are the effects of multisensory stimulation in managing neuropsychiatric symptoms such as delusion, hallucination, agitation, aggression, mood liability, anxiety, apathy, motor disturbances, night-time behavior and eating disorders in elderly patients with major neurocognitive disorder?
... 0 studies -1970s in the Netherlands, [9][10][11] and it was initially used as a form of therapy for young people with learning difficulties. 12 However, since the beginning of the 1990s, it was introduced in the care of people with dementia. ...
... 9,10,12,17 It is important that there is a balance between sensory-stimulation and sensory-calming activities, particularly among older adults. [9][10][11][12] This form of therapy aims at stimulating primary senses with a view to achieving a balance between sensorystimulating and sensory-calming activities. 9,11,18 Therefore, health professionals should work individually with each older patient, stimulating visual, auditory, proprioceptive and olfactory senses through a variety of sensory activities, namely, different types of food, clothes, tactile objects, light and music. ...
... [9][10][11][12] This form of therapy aims at stimulating primary senses with a view to achieving a balance between sensorystimulating and sensory-calming activities. 9,11,18 Therefore, health professionals should work individually with each older patient, stimulating visual, auditory, proprioceptive and olfactory senses through a variety of sensory activities, namely, different types of food, clothes, tactile objects, light and music. 11,15 Furthermore, multisensory stimulation is an intervention that can be applied at any stage of major NCD, including severe and very severe stages. ...
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Objective: The objective of the review was to synthesize the effectiveness of multisensory stimulation in managing neuropsychiatric symptoms (NPS) in older adults with major neurocognitive disorder (NCD). Introduction: Major neurocognitive disorder is characterized by changes in specific cognitive domains with a progressive deterioration in cognitive ability and capacity for independent living. Most older adults with this condition have one or more concomitant symptoms known as NPS. Evidence shows that nonpharmacological therapies have been effective in controlling these symptoms, with multisensory stimulation attracting further investigation. Inclusion criteria: The review considered studies on older adults aged 65 years or over with major NCD. The intervention of interest was multisensory stimulation, and the comparator was usual care (e.g. no occupational therapy, no cognitive training, and no art therapy, but with possible control of activities such as looking at photographs or doing quizzes), or another intervention (e.g. occupational therapy, cognitive training and art therapy). Primary outcomes were NPS (agitation, aggression, motor disturbances, mood liability, anxiety, apathy, night-time behaviour, eating disorders, delusion and hallucination). Secondary outcomes were quality of life, functional status in activities of daily living, cognitive status and caregiver burden. Experimental study designs were considered. Methods: A broad range of keywords and a three-step search strategy were used to identify potentially eligible published and unpublished studies from January 1990 to June 2016 in major healthcare-related online databases. Studies in English, Spanish and Portuguese were included. Two independent reviewers assessed the methodological quality of eight included studies using the Joanna Briggs Institute (JBI) Critical Appraisal Checklists for Randomized Controlled Trials and Quasi-Experimental Studies. Data were extracted using the standardized data extraction tool from the JBI System for the Unified Management, Assessment and Review of Information (JBI SUMARI) and included details about the interventions, populations, study methods and outcomes of interest. Significant differences were found between participants, interventions, outcome measures (clinical heterogeneity), and designs (methodological heterogeneity). For these reasons, a meta-analysis could not be performed. Therefore, the results have been described in a narrative format. Results: Eight studies (seven randomized controlled trials and one quasi-experimental study) were included, with a total sample of 238 participants (pre-intervention). Four studies confirmed the effectiveness of multisensory stimulation in domains such as physically nonaggressive behavior, verbally agitated behavior and agitation. However, these effects did not always persist in the long-term. Six studies showed poorly consistent results on the effects of multisensory stimulation in improving mood, with only one displaying significant effects. Similarly, despite poor results, two studies showed benefits concerning anxiety. Participants reported significantly decreased levels of anxiety over the course of the intervention, and this improvement persisted in the long-term. In regard to functional status in activities of daily living, two studies reported an improvement in the short-term. Moreover, the effectiveness in cognitive domains such as memory and attention to surroundings also showed inconsistent results across the seven studies that analyzed this outcome. Two studies reflected an improvement during the intervention, but also reported a gradual decline in the long-term. Only one study observed significantly better results during the intervention that persisted until the follow-up assessment. Apathy, night-time behavior, eating disorders, delusion and hallucination were NPS that were not explored in the studies that met the criteria to be included in this review. Conclusions: These findings suggest that multisensory stimulation could be an effective intervention for managing NPS in older adults with major NCD in a mild to severe stage, particularly for managing behavioral symptoms such as agitation. This research provides an indication of the likely effect of the multisensory stimulation on NPS such as agitation and anxiety, as well on cognitive status.
... En 1975, se desarrolló la idea de los espacios Snoezelen® (Hulsegge & Verheul, 1988), cuyo objetivo fue brindar a adultos institucionalizados, por discapacidad mental, un espacio recreativo que involucrará dinámicas multi-sensoriales (Hulsegge & Verheul, 1988). En estos ambientes se fomenta la exploración libre del usuario sobre distintos estímulos visuales, auditivos, táctiles, olfatorios y propioceptivos, acompañado de forma no directiva por un facilitador (Fowler, 2008;Haegele & Porretta, 2014;Hulsegge & Verheul, 1988). Los espacios Snoezelen® se caracterizan por la combinación de luces, sonidos, aromas y texturas, cuyo objetivo es generar una experiencia agradable y de relajación en los participantes (Haggar & Hutchinson, 1991). ...
... Su utilización se ha extendido a diferentes países, entre ellos Costa Rica (Rojas, 2014), y cada vez son más las escuelas, centros recreativos, hospitales y clínicas que lo implementan (Bozic, 1997;Haegele & Porretta, 2014;Shapiro, Melmed, Sgan-Cohen, Eli, & Parush, 2007). ...
Article
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La discusión en torno a la influencia del ambiente sobre la ontogenia ha alimentado la interrogante sobre cuál es el grado en el que, a través de la manipulación del contexto, se modifican las características de los individuos. Actualmente, la evidencia científica desde distintos campos (e.g., Psicología del desarrollo, Neurociencias) describe cómo el ambiente es capaz de modular los procesos del desarrollo y las distintas capacidades del cerebro, así como los mecanismos plásticos que subyacen a dicha modulación. Con base en esta evidencia, distintas aproximaciones metodológicas orientadas a la estimulación temprana (ET) se han propuesto potenciar el desarrollo o remediar problemas que se presentan durante las etapas tempranas del ciclo vital. En este contexto, se brinda una revisión del tema y se ofrece un marco teórico general sobre los antecedentes y sobre los principios que sustentan la estimulación del sistema nervioso (i.e., plasticidad cerebral). Además, a través de una aproximación empírica y un proceso de revisión bibliográfica, se presenta la evidencia disponible de algunos de los métodos de mayor conocimiento/uso en Costa Rica (i.e., Doman-Delacato, Snoezelen®, Point y Bebé Políglota). Al recapitular los alcances y las limitaciones de la ET, se concluye que es necesario sistematizar las experiencias profesionales de forma tal que permitan abrir un debate académico sobre el tema.
... En 1975, se desarrolló la idea de los espacios Snoezelen® (Hulsegge & Verheul, 1988), cuyo objetivo fue brindar a adultos institucionalizados, por discapacidad mental, un espacio recreativo que involucrará dinámicas multi-sensoriales (Hulsegge & Verheul, 1988). En estos ambientes se fomenta la exploración libre del usuario sobre distintos estímulos visuales, auditivos, táctiles, olfatorios y propioceptivos, acompañado de forma no directiva por un facilitador (Fowler, 2008;Haegele & Porretta, 2014;Hulsegge & Verheul, 1988). Los espacios Snoezelen® se caracterizan por la combinación de luces, sonidos, aromas y texturas, cuyo objetivo es generar una experiencia agradable y de relajación en los participantes (Haggar & Hutchinson, 1991). ...
... Su utilización se ha extendido a diferentes países, entre ellos Costa Rica (Rojas, 2014), y cada vez son más las escuelas, centros recreativos, hospitales y clínicas que lo implementan (Bozic, 1997;Haegele & Porretta, 2014;Shapiro, Melmed, Sgan-Cohen, Eli, & Parush, 2007). ...
Article
Full-text available
De la neuroplasticidad a las propuestas aplicadas: estimulación temprana y su implementación en Costa Rica From Neuroplasticity to Applied Proposals: Early Stimulation and Its Implementation in Costa Rica Resumen La discusión en torno a la influencia del ambiente sobre la ontogenia ha alimentado la interrogante sobre cuál es el grado en el que, a través de la manipulación del contexto, se modifican las características de los individuos. Actualmente, la evidencia científica desde distintos campos (e.g., Psicología del desarrollo, Neurociencias) describe cómo el ambiente es capaz de modular los procesos del desarrollo y las distintas capacidades del cerebro, así como los mecanismos plásticos que subyacen a dicha modulación. Con base en esta evidencia, distintas aproximaciones metodológicas orientadas a la estimulación temprana (ET) se han propuesto potenciar el desarrollo o remediar problemas que se presentan durante las etapas tempranas del ciclo vital. En este contexto, se brinda una revisión del tema y se ofrece un marco teórico general sobre los antecedentes y sobre los principios que sustentan la estimulación del sistema nervioso (i.e., plasticidad cerebral). Además, a través de una aproximación empírica y un proceso de revisión bibliográfica, se presenta la evidencia disponible de algunos de los métodos de mayor conocimiento/uso en Costa Rica (i.e., Doman-Delacato, Snoezelen®, Point y Bebé Políglota). Al recapitular los alcances y las limitaciones de la ET, se concluye que es necesario sistematizar las experiencias profesionales de forma tal que permitan abrir un debate académico sobre el tema.
... A literature review indicated that there are some commonly accepted features for an MSE ( Hotz et al., 2006; Maseda, Sanchez, Pilar Marante, Gonzalez- Albraldes, Bujan, et al., 2014;McKee et al., 2007). These typically include a windowless room or covered windows; padding on the walls and floors; and ensuring the user can explore the environment in safety (Haegele & Porretta, 2014). A range of equipment can be installed, including: (1) projection equipment to provide changing light colours and patterns, (2) sound (music) equipment, (3) bubble tubes offering visual, audible and tactile stimulation, (4) waterbed, (5) fibre optic lighting, (6) tactile objects, (7) usercontrolled switching for changing lighting and other equipment, (8) weighted blankets, (9) self-massagers, (10) rocking chair(s), (11) exercise balls, and (12) squeeze balls (Collier & Truman, 2008). ...
Article
This article presents a review of studies published between 2006 and 2016 on research into multi-sensory environments (MSEs), as part of a project to develop a community-based MSE. This scoping review aimed to identify the settings MSEs are used in, rationale for implementation, equipment installed and the reported effects of the MSE upon users. The Scopus and Web of Science databases were searched for studies reporting on the applications and effects of MSEs. Thirty-three studies met the inclusion criteria and were allocated to groups based on the population they were designed for. These were mental health, intellectual and developmental disabilities, dementia, traumatic brain injuries and maternity. It was difficult to clearly determine what equipment, specific sensory experiences or patterns of implementation were most effective, due to the wide range of research designs and methodologies employed. Overall MSEs show promise through offering benefits to users with a range of disabilities or other conditions; however further studies are required to develop a stronger evidence base on the reported effects of MSEs for particular user groups. A framework has been proposed to address current inconsistencies in reporting the effectiveness of MSEs, to provide a more uniform approach.
... The Snoezelen room is a multisensory environment (MSE) initially designed to support individuals with cognitive disabilities to relax, engage, and interact with their environment (Haegele & Poretta, 2014; http://www.snoezelen.info/). Snoezelen rooms contain specialized equipment that stimulate visual, olfactory, auditory, tactile, and/or vestibular systems. ...
Article
How are mental health practitioners using Snoezelen rooms with children with fetal alcohol spectrum disorder (FASD) within a community mental health setting? Using purposive sampling, we collected information from seven practitioners on how they currently use Snoezelen rooms to support children with FASD and what evidence they believe is needed to assess Snoezelen’s treatment efficacy. Using grounded theory methodology, results indicated that priority research areas include the efficacy of Snoezelen for increasing self-regulation skills, positive parent–child interactions, and parent education. To support evidence-driven use of Snoezelen rooms for mental health treatment, we recommend that future research be focused in these areas.
... Educators must be mindful of the instructional strategies that they use to stimulate sensory inputs. One approach that is becoming more common in physical education is the multisensory approach (Haegele & Porretta, 2014). Although multiple or planned sensory inputs might be effective for some students, they can aggravate challenging behaviors for others. ...
Article
Challenging behaviors of students with autism spectrum disorder (ASD) may occur for a variety of reasons. These behaviors can contribute to the emotional burnout of teachers and impact the learning and safety of the student with ASD and his or her classmates. Physical education is one educational context where high and multiple risks of challenging behaviors may occur due to its unique characteristics compared to other subject areas (e.g., natural stimuli in the gymnasium, variety of equipment, need for physical assistance). The purpose of this article is to address several possible reasons why students with ASD demonstrate challenging behaviors, and to provide strategies for physical educators to minimize these behaviors.
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É uma prioridade societal disponibilizar condições que promovam o envelhecimento da população na comunidade. A par do envelhecimento temos o aumento da prevalência de doenças crónicas, como é o caso das Perturbações Neurocognitivas (PNC). Neste contexto, viver na comunidade, pelo maior tempo possível, inclui a prestação de cuidados multimodais pelo cuidador familiar/informal. Este estudo centra-se na estimulação cognitiva (EC) individual, como uma intervenção a ser promovida pelo cuidador, em ambiente familiar. Objetivo: avaliar a aceitabilidade, aplicabilidade e o impacto de um programa de EC individual (PECI) em pessoas com PNC (PcPNC), implementado pelo cuidador em contexto domiciliário. Metodologia: O PECI testado foi o Making a Difference 3 - Individual Cognitive Stimulation Therapy (MD3), em português Fazer a Diferença 3 - Intervenção Individual de Estimulação Cognitiva (FD3). Metodologicamente o trabalho foi organizado em seis tarefas. As duas primeiras tarefas foram duas revisões sistemáticas da literatura (RSL) sobre a evidência de eficácia, segundo a metodologia do Joanna Briggs Institute. Estas duas RSL serviram de fundamentação conceptual para o presente trabalho. A primeira centra-se na eficácia das intervenções cognitivas promovidas pelo cuidador na cognição e a segunda sobre a eficácia da estimulação multissensorial (EM) na gestão dos sintomas neuropsiquiátricos (SNP). As três tarefas seguintes (Tarefa III, IV e V) consistiram na preparação do estudo piloto: a Tarefa III corresponde à tradução e adaptação para cultura e língua portuguesa do PECI-MD3, que metodologicamente segui as orientações do Formative Method For Adapting Psychotherapy; na Tarefa IV identifica-se o ponto de corte e as propriedade psicométrica do Teste de Declínio Cognitivo de Seis Itens (6CIT, instrumento de rasteio cognitivo); a Tarefa V corresponde à tradução e validação para a língua e cultura portuguesa da escala Quality of the Carer-Patient Relationship, que decorreu em quatro etapas (tradução, síntese, retroversão e criação da versão consensual). Por fim, na Tarefa VI, apresenta-se o estudo piloto que metodologicamente foi um ensaio clínico randomizado controlado (RCT). Resultados: A RSL sobre de eficácia das intervenções cognitivas promovida pelos cuidadores identifica efeitos benéficos a favor desta abordagem, em vários domínios cognitivos como memória, atenção, fluência verbal e resolução de problemas. Na segunda RSL (sobre a eficácia da EM) os resultados, dos estudos primários incluídos, apoiam o uso desta intervenção no controlo do comportamento fisicamente não agressivo, como agitação comportamental e verbal, do humor e da ansiedade. Pelo desenvolvimento da Tarefa III, obteve-se a versão pré-final do PECI-FD3 (versão β) que permitiu a condução do estudo piloto (Tarefa VI). Pela Tarefa V afere-se que o 6-CIT, pelas suas propriedades psicométricas e de precisão, é um instrumento de rastreio robusto; e também adequados pontos de corte, ajustados à população portuguesa, para o 6CIT são aferidos. A escala QCPR versão portuguesa apresenta propriedades psicométricas consistentes para uma das suas duas subescalas. É necessário o desenvolvimento de trabalhos futuros que permitam a continuidade deste processo de validação. Por último, na Tarefa VI, verifica-se pelo desenvolvimento do RCT, que grupo que recebeu a EC pelo programa FD3 apresenta ganhos na cognição, em comparação com o grupo controlo, mais especificamente na orientação e compreensão de ordens. Discussão/Conclusão: A evidência identificada pelas RSL e pelo RCT apoiam as intervenções não farmacológicas na gestão dos domínios cognitivos e SNP. Este trabalho colocou à disposição para a população portuguesa um PECI, com 75 sessões de EC, que permite ao cui dador familiar/informal ter um papel mais ativo no cuidado à PcPNC. Considera-se que, no global, este trabalho fornece instrumentos essenciais para o cuidado à PcPNC/cuidador, como o 6CIT (rastreio cognitivo) e a escala QCPR (que avalia da qualidade da relação entre a díade).
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Special educators are aware of the need to use evidence-based academic and behavioral interventions in their classrooms. Using research to guide decision making in the classroom— whether at the program, school, or district level—can help ensure students are effectively served. A second-grade resource room teacher, Mark, struggles with managing the behavior of several students who have trouble staying on task and completing work. Cindy, a middle school special education teacher, teaches a self-contained program and is looking for a way to teach writing skills to a seventh-grade student with a learning disability. How can Mark and Cindy find out about best practices, and read reviews or summaries of recent studies? Currently , there is no rigorous and comprehensive database to support educators. It also can be difficult for teachers , schools, and policy makers to interpret the results of research. Despite the limitations in currently available resources, there are ways for special education teachers and administrators to identify evidence-based practices that fit their specific contexts.
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The evidence-based practice (EBP) movement has been extremely influential over the last 20 years. Fields like medicine, physiotherapy, occupational therapy, nursing, psychology, and education have adopted the idea that policy makers and practitioners should use interventions that have demonstrated efficiency and effectiveness. This apparently straightforward idea is beginning to affect adapted physical activity; however, researchers and practitioners in our field often appear to be unaware of fundamental questions related to them. The major purpose of this paper is to outline and discuss 10 of these fundamental questions. This analysis leads us to conclude that EBP is a good direction to pursue in adapted physical activity if we develop a type of EBP congruent with the main tenets of our field.
The use of multisensory environments in school servicing children with severe disabilities
  • M Carter
  • Tephenson
Carter, M., tephenson,. (2012). The use of multisensory environments in school servicing children with severe disabilities. Journal of Developmental and Physical Disabilities, 24, 9 -109. doi 10.100 /s10 2-011-9257
Snoezelen, another world: A practical book of sensory experience environments for the mentally handicapped
ulsegge,., erheul, A. (19 7). Snoezelen, another world: A practical book of sensory experience environments for the mentally handicapped. London, England ompa ublishing. in,., un,. (2010). Evidence-based practice in adapted physical education. Journal of Physical Education, Recreation, and Dance, 81(4), 50-54. doi 10.10 0/07 0 0 4.2010.1059 465
An overview of research with people with developmental disabilities and dementia
  • . E Lancioni
  • A Cuvo
Lancioni,. E., Cuvo, A.., ' eilly, M. F. (2002) noezelen An overview of research with people with developmental disabilities and dementia. Disability and Rehabilitation 11(4), 175-1 4. doi 10.1080/09638280110074911
A comparison of e ects of four therapy procedures on concentration and responsiveness in people with profound learning disabilities
  • W . Lindsay
  • D Itcaithly
  • , Eelen
  • L Buntin
  • , Broxholme
  • M Ashby
Lindsay, W.., itcaithly, D., eelen,., Buntin, L., Broxholme,., Ashby, M. (1997). A comparison of e ects of four therapy procedures on concentration and responsiveness in people with profound learning disabilities. Journal of Intellectual Disability Research, 41(3), 201-207. doi 10.1046/j.1365-2788.1997.03535
Meta-analysis of the e ects of individuals intervention in the controlled multisensory environment ( noezelen) for individuals with intellectual disability
  • M Lotan
  • C Old
Lotan, M., old, C. (2009). Meta-analysis of the e ects of individuals intervention in the controlled multisensory environment ( noezelen) for individuals with intellectual disability. Journal of Intellectual & Developmental Disability, 34(3), 207-215. doi 10.1080/13668250903080106 achs, D., asser,. (2009). Facilitating family occupations Family member perceptions of a specialized environment for children with mental retardation. The American Journal of Occupational Therapy 63(4), 453-462. doi 10.5014/ajot.63.4.453 noezelen. (2013). etrieved from http //www. aghouse.com/philosophy AL.asp Title tephenson,., Carter, M. (2011). The use of multisensory environments in schools for students with severe disabilities perceptions from teachers. Journal of Developmental and Physical Disabilities, 23, 330-357. doi 10.1007/s10882-011-9232-6
Porretta is a professor of adapted physical education in the Kinesiology Program at The Ohio State University
  • L David
David L. Porretta is a professor of adapted physical education in the Kinesiology Program at The Ohio State University.