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Changing lives with trauma; Sensory Ladders, Sensory Strategies and Ayres’ Sensory Integration

Last week I found a copy of a therapy review that a young person wrote a few years ago.

“My sensory me is about me – and only me. It’s not about anybody else. It helps me be me.  I don’t worry about what other people think I should be. I am starting to like me now. I’m not so sad anymore. Knowing why I’m different helps me to not worry anymore, and it means I can say what I need.”

He continued “before people told me what to do and how I should feel, and what I needed. It didn’t match up with what I really wanted. That confused me. It made me worry because I kept being wrong. When I did things, people didn’t understand what ‘made me’ do these things. I could see that, but I couldn’t understand why.

I loved therapy and all the stuff we could do. Making safe spaces on my first session helped me know you really knew what I was feeling inside. That was a bit scary. It was like you were a mind-reader. Then I got to know it was because you know about the brain and the senses, and you watch a lot. We did lots of experiments to discover how my body works. I liked that. All the stuff we got to use, the big golden hippo, barrel and all the swings. I loved playing Harry Potter with you – with the golden snitch, the hats and the magic wand. The swing was my fantastic flying broomstick. It was the best part of all. I liked to ride it with my cat.  I really liked bouncing on the mattresses and trampette. And the hot chocolate with cream was the best.

It’s different now. I can stop and wait to find the words. Then I check it out. I have much less meltdowns. My Sensory Ladder helps me explain what is going on. I use it with my new Mum and Dad, my new Gran, my teachers and even my friends know that when I am a techy scratchy cat, then the snarly spitting cat is not far away and I need a sensory movement break.

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And because of therapy, my body knows more now. I get it right more. I think I am just able to do everything easier. My new friends understand me better now. I don’t always get it right everytime.e, but it is better than ever before. I am calmer, clearer and concentrate better. I even join in with Netball now. My room is tidier now, and I can finally have shoes that have laces.

Thank you for helping me learn about how my brain is changing all the time.  It means I didn’t have to worry about how it was wired. I could just work on making new wires ready for my new life.

In the beginning, therapy can be really scary. You don’t want anyone to know what is hard. The book we used to get to know more about my senses helped me know it might really work when I didn’t know it would.”

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Here is a copy of the James’ My Sensory Me document including his sensory strategies – made during OT sessions. We made his Sensory Ladder together so others would know how to help and support me at school and home. He used it and practiced telling people his story until he didn’t need to use it anymore.

His Sensory Ladder was printed off and made into keyring sized tags to attach to his pencil case, his Foster Mum’s key ring with copies on the fridge at home, on his desk at school and a copy went to his first visit with his forever family.

“Our Harry Potter Therapy was the best thing I ever did and I will never forget it. I believe in the magic.”

The first Sensory Ladder was made in 2001. It is reported in articles published in 2006 and 2009.

1. Brown S, Shankar R, Smith K, et al. Sensory processing disorder in mental health. Occupational Therapy News 2006; May:28-29.

2. Brown SShankar RSmith K2009Borderline personality disorder and sensory processing impairment. Prog Neurol Psychiatry 13:1016.

Thank you to James’ and his forever family for allowing me to share his story, with a few changes made to protect his identity.

 

 

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About Dialectical Behaviour Therapy and Ayres Sensory Integration

This feature article was written by Claire Smith, one of the first UK OT’s to deliver Sensory Integration alongside Dialectical Behaviour Therapy (DBT). I am delighted to introduce Claire to you, as she was one of the first people I ever lectured about how to apply Sensory Integration’s in Mental Health. That was way back in 2004 and tonight she features on a BBC Documentary – Girls on the Edge.

Here is what Claire would like to add about how Ayres’ Sensory Integration can be used when we work with adults who have trauma and related sensory integration challenges.

As a DBT therapist and SI Practioner I am fortunate to be able to deliver a full DBT programme, alongside an inter-disciplinary DBT team, provide ASI intervention and use sensory strategies that I believe make a real difference to people’s lives.

We combine sensory strategies with DBT skills that support young people to self-regulate and reduce high emotional arousal. These are personalised and individualised to each young person forming part of their positive behavioural support care-plan. Sensory strategies are often used to help young people become ‘talking therapy ready’ prior to starting DBT. There is much stigma around mental health and what it means to be in a secure unit.

Three teenage girls and their families will be sharing their stories and lookIng at the impact on families in a documentary on Thu 22nd Feb, Girls on the Edge, at 9pm on BBC2. Their bravery, openness and honesty helps to break some of this stigma.

The programme has footage of some of the activities offered at FitzRoy House and features glimpses of a number of OT’s I work with providing meaningful occupations and supporting young people in their journey to recovery.

You can see some short clips from the documentary here, and once it has aired, links to watch it again on the BBC.

You can learn more about DBT here.

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Claire Smith OT on BBC2

Get your coffee and get ready to watch for Claire on BBC 2 in the next 5 minutes…

http://www.bbc.co.uk/programmes/p05z13hx

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Sensory Integration Ideas for the Classroom

teachers sensory strategies

This very practical book is laid out in an easy to use manner, and is very accessible to anyone, even those new to Ayres’ Sensory Integration (AS)). There is enough science to convince someone new to ASI that it is a theory and approach based in science, but it is not overwhelming.

The focus on the environment, written in a common-sense no-nonsence way includes lots of practical ideas. This book is a great place to start when trying to create just right sensory spaces to support different kind of learning for young people. It supports therapist and teachers to consider how to do this, catering for different sensory needs.

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Not only a good book for therapists who deliver in school services, consultancy or training, it also provides a great introduction to sensory strategies to parents and teachers. A great book for the SENCo’s office too.Why not share this book with the teachers you support?

A great handout from AOTA is about Providing Occupational Therapy Using Sensory Integration Theory and Methods in School-Based Practice. 

Another great article explores the Effects of Sensory Integration Intervention on Self-Stimulating and Self-Injurious Behaviors. The study from 2005 by Smith et al was published in Am J Occup Ther 2005;59(4):418-425. doi: 10.5014/ajot.59.4.418 is particularly relevant to those working with children and young people who have behaviours that challenge.

A lovely article from AJOT December 2017 explores and presents Specific Sensory Techniques and Sensory Environmental Modifications for Children and Youth With Sensory Integration Difficulties: A Systematic Review.

 

 

 

 

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Dyslexia and Sensory Processing, is there a link?

Dyslexics show a difference in sensory processing

In 2016 Neuroscientists discovered that a basic mechanism underlying sensory perception is deficient in individuals with dyslexia. The brain typically adapts rapidly to sensory input, such as the sound of a person’s voice or images of faces and objects, as a way to make processing more efficient. But for individuals with dyslexia, the researchers found that adaptation was on average about half that of those without the disorder.
“Dysfunction of Rapid Neural Adaptation in Dyslexia” by Tyler K. Perrachione, Stephanie N. Del Tufo, Rebecca Winter, Jack Murtagh, Abigail Cyr, Patricia Chang, Kelly Halverson, Satrajit S. Ghosh, Joanna A. Christodoulou, and John D.E. Gabrieli was published in Neuron online December 21 2016 doi:10.1016/j.neuron.2016.11.020
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Another study by Jaffe-Dax, Frenkel & Ahissar was published in 2017 in eLife6, e20557. http://doi.org/10.7554/eLife.20557 ; “Dyslexics’ faster decay of implicit memory for sounds and words is manifested in their shorter neural adaptation”.
Dyslexia is a reading disability, although why it happens is still not understood.  In the 2017 study, they studied if neural mechanisms underlying dyslexia could be explored using a simple frequency-discrimination task. Participants were asked to compare two tones in each trial – and the study was devised to explore if implicit memory of previous trials affected their responses. They had hypothesized that implicit memory decays faster among dyslexics.
People with dyslexia showed a faster decay of implicit memory effects. They discovered that faster decay of implicit memory also characterised the impact of sound regularities in benefitting dyslexics’ oral reading rate. The study suggests that people with dyslexia had a shorter neural adaptation, with is in contrast to their longer reading times. They hypothesised this is because it reduces their temporal window of integration of past stimuli, resulting in noisier and less reliable predictions for both simple and complex stimuli.