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The importance of a comprehensive assessment

Thank you to the families who gave consent and our secret blogger OT for this contribution.

“A little while ago, two mums approached me and both asked about assessments for their children. Both were young adults, academically highly able and struggling with their self-organisation and motor skills.

Both young people consented to an assessment and completed, through self-report, the Adult/ Adolescent Sensory History (AASH) questionnaire. They were also assessed with the Sensory Integration and Praxis Test (SIPT). The SIPT is a standardised assessment with normative data for ages 4 through 8 years, 11 months. On this particular assessment tool, sensory integration and processing skills scores plateau at around this age, though the test is still informative for people beyond this age, who should have achieved.

The young lady assessed has a diagnosis of social anxiety and has low confidence, while the young man is quite a confident character. She has a history of bumps, trips and spills, and will tell anecdotes of these with great humour; while he prefers to focus on what he does well in conversation.

I love the AASH, the reports it gives highlight each sensory system, differentiate between discrimination and modulation difficulties and addresses motor planning, sequencing and social/ emotional aspects of sensory integration and processing needs.

It uses clear, non-patronising language and activities appropriate to adults and adolescents. It shows up really clearly a person’s (or their caregiver’s as necessary) perception of their sensory integration and processing needs and how these affect their day to day life. In this instance, the young lady highlighted many sensory processing needs.

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The young man reported almost no difficulties, his only score in the primary sensory systems section was mild proprioceptive difficulties. When questioned as to the accuracy of his answers, he tended to reply “well, nobody likes that, do they?”

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Having scored the AASH checklists, I completed a SIPT with each person. The SIPT is a battery of 17 tests which assess a person’s sensory integration and processing including perceptual-motor skills through tasks with standardised administration and normative data against which to compare an individuals test results. Guess which person showed more significant difficulties in the direct assessment? 

On the SIPT assessment scores between -1 and +1 standard deviation are considered typical, above +1 are strengths and scores below -1 are of clinical significance and require support and will benefit from direct intervention.

The exception to this being Post Rotatory Nystagmus in which a low (below -1) or high score (above +1) indicates significant difficulty inhibiting response to vestibular information and often relates to a low Standing and Walking Balance score.

Here are the young lady’s SIPT results:

 

 

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Definite movement, balance and body awareness difficulties but also some areas of significant strength, particularly around her visual skills and imitation, which she uses to compensate for her body awareness difficulties.

Here’s the young man’s chart:

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Strong visual skills, compensating for significant challenges in the other areas.

This experience taught me so much. From the AASH scores, I was expecting the young lady to have much more problems in the SIPT than the young man, their conversation about their lifestyles confirmed this expectation. Still, then the assessment showed so clearly how much of that was related to confidence.

An evaluation based solely on checklists is not enough. It tells you what a person perceives to be their difficulties, guides the direction of evaluation and adds experiential evidence to the overall assessment.

A good questionnaire is evidence-based and norm-referenced, but it always needs to be triangulated with direct observation and where possible structured and standardised assessment. These tools can tell you so much about the respondent’s confidence and resilience and what they find easy or difficult in day to day life. But I have learned it is a mistake to rely upon one alone when assessing somebody’s sensory integration and processing skills and needs”.

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From the ASI Wise Support Desk

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We have had higher volumes of enquiries than usual in this unprecedented time. We want to assure you that we have seen your enquiries and will get back to you soon. Our team is working hard to ensure that nothing gets missed.

We are also aware that due to a global strain on the GoTo Webinar system, there were some email glitches. The technicians have speedily resolved this and all should be well shortly. We will keep you in the loop with any information you may have missed.

Please do continue to reach out via our helpdesk hello@asi-wise.org if you feel there is anything we may have missed.

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Book now another date released: Live Webinar Sensory Ladders supporting Self Regulation

We are presenting more live ‘Sensory Ladders supporting Self Regulation’ Webinar this week, to meet the current demand and requests.

This webinar for teachers and therapists is also open to health care professionals supporting clients to recover or maintain their mental health and wellbeing, especially during C-19.

The webinar will include an introduction to the theory behind these intensely individualised and personalised tools. Sensory Ladders support the development of our client’s/carer’s awareness of self-states. Sensory ladders promote the use of sensory strategies to manage fear and anxiety, promoting increased engagement and successful participation in everyday life.

This unique combination of theory and neuroscience, developed in 2001 is grounded in the philosophies of Ayres’ Sensory Integration and psychological theories including Dialectical Behaviour Therapy.

Join us discover how this tool supports ways to engage with clients; children, teens, adults and their carers via telehealth.

Teachers and Therapists – learn how to make interactive Sensory Ladders for Self Regulation online with Powerpoint – personalised with photo’s music and more.  Explore ways to deliver this therapeutic intervention for sensory people stuck at home.

Building on our first webinar about using the technology – join us to discover more about an application in practice.

If you are thinking of attending these sessions we recommend you visit www.sensoryproject.org/technology [password Tech123] and you listen to the very first complimentary webinar we did on Telehealth technology.

Book here:

21 April 2020 – Evening Webinar – 7.40pm (BST)

https://attendee.gotowebinar.com/register/762613974810046476

After registering, you will receive a confirmation email containing information about joining the webinar.


See more about Sensory Ladders here.

www.sensoryladders.org

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

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Your Mental Wellbeing and the Coronavirus

This can be a tricky time, but there are still lots of opportunities to look after our mental health. Here is a link to some fantastic advice from Mind charity with ideas about how to take care of your wellbeing during this time.

This information is helpful for those who might be feeling anxious about the virus or if you are wondering how you will cope if you need to work from home or self-isolate.

Read more here – Mind Charity, Coronavirus and your wellbeing

 

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Sensory Integration, praxis and speech and language difficulties.

Language and communication difficulties commonly co-occur in children and adults with movement and coordination difficulties.

Speech is not just about understanding and using language it’s also about timing, sequencing and movement of mouth and body muscles. Body language can make up 90% or more of how we communicate.

You need to be able to have adequate praxis to know what you wanted to say, plan it and execute – the same praxis skills required for playing, walking, doing a sport or managing skills for daily life like dressing and eating.

Read more about Childhood Apraxia of Speech

Read more here about speech delays and CAS