Posted on Leave a comment

Best Practice Guidelines? Analysing Novak and Honan (2019)

Novak and Honan (2019) published a paper in the Australian Occupational Therapy Journal which has caused controversy, which was discussed in an earlier Sensory Project blog post:

Particularly upsetting was a traffic light system which indicated that sensory integration therapy is a red light (or do not do) intervention but that ABA (short for applied behaviour analysis) could be viewed as a green light (or can definitely use) intervention.

This is especially concerning as ABA has been linked to PTSD. Testimonials from those who have had ABS therapy have told us about the negative affect they have found this therapy has had on their lives.

Recently, the US Government has issued a report worth sharing that adds further information about ABA and it’s usefulness, which is in contrast to Novak’s article. The report, about comprehensive autism care, found that at best ABA does not change symptoms and at worst, ABA worsens them:

We are keen to hear your thoughts about the Novak’s article and the traffic light system. Follow the link below and join the discussion:

Posted on Leave a comment

Sensory Integration Matters: Coping with Christmas with children and adults with sensory integration challenges

Christmas can be a wonderful time of year but also a stressful confusing time of year for our children. For children who are more comfortable with routine, everything is changing. Consider the following if Christmas feels stressful:

  • Stay at home – prepare relatives for different expectations
  • Spread visits over a longer time
  • Allow your child to leave the room
  • Make time to go outside
  • Minimise the build up to Christmas
  • Maintain routine
  • Only put up decorations just before Christmas
  • Avoid flashing lights
  • Don’t wrap presents individually
  • Don’t wrap presents at all
  • Put batteries in in advance
  • Share out presents over a few days
  • Give permission to open presents elsewhere – e.g. away from the giver – thank you cards can be sent afterwards
  • Choose food so it’s easy to prepare and comfortable for everyone to eat


Posted on Leave a comment

Top Tips for Sleep

In a Children’s Occupational Therapy practice, many parents tell OTs that they feel they could cope better if they just got more sleep. When I heard about Matthew Walker’s “Why We Sleep” book from a colleague on a course, I bought it and read it cover to cover. I then shared it with everyone in my life struggling with sleep because this book links sleep with mental health, physical health and sleep through the lifespan.

Here are “Why We Sleep” top tips for sleep hygiene from the appendix- is you want more information about why for any of these tips, go back to the book and dig deeper:

1)    Stick to a sleep schedule: go to bed and wake up at the same time each day as people have a hard time adjusting to changes.  Sleeping in on weekends can’t repay our sleep debt.

TOP TIP: set and alarm for bedtime

2)    Don’t exercise too late in the day: try to exercise 30 minutes on most days but no later than 2 or 3 hours before your bedtime

3)    Avoid caffeine: Coffee, cola, certain tea and chocolate contain stimulant caffeine and can take 8 hours to fully wear off.  Older teens may benefit from being cautioned that nicotine and alcohol also worsen sleep.

4)    Avoid large meals before bed: these can cause indigestion and having too many fluids might mean you need to get up to use the toilet

5)    If possible avoid medications that disrupt or affect sleep: over the counter and herbal remedies for cough, cold or allergies can disrupt sleep.  If you are worried, talk to a pharmacist or health care professional to see if any drugs you take might contribute to insomnia

6)    Don’t take naps past 3pm: Naps can help you catch up on lost sleep but if you nap too late in the day, it can be harder to fall asleep at night

7)    Relax before bed: don’t overschedule your day so you have no time to unwind.  Reading or listening to music could be part of your bedtime ritual

8)    Take a hot bath before bed:  Your body temperature will drop after getting out of the bath and this may help you feel sleepy and relaxed so you are more ready to sleep

9)    Have a dark, cool, gadget free bedroom:  Noises, bright light, an uncomfortable bed or warm temperatures can distract you from sleep.

10) Have the right sunlight exposure: Try to get outside in natural sunlight for 30 minutes a day.

11) Don’t lie in bed awake if you are still awake after 20 minutes or starting to feel anxious or worried get up and do some relaxing activity until you feel sleepy.  The anxiety of not being able to sleep can make it harder to fall asleep


Screen Shot 2019-12-08 at 10.38.05
Buy here from Amazon
Posted on Leave a comment


As a Healthcare Professional, we are encouraged to practise reflective learning; thinking more deeply about a critical incident to support or challenge how a situation we find ourselves in went well or if our response could have been better. I intend to use reflective learning to discuss how a very meaningful learning exercise I undertook was successful, using learning topics from this course.

I intend to describe a learning experience and then discuss how it can be applied to serve as an example of the following three topics:

  • transfer of ideas and concepts from one areato another
  • focused and diffuse modes of thinking
  • lifelong learning and broadening my passions

My story begins when I had been an Occupational Therapist for a few years and worked in a Neurological Rehabilitation unit. My main patients were adults who were trying to recover lost skills due to any number of misadventures that had befallen them. I worked with a very skilled team, but it could be difficult to convince patients to trust our assessment of their ability to shift weight through a leg with hemiparesis for example so that they would be able to step and walk. I was teaching physical skills but the patients who did best were those who got interested in learning about their learning.

climbingAt the same time, a friend invited me to try out a climbing wall and I embraced the opportunity to learn a new skill. What I didn’t realise at the time, was how powerfully the acquisition of that skill would transfer to other areas of my life, namely to my OT practice. It was a real shock to be on a rope, halfway up a wall at an indoor climbing centre and hear a climbing partner shout “okay, transfer your weight through your left leg so you can step up to that ledge with your right foot” and hear myself shout down “I can’t! I’ll fall!” This “I can’t, I’ll fall!” was what my patients told me when I asked them to try skills within their grasp.

Two things quickly became obvious to me, through transfer of ideas and concepts from one area of learning to another. The first was a lightbulb; “This is what my patients feel!”. We have heard in video lectures that the most powerful lessons are tied to the sensory memories we create, and the fact that I still remember looking down from up high, feeling the fan blowing cool air against my skin, hearing slight impatience with my refusal to progress, and feeling the tension in my arms as I clung on for dear life – and the fear in the pit of my stomach certainly backs this up.

I remember learning what it was like to feel how scary it is to trust others to see your way through a challenge. The second thing I knew was, if I was right every day, when I encouraged patients to achieve, then my climbing friends encouraging me from the bottom of the climb must also be right. I learned to trust my climbing partner and their assessment of a climbing problem, and I had to learn this over and over again. Trust was a whole new skill again when I had to lean out and trust that the hold my partner could see and I couldn’t, was really there. But I did learn, well enough that I could teach it to others and transfer it to being a crucial part of how I understood setting and achieving rehabilitation goals with my patients.

Climbing is actually a brilliant sport to discuss the interplay between focused and diffuse modes of thinking. Of course, when if you are working out a particularly hard climbing problem, all your focus is diverted to that. Sometimes trying to follow the route you want to take is frustrating. Like other problems in life, sometimes it’s best to let things become more diffuse so that your body can automatically do movements that your brain might not consciously choose. When you are just enjoying a climb, your mind can wander to earlier learning and try to make those connections that cannot be learned in focused mode. The connections that were made weren’t limited to learning how to climb and it also seemed especially easy to develop new insight when the topic might involve anatomical or functional knowledge. It seemed that earlier questioning about my range of motion to reach a hold might lead me to think about biomechanics or something related. Lastly, just as Dr. Sejnowski described with his running, my diffused focus might shift to make connections about other learning topics.

I dread to think that none of this learning would have occurred without embracing lifelong learning and broadening my passions. It has become my belief that if I am going to teach others how to meet physical challenges, I need to keep teaching myself the same lessons. In that spirit, I have embraced adult gymnastics, yoga and kickboxing. There is nothing like feeling new muscles working to take you back to an anatomy text so you can be precise about training muscles and their antagonists and not just by using the ‘trick movements’ that we all use to get things done. Every new activity I try teaches me something different about myself, something about learning and something about teaching. New skills keep me engaged in my life and also give me treats to strive for when I have completed those pomodoro tasks.

I will always teach physical skills, but lately, I have started to work in schools as well. Naturally, it was important to see what “going back to class” would teach me about learning how to learn. I first discovered free online classes through the Coursera platform in neurology and behavioural economics, and then moved onto ‘learning about learning’ to help me to discover and work towards correcting some of my learning errors and give me insight and empathy to help others learn.

My new academic passion is the work I am putting into an MSc with specialising in understanding sensory integration. Like my Coursera experience, I am discovering a fantastic supportive network of friends and mentors who have now involved me in a new way to share my learning, blogging to all of you.

I hope my reflections on learning have reflected or renewed your own enthusiasm for learning and continued professional development. Warm wishes to you all.

This slideshow requires JavaScript.

Posted on Leave a comment

Weighted Snakes



This post is about a sensory project I found, making weighed snakes from recycled tights.  I first discovered this project on Pinterest, and while most of the ideas I find there remain pinned to virtual idea boards, I couldn’t stop sharing this one, until someone challenged me to make it happen.  This post is all about that process.


First though, a little about me.  As a Children’s Occupational Therapist and mother of four children aged 12 to 6 years, there are many of times when 2 worlds collide.  I often resist the urge to over-examine my own kids and develop hacks to make them more independent.  And it’s hard to escape my husband’s protests that if the kids are struggling with anything, I must have “brought it in from work” and should fix it.  This is especially true of the sensory issues… especially my daughter who hates certain clothes and hair brushing and who has literally turned her need to spin into gymnastic prowess.

This takes me back to Pinterest and the weighted tight snake, whose sheer genius seemed undeniable.  I had assessed children for years and at times had recommended weighed products for those children.  The extra deep pressure provided by weight isn’t for everyone but the kids I met who liked to sleep under all the stuffed toys on their bed or who would climb into the dog’s bed with the family dog for cuddles had already discovered for themselves that it made them feel better: more calm, more alert.  Some teen girls who struggled with the unbearable feeling of tights had told me that when they used something weighed as well as other strategies, they could wear certain tights that they usually couldn’t tolerate.  At our house, my daughter’s main struggle with dressing was how to get dressed for school when the weather grew cold and it was time for tights.  So I collected my daughter’s rejected tights and ordered some weighed beads and planned my project, which I will share with you so that you might have a go at creating some of your own.

You need / I used:


  • A pair of rejected tights
  • Something to fill them with (weighed beads, rice, lentils etc)*
  • Needle
  • Pins (not 100% crucial but they will help to hold things in place, especially if you don’t sew often)
  • Thread
  • Matching buttons 2 or 4 (if you want eyes)
  • Felt/fabric (if you want a tongue)
  • Velcro (one leg will be the inner layer, the second will protect it and can be sealed with Velcro)

*a note on filling- if you choose dried food, like uncooked rice or lentils, they might sprout or worse if the snake gets wet UNLESS you commit to a strategy like using the bags banks give you to sort coins into to place the filling in (you will definitely need a strategy like this if you have a kid who likes to chew things, like my son)

Here we go!

  • Cut the legs off the tights as high as you can for a long snake
  • Decide if you want your snake to be
    • straight (you will need to then cut off the feet at the heel and sew the ends together)
    • or if you don’t mind a slightly foot shaped snake, you are ready to fill!
  • Fill the snake with the material of your choice (see * above if you need help to decide)
    • How much to fill
    • Remember to leave space to bring the ends together (preferably
    • To add channels or no (stripes)
  • Use the other leg to pull over the first as a protective layer
    • Fold and pin a small hem and then stitch one end shut
      • If you want a tongue, remember to stitch it in now
    • Add button eyes (if wanted) -I am partial to using 2 buttons each eye so that you have a white part with a black center
    • At the other end, you will create a small hem and sew down and then attach Velcro to.
      • I learned the hard way that using one long Velcro strip makes it harder to get the weighed snake inside its cover, use two or more smaller Velcro pieces
  • Pull your cover over your snake / weighted tight leg.

Your weighted snake is now ready to regulate- enjoy!