Our two day workshop is a “great opportunity to reflect on clinical practice and learn new skills”. Find out more about the application of Ayres’ Sensory Integration beyond childhood to support health and wellbeing.
As children and young people go back to school here is a reminder of a fantastic resource from Inner World Work.
This parent and carer online resource and support site, explains how children with trauma might respond and react in difficult situations.
Beautifully illustrated and easy to read it is a great way to help teachers and other adults, who come into contact with children living with trauma, to understand a little more about what might be going on inside when children are in the protective survival states of fight, flight, freeze or submit.
Back to school is just around the corner. School can be tricky for young people with sensory integration challenges, and especially those first few weeks in a new schools, classrooms, with new teachers and sometimes new classmates. New uniforms and shoes can be challenging also.
Practising these exercises at home over the next 2 weeks may help young people have some ways to reduce anxiety and provide the brain with calming proprioceptive input. Get everyone in the family practising at breakfast and dinner time so those brain networks learn and know how to do these when they are most needed – in times of high stress. Mum and Dad doing these in front of everyone when they feel stressed will make them OK and something everyone does when they are bothered by tricky things.
This handout is available to download and print out – and despite the title, they are suitable for all ages. These ideas can be used at home, school, work and out and about.
“Early trauma is stored in the body via the senses, this is why therapy through the senses is effective.”
Smith, K BPD and SI 2004
Occupational Therapists are ideally placed to work through play and via the senses to promote the development of healthy neurological pathways and structures; impacting the development of sensory motor skills and abilities that underpin our ability to move, learn, play, develop, communicate, think and process emotions.
Sensory integration is integral to the process of healthy development ‘when the functions of the brain are whole and balanced, body movements are highly adaptive, learning is easy and good behaviour is a natural outcome’
They can do this with clients who are very young, or those who are adults with childhood trauma, who often find talking therapies very hard to engage with as the trauma memories are stored before language has developed, so are instead stored in the body and via the senses.
These young people do need trauma-informed schools, but this is not enough! The problem with whole school approaches to trauma is that for these children whole school strategies are not individualised and personalised and as such, are not specifically targeted. Specialist assessment and intervention is needed for these young people to reduce the impact of trauma on their young plastic brains, still in development.
Postgraduate education in Ayres’ Sensory Integration theory and practice alongside undergraduate education in infant and child development means that occupational therapists are ideally placed to address the sensory-motor needs of looked after children who have often been subjected to trauma in utero and early childhood.
Ayres’ Sensory Integration is a theory that suggests that brain “maturation is the process of the unfolding of genetic coding in conjunction with the interaction of the individual with the physical and social environment. As a result of experience, there are changes in the nervous system.”
Spitzer and Roley 1996
Sensory qualities of the environment can positively or negatively interact with function and development.
Schneider et al, 200
Occupational Therapists working in this area are able to use a discreet but comprehensive range of skills and resources within their scope of practice to offer direct one to one sensory integration – based intervention. These may be with the individual child, while also supporting foster and adoptive families, and typically includes parent participation in therapy. Occupational therapists will also offer parent and family education and work alongside schools and other organisations via a consultation model, offering education, in-service training, supervision for staff.
“Adopted children who have suffered traumatic early experiences are “barely surviving” in the current high-pressure school environment and need greater support if they are to have an equal chance of success, a charity has said.
They are falling behind in their studies because they are struggling to cope emotionally with the demands of the current education system which “prizes exam results at the expense of wellbeing”, according to a report from Adoption UK.”
The development of Occupational Therapy care pathways for children, adolescents and adults with trauma is increasing, as the role of Occupational Therapists in this area is increasingly being recognised.
‘Sensory Integration sorts, orders and eventually puts all the sensory inputs together into whole brain function.’
What emerges from this process is increasingly complex behaviour, the adaptive response and occupational engagement.
Allen, Delport and Smith 2011
You can read more about work in this area by following these links:
1. May–Benson, T. A. (2016). A Sensory Integrative Intervention Perspective to
Trauma–Informed Care. OTA The Koomar Center White Paper. Newton,
3. Werner, K. (2016) “Occupational Therapy’s Role in Addressing the Sensory Processing Needs of Young Children with Trauma History” Entry-Level OTD Capstones. 8. http://commons.pacificu.edu/otde/8[accessed Jul 01 2018]
In my time as a special needs parent, I’ve had a variety of responses to telling people my child has special needs. Some responses have been great, others have left me crying all the way home. Literally. Some have opened up conversations, others have shut them down. I know that those people who have not been so helpful have just been looking for the right thing to say and found the wrong one. So here are some cues to think about what you’re saying. Remember when the parent says the “we think (s)he might have….” Or “(s)he’s got…” they are very vulnerable. They will have cried and fretted and lost sleep over the information they are giving you and they will be at some stage of processing that information. If they are giving you that information, they either need you to change the way you are interacting with their child, or they need to talk about it. Choose your words carefully to open up the conversation and hear what they’re trying to tell you.
Please don’t say: “(s)he seems fine to me”. I know you’re trying to be reassuring, but by saying this, you imply that you are more able to identify the child’s developmental needs than the parents and the professionals working with the child. It pretty much shuts the conversation down, but if it continues, you force the parent into the role of pointing out their child’s deficits while you defend them. This is not a natural way of things, the parent spends enough time pointing out their child’s deficits with professionals, you need to enable them to big their child up and point out what a wonderful person they are.
Say instead: “I hadn’t noticed. What’s going on?” By saying “I hadn’t noticed”, you can reassure the parent that it isn’t that obvious, but also put yourself not the parent in the position of the person who needs educating about the child. You open up the conversation, and you give the parent the choice about how much information to give you, they might just tell you a load of assessments and appointments or they might tell you what the child is struggling with. It’s up to them.
Please don’t say “I couldn’t do it” the truth is you could. Of course, you could and a whole lot more, if that was what your child needed. Don’t point out how lucky you are that you don’t have to. The parent might well be wondering whether they can do it, and how long they can keep doing it for, they need you to reassure them that they can keep going.
Say instead “I really admire the way you’re doing it” This way, you’re complimenting the parent, you’re recognising how hard they’re working but you’re not sowing that seed of doubt that they might not be able to keep going.
Also, say “how can I help you do it?” they probably won’t know, but they’ll really appreciate being asked. It might be as simple as “watch my child while I have a pee in peace”. Do that. Then offer to do that again, don’t wait to be asked.
Please don’t say “(s)he’ll catch up” (s)he might well not. People were telling me this when the doctors were telling me she might well steadily regress. It wasn’t reassuring, it was frustrating. Again, it puts you in the position of the expert over the parent and professionals and the parent in the role of pointing out the deficits. Parents do not want to point out their child’s deficits, please don’t make them do it. Please don’t encourage the parent to compare their child to typically developing children, the only person a child needs comparing to, to track their learning is themselves.
Say instead “what does (s)he really love doing?” Give the parent a chance to gush about their kid, what they love, how much fun they are etc. Most parents will leap at this chance, it’s so refreshing after appointment after appointment telling professionals what their child can’t do.
Please don’t say “is there a cure?”The child may well not need a cure, they’re probably not ill. If the child is ill and there is no cure, they really won’t want to keep repeating that and if they know there is a cure, they’ll be doing it. Trust me, they will have researched treatment options very thoroughly.
Say instead “what are you thinking about for the future?” Again, keep it open. The parent might be trying really hard not to think about the future, they might well be taking one day at a time or they might be able to think of nothing else. They can choose how to interpret “the future” in your question and might tell you about getting them to eat just one more type of food or school support options, or they might be racing ahead to adulthood prospects.
Please don’t say “have you tried…?”again, you’re putting yourself in the role of expert with this one and the parent in the role of person to be taught how to raise their child. Unless you’re really actually a professional expert in what you’re suggesting, and you’ve spent time really interacting with the child, please just don’t.
Say instead “what do you think might help?” A parent who thinks their child has some additional needs will have done very thorough research, trust me. Give them time to talk about what they’ve learned. They might say “nothing” and then you’ll feel really awkward. Live with that, they feel awkward a lot of the time. They’ll probably tell you things that have been suggested and why they think/ don’t think that’s any good. Listen.
Please don’t say “you won’t want to come” Don’t presume, parenting a child with additional needs is isolating and exhausting. They might say no. Don’t be offended if they do but give them that option.
Say instead “I know (s)he finds this difficult, but I wanted to invite you in case you think they’d like it” Invite the child, acknowledge that it might be hard for them and they might want to say “no” and that’s OK, but make sure they know you want them there and you value time with them.
Please don’t say too much in front of the child.Remember they may well understand more than they can say and for any child seeing their parent upset is confusing and frightening.
Say instead “how am I best to communicate with him/her?” Then get down on the floor and do it. Playing with a child, talking with them on their level and really getting to know them is the biggest compliment you can pay the child and the parent.
My biggest advice if someone is telling you their child seems to have additional needs or a developmental difficulty is to listen to them, make them feel validated, treat them as the expert on their own child and don’t belittle their experiences. Your role is not to fix the child, you can’t do that. Your role is to support the parent, build their confidence and to be their friend.