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Coffee and Chat: Ayres’ SI and Learning Disabilities

Tonight’s Coffee and Chat is all about Ayres’ SI and Learning Disabilities with special guest working in the field of learning disabilities across the lifespan.

Come and Listen to our practising therapists and experts explore assessment tools, the role of consultation and how to deliver services that draw on the theory and practice of Ayres’ Sensory Integration.

Join us tonight 3 March 2021 at 7.30pm.

Book your FREE place now on Eventbrite.

Read about the application of Ayres’ SI in Learning Disabilities on this reference and reading list below.

Papers here include from therapists, Ros Urwin, whose Master’s in 2005  was the first UK study to investigate ASI with adults with learning disabilities in the UK, our colleague Rachel Daniels, whose work in this field was the focus of a research project and Ciara McGill, who we had the pleasure to teach on the journey that led to her Master’s Study publication with Ulster University.

  1. Cahill, S.M. and J. Pagano. 2015. Reducing restraint and seclusion: the benefit and role of occupational therapy. American Occupational Therapy Association.

  2. Champagne, T. and N. Stromberg. 2004. Sensory approaches in an-patient psychiatric settings: Innovative alternatives to seclusion and restraint. Journal of Psychosocial Nursing 42(9): 35–44.

  3. Daniels, R. 2015. Community occupational therapy for learning disabilities: The process of providing Ayres sensory integration therapy and approaches to this population. Birmingham: European Sensory Integration Conference. www.iceasi-org

  4. Department of Health. 2012a. Department of Health review: Winterbourne View hospital interim report. London: Department of Health.

  5. Department of Health. 2012b. Transforming care: A national response to Winterbourne View Hospital: Department of Health review final report. London: Department of Health.

  6. Department of Health. 2014. Positive and proactive care: reducing the need for restrictive interventions. London: Department of Health.

  7. Gay, J. 2012. Positive solutions in practice: using sensory focused activities to help reduce restraint and seclusion. Victoria: Office of the Senior Practitioner.

  8. Green, D., Beaton, L., Moore, D., Warren, L., Wick, V., Sanford, J. E., & Santosh, P. (2003). Clinical Incidence of Sensory Integration Difficulties in Adults with Learning Disabilities and Illustration of Management. British Journal of Occupational Therapy, 66(10), 454–463

  9. Lillywhite, A. and D. Haines. 2010. Occupational therapy and people with learning disabilities: Findings from a research study. London: College of Occupational Therapists.

  10. Leong, H. M., Carter, M., & Stephenson, J. (2015). A systematic review of sensory integration therapy for individuals with disabilities: Single case design studies. Research in developmental disabilities, 47, 334–351.

  11. McGill, C & Breen, C. 2020. Can sensory integration have a role in the multi‐element behavioural intervention? An evaluation of factors associated with the management of challenging behaviour in community adult learning disability services. British Journal of Learning Disabilities.

  12. Royal College of Psychiatrists. 2013. People with a learning disability and mental health, behavioural or forensic problems: The role of inpatient services. London: Royal College of Psychiatrists.

  13. Transforming Care and Commissioning Steering Group. 2014. Winterbourne View – Time for change: Transforming the commissioning of services for people with learning disabilities [Bubb Report]. London: NHS England.

  14. Urwin, R., & Ballinger, C. (2005). The Effectiveness of Sensory Integration Therapy to Improve Functional Behaviour in Adults with Learning Disabilities: Five Single-Case Experimental Designs. British Journal of Occupational Therapy, 68(2), 56–66. 

sensory integration leanring disabilities Ciara McGIll
Ciara McGill, Occupational Therapist

Click to access Reducing-Restraint-and-Seclusion-20150218.pdf

The effectiveness of sensory integration therapy to improve functional behaviour in adults with learning disabilities: five single-case experimental designs

Urwin, Rosalind and Ballinger, Claire (2005) The effectiveness of sensory integration therapy to improve functional behaviour in adults with learning disabilities: five single-case experimental designs. British Journal of Occupational Therapy68 (2)56-66.
 

Abstract

This paper describes a research project using a single-case experimental design (A-B-A), which aimed to explore the impact of sensory integration therapy (SIT) on level of engagement and maladaptive behaviour (measured through timed scores) and function (using Goal Attainment Scaling, GAS) for five learning disabled adults with tactile sensory modulation disorder.

Each phase lasted 4 weeks and consisted of 24 measurements in total. Individually tailored SIT was given twice weekly for 4 weeks during the intervention phase (B), immediately prior to each individual’s participation in his or her prescribed horticulture task. The changes between phases in engagement, maladaptive behaviours and function scores, measured as the difference between baselines and intervention, were analysed visually and statistically for each participant.

The intervention produced significant improvements in engagement for participant four, with a highly significant deterioration in scores for all five participants on withdrawal of SIT. All the participants’ maladaptive behaviour decreased significantly on the introduction of SIT. Although there was no significant change to GAS scores for four participants, participant four’s score improved significantly with SIT. The withdrawal of SIT resulted in a highly significant deterioration in GAS scores for participants one, two, four and five. This study may be the first to suggest that SIT is effective in improving functional performance in adults with a learning disability with a tactile sensory modulation disorder.

Click to access Resource-OT-and-Learning-Disabilities_0.pdf

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Workshop: Ayres’ Sensory Integration, Trauma and Wellbeing

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.

We can also offer 2 or 3 day onsite bespoke training and consultation for your organisation to support the development of sensory integration informed care pathways.

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What survival looks like in school – a resource for understanding children with trauma

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.

Download the full pdf here

 

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Back to School: help and ideas for all

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.

PDF Download: goo.gl/kYr9RY

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Early trauma is stored in the body via the senses, this is why therapy through the senses is effective

“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
boy wearing gray hoodieOccupational 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’

Ayres, 1979

girl jeans kid lonelinessThey 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

IMG_2043
created, a sensory ladder key ring with football players, to support a young man with trauma to develop improved self-awareness and how to communicate what he needs and when to others

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.”

from The Guardian 27 June 2018

https://www.theguardian.com/society/2018/jun/27/adopted-children-barely-surviving-in-high-pressure-schools

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.’
Ayres 1979
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. MayBenson, T. A. (2016). A Sensory Integrative Intervention Perspective to
TraumaInformed Care. OTA The Koomar Center White Paper. Newton,
MA: OTA The Koomar Center(PDF) A Sensory Integration-Based Perspective to Trauma-Informed Care for Children. Available from: https://www.researchgate.net/publication/303383214_A_Sensory_Integration-Based_Perspective_to_Trauma-Informed_Care_for_Children [accessed Jul 01 2018]
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]