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.
So I was just asked “Why didn’t Ayres consider and put more importance of the visual system? I was a bit perplexed and so explored this further with the therapist asking the question. The OT explained that she has been taught that Ayres did not consider the visual and auditory systems and that this means that for School OT’s where many difficulties link to visual processing deficits, learning the SIPT is not a useful and that therapists should instead use other tools linking vision to motor skills like the Bruinicks or Movement ABC alongside TVPS or VMI to ensure they understand and consider visual deficits.
This OT is not the first person to ask this question, so here is a bit more information about the visual system in Ayres’ Sensory Integration, and her understanding about the impact of sensory integration difficulties on academic learning.
” Those of us who study the overt behavior of children with academic deficiencies, and, at the same time, try to keep informed on related neurological research, are making an effort to interweave both approaches to knowledge into a theoretical structure which may be used as a provisional basis for treatment of children with learning problems.”
Ayres 1964 re-printed in Ayres 1974
The Sensory Integration and Praxis Test(SIPT) has 2 tests that are motor free and directly assess visual skills; Space Visualisation (SV) and Figure-Ground (FG), and 4 more that further explore visual skills in conjunction with other sensory systems and contribution to function; Manual Form Perception (MFP), Design Copy (DC), Constructional Praxis (CPr) and Motor Accuracy (MAc).
MFP 14 Recognition of forms held in hands; visualization
DC 4 Visuopraxis; two-dimensional construction
CPr 3 Three-dimensional visual space management
MAc 6 Eye-hand coordination; somatopraxis
Jean A Ayres’ absolutely understood the importance of the visual system, her papers, books, and the SIPT manual make clear reference to this. Ayres did not consider vision just in terms of assessment, but also in how she recommended intervention approaches that would address deficits in the visual systems ability to support participation in daily life.
“Visual perception of the external world is at least partially dependant upon adequate perception of the construction of one’s own body or body scheme. The ability to perform complex motor tasks is dependant on mastery of the ability to do certain basic motor planning. Acquiring these two kinds of ablities occur sumultaneously and the acquisision is mutually dependant…
…any child who is severaly deficient in visual-motor function should begin…by learning to roll over, initiating motion by looking at a bright object placed at the side. This is an early step in ocular control…
…a recreational game through the ingenuity of the supervisor of the activity…
…The use of the eyes along with the body is essential, for it is the beginning of the dvelopment of one of the fundamental uses of the eyes – the guiding of total body action.”
Ayres 1961 in Ayres 1974
Research data from the SIPT and its predecessor, the SCSIT clearly showed the emergence of a pattern linking visual and movement difficulties called visuo and somatodyspraxia;
In her seminal work, Sensory Integration and Learning Disorders, Ayres 1972 discusses the importance of the development of Form and Space Perception, summarising the significant work of the time by Goins, Punwar, Frostig, and others. She describes the underlying neuroanatomy of visual perception, and it’s development in man. Ayres concluded the chapter exploring theories of dual modes of vision, advanced by Trevarthen, Gibson, and Held in the late 1960’s, before describing treatment approaches to develop form and space perception.
“…it is appropriate to close a therapeutic session which emphasized somatosensory and vestibular stimulation with task that focus on visual form and space perception. It is anticiapted that the earlier treatment enhances the capacity for visual perception and that sitting still while engaged in visual perception tasks helps quiet the child before he leaves the therapy area.” Ayres 1972
from Chapter 15 – Sensory Integration and Visual Deficits, including Blindness in the book Sensory Integration with Diverse Populations written by Smith Roley, Blanche and Schaaf published in 2001.
The ASI Wise lecture team have been at Abbot’s Lea School in Liverpool this weekend with a fantastic group of committed and enthusiastic occupational therapists, speech and language therapists and teachers exploring the use of sensory strategies and Ayres’ Sensory Integration therapy to support children, young people and adults mental and wellbeing health.
Experiential learning opportunities, embedded into the course, help participants to understand their own sensory systems and to experience the challenges that the people they are working with face on a daily basis.
With a mixture of classroom-based and hands-on practical learning, participants explored how to use the spaces and environment available in both school and clinic to support regulation and praxis. The workshop provided an opportunity to hear about the theory and practice of Ayres’ Sensory Integration, it’s application supporting those with autism, ADHD and dyspraxia, with up to date research and evidence supporting practice.
To find out more about our courses and learning here
We are so grateful to Abbot’s Lea School who have allowed us to use such a beautiful spacious venue. The three lovely well-lit rooms allowed us to create a pop-up sensory clinic, where participants had space to move about; extra room to break into groups supporting learning and the sharing of ideas. The school staff and local therapist volunteer support team have been incredibly welcoming and supportive, helping the workshop to run smoothly. As a bonus, the sun has shone all weekend which has allowed us to use the outdoor spaces, we have spotted a few daffodils and blossom trees around the city – it feels like spring is on its way.
Thank you to our volunteer therapists who helped to make the weekend such a success.
The first Sensory Ladders were made in 2001 for adults with sensory integration difficulties receiving help with mental health difficulties in Cornwall. Influenced by the paediatric Alert Program, they offered therapists a way to combine Dialectical Behaviour Therapy and Ayres’ Sensory Integration, addressing the development of the person’s self-awareness in collaboration with ward staff on an acute psychiatric inpatient unit.
The need to start with the person where they are at, before introducing learning about new ways of being, including the development of new skills, made it necessary for the Sensory Ladder to remain a very individualised and personalised journey within a close safe therapeutic relationship.
Both Ayres’ Sensory Integration(ASI) and Dialectical Behaviour Therapy(DBT) share a common understanding that development and change can only occur within a safe environment. The DBT idea of balancing safety and challenge reverberates strongly with Ayres’ concept of the ‘just right challenge’.
Creating a Sensory Ladder is about creating opportunities for an adult or child to learn to become aware of themselves in a new way – to explore and discover new things about mind, body and brain. It allows the therapist and person to do “curious wondering” together, and for the person to try new things – creating and promoting active but informed risk-taking; testing how we might feel and experience something when we do it differently; new ways of being – new ways of responding.
Making and using a Sensory Ladder is about the journey together within a safe therapeutic relationship. It’s about getting to see and know someone in a very different way, getting underneath the skin of behaviours that are perhaps being described by others as tricky or challenging.
The Sensory Ladder facilitates the reframing of behaviour that are a result of sensory integration challenges, providing the first step of acceptance of the behaviour necessary before strategies and therapy support development and change to happen.
The SENSORY INTEGRATION INVENTORY REVISED FOR INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES is available from Therapro.
Developed by Judith Reisman and Bonnie Hanschu, in 1992, but just as relevant today. This assessment tool was developed in collaboration with OT’s who worked with people with severe and profound learning disabilities, who could not cooperate fully in more formalised testing of their sensory integration.
The guidebook gives a rationale for the inclusion of each item in the Inventory, as an indicator of sensory integration difficulties. It also provides an alternative, sensory explanation for behaviors that challenge staff teams and carers, that are often presumed to be primarily learnt, behavioural or psychosocial in origin.
We recommend the User’s Guide as a learning tool for all novice sensory integration students as it provides down-to-earth examples that help explain many sensory integration concepts.