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What is Ayres’ Sensory Integration Therapy?

At ASI Wise, to avoid confusion, we use the term sensory integration and processing difficulties. Different terms are used in different places to describe sensory integration difficulties. Some therapists may use sensory processing difficulties instead. Some may even use sensory processing disorder.

We currently have a robust test,  the SIPT, that allows us to describe sensory integration difficulties and reference research evidence to interpret the unique scores and pattern of scores that the child gets across 17 test items. We can use this data to inform our clinical reasoning, create a hypothesis about what sensory difficulties are contributing to participation challenges in everyday life. We set goals, plan and deliver the intervention, Ayres’ Sensory Integration Therapy measuring therapy outcomes. This is best practice.

“Active, individually tailored, sensory motor activities contextualised in play at the just right challenge, that targets adaptive responses for participation in activities and tasks.”

ESIC Schaaf 2019

Ayres’ Sensory Integration assessment and therapy is typically post-graduate education for Occupational Therapists, Physiotherapists and Speech and Language Therapists. Please check that your therapist has ASI Education that meets level 2 education standards as recommended by ICEASI.

For more information about programmes offering Certification in Ayres’ Sensory Integration across the globe, please visit www.cl-asi.org.

 

Thank you Saša Radić – Kabinet aRTisINCLudum aRTis INCLudum for sharing these.

Read “Occupational Therapy Interventions for Children and Youth With Challenges in Sensory Integration and Sensory Processing: A School-Based Practice Case Example”  – one young person’s story from AJOT May 2019 here. [Frolek Clark et al 2019].

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An introduction to Ayres’ Sensory Integration

Sensory integration…the ability to organize sensory information for use…perception and synthesis of sensory data that enables man to interact effectively with the environment.’

Jean. A. Ayres (1972)

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Ayres’ Sensory Integration combines theories and concepts from human development, current neuroscience, psychology with occupational science into a holistic framework through which we can consider a person’s development, learning and behavior. 

Integrating sensory input is essential for development, it underpins learning and ensures we can participate in daily life, helping us to ;

  • make sense of and join together cues in the environment
  • ‘do the right thing at the right time and in the ‘just right’ way’ – moving and using our bodies to get things done
  • be aware of what goes on within our own bodies;
  • know who we are – where we stop and start and where others begin
  • manage emotions and self -regulate
  • interact with others and the world around us – and safely

Here is a great resource to share with therapists, teachers, and families new to  Ayres’ Sensory Integration to help explain Ayres’ SI in more detail.

Thank you to Ms Grieco and Ms Wooldridge for sharing this on YouTube

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ASI and Supporting Parents of Children With Autism: The Role of Occupational Therapy

“…When creating an intervention plan, occupational therapy practitioners evaluate children with autism using observation and parent and teacher reports and also interview parents about their child’s relationships and eating, self-care, and daily living skills…”

Ayres Sensory Integration intervention is one of the most frequently requested and highly utilized interventions in autism. This intervention has specific requirements for therapist qualifications and the process of therapy. This systematic review of studies providing Ayres Sensory Integration therapy to children with autism indicates that it is an evidence‐based practice according to the criteria of the Council for Exceptional Children.” Schoen et al 2018 read more here

National Autistic Society in the UK explains Why is occupational therapy important for autistic children?

Occupational therapy using an Ayres’ Sensory Integrative approach – research supports the use of Ayres’ Sensory Integration, not just for Autism but also for other neurodevelopmental difficulties. See ASI 2020 Vision Goal 1 – Scholarship recent research and FB Group Evidence ASI

You can also read more about The Role of Occupational Therapy in Supporting Parents of Children With Autism on  AOTA’s website

 

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Workshop: Ayres’ Sensory Integration for Health 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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Christmas Themed – Calm Down Glitter Bottle Timer

Thanks so much for this beautiful, simple idea sent to us by one of our families.

Have you tried making and using a glitter-filled calm down bottle timer to help your little ones? It’s easy to put a Christmas theme into them by using festive colours and adding seasonal themed sequins or beads.

With so many versions on the internet, here is a blog post from my Crazy Blessed Life with tried and tested instructions to make your own. While Mama OT explains how the bottles can work by aiding self-regulation http://mamaot.com/sensory-calm-down-bottle/

And a Christmas themed jar from Teaching Mama

Christmas Sensory Bottle

Don’t forget there is still time for you to win a copy of Love Jean by entering our Christmas time book give away. Share your Christmas themed sensory ideas with our community… by leaving a comment on one of our Christmas themed blog posts or on our facebook page … before the 15th December 2018

love jean book

 

 

 

assorted color sequins

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Choosing Wisely ® and ASI – a fantastic initiative from AOTA – it got me thinking about why people think sensory is easy and just anyone can do it.

Just like a parent can decide a child has a cold and needs Calpol, a sensory rich home environment can help support development. However just like a child may need a Dr, Dentist or other specialist if they have a more serious illness, what some people need is specialist intervention.

Sensory Integration therapy requires years of training, first just to become a therapist and then the advanced training needed to accurately assess, develop a personalised intervention plan and then carry out the intervention. We might all know when tonsils need removing, but few of us would do it at home. Telling someone about how tonsils get removed or how sensory integration happens is very different to actually doing it, and doing it safely and so that the outcome is as expected. Sensory integration therapy is not just about swinging on a swing or bouncing on a ball – it is about so much more. And is definitely not about just about wearing headphones and having a bouncy cushion.

The superb article from AOTA’s CHOOSING WISELY programme – see link below – got me thinking. I get weekly emails from people offering to treat other people’s children without training, offering Sensory Profile assessments by mail from a questionnaire when they are not even a therapist.

Share this blog and have interesting discussions with clients, colleagues and line managers. As relevant here in UK and Ireland as in US. This really confirms what we teach in our modules and promote as an organisation; including the best standardised norm referenced tool currently at our disposal – the SIPT. No or limited assessment waters down efficacy. Standardised assessment (when possible) structured clinical observations and thorough clinical reasoning using a clear process are imperative. Data driven decision making.

https://www.aota.org/AboutAOTA/Membership/Tools/Periodicals/choosing-wisely-sensory.aspx

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The next step in my learning journey starts this week…

IMG_E8636I’m so excited that 3 years after starting my postgraduate training in Ayres Sensory Integration, I have finally been able to take the next step in my journey and this week I have started to study the materials for ASI WISE CLASI CASI Module 2 online, with face to face M3 later in August.

Next year will mark 20 years since I completed my Master’s degree in medicinal chemistry and I have thoroughly enjoyed having the opportunity to return to academia by studying occupational therapy. I love the parallels and overlaps between the theory in chemistry and neuroscience, and how both subjects challenge me to understand how microscopic unseen worlds impact on everyday life in tangible ways.

I am enjoying all the fresh challenges and the immense opportunities which the new ASI WISE CLASI CASI offers; blended learning combining digital and online learning (including the chance to be part of an international global community) alongside face to face hands on learning – putting the theory into practice, while thinking about local, regional and national challenges with lectures from the U.K. and Ireland. At university, the research and evidence-based practice modules give me the opportunity to reflect on how far I have come and I am inspired to use both my upcoming final year projects and my learning and work with ASI WISE to both explore and contribute to the latest most up to date research in ASI – including development of the EASI.

I have a long way to go and a lot to learn, I am so thankful to everyone who has supported me so far and for those who continue to guide me especially my mentor Kathryn Smith and the teams at Ayres’ Sensory Integration WISE and Collaborative for Leadership in Ayres Sensory Integration – CLASI for making all this possible.

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Right now, just to match the beautiful colour scheme, I’m celebrating with a new purple folder and some yummy purple chocolates!

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Messy Play 1 – What is messy play and how can it help?

Submitted by guest blogger, Ruth OT

It’s the summer holidays for most schools in England, including my kid’s schools. I’m well known for my love of messy/ tactile play, and summer holidays and messy play are made to go together.

First of all, can I just say that messy play is not just about the sensory input, it’s not a “sensory session”, it’s certainly not a substitute for “sensory integration therapy”?

All play is sensory.

All activity is sensory.

Messy play is a about normal development and learning through a playful activity using tactile experiences and experimentation. It should be fun, it can be intensely therapeutic, and it can form a part of sensory integration therapy session, but overuse of the word “sensory” for activities like this weakens the power of true sensory integration therapy.

Second of all, can I just say that messy play is not a substitute for natural tactile experiences? Messy play is not a substitute for muddy walks, tree climbing, animal handling and other important life and learning experiences. It can scaffold and enable those activities for children who find these experiences difficult to tolerate, but there’s nothing like nature and the great outdoors for kids’ sensory skills.

Here are some of the reasons I love messy play…

It teaches basic cookery skills, but nobody has to actually eat the product

Through making recipes, you can practice opening packages, pouring, measuring, stirring (and holding the bowl still at the same time) and following a recipe. But you don’t have to worry about food hygiene, if the child drops it on the floor, picks their nose, spits, or anything els. You don’t have to pretend it’s delicious. But there is still a tangible result.

It teaches flexibility of thinking and problem solving

So many times I say to kids “OK, that doesn’t look like it does on my picture, what did we do wrong?”, followed by “OK, let’s try that then!”. It’s amazing to watch our children move from “it’s gone wrong, bin it” to experimenting to try and improve the outcome. When I hear “it’s too runny, add more flour” I smile, I count this as a breakthrough parenting moment.

It can be really helpful to use non-specific language, I love seeing that look and a laugh when I say ‘you need a good amount of this’ or ‘give it a squirt of that’. I say we’re working on estimating.

It teaches art, creativity and scientific experimentation

We’ve made beach scenes out of shaving foam and cornflour gloop, farms from rice and silly string and just beautiful visual effects from any range of strange concoctions. I love that moment of “what happens if I mix this with that?”. So long as you’ve checked what you’re using properly, to make sure it’s safe, the worst that will happen is a sticky mess.

Beware of borax as a substitute in cheap homemade slime recipes!

It teaches communication

It can be a great motivator that isn’t food-based; practising choice-making, turn-taking and asking for help is really easy with a tin of shaving foam and some dry pasta. You can follow a recipe, practising reading and maths. Make visual recipes pictures of the scoops of flour and oil, with laminated recipes so the child can tick off each step they do – wiping clean at the end. Get older kids to research their own recipes on the internet and print them off ready for the session.

It teaches motor skills and tactile discrimination

Opening packets, pouring to a measure and sprinkling need I go on? And then squeezing, pressing, rolling, stretching and cutting. It’s amazing for fine motor skill development. You can hide things in a messy play tray or a ball of playdough for the child to find and choose the perfect texture. 

It exposes the child or young person to new sensations

You will make lots of smells with microwaveable soap kits, you will spill liquids, you will touch textures and the outcome is often unpredictable.

It can help with food aversions

Food-based textures and odours can become familiar through messy play. Exploration of food and food-like substances in a calm, fun activity without the pressure and anxiety of being pushed to eat can help to break down anxiety responses to foods, meals and eating.

It’s fun

Or at least, you should make sure it is. 

So, with all of that in mind, Over the next few days, I’ll give you 6 of my favourite recipes, one for each week of the English summer holidays. There are loads of recipes out there, I have a whole book of slime recipes (yes, really) but these ones are tried and tested and hopefully varied.

Hope you have fun trying them out…

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Assessment tools are just that – tools in our toolbox!

We should use and value our specialist skills – promoting our profession – information from one assessment tool is not a comprehensive assessment. We should act with integrity and only practice what we are skilled in and trained to do. This can and must include postgraduate training and we should value this investment in our own skills to deliver a great service to our clients. I felt ashamed of my own profession today, and here is why.

selective focus photography of three disney princesses figurines on brown surface

Today I chatted with a parent I was introduced to on social media. They had paid almost more money than I earn in 2 days in private practice for a 10-page report written after the parent returned a completed Sensory Profile to a therapist via the mail. Then after a 45-minute meeting where the child played on the floor while the therapist interviewed the Mum, the report and recommendations were written.

On the back of this report, the child who lives far away from the assessing therapist is now about to undertake:

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  1. Balance exercises every morning which the Mum was training to do over the internet. These include standing on one leg eyes open and eyes closed, and, hopping eyes open and eyes closed along a line.
  2. A brushing programme; which Mum will be soon be trained to do over the internet – this needs to be done every morning and every night.
  3. Using a sensory diet sheet and the child will follow 5 activities off this sheet each day with her TA at break-time while her friends are out on the playground.
  4. Using a wobble cushion at lunch to facilitate eating new foods.
  5. An after-school calming plan – spinning on a wheelie board and jumping on a trampoline for 10 mins.

The final recommendation was getting sensory therapy from a ‘Sensory OT’ if these things didn’t work. I am apparently one of the closest ‘sensory therapists’, so I got a call. The therapy has not worked. Where do I start? What is a ‘Sensory OT’? Am I one of these?

I have to be professional. So I started with educating the parent about our profession and how we practice.

Screen Shot 2018-07-03 at 08.41.10Then I told her about Jean A Ayres and about Ayres’ Sensory Integration and Practitioner Education including the ICEASI. I had to dispel some myths she’d been sold that sensory diets are not related to Ayres’ Sensory Integration – exploring the history of the theory’s development, explaining how the theory should be used to inform assessment and clinical reasoning even when we can only provide advice and strategies – but that these should still be individualised following a comprehensive assessment.

Screen-Shot-2018-07-03-at-08.16.50.pngThe approach used and charged for is not what I recognise and not what encompasses best practice – best practice in occupational therapy, wherever we work, involves using assessment tools; some standardised and with norms or some just structured questionnaires that collect and collate our clinical observations. Then we listen and hear the client’s voice/story via their narrative and then using this to confirm our clinical observations. Then using the best possible evidence we should work alongside clients to develop goals and set a way to measure if what we then do makes a difference – improving participation in daily life.

ASI WISE RCOT 2018 Poster ASI Beyond ChildhoodOur recent poster at Royal College of OT Conference in Belfast shows the 2015 Schaaf and Mailloux data-driven decision-making process.

This is not a process restricted to Ayres’ Sensory Integration, but one that should guide best practice in any area of clinical practice; judicious collection of data through assessment to inform clinical reasoning that will allow the setting on individualised, personal goals to inform intervention planning and implementation – with careful measurement of outcomes alongside reflective practice.

This is our profession – working with people in partnership, alongside them in conversation and while using assessment tools in the assessment is expected, we choose tools specific to the person, the referral reason using our clinical reasoning. This is our expertise and what makes our jobs a profession.

The Sensory Profile, like all assessments, is meant to only guide and inform clinical reasoning. Otherwise, we could just hire number crunching computer programs that use algorithms to assess plan intervention and write reports instead of OT’s.

[This blog was written a while ago, with some details changed to protect the family, but at their request and with their permission. It was written just after my father in law fell and then sadly did not recover. I was very sad anyway, but after this conversation, I was really very very sad and I waited to make sure I still felt as concerned and as sad after some time had passed.]