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Research Updates: DCD and Sensory Integration

So often people ask about DCD and sensory integration, and often the reply given is a quote from Bundy Lane

A recent study concluded that

“Our findings indicate that sensory processing abnormalities may contribute to the pathophysiology of DCD, suggesting the importance of assessing sensory processing functions in children with DCD.”

MIkami et al, 2020

This useful article from Pathways is often also referred to; https://pathways.org/developmental-coordination-disorder-and-sensory-processing-issues-in-children/

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Connection and community matters

Summer is here, and we have hope that we are now leaving behind the struggles of Spring 2020 and C-19. The world has been reminded about the importance of social relationships – we have all realised how much we value family, friends and having strong support and connections. Stay with us or join us and be a part of our Sensory at Home communities as we enter a new phase after being ‘sensory stuck at home’.

Sensory at Home

Sensory at Home Teens

Sensory at Home Grown-Ups

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Practice Update: The Brain and Covid-19

A great clip from the BBC – with input from Dr Susan Whitbourne who has been providing insight into our behaviours throughout this pandemic.

Creating Sensory Ladders online during telehealth has been one way OT’s across the UK have been supporting the mental health of children, teens, adults and students manage their health and well-being during COVID lockdown. You can see some of these and read more here. http://www.sensoryladders.org

If you have made a Sensory Ladder during Covid-19 you are happy to share, please post to our Sensory Ladder FB page community or send to us via our Contact Us link on this website.

‘But, in our brains, there’s a lot of screaming going on right now…’

Whitbourne, Susan (2020)

You can read the full article here.

https://www.magzter.com/article/Culture/The-Walrus/Your-Brain-on-COVID-19

Dr Whitbourne’s commentary and views about why some people felt and may still feel that they won’t be affected by this virus is fascinating and will help healthcare professionals understand why some people struggle with the idea of lockdown and guidance on social distancing. https://www.psychologytoday.com/gb/blog/fulfillment-any-age/202004/why-do-some-people-think-theyre-invulnerable-covid-19

 

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Research into Practice: A study of safety and tolerability of rotatory vestibular input for preschool children

The answer to a question on SI4OT, a FB group for OT’s curated by our social media team, includes this interesting article.

This study was focussing on the vestibular system, and the researchers tried to work out the exact amount of vestibular input needed in therapy. The results strongly suggest that it is very individualised and requires direct therapist observation to know. This is exactly in line with Ayres’ teachings. There is no exact amount that can be prescribed

A study of safety and tolerability of rotatory vestibular input for preschool children

The use of sensory input to support function, health and wellbeing is an art and a science.

The science is knowing for instance that habituation of tactile input to Ruffini nerve ending is usually fairly rapid – eg light touch as we put arms in shirt sleeves while habituation to pain receptors will vary a lot and maybe ongoing after tissue damage we can’t always see.

The art is that our response to sensory input to sensory systems will vary greatly and is very individualised. This response is not just linked to immediate registration and perception of the input – meaning and memory need to be considered too.  Think about happy smells and songs that stay in your head all day. Think too about the response to trauma when a person smells their abuser’s perfume.

There is no recipe for how much to give and when. This is the art and science of ASI. So many factors impact on what a person needs and when to have an adaptive response.

This is why sensory input is not just something you can prescribe someone by saying;

“Give Jane 20 mins on a swing 3x a day” 

gray swing

Essential to practice is the person’s response to sensory input – Do they have an adaptive response?

“Ayres (1972b) described the adaptive response as central to praxis intervention. Adaptive responses are purposeful actions directed toward a goal that is successfully achieved, and the production of adaptive responses is thought to be inherently organizing for the brain. Ayres (1972b, 1985) further emphasized that SI intervention was a transaction among client, task, and environment.”

Bundy, A. and Lane, S. [2019], Sensory Integration Theory and Practice, 3rd Edition, [Philadelphia]. Available from: FADavis.

Watching and seeing this response to input, alongside feedback from the parents/family/person is what we do to understand each person’s unique responses and pattern. However, knowing and remembering that many things can impact on this, day to day and even minute by minute is essential. 

 

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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