The “just right challenge: for this plucky young lady. She clearly likes the sensory input these activities are providing to her body and brain. These are exactly the outdoor sensory system challenging opportunities afforded by climbing trees and jumping streams that Jean Ayres’ wanted to recreate in her therapy spaces. For those of us lucky enough to live in rural areas and near great parks and other outdoor spaces, do we think about these natural spaces and resources enough.
I will be sharing this with every family I work with for Easter half term when it is a great time to start to once again out and about, now the snow has gone.
The SIPT (Ayres 1989) is one test battery used to assess for sensory integration difficulties. It is a collection of 17 tests that are designed to test various aspects of sensory perception, discrimination, reactivity and contribution to our praxis and ability to participate in everyday life.
It can, with mindful clinical reasoning, be used to assess people from 4 years, right across the lifespan – children, teenagers, adults and even older adults.
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The 17 tests include tests that can identify patterns of sensory integration difficulties often associated with autism, ADHD, dyspraxia (sometimes considered a subtype of Developmental Co-ordination Disorder – DCD) and more generalised sensory integration/sensory processing difficulties (sometimes called sensory processing disorder or SPD). This set of tests can identify if difficulties in participating in everyday life are a result of problems registering, processing, integrating or reacting/responding to sensory information from the proprioception, touch, balance and visual systems.
The test was originally designed for use with children between the ages of 4 years through 8 years 11 months, but is increasingly used for older young people and adults, to indicate where sensory processing difficulties may have impacted on development and ability to participate in daily life.
The SIPT is intended to be primarily a tool to diagnose sensory integration dysfunction including praxis difficulties.
It should be only be used by those with post-graduate (or specific under-graduate) education in sensory integration. Assessment should gather and collect information in different ways and sensory integration assessment typically includes the use of a combination of assessments tools including parent/carer or self report tools like the Sensory Processing Measure (SPM)or Adolescent/Adult Sensory History (AASH) alongside interview, other testing and clinical observations to develop appropriate goals, plan outcomes measure and develop and carry out treatment plans.
The SIPT does not require the person to make verbal responses to the test items. It does require a person is able to focus and attend and be able to follow demonstration and verbal instructions. It may not be appropriate for use with all children with sensory integration and processing dysfunction.
NOTE:
The SIPT is increasingly being considered as a suitable assessment for use with adolescents and adults who are able to participate in more formal assessments techniques.
The plateauing of results above 8 years 11 months in the standardisation sample indicates developmental maturity of sensory integration.
Therefore deviations from the 8 years 11 months score in adolescents and adults may, as in the standardisation population, indicates specific organic problems processing sensory information, associated with learning disabilities, emotional disorders, and minimal brain dysfunction.
Statement compiled by Kathryn Smith, OT, 2011, following personal communication with Susanne Smith-Roley and Zoe Mailloux, SIPT Instructors, WPS.
When a person registers, processes and responds to sensory input we call this Sensory Integration (Ayres 1972). Sensory Integration happens when a person uses sensory input from inside their own body and from the world around them to understand the world, what just happened, is happening and what might happen next.
When sensory integration and development can’t happen like it should, sensory integration difficulties (sometimes called sensory processing disorder) can happen. This can mean that managing feelings, moving about, learning and getting along with others can be tricky.
It can stop a person learning the skills they need for everyday life – being organised, looking after themselves, joining in with others, focussing and listening, sitting still and even behaving in a way that makes learning possible and everyday life easier.
Sensory Integration makes it possible for people to successfully carry out all the activities that make up their daily lives. To do this the senses, nerves and the brain collect, filter and organise sensory information so it can be used. When the senses cannot be properly integrated or don’t work as well as they should, life becomes hard and some things are impossible to do.
Sensory difficulties interfere with being able to cope with feelings, get along with others, move about and do things like work, play, learning and being able to do self-care. In children, sensory integration difficulties can delay and hamper normal development and participation in home and school activities.
Smith 2013
Hear Ryder’s story and how sensory difficulties impacted on his early development and learning.
This feature article was written by Claire Smith, one of the first UK OT’s to deliver Sensory Integration alongside Dialectical Behaviour Therapy (DBT). I am delighted to introduce Claire to you, as she was one of the first people I ever lectured about how to apply Sensory Integration’s in Mental Health. That was way back in 2004 and tonight she features on a BBC Documentary – Girls on the Edge.
Here is what Claire would like to add about how Ayres’ Sensory Integration can be used when we work with adults who have trauma and related sensory integration challenges.
As a DBT therapist and SI Practioner I am fortunate to be able to deliver a full DBT programme, alongside an inter-disciplinary DBT team, provide ASI intervention and use sensory strategies that I believe make a real difference to people’s lives.
We combine sensory strategies with DBT skills that support young people to self-regulate and reduce high emotional arousal. These are personalised and individualised to each young person forming part of their positive behavioural support care-plan. Sensory strategies are often used to help young people become ‘talking therapy ready’ prior to starting DBT. There is much stigma around mental health and what it means to be in a secure unit.
Three teenage girls and their families will be sharing their stories and lookIng at the impact on families in a documentary on Thu 22nd Feb, Girls on the Edge, at 9pm on BBC2. Their bravery, openness and honesty helps to break some of this stigma.
The programme has footage of some of the activities offered at FitzRoy House and features glimpses of a number of OT’s I work with providing meaningful occupations and supporting young people in their journey to recovery.
In 2016 Neuroscientists discovered that a basic mechanism underlying sensory perception is deficient in individuals with dyslexia. The brain typically adapts rapidly to sensory input, such as the sound of a person’s voice or images of faces and objects, as a way to make processing more efficient. But for individuals with dyslexia, the researchers found that adaptation was on average about half that of those without the disorder.
“Dysfunction of Rapid Neural Adaptation in Dyslexia” by Tyler K. Perrachione, Stephanie N. Del Tufo, Rebecca Winter, Jack Murtagh, Abigail Cyr, Patricia Chang, Kelly Halverson, Satrajit S. Ghosh, Joanna A. Christodoulou, and John D.E. Gabrieli was published in Neuron online December 21 2016 doi:10.1016/j.neuron.2016.11.020
Another study by Jaffe-Dax, Frenkel & Ahissar was published in 2017 in eLife, 6, e20557. http://doi.org/10.7554/eLife.20557 ; “Dyslexics’ faster decay of implicit memory for sounds and words is manifested in their shorter neural adaptation”.
Dyslexia is a reading disability, although why it happens is still not understood. In the 2017 study, they studied if neural mechanisms underlying dyslexia could be explored using a simple frequency-discrimination task. Participants were asked to compare two tones in each trial – and the study was devised to explore if implicit memory of previous trials affected their responses. They had hypothesized that implicit memory decays faster among dyslexics.
People with dyslexia showed a faster decay of implicit memory effects. They discovered that faster decay of implicit memory also characterised the impact of sound regularities in benefitting dyslexics’ oral reading rate. The study suggests that people with dyslexia had a shorter neural adaptation, with is in contrast to their longer reading times. They hypothesised this is because it reduces their temporal window of integration of past stimuli, resulting in noisier and less reliable predictions for both simple and complex stimuli.
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The SIPT does not require the person to make verbal responses to the test items. It does require a person is able to focus and attend and be able to follow demonstration and verbal instructions. It may not be appropriate for use with all children with sensory integration and processing dysfunction.
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