ASI WISE was recently invited to deliver a presentation about Autism and sensory issues to a UK National Autistic Society meeting. Our presentations to the audience addressed the science and evidence behind autism and explored a families experience of sensory integration therapy.
Since the presentation we have had interesting conversations with some parents who attended. A common theme has been parents discovering that motor and praxis difficulties are part of sensory integration theory and therapy, and that ‘sensory’ in autism isn’t just about sensitivity.
Here is a great blog by an adult with autism who describes those sensory integration difficulties from visual scanning to actually doing.
Here are some great hand-eye coordination activities for clients across the lifespan – some are especially good for teens! Try these with tweenies and teens with difficulties with sensory-motor coordination, to get them off devices and outdoors over the summer.
Our seven senses are critical to early development. Watch this video below to see more.
Ayres (1972) defined sensory integration as “the neurological process that organises sensation from one’s own body and from the environment and makes it possible to use the body effectively within the environment”
When they do not work well, or the environment we live in does not allow this to happen, we can’t get the sensory information our bodies and brain need. This interferes with our development, learning and participation in all the activities of our everyday lives.
“Sensory integration difficulties can influence self-regulation, movement, learning and interaction with others.”
I meet so many parents who are concerned about their children’s motor or sensory processing skills who tell me their child never 4-point crawled, or did so only briefly. They proudly tell me how their child was ahead of their motor milestones and walked early, and never realise how important crawling is.
What is so special about crawling?
In crawling, the baby supports their weight on their hands and arms, this works wonders for developing shoulder girdle stability and proprioceptive awareness of the hands and arms which is foundational for fine motor skills like handwriting, fastening clothing, threading, sewing, crafting etc. Crawling also requires the baby to hold their core flat and stable off the ground, developing core stability against gravity. It also puts the baby’s neck into extension (ie bent back so that the baby is looking forwards not at the ground), this activates areas of the brain stem and supports baby’s developing understanding of their relationship with gravity and thus vestibular processing.
But what good is telling you all this now if your baby wasn’t a crawler? My youngest child was a very proficient bum shuffler, he could get anywhere over any surface (but not steps!) very quickly shuffling along on his bum. If I put him into the tummy time position, he just laid there and cried until I sat him up. I knew crawling was important for his development and that bum shufflers are late to walk, but I couldn’t make him do it once he’d learned a really efficient way to get where he was going!
So now that he’s a confident walker, we’re going back to crawling activities, and I thought I’d share some of the activities we do without any extra equipment at home to get those crawling benefits…
Going back to crawling…
Climbing! There’s a lot of motor planning and problem-solving in this as well, depending on where you climb. Over rocks, up muddy hills, up slides (you will get looks from other mums), in soft play, anywhere where they need to use their hands to support their movement is good by me
Cars and small world toys- some kids I know will squat down on their feet and use their hands to play, if this is your kid try setting up a small world where the kid has to reach far enough that they have to support their weight with their hands to reach the middle.
Big floor art, floor puzzles etc. We love messy art at the best of times, but if you can get a roll of lining paper on the floor to do your art on, you can work on shoulder girdle stability, prone extension and motor planning while you do it.
Tunnels, those pop up tunnels you can get for kids are great for encouraging crawling (you can’t bum shuffle through one, we speak from experience!)
Ball pools, he loves falling face first in them and then crawling back to standing up.
Ditch the train tables, lego tables and tuff tray stands. I know they make tidying up easier and are more comfy for parents, but playing on the floor is about so much more than the game.
As I read the recent article “14 Phrases Kids Said That Were Code Words for ‘I’m Anxious“ from The Mighty, It felt familiar – like I had met every one of these responses to anxiety and not just from children.
“What’s wrong with me?”… “I’m tired.” … “Can’t we stay home?”
“I don’t feel well.”
Anxiety affects so many people and they are not all confident naming and talking about it. Some may know they are anxious but be embarrassed about telling people, for others, it may be that long-term anxiety is new to them and they haven’t really grasped that the physical symptoms are related to their anxiety.
So how does anxiety play out in real life and how can we help?
The elderly lady who has had a reduction in her mobility now feels sick when she goes in the car (but her doctors can’t find anything physically that would cause this), may not understand that her body and brain has become accustomed to less movement and so is less able to integrate vestibular stimulation with other sensory stimulation hence she feels sick now avoids leaving her chair for fear of some as yet unidentified illness but is embarrassed to say she feels scared. Her fears about illness then generate yet more anxiety symptoms e.g. Feeling sick racing heart and more, confirming that she really has got some mystery illness that the doctors are missing, so she avoids leaving her chair whenever she can. This leads to a further loss of integration between her senses as she is not moving much (vestibular) and she is not using her muscles much (proprioception) and will eventually lead to loss of function.
Or that friend who is always tired or busy when you want to go out (there might be other reasons) and cancels at the last minute. But to be honest, as a mother to a lovely but anxious young lady it is the young people who concern me most
My concern for young people is driven by the knowledge that the young brain is primed to learn (Jenson 2015)… And learn it will – either good things or less good things, so if like the elderly lady the young teen avoids activities there is a good chance that these coping strategies will become an ingrained life pattern.
So what can we do to help?
First get to know the symptoms of anxiety there are numerous self-help books and Web pages e.g. The NHS Web site, Web MD, mind etc.
Second help the young person to choose activities that are likely to reduce anxiety… From a sensory integration perspective, these are likely to be ones that involve heavy muscle work and muscle stretch (proprioception) and ones that make the young person think like Martial arts, dance, rock climbing gymnastics etc. Will be better than just proprioception alone. We do dance and acrobatics.
Consider 1 to 1 tuition if they need to gain skills to catch up with their peers… But if you do this it’s good to plan to reintegrate the young person into group lessons… So that they can deal with social anxieties. We went to a group lesson and it was clear my daughter had a lot to learn so we had a year of individual lessons (and still supplement the group lessons with the occasional individual lesson). But then we went to group lessons, it took half a term but now she is enjoying doing acrobatics duets which brings me to my next point.
Make sure the young person attends regularly and on time for a good chunk of time…..
Be prepared for ongoing anxiety and be firm that they go… My daughter frequently tells me on the way home “oh sensory mum you’re right I do feel better.“
Try to avoid surprises… We have a wall planner for the term and all activities are written on it… And I have noticed my daughter (and I am) much calmer knowing what needs to be done and when.
Discuss and consider professional help… Some Ayres’ Sensory Integration trained occupational therapists use other techniques in conjunction with their sensory integrative therapy, others will work alongside mental health professionals and for some people, Ayres’ Sensory Integration therapy will be enough on its own.
You may also decide to work through a self-help book and this can be a good option… But if in doubt always consult with your GP or/and any other health professional who is working the young person.
So what about those adults… Its a little different to the young people but listening and understanding or trying to understand is a good first step. Giving them information about sensory integration and mental health issues can also be helpful. Then asking them what they want you to do and staying in touch with them even if it’s difficult. And always remember it’s never too late for someone to get help.
Reference The teenage brain by Frances Evans Jenson. L
We need to consider the importance of maintaining tactile discrimination skills – adequate tactile perception is necessary for using tools in a skillful way for participation in lifelong hobbies like sewing, model making, cake icing and painting.
Last night we were delighted to receive a great fb update from our friend and colleague Tina Champagne. She has just received her advance copy of her book, which will be a great resource to inform and support healthcare professionals working with older adults with dementia, using a sensory integration frame of reference.
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 “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.
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.