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Research update: Forest design for mental health promotion—Using perceived sensory dimensions to elicit restorative responses

Forest design for mental health promotion—Using perceived sensory dimensions to elicit restorative responses, research into the qualities of the natural environment which promote restoration

forest design for mental health promotion - research update

download full article – open access pdf here  

 

gray bridge and trees

 

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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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‘Sensory’ in Autism isn’t just about sensitivity.

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.

http://idoinautismland.com/?p=376

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Summer fun ideas for challenging Tweenies and Teens

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.

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About the senses and development.

Our seven senses are critical to early development. Watch this video below to see more.

pexels-photo-1183960

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.

pexels-photo-1166990“Sensory integration difficulties can influence self-regulation, movement, learning and interaction with others.”

Allen and Smith 2011

 

You can watch more here.

 

 

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Supporting Practice – Your Questions Answered: Why did Ayres’ not consider the visual system?

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).

SV         5                    Motor-free visual perception; mental rotation

FG         2                    Motor-free figure-ground perception

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;

Read more here:

Verification and Clarification of Patterns of Sensory Integrative Dysfunction

Patterns of sensory integration dysfunction in children from South Africa

Correlational study between structured clinical observations and the Sensory Integration and Praxis Test

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.

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Ayres’ Sensory Integration and the great outdoors

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.

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About the Sensory Integration and Praxis Test (SIPT)

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.

IMG_1961

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.

Screen Shot 2018-03-16 at 20.41.08

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.

Screen Shot 2018-03-16 at 20.47.44The 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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About Dialectical Behaviour Therapy and Ayres Sensory Integration

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.

You can see some short clips from the documentary here, and once it has aired, links to watch it again on the BBC.

You can learn more about DBT here.

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Why how a child moves, stands and sits is essential to eating and more

Occupational Therapists, Physiotherapists and Speech and Langauge Therapists practicing Ayres SI are frequently asked about eating difficulties; this is a common feature of sensory integration difficulties for many young babies and children.

Sensory and motor based eating issues require a whole child approach, starting with how a child moves and sits. Adequate and stable postural control facilitates a good head position and frees the hands up to help with eating.

Try this little exercise – sit on a low stool or chair, slump forward, with your chin almost on your chest and then try to sip a glass of water and chew and swallow a piece of soft fruit? How easy was it to do?

So how do we know if eating difficulties are more about sensory hyper or hypo-reactivity or poor oral sensory discrimination affecting the child’s motor skills? We have a range of tools in our toolbox. For older children, the SIPT Assessment provides excellent information about oral praxis, tactile reactivity and tactile discrimination, vestibular processing and proprioception. The Sensory Processing Measure can provide information for school-aged children, but also younger toddlers from 2.

Clinical Observations and parent report, as well as hypothesis testing through early intervention allows a therapist to test and confirm an early hypothesis through play with toys and games.

Therapy activities used might include a rice tub, play dough, messy paint play, kinetic sand, water play, shaving foam, play on balls, in tunnels, on swings and over foam rollers and with lots of textured surfaces. Careful observation will all help confirm why sensory differences may be contributing to tricky eating.

Then we also need to consider the child’s level of alertness, are they very tired, under-responsive and sleepy, or whizzing and fizzing – neither of these states is right for a task that needs focus and attention.

Do you feel like eating immediately after you wake up, or while trying to concentrate on a difficult task? Or while learning to walk a tight rope? Clear focus and attention is required for success at the table.

I really love this table from this amazing book, which provides an outline of questions to shape your parent interview and to use to inform your clinical reasoning during unstructured clinical observations.

copy from eating with senses file

from  Arvedson, JC.,  Brodsky, L. (2002)  – Pediatric Swallowing and Feeding: Assessment and Management

Addressing the underlying sensory or motor issues, whether this is an under -responsive vestibular system, over responsive tactile system, poor oral discrimination or poor proprioception and related motor muscle skills required for chewing does not have to be with food.  And often it helps if initially, it is not about food. This is because when families first come for assessment and therapy food may already be an emotive subject. Helping our children to eat is key to helping them survive – and when for whatever reason they struggle with eating, Mum’s and Dad’s can feel sad, scared and even desperate. Growing and developing the postural, motor and sensory especially tactile discrimination skills needed for eating through play is fun and allows everyone to relax and new learning to occur without pressure.

Education about family mealtimes is also important, especially for younger children who may need to watch and observe, to model eating skills and see others trying new foods. For slightly older children, sometimes doing this with friends, at friends houses and even at school, cooking groups can allow a child to take risks, modelling peers. It is however essential that there is never pressure applied!

Other information and resources to support eating can be found here, and we will be posting again on eating and feeding difficulties.

The Importance of Postural Control for Feeding

POSTURAL CONTROL, GROSS MOTOR DEVELOPMENT AND MEALTIME

Attention, Behavior, and Meal Time Problems

Cheerios Milk and Spoon – A Mum’s Blog about all things eating

Visual skills for Eating

Parenting Science Gang

Division of Responsibility – a great supportive way about thinking about who is responsible for what part of eating.