Description
Seeing Differently in Neurorehabilitation
Sensory Integration, Neurological Change & Participation
What happens when a brain and body that once worked together in familiar ways are changed by neurological illness, injury or critical care?
And when someone finds movement, activity, relationships or everyday life more difficult, how do we work out what we are actually seeing?
This one day specialist workshop takes the foundations of Seeing Differently into neurorehabilitation, exploring sensory integration alongside neurological change, perception, movement, body awareness, praxis, fatigue, pain, cognition and participation.
This day builds on Seeing Differently
This is not an introductory sensory integration course.
Participants should first complete Seeing Differently Parts 1 to 3: Sensory Integration, Participation & Wellbeing.
You will already have explored sensory integration foundations, Sensory Ladders®, Sensory Spiders™, Sensory Grids™, PEAR TREE™, observation, participation and the importance of noticing more, assuming less and asking differently.
On this specialist day, we take that learning into neurorehabilitation.
Explore Seeing Differently Parts 1 to 3When the nervous system changes
Neurorehabilitation can be complex because what we notice rarely has only one explanation.
A person may struggle to initiate an activity, tolerate movement, locate their body in space, organise an action, manage the sensory demands of a busy rehabilitation environment, sustain alertness or remain available for therapy.
But is what we are seeing about sensory integration?
Could it reflect altered sensation, perception, neglect, apraxia, fatigue, pain, vestibular change, cognitive demand, trauma or changes in body awareness?
Could several of these be interacting at the same time?
Seeing Differently in Neurorehabilitation invites us to slow the clinical reasoning down enough to explore the whole picture.
The questions guiding the day
What we will explore
The day brings sensory integration theory into conversation with contemporary neurorehabilitation and everyday clinical reasoning.
Sensation, integration and perception
Exploring what happens when sensory information is altered, lost, difficult to discriminate, differently integrated or differently interpreted following neurological change.
The changing body
Considering body awareness, postural control, movement, vestibular and proprioceptive information, touch, vision, interoception and the experience of inhabiting a body that may now feel or respond differently.
Praxis and doing
Looking at the sensory foundations of knowing what to do, organising action, motor planning and translating intention into meaningful participation.
Looking beyond “sensory”
Differentiating sensory integration differences from altered sensation, perceptual change, neglect, apraxia, fatigue, pain, cognition, arousal and other neurological presentations.
Availability for rehabilitation
Exploring why someone may struggle to initiate, tolerate, organise or sustain participation and what their body and brain may be managing before rehabilitation even begins.
Participation begins in the body
Connecting what we notice to washing, dressing, eating, mobility, communication, therapy, relationships, sleep, home, community, work and the occupations that matter to the person.
Looking through PEAR TREE™
We will use the PEAR TREE™ Lens to hold sensory and neurological information within the wider picture of the person.
Rather than asking only what impairment a person has, we will consider the Person, Environment, Activity and Relational response, alongside appropriate triage, evaluation and ethical clinical reasoning.
The question becomes not simply:
“What sensory difficulty does this person have?”
but:
“What is happening here, what is getting in the way of participation, and what might need to change?”
Sensory Ladders® in neurorehabilitation
Sensory Ladders® provide a way of exploring changing body states with the person rather than simply describing behaviour from the outside.
During the day we will consider how a Sensory Ladder may help a person and their rehabilitation team notice changes in alertness, fatigue, sensory experience, pain, movement tolerance and availability for activity.
We will explore what makes participation easier or harder and how this information can support shared understanding across the rehabilitation team.
Instead of simply recording that somebody “refused therapy”, we can begin asking:
What state was their body in?
What had happened before we arrived, and what was their nervous system already managing?
What did the activity demand?
What sensory, motor, cognitive, relational and environmental demands were being placed on the person?
What could we change?
What could we offer, adapt or support differently to make meaningful participation more possible?
Applying the thinking across neurorehabilitation
Case discussion and clinical reasoning will draw on presentations encountered across neurorehabilitation, including:
Acquired brain injury
Exploring sensory, perceptual, motor, cognitive and participation changes after acquired or traumatic brain injury.
Stroke
Considering sensation, body awareness, perception, movement, praxis and participation within the wider neurological presentation.
Critical illness recovery
Considering sensory experience, fatigue, deconditioning, changed body states and the journey from critical care through rehabilitation and home.
Other neurological change
Applying the same curious clinical reasoning to other neurological conditions while recognising that presentation, progression and rehabilitation needs will differ from person to person.
Following participation across the rehabilitation journey
Throughout the day we will keep returning to the life beyond the impairment.
Learning outcomes
By the end of the day, participants will be able to:
Who is this day for?
This specialist application day is for people working within, alongside or supporting neurorehabilitation services who have already completed Seeing Differently Parts 1 to 3.
Allied health professionals
Including occupational therapists, physiotherapists and speech and language therapists working across neurological pathways.
Nursing and rehabilitation teams
Including nurses, rehabilitation assistants, support staff and others involved in everyday rehabilitation and participation.
Wider interdisciplinary teams
For teams wanting a shared way of noticing, discussing and understanding the sensory foundations of rehabilitation and participation.
Different professions will apply the learning differently according to their role, professional responsibilities, competence and scope of practice.
A lens for rehabilitation, not a new professional role
Seeing Differently in Neurorehabilitation does not qualify participants to undertake specialist Ayres Sensory Integration® assessment or to deliver intervention according to ASI fidelity.
Instead, it develops a shared sensory integration informed lens for understanding people, participation and rehabilitation.
For therapists undertaking specialist postgraduate education in Ayres Sensory Integration®, the day also provides an opportunity to connect existing ASI knowledge with adult neurorehabilitation clinical reasoning.
Seeing Differently does not stop when we recognise a sensory pattern.
In neurorehabilitation, the challenge is to understand what has changed, what remains possible, what the person is experiencing and what might help participation become possible again.
Sometimes what needs to change is the task.
Sometimes it is the environment.
Sometimes it is timing, sensory demand, movement, relationships or the way rehabilitation is being offered.
And sometimes, seeing the person differently changes what we do next.
