Practice history
Dated teaching, publications, resources and professional records help establish when and where the work developed.
History and impact
A practice history built slowly, shared freely and still learning.
Sensory Ladders® did not begin as a finished behaviour programme. They grew through more than 25 years of occupational therapy, NHS practice, lived experience, family knowledge, teaching, co-production and international exchange.
Beyond childhood
Sensory integration continues throughout life.
In the late 1990s, sensory integration was still far more likely to be discussed within children’s services. Yet adults in mental health, learning disability and wider NHS services were living sensory lives too. Their bodies, environments, relationships and daily activities continued to shape comfort, communication and participation.
Sensory Ladders grew from the need for a shared language that could hold underalert, overalert, freeze, calm and alert, and sleep across adulthood as well as childhood. The approach was shaped with people, not transferred into adult services as a fixed children’s tool.
Milestones
From local practice to a global, co-produced project.
This is a continuing practice history rather than a claim that one team created every part of sensory work beyond childhood. It shows how this particular project developed and why its current values matter.
- 1999
Sensory Levels
Early work in adult mental health began making changes in alertness and body state more visible and discussable.
- 2001
Early ladders and About Me practice
Adult mental health, DBT learning and co-produced plans shaped a more practical language for state and support.
- 2004
The Sensory Project began in Cornwall
Live teaching with therapists, families and services helped the work travel beyond its local NHS roots.
- 2005–2009
Be SMaRT™, professional writing and recognition
Practice development, Medical Futures recognition, OT News publication and peer reviewed writing made the wider approach more visible.
- 2013
Live online teaching
Remote learning with families and rural communities began widening access before online delivery became commonplace.
- 2021
Anyone, anywhere, anytime
Free online learning opened the door to individuals, families and teams, including support shared with refugees and displaced people.
- 2023
International learning and translation
The Global Translation Project and international teaching strengthened a community of shared adaptation and exchange.
- 2024–2026
More languages, more local leadership
Arabic, Greek, Zulu and Setswana resources were shared, with further language communities continuing the work.
- 2026
PEAR TREE™ Lens
The project’s sensory, relational, embodied and participation-focused thinking was held more explicitly within a whole-person lens.
Read the history in its published form
Original articles add detail to the timeline.
These pages trace open access, professional sharing and the work of carrying sensory integration beyond its better known childhood context.
Project foundations
Sensory Ladders Beyond Childhood
Read the lifelong neuroscience and practice story behind the project.
Read article Open accessAnyone, anywhere, anytime
Follow the decision to make core Sensory Ladders learning freely available.
Read article Professional sharingRCOT 2021 | Sensory Ladders
See a published record of the project’s occupational therapy contribution.
Read articleConference sharing
Sensory Ladders at ISIC Porto 2025/2026.
The Porto conference pages preserve the posters, contributor lists and project context in their original published home.
What impact means here
Reach, use and outcomes are different kinds of evidence.
A mention in guidance shows documentary spread. Training feedback shows acceptability. A service account can describe implementation. Outcome evidence asks a further question about what changed. These should never be collapsed into one claim.
How the project documents reach and impact
A transparent process protects credibility.
The purpose is not to collect the largest possible number of mentions. It is to understand what each source can genuinely tell us and where more evidence is needed.
- 01
Find
Search public guidance, service documents, research, teaching records, translations and community accounts.
- 02
Verify
Return to the original source, confirm dates, organisations, wording and the exact resource named.
- 03
Classify
Separate a mention from recommendation, training, implementation, evaluation and outcome evidence.
- 04
Rate
Record confidence, limitations and what the source cannot support as well as what it can.
- 05
Listen
Include lived experience, family and workforce accounts without treating one voice as universal.
- 06
Learn
Use gaps, corrections and new findings to strengthen resources, teaching and future research.
Four evidence layers
What we know, what we are learning and what remains uncertain.
Documented reach
Public guidance, NHS and local authority resources, international teaching and translation records show where the project has travelled.
Experience and implementation
Feedback and service accounts can describe usability, shared language and how implementation happened in a particular context.
Outcome evidence
Stronger evaluation is needed to examine participation, quality of life, service outcomes and possible harms over time.
A public mention is evidence of spread, not proof of effectiveness. Early feedback can guide learning, but it should not be presented as final outcome evidence.
A living learning loop
Practice shapes resources. Communities reshape the project.
The project continues through a reciprocal process: people use and adapt a tool, share what fits and what does not, and that learning returns to teaching, translation, resources and research questions.
1Listen
2Co-produce
3Try in life
4Reflect
5Share learning
Carry the history forward
Keep access open and the person at the centre.
Begin with the free learning, adapt carefully and tell the project what you discover. Shared resources become stronger when people can question them as well as use them.