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Reflective Practice | A Research Reminder | Altered Cervical Vestibular-Evoked Myogenic Potential in Children with Attention Deficit and Hyperactivity Disorder.

When supporting other therapists to interpret their clinical data, I find a common theme tricky patterns emerging while trying to make sense of assessment data. It is always helpful to remember to explore and reference the latest supporting evidence.

Dr Susanne Smith Roley reminded our Module 6 delegates of this just last night. She emphasised the importance of staying up to date and using evidence from the last 5 or so years to support our clinical reasoning, as the evidence base about ASI is rapidly expanding, mainly within our domain of practice, occupational therapy. There is also a raft of evidence in related fields like ENT, neurology, mental health, trauma and other related areas. We need to search widely. This reminder from Susanne was the perfect timing for a conversation this morning and my reflections on that conversation this morning.

In summary; we should all remember to link our clinical findings with the latest research and evidence. This means we should link our evidence searches to the clinical patterns we suspect may be emerging from our assessment data.

If it doesn’t make sense – keep looking and exploring. Go back and ask more questions. Clinical reasoning is about data from a range of sources pointing to and in sync with performance and participation challenges.

Data from standardised testing, questionnaires, narrative and interview and clinical observations provides a holistic and individualised view of your client’s strengths and challenges. Exploration and understanding of their interests will allow you to capitalise on what will motivate them in therapy; supporting engagement and creating the right conditions of neural plasticity needed for therapeutic change.

Smith 2020

Emerging evidence suggests that children with attention deficit and hyperactivity disorder (ADHD) present more difficulties in standing and walking balance than typically developing children.

Isaac’s et al 2017

Read the full article here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5346589/

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Research Update: Sensory Over-Responsivity as an Added Dimension in ADHD

Anecdotally many Occupational Therapists who use Ayres’ Sensory Integration to inform assessment and practice report the close links between ADHD and sensory integration challenges. This article by expert Sensory Integration researchers Shelley Lane and Stacey Reynolds offers research evidence and neuroscience in strong support of the links between differences in processing and integrating sensory input for those who meet criteria for a diagnosis of ADHD.

Abstract “Years of research have added to our understanding of Attention Deficit Hyperactivity Disorder (ADHD). None-the-less there is still much that is poorly understood. There is a need for, and ongoing interest in, developing a deeper understanding of this disorder to optimally identify risk and better inform treatment. Here, we present a compilation of findings examining ADHD both behaviorally and using neurophysiologic markers. Drawing on early work of McIntosh and co-investigators, we examined response to sensory challenge in children with ADHD, measuring HPA activity and electrodermal response (EDR) secondary to sensory stressors. In addition, we have examined the relationship between these physiologic measures, and reports of behavioral sensory over-responsivity and anxiety. Findings suggest that sensory responsivity differentiates among children with ADHD and warrants consideration. We link these findings with research conducted both prior to and after our own work and emphasize that there a growing knowledge supporting a relationship between ADHD and sensory over-responsivity, but more research is needed. Given the call from the National Institute of Health to move toward a more dimensional diagnostic process for mental health concerns, and away from the more routine categorical diagnostic process, we suggest sensory over-responsivity as a dimension in the diagnostic process for children with ADHD”.

Read the full article here: Sensory Over-Responsivity as an Added Dimension in ADHD