During and post Covid-19 many of us who work with adults using sensory integration theory and principles are being asked about ways to help this client group post Covid-19 rehab. Join us to share resources, knowledge and learning about the senses and sensory integration about neuro-rehab including from Covid-19. Join in our community of practice on Telegram.
Our Telegram space includes articles including about stimulating the sense of smell and the importance of movement.
Yesterday, to a conference in Ireland Kath Smith presented about the journey she started in 1998 when she first treated her first adult in the UK using ASI. The presentation was built on an original one presented at an RCOT Conference in 2003. This journey has been awesome – it is where she met her now colleague and fellow Director of ASI Wise Ros Urwin and was encouraged and mentored by world leaders in ASI, themselves taught by A Jean Ayres. It is more than 20 years since both Ros and Kath started to build on the early research and evidence base publishing their own research, developing tools and resources to support first their own and then the practice of others. They have taught therapists and nursing staff in the UK and across the globe how to work with adults with mental health difficulties with sensory integration challenges. Learn about the application in ASI on our modular programme – ASI Wise CLASI Certification in ASI and our 2-day workshop which explores the application of ASI across the lifespan.
So today, Bear the Cockapoo will be helping out on Zoom. The little lad, let’s call him Ed, has ASD and doesn’t speak much. He does though talk to Bear. So Bear usually joins in at the clinic Ed. But not at the moment as C-19 means even dogs need to be socially distanced. Ed is missing Bear.
We are planning a double treasure hunt and obstacle course build today. Bear will do his obstacle course that’s designed by and built to Ed’s instructions. Ed will be building and doing an obstacle course developed by Bear and I. Read more below about why dogs are an incredible way to reach children with autism.
In a Children’s Occupational Therapy practice, many parents tell OTs that they feel they could cope better if they just got more sleep. When I heard about Matthew Walker’s “Why We Sleep” book from a colleague on a course, I bought it and read it cover to cover. I then shared it with everyone in my life struggling with sleep because this book links sleep with mental health, physical health and sleep through the lifespan.
Here are “Why We Sleep” top tips for sleep hygiene from the appendix- is you want more information about why for any of these tips, go back to the book and dig deeper:
1)Stick to a sleep schedule: go to bed and wake up at the same time each day as people have a hard time adjusting to changes. Sleeping in on weekends can’t repay our sleep debt.
TOP TIP: set and alarm for bedtime
2)Don’t exercise too late in the day: try to exercise 30 minutes on most days but no later than 2 or 3 hours before your bedtime
3)Avoid caffeine: Coffee, cola, certain tea and chocolate contain stimulant caffeine and can take 8 hours to fully wear off. Older teens may benefit from being cautioned that nicotine and alcohol also worsen sleep.
4)Avoid large meals before bed: these can cause indigestion and having too many fluids might mean you need to get up to use the toilet
5)If possible avoid medications that disrupt or affect sleep: over the counter and herbal remedies for cough, cold or allergies can disrupt sleep. If you are worried, talk to a pharmacist or health care professional to see if any drugs you take might contribute to insomnia
6)Don’t take naps past3pm: Naps can help you catch up on lost sleep but if you nap too late in the day, it can be harder to fall asleep at night
7)Relax before bed: don’t overschedule your day so you have no time to unwind. Reading or listening to music could be part of your bedtime ritual
8)Take a hot bath before bed: Your body temperature will drop after getting out of the bath and this may help you feel sleepy and relaxed so you are more ready to sleep
9)Have a dark, cool, gadget free bedroom: Noises, bright light, an uncomfortable bed or warm temperatures can distract you from sleep.
10)Have theright sunlight exposure:Try to get outside in natural sunlight for 30 minutes a day.
11)Don’t lie in bed awake: if you are still awake after 20 minutes or starting to feel anxious or worried get up and do some relaxing activity until you feel sleepy. The anxiety of not being able to sleep can make it harder to fall asleep
Ayres’ published her research findings, making a case for emerging patterns of sensory integration dysfunction including;
developmental dyspraxia – this pattern linking motor planning difficulties with deficits in tactile perception
difficulties with integration of both sides of the body; poor right-left discrimination, difficulties crossing the midline, and reduced bilateral motor coordination – impacting on posture and postural control, thought to related difficulties processing vestibular input
visual perception, form and space perception deficits impacting on visual-motor functions
difficulties with visual figure-ground discrimination
deficits in auditory and language functions.
tactile defensiveness and related sensory reactivity difficulties impacting negatively on attention
A key feature of Ayres’ Sensory Integration is the adaptive response; “an adaptive response is a purposeful, goal-directed response to a sensory experience … play consists of a series of adaptive responses that make the sensory integration happen. In turn, as sensory integration develops, better organization and more complex skills are possible” Ayres 2005.
In 2013, Viana et al reported that children with dyslexia show poor performance and variability while relating visual and somatosensory information. Children with dyslexia showed less coherent and more variable body sway; suggesting difficulties in multisensory integration from sensory cues coming from multiple sources.
Studies with adults and children found that there is reduced neurophysiological adaptation in adults and children with dyslexia. In 2016, Perrachione et al published research suggesting that people with dyslexia are likely to have differences in sensory integration and processing, noting significantly reduced adaptation to speech from a consistent voice and less adaptation to the repetition of words, objects, and faces. They provide evidence to support the hypothesis that reading skills in dyslexia are related to the degree of neural adaptation.
In 2017 Wandel and Le confirmed the importance of the effective processing of multiple sensory inputs, including successful sensory integration for competent reading.
“Successful reading involves the ability to efficiently integrate visual signals with the sounds of speech and the language system; thus, diagnosing the reading circuitry requires testing the cortical and white matter regions that carry reading information from the visual, auditory, and language systems. Reading impairment can result from problems within neural circuits that are used for multiple purposes, not uniquely reading (Rayner et al., 2012, Seidenberg, 2017). Hence, we advocate assessing the circuitry broadly, not just portions that are highly specialized for reading.”
In clinical practice, some children with sensory integration difficulties benefit more from the use of coloured overlays. Research from Kriss and Evans (2005) suggests that
“Children with dyslexia seem to benefit more from coloured overlays than non‐dyslexic children. MIS and dyslexia are separate entities and are detected and treated in different ways. If a child has both problems then they are likely to be markedly disadvantaged and they should receive prompt treatments appropriate to the two conditions. It is recommended that education professionals as well as eye‐care professionals are alert to the symptoms of MIS and that children are screened for this condition, as well as for other visual anomalies.”