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.
Pain and sensory integration difficulties including sensory sensitivity are thought to be features in many disorders including CFS/ME and hyper mobility. Recent research and evidence is exploring the links.
Abstract “Sensory modulation disorder (SMD) affects sensory processing across single or multiple sensory systems. The sensory over-responsivity (SOR) subtype of SMD is manifested clinically as a condition in which non-painful stimuli are perceived as abnormally irritating, unpleasant, or even painful. Moreover, SOR interferes with participation in daily routines and activities (Dunn, 2007; Bar-Shalita et al., 2008; Chien et al., 2016), co-occurs with daily pain hyper-sensitivity, and reduces quality of life due to bodily pain. Laboratory behavioral studies have confirmed abnormal pain perception, as demonstrated by hyperalgesia and an enhanced lingering painful sensation, in children and adults with SMD. Advanced quantitative sensory testing (QST) has revealed the mechanisms of altered pain processing in SOR whereby despite the existence of normal peripheral sensory processing, there is enhanced facilitation of pain-transmitting pathways along with preserved but delayed inhibitory pain modulation. These findings point to central nervous system (CNS) involvement as the underlying mechanism of pain hypersensitivity in SOR. Based on the mutual central processing of both non-painful and painful sensory stimuli, we suggest shared mechanisms such as cortical hyper-excitation, an excitatory-inhibitory neuronal imbalance, and sensory modulation alterations. This is supported by novel findings indicating that SOR is a risk factor and comorbidity of chronic non-neuropathic pain disorders. This is the first review to summarize current empirical knowledge investigating SMD and pain, a sensory modality not yet part of the official SMD realm. We propose a neurophysiological mechanism-based model for the interrelation between pain and SMD. Embracing the pain domain could significantly contribute to the understanding of this condition’s pathogenesis and how it manifests in daily life, as well as suggesting the basis for future potential mechanism-based therapies.”
Read more here: Sensory Modulation Disorder (SMD) and Pain: A New Perspective
Many Occupational Therapists using a sensory integration approach in their clinical practice have worked productively and mindfully with children, adults and older adults with trauma. Our unique education and training facilitates our practice in a range of settings- schools, mental health settings and hospitals, where as a profession we are tasked to address barriers to participation in everyday life.
Occupational Therapists are uniquely placed to be able to offer not only cognitive behavioural and occupation based activities.
Neuroscience now provides us with the evidence to support our practice of Ayres’ Sensory Integration with our clients with trauma – confirming our understanding about how trauma impacts early and ongoing sensory and motor development, underlying physiology and levels of arousal and attention.
Now and into the future, we will need to further consider the evidence for how inter-generational trauma manifests in underlying neurobiological processes that underpin function – the sensory, motor and cognitive building blocks of participation in everyday life.
To read the full article please follow this link. https://www.aota.org/~/media/Corporate/Files/Publications/CE-Articles/CE-article-May-2019-Trauma.pdf
For a number of years, OT’s have been talking about the risks of loss of occupation, social connection and homelessness for their clients with Autism. We know once the structure, safety and services of childhood and school and sometimes higher education are gone, things can become tricky. And we know about Ayres’ Sensory Integration, can help minimise the impact of sensory differences on development and skills necessary for everyday life.
In 2015 a briefing for frontline staff on Autism and Homelessness suggested that 12% of people diagnosed with autism in Wales had experienced homelessness. while among rough-sleepers in Devon, 9/14 might be classified as being on the autistic spectrum.
“The profession of occupational therapy should now wholeheartedly embrace the opportunity to grow our profession’s reputation – addressing sensory difficulties that challenge our clients with autism and prevent them from full participation in the occupational activities they choose to engage in.” Smith @ ISIC 2018
“Sensory Integration sorts, orders and eventually puts all the sensory inputs together into whole brain function. What emerges from this process is increasingly complex behavior, the adaptive response and occupational engagement.”Ayres 1979
A recent research study from a randomised control trial (one of the best types of research there is) in the USA by Schaaf and colleagues; An Intervention for Sensory Difficulties in Children with Autism: A Randomized Trial has shown Ayres’ Sensory Integration* makes a big difference to some of the skills children need to develop to become increasingly independent from caregivers as they get older.
Young people in the study group scored significantly better after therapy with Ayres’ Sensory Integration than young people in the care as usual group. Goal Attainment Scales scores and scores about self-care and socialisation skills all showed that after Ayres’ Sensory Integration Therapy* there was a significant improvement not seen in those just getting care as usual.
*Ayres’ Sensory Integration Therapy is usually a postgraduate qualification, and it is recommended that practitioners have qualifications equivalent to ICEASI Level 2. Please ask your therapist about their level of education in Ayres’ Sensory Integration.
Executive function skills help us plan, focus attention, switch gears, and juggle multiple tasks—much like an air traffic control system at a busy airport.
This downloadable paper provides a great way of explaining executive function to teachers and parents, drawing on the latest neuroscience and research in early development. The air-traffic analogy makes is a great tool in the therapist tool box when education parents about the importance of early development, the environment in which we learn and develop and how to support and promote development, ultimately enhancing participation in all activities and occupations of daily life – you can download the free resource here: developingchild.harvard.edu/resources/building-the-brains-air-traffic-control-system-how-early-experiences-shape-the-development-of-executive-function/