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  • 11 Mar 2020 18:04 | SIE News (Administrator)

    Hand washing is crucial in reducing the risk of contracting the Coronavirus (CORVID-19) but many people with sensory difficulties can experience distress or struggle with the experience of hand washing. We’ve collated some advice for encouraging and improving hand washing.

    People with difficulties with sensory integration or sensory processing can experience aversion to the smells, images, sounds and the tactile sensations of hand washing; have problems with balance, tone or co-ordinating their hand movements; or not understand the step-by-step process of hand washing. The following suggestions should be tailored to specific sensory challenges or different abilities and age groups, as appropriate.

    Explaining the Process of Hand Washing

    Use an illustrated guide to the process of hand washing to explain each individual step and help the individual understand what to expect. The World Health Organisation has published this step-by step guide to cleaning hands to protect against infection but there are also simpler guides, or social stories, that may be more useful with younger children. There are many to choose from online (seach “washing hands social story”) or you can make your own. Some individuals may have difficulty transferring skills learned from home to other environments: in this case it may be helpful to have a specific social story for both scenarios.

    Washing for Long Enough

    The NHS has provided this hand washing sequence using photos and a video which suggests washing hands for as long as it takes to sing the Happy Birthday song twice. Or you could count, use a timer or another song.

    This Washy Washy Clean video demonstrates the correct technique accompanied by a song suitable for young children.

    Prompting Hand Washing

    You may need to prompt hand washing at all appropriate times, either verbally and/or by gesture (miming turning on a tap and rubbing hands together). It may help to have a handwashing poster or symbol on display by the sink. If required, you may need to physically help the individual to wash their hands. Remember to promptly give praise and acknowledgement each time.

    Tackling Sensory Issues With Soap

    Find out if the individual has a preference for liquid soap or bars of solid soap. Find out if a particular smell is preferred or if they prefer unscented soap. Some people find it easier to manage soap when it is inside a fabric pouch so they only touch the soap suds and not the soap itself. An automatic soap dispenser which doesn’t require you to pump the soap may be helpful. If you find a soap that is better tolerated, include it in your sensory kit when away from home.

    Water Temperature

    Assessing a safe water temperature may be difficult for some individuals and they will need assistance. Some people may find slightly warm water more tolerable than cold water.

    Sink Height, Balance and Taps

    Use a step to enable children to reach sinks easily. Consider using a chair or safe stool if they find it easier to sit down whilst washing their hands. You can fit handle extensions to some taps to make it easier to grasp and turn them.

    Drying Hands and Noisy Hand Dryers

    Some people can be very sensitive to the sound of electric hand dryers in echoing bathrooms. You could reassure the individual in advance that they don’t need to use the hand dryers, if this is the case, but emphasise the importance of still drying hands. Use paper towels instead (you may need to carry your own supply). When visiting public toilets to wash hands, you could try using ear plugs or ear defenders to limit the amount of distressing sounds.

    When drying hands, some individuals prefer a slow, deep pressure with the towel rather than a light touch.

    Antibacterial Hand Gel

    If soap and water are really not an option or available, then use antibacterial hand gel. You may need to demonstrate how to use this and assist. Again, you may need to investigate whether scented or unscented ones, gel or spray ones are preferred.

    Hand Lotion

    Some individuals are distracted by the tactile sensation after they have washed their hands: investigate if this is eased by using a preferred hand lotion immediately afterwards.

    Seek Specific Advice From Your Sensory Integration Trained Therapist

    If your child has an SI therapist or SI trained occupational therapist, ask their advice on how to accommodate your child’s specific sensory needs when hand washing.

  • 01 Mar 2020 18:40 | SIE Support (Administrator)

    SIE Newsletter 1 March 2020: Mental Health 


    This issue, we are focusing on mental health and sensory integration, including research into the comorbidity of mental health problems and sensory integration difficulties; first person accounts of experiencing anxiety and SI difficulties; and advice for parents, caregivers and therapists. 

    As a secondary topic, we're also looking at how to enable children with sensory sensitivities to properly care for their teeth and to improve the experience of having a dental check-up for these children.

    This month, there are a few dates that you might want to incorporate into your own client communications:

    • World Hearing Day , 3 March: the World Health Organisation will highlight that timely and effective interventions can ensure that people with hearing loss are able to achieve their full potential.
    • Neurodiversity Celebration Week 2020, 16-20 March:  a call for schools to acknowledge and celebrate the strengths of their SEN pupils.
    • Brain Awareness Week, 16-22 March:  a global campaign to foster public enthusiasm and support for brain science. Every March, partners host imaginative activities in their communities that share the wonders of the brain and the impact brain science has on our everyday lives.
    • Swallowing Awareness Day 2020, 18 March:  RCSLT's  campaign to highlight how dysphagia affects people’s lives, and how speech and language therapy transforms the experiences of those living with the condition.
    • World Down Syndrome Day 2020, 21 March:  this year's theme is "We Decide",  and the campaign calls for all people with Down syndrome to have full participation in decision making about matters relating to or affecting their lives.
    • World Autism Week, 30 March - 5 April:  spreading awareness and increased acceptance of people living with ASD. There are lots of free resources on their website.

    Best wishes

    EmphaSIze Team

    Read the free Emphasize newsletter here.

  • 27 Feb 2020 20:32 | SIE Support (Administrator)

    Linking Neuroscience, Function, and Intervention: A Scoping Review of Sensory Processing and Mental Illness

    This research article explores the correlation between sensory processing and mental illness. The researchers charted the available literature on the subject and detected gaps in the current knowledge base. Results indicated that there is an evolving area of research using MRIs and electroencephalography that demonstrates a relationship between atypical neurosensory activity and mental illness. The research concludes that further research is needed to identify the efficacy of sensory processing approaches with adults with mental illness.

    Schizophrenia Spectrum Disorders: Linking Motor and Process Skills, Sensory Patterns, and Psychiatric Symptoms

    In this study, researchers found significant relationships between sensory processing differences, skill deficits, and psychiatric symptoms in adults with Schizophrenia Spectrum Disorder. They hypothesize that these differences and deficits contribute to decreased occupational functioning and performance observed with this population.

    Sensory Processing and Intolerance in OCD

    This chapter, in Obsessive-compulsive Disorder: Phenomenology, Pathophysiology, and Treatment,  reviews evidence documenting increased sensitivity to external sensory stimuli (auditory, olfactory, tactile) and reduced sensory gating in patients with OCD. In some individuals such sensitivity can present as a primary symptom.

    A Path From Childhood Sensory Processing Disorder to Anxiety Disorders: The Mediating Role of Emotion Dysregulation and Adult Sensory Processing Disorder Symptoms

    This research article investigated the link between childhood sensory processing Disorder symptoms with an elevated likelihood of an anxiety disorder diagnosis in adulthood. The results demonstrated that individuals whom self-reported childhood SPD symptoms were significantly linked with a higher probability of a lifetime anxiety disorder diagnosis. The results also indicated that these anxiety disorders in adults may occur as a result of difficulties with emotional regulation due to life-long sensory processing difficulties.

    The Relationship Between Sensory Reactivity Differences and Anxiety Subtypes in Autistic Children

    This new research study examined the correlational relationship between sensory reactivity differences and anxiety subtypes in 41 autistic children aged between 3 and 14 years, using parent‐ and self‐reported measures. The authors found positive correlations between sensory hyperreactivity and total anxiety, separation anxiety and physical injury fears. However, when controlling for autism traits, they found sensory hyperreactivity to be related to physical injury fears and specific phobia, and sensory hyporeactivity to be related to lower total and social anxiety. The results indicate that sensory hyperreactivity and hyporeactivity might be implicated in specific anxiety symptomology.

    Association of Sensory Sensitivities and Toothbrushing Cooperation in Autism Spectrum Disorder

    This new research study compared tooth brushing cooperation at home and in a dental office between sensory over‐responsivity (SOR) and sensory not over-responsivity (SNOR) children with ASD. A cross-sectional observational study was conducted with 51 children with ASD aged 4 to 17 years. It was found that SNOR subjects had significantly higher scores in tooth brushing cooperation at home and in the dental office than did SOR subjects. The researchers found that oral sensitivity was significantly associated with tooth brushing cooperation at home, whereas oral, light, sound, and touch (face) sensitivities were significantly correlated with tooth brushing cooperation in the dental office. In conclusion, SOR subjects showed less tooth brushing cooperation than SNOR subjects both at home and in the dental office.

    Relationship Between Screen‐time and Hand Function, Play and Sensory Processing in Children Without Disabilities Aged 4–7 years: An Exploratory Study

    This new study explored the association between children's screen‐time, fine motor, in‐hand manipulation, visual‐motor integration, sensory processing and parent‐reported play skills in children without disabilities aged 4–7 years. An increase in screen‐time was associated with decreased visual motor integration, in-hand manipulation, bilateral coordination, sensory processing, enjoyment of play and engagement in more complex play, such as creating stories. Playing with toys and using object substitution in play (e.g., a child uses an object for something else other than its intended use when playing with it) potentially appear to be a moderating factor of the impact of children's screen‐time on their bilateral coordination and visual‐motor integration skills. Clinicians can encourage children's active and dynamic involvement in games and play pursuits to counteract the potential impact of increased use of devices that involve screen‐time.

  • 24 Feb 2020 14:33 | SIE News (Administrator)

    A: You’re asking the right question! Helping your dentist to understand your child’s specific sensory needs should enable the clinic to make any accommodations necessary to improve the experience for your child.

    We’d recommend calling your child’s dentist, well in advance of your child’s check up, and asking to discuss how your child might react, suggesting what might help, or even organising a ‘practise visit’ where your child simply visits the clinic and is shown around to familiarise themselves with the rooms, equipment, lighting, noise, smells etc.

    You could also forward your dentist this informative article from the US-based Star Institute (written by Heather Miller-Kuhaneck, MS OTR/L BCP) to brief them on sensory defensiveness during dental visits. 

    The article describes how a sensory defensive child may react during a dental check up; eg, pulling away from or over-reacting to unanticipated touch; difficulty tolerating the overhead light; fear responses to the equipment, noises, scents and textures; over-reactive gag responses, etc.

    The article also suggests ways the parent and dentist can reduce sensitivity during the check-up: for example, by verbally telling the child what is about to happen before any action is taken; allowing the child to wear the X-ray vest during the entire appointment to provide extra weight and deep pressure; encouraging the child to brush their teeth using an electric toothbrush prior to the appointment to provide oral motor and proprioceptive input around their mouth, lips and jaw; letting the child wear their own sunglasses to reduce glare from the lights; asking all dental staff to use firm, not light tickly, touch when touching the child’s face, etc.

    You could also forward your dentist the link to this video, (also on the Star Institute website) in which Rachel S. Schneider, M.A. MHC, a mental health counselor and adult with SPD, talks about the experience of going to the dentist when you have sensory processing difficulties and the strategies that worked for her. 

  • 06 Feb 2020 12:05 | SIE News (Administrator)

    It’s a new decade and you have a new goal - to become an Advanced Practitioner in Sensory Integration! The following could be your new reality…

    • in a catch-up meeting with a colleague you confidently share a new piece of research on sensory integration, highlighting its applicability to a client but also an aspect that would need taking into account in this specific case.
    • during a session with a new client, you recognise a gap in their multidisciplinary team care plan which, if filled, would promote their ability to engage in your treatment and facilitate their independence. You’re able to argue for this additional resource, backing your case with a range of evidence.
    • you are invited to lead on a service improvement project that you’ve been keen to contribute to for ages.
    • you are asked to be an expert witness in a tribunal case.

    Becoming an Advanced Practitioner in Sensory Integration is more than ‘learning more about SI’: it’s about transforming your professional life by advancing your clinical skills within your particular setting and clinical population; enabling you to discerningly use and apply research in your day-to-day work life; and developing the confidence and ability to bring about positive change within your service. And it’s the integration of these skills that creates the Advanced Practitioner. Are you ready for the challenge?

    If you’ve already achieved SI Practitioner status by completing SI Module 3 on our practitioner pathway, then you are eligible to embark on the UK-university accredited SI Module 4: Advanced Practice. For 2020, we’ve completely rewritten this module using the NHS’s advanced clinical practice definition as our starting point:

    “It is a level of practice characterised by a high degree of autonomy and complex decision making. This is underpinned by a master’s level award or equivalent that encompasses the four pillars of clinical practice, leadership and management, education and research, with demonstration of core capabilities and area specific clinical competence. Advanced clinical practice embodies the ability to manage clinical care in partnership with individuals, families and carers. It includes the analysis and synthesis of complex problems across a range of settings, enabling innovative solutions to enhance people’s experience and improve outcomes.”

    Your learning will be focused on:

    • Clinical practice
    • Clinical application of research
    • Clinical service development

    We recognise that therapists work in a wide range of settings and diverse populations and we’ve ensured the course content and assessment is appropriate for a variety of paediatric and adult clinical populations .

    Course content (around 30 hours) is delivered online via videos from international experts, videos from SIE Advanced Practitioners, animated presentations, case study vignettes, quizzes to check your learning, and independent study tasks. There are three clinically focused assessment pieces to complete. Our Advanced Practitioner Module e-Mentors will support you throughout and you can share questions and insights with your peers in your cohort’s forum. You’ll have access to the university’s library resources and student support facilities. You can also access downloadable transcripts of the course for offline study.

    In order to continue to advance your ability to relate the theory to practice and embed your learning in real life clinical practice, you will undertake 20 hours of clinical practice supported by a Clinical Mentor. You will need to have access to at least one client who would benefit from an Ayres’ Sensory Integration approach to intervention and for whom you can offer key aspects of SI management. If you can’t access a Clinical Mentor within your workplace, we have a register of AP Clinical Mentors whom you can book.

    Successful completion of SI Module 4 conveys 20 academic credits and Advanced SI Practitioner status. You will be listed as an AP in the Association of Sensory Integration Practitioners’ Register.

    The next cohort starts in March, so you’ve just got time to book before the 23 February 2020 deadline. Find out more now and you could qualify as an Advanced Practitioner this year. Now, imagine how that would feel.

  • 04 Feb 2020 12:42 | SIE News (Administrator)

    We’re delighted to bring you this post from Emily of the 21andsensory blog. A UK-based graphic designer, Emily is in her twenties, has a diagnosis of autism and sensory processing disorder and publishes posts and podcasts on ‘daily living as a sensory-being’. Here, Emily discusses her experience of masking:

    “So what actually is masking? Masking involves trying to hide being autistic so others will accept us. It’s also referred to as camouflaging. This means we act in ways that other people will think we are ‘normal’ and to try and be accepted socially. My doodle includes a few examples of trying to mask.

    “Over the course of my life I feel I have perfected the art of masking (which isn’t necessarily a good thing). I am extremely good at with-holding my feelings and emotions, bottling them up until I get home. I would cry when I had to go to primary school each morning. Then speed forward a bit in time and I’d come home from secondary school each day very tearful. I even used to cry up in the SENCOs (special needs support) room at break and lunch times because secondary school is quite literally THE most overwhelming place I have ever had to cope in . But slowly through sixth form and university I began to build up a resilience to the world and although I still get overwhelmed I can always come home, have a bit of a sensory meltdown (and a good cry) then move on with things.

    “Socialising will always be hard for me and I think I will always cope with the world like this. But that’s okay. I have to actively remind myself that ‘normal’ isn’t real. And I think you should too. Masking is an autistic and sensory way of coping with the everyday and just trying to get by. Now that is brave. To go out in the world and just exist is a huge thing.”

    You can follow Emily on social media: @21andsensory

  • 30 Jan 2020 13:48 | SIE Support (Administrator)

    The latest issue of SensorNet is now available to download for members.

    This edition includes:

    • The SI Education Autumn Conference.  We bring all the action to you: reflections, interviews and photos.
    • The Big Interview: Featuring Dr. Shelly Lane and Dr. Anita Bundy
    • International Sensory Integration Congress 2019. We have four of the presenters from the congress contributing to this edition.
    • Practice based Feature Interview: Greek Occupational Therapist, Maria Protopapadaki, discusses sensory integration intervention on a green care farm.
    • SIE Modular Pathway: SI Module 4 launches online.
    • SIE students.  We honour the achievements of our students and hear from Hannah Garry, who reflects on completing SI Module 3.
    • Research updates. References and abstracts for recent articles related to sensory processing and neuroscience

    Remember that the easy click-on links in the magazine will put you directly in touch with the editorial team and we welcome feedback and ideas for future editions. Thank you to all our contributors for this edition.

    Kind regards,

    Gina Daly

    SensorNet Editor

  • 30 Jan 2020 13:29 | SIE Support (Administrator)

    We have received the following information about a research questionnaire from Reading University School of Psychology & Clinical Language Sciences.

    We are currently looking for parents of children with sensory processing or sensory integration difficulties and therapists to take part in an online study “Parents of children with sensory integration difficulties: what helps?” which takes around 15 minutes to complete. If you are a parent or therapist of a child with sensory integration or processing difficulties, live in the UK or Ireland and are willing to complete a survey please click on the following links:

    For parents: https://reading.onlinesurveys.ac.uk/parents-of-children-with-sensory-integration-difficulties

    For therapists: https://reading.onlinesurveys.ac.uk/therapist-experience-parents-of-children-with-sensory-int

    Please feel free to forward the link to anyone who might be interested. If you have any questions, please contact s.c.f.allen@pgr.reading.ac.uk.

    This study has received ethical approval by the PCLS School Ethics Research Committee, University of Reading, project 2019-191-FK, end date 01-01-21.

  • 28 Jan 2020 13:26 | SIE News (Administrator)

    You don’t grow out of sensory difficulties: children with sensory integration or processing difficulties grow into teens and adults with those same issues but, hopefully, plenty of tools to handle them. The teenage years can be a tricky time for individuals with sensory difficulties as they experience all the hormonal chaos of puberty on top of their sensory challenges. This can hamper their ability to self-regulate and make handling all the transitions at this time (different classes, teachers, social situations, bodily changes, etc) hard. You’re quite right to identify that your child will need support during these years.

    Individuals with sensory processing difficulties can experience emotions more intensely so it’s important to help them recognise and validate their feelings and employ appropriate calming strategies. Alice Boyes, PhD, writes that there are ten skills of emotional self-regulation that we need to learn before adulthood:

    1. Identifying which specific emotions you’re feeling.
    2. Identifying which specific emotions someone else is feeling.
    3. The ability to start and persist in pursuing goals even when you feel anxious.
    4. The ability to tolerate awkwardness.
    5. The ability to have intimate conversations rather than stonewall, avoid, or flee.
    6. The ability not to crumble when someone is pressuring you.
    7. The ability to soothe your own emotions.
    8. The ability to soothe other people’s emotions.
    9. The ability to delay gratification.
    10. Understanding how to manage your positive emotions.

    It might help to consider which of these areas your teen needs help with and to acknowledge areas they are already good at.

    Here are some ways that parents can support their teenagers to develop their emotional and self-regulation skills:

    Be a self-regulation role model

    Can you model good emotional self-regulation and discuss with your teen what strategies you find helpful when feeling strong emotions? Also, just as when your child felt overwhelmed as a toddler and needed a safe, calm adult presence, your teen still needs an adult in their life who can respond appropriately and calmly.

    Create emotionally expressive environments at home and school

    Writer Linda Stade describes these as “spaces and places for kids where they feel free to say how they feel without fear of being ‘shut down’. There is a limit on behaviour but there is not a limit on emotion.” It’s easier to talk to your teen about emotional regulation and strategies when they are calm, not in the middle of a meltdown.

    Seek a sensory integration evaluation by a trained professional

    Teens may develop different sensory preferences and may need different sensory activities presented to them. The best way to find out how to support your teen's sensory needs is to seek an evaluation by a Sensory Integration Practitioner who can make recommendations specific to your teen and circumstances.

    Allow your teen to make choices

    Your teen will be well aware of what type of clothes, food, sounds, smells or activities soothe them and which distract them to the point of having to focus so much on tolerating them that they have no reserves left to cope with anything else. It’s easier to respect and work with these preferences rather than trying to fight them.

    Find self-regulation strategies that work for your teen

    These could include incorporating sensory activities (appropriate to your teen’s sensory needs) into the daily schedule; employing mindfulness exercises; encouraging healthy eating and sleep patterns; learning how to recognise and gauge the intensity of emotions; discussing scenarios and how one might best react; or learning cognitive reframing techniques (reinterpreting a situation in order to change your emotional response to it).

    A Sensory Integration Practitioner can help you refine a toolkit of strategies for your teen to help themselves to manage their emotions and responses.

    Help your teen build social awareness skills and learn that even positive emotions need to be regulated

    Explain to your teen that their emotional behaviours impact on how other individuals behave and feel towards them. For example, talking over others, not respecting personal space and being over excited can be off-putting to friends.

    Be aware of your teen’s mental health

    Learn the indicators of anxiety or depression in your teen, and make time to discuss with them what that might feel and look like so they can self-report it to you too. Seek help from mental health professionals as appropriate.

    Celebrate the strengths

    Teenagers with sensory processing difficulties may be more aware than when they were younger of how their sensory difficulties make them different than their peers. Support them to find and be proud of the strengths of their different sensory experiences and unique perspectives.

    The Out-Of-Sync Child Grows Up: Coping with Sensory Processing Disorder in the Adolescent and Young Adult Years by Carol Stock Kranowitz is a fantastic resource. It offers practical advice on living with sensory processing difficulties as well as covering the social and emotional issues that young people face. Topics include strategies for coping with the sensory aspects of grooming, social lives and dating, playing sports and music, and other issues, as well as how to find support and help from loved ones, occupational therapy, and other resources.

    Finally, it may help your teen to read first-person accounts from other young adults with sensory processing difficulties:

    “Sometimes we need things done a little differently because we can get overwhelmed, but if our needs are met we can be very successful. Do not think of people with sensory processing disorder as less than, because we are not. We can thrive just like everyone else. Sometimes we just need a little extra patience and help” - Alexzandra Benefield Puckett, What It's Like Having Sensory Processing Disorder as a Teen.

  • 24 Jan 2020 13:53 | SIE News (Administrator)

    Consider your situation, right now, as you are reading this article. Say your goal is to get to the end of the article. This goal requires you to focus your attention: you may have reduced external distractions; you will need to manage any emotional or physiological intrusions that could interfere with your attention; and you will need to stay alert - so you may be sipping a drink or shifting in your chair.

    During these few moments, your central nervous system has been registering, integrating and processing a huge amount of complex information from your external and internal environment. The process is both “top-down”, as you consciously ready yourself to focus on the article, but also ‘bottom-up”, as various structures in your brainstem and limbic system monitor and respond to demands in your environment. Your body is doing an awful lot for you to self-regulate enough to simply sit still and read to the end of this article!


    But what do we mean by self-regulation? For our purposes, we mean the way in which we regulate our emotions, our levels of arousal, stress levels and levels of attention so that we can carry out the things we need and want to do in our daily life. Self-regulation occurs within our central nervous system and it includes both our ability to to consciously and automatically regulate our emotions, stress response, alertness and attention. It’s the conscious element of self-regulation which means we can learn strategies to improve focus, or help to keep us calm or alert.

    Sensory Integration

    What is the link between self-regulation and sensory integration? Firstly, a little about sensory integration. Sensory integration is a theory and a therapeutic approach originally proposed by Dr Jean Ayres. Sensory integration theory draws on evidence related to how the brain works and how neurons in the brain can develop new pathways and strengthen pathways through learning and repetition.

    The different parts of our body that receive sensory information from our environment (such as our skin, eyes and ears) send this information up to our brain. Our brain interprets the information it receives, compares it to other information coming in as well as to information stored in our memory and then the brain integrates and uses all of this information to help us respond to our environment. Therefore, sensory integration is important in all the things that we need to do (such as getting dressed, eating, socialising, learning and working).

    For most of us, the development of sensory integration occurs when we are young as part of our normal development and in the things we do such as rolling, crawling, walking and in play; for others sensory integration is less well developed – and this can lead to difficulties.

    Link Between Self-Regulation and Sensory Integration

    The association between sensory integration difficulties and self-regulation has long been of interest to SI therapists. And many parents of children with sensory integration, or sensory processing, difficulties express concerns about their child’s abilities to manage their emotions. A study by Cohn and colleagues (2014) found that 72 percent of parents whose children were referred to sensory integration therapy reported concerns for, or hopes of improvement in, their child’s self-regulation ability.

    Ayres identified that successful development of sensory integration underpins emotional stability, attention span and activity levels.

    Because tactile, vestibular and proprioceptive systems support the child’s ability to engage with their environment, Ayres argued that these systems also support development of emotional stability because being unable to properly engage with the environment would be a frustrating, overwhelming or disengaging experience. The auditory and visual systems are also important: if a child’s auditory or visual threshold is too low, they are more likely to focus on these sensations and find it difficult to pay attention and focus on other stimuli, impacting on their ability to focus and engage with the social world.

    Sometimes, our level of arousal can be very high:for example, when we are feeling worried, angry, stressed or excited. Other times, our level of arousal is too low, such as when we are feeling sad or tired. When our level of arousal is too high or low this can impact on our ability to do daily tasks. We need our level of arousal to be just right for that activity, whether it is reading, playing a game of tennis or winding down for bed.

    Sensory integration difficulties can lead to increased sympathetic nervous system arousal and a heightened stress (fight-or-flight) response.

    Think about a person who is under-responsive to sound or even a situation where you are so focused on what you are doing that you are not aware of sounds around you. Someone calls your name but you don’t notice. By the time the call has got your attention, they are so close and loud that it startles you, triggering a fight-or-flight response in your sympathetic nervous system.

    On the other hand, if a person’s central nervous system struggles to inhibit sensory information, such as sound, they would experience those senses more intensely than other incoming information. Situations that others would find non-threatening, would be for that individual very stressful. Think about a person who is over-responsive to sound or times when you are more alert to a sound, such as when you are convinced there is someone outside your home. Every sound then would alert your sympathetic nervous system.

    Research has shown that sensory over-reactivity and anxiety are found to occur together. And we understand that sensory reactivity can lead to a fight-or-flight response. This heightened activity of the sympathetic nervous system can make it more difficult for a person to regulate their stress response.

    It is also important to note that a person who has needed to manage difficulties related to sensory integration all day, will have been in a constant state of fight-or-flight, and will have depleted resources by the end of the day. For example, an adult who has had to try to focus at work with auditory over-reactivity or the child with low postural tone who has had to sit still all day, will come home tired with their reserves run low. That child, struggling to self-regulate at home after school, could react by charging around the house, being over emotional and quick to react or be unwilling to do anything: they can’t modulate their responses any longer after having held it together at school all day.

    How Can SI Therapy Help?

    A qualified sensory integration practitioner can assess an individual’s needs and abilities and make recommendations for specific exercises and activities, as well as adjustments to their home/school/work environment, that can help support their self-regulation.

    A qualified sensory integration practitioner will have gained additional in-depth postgraduate training following their initial qualification to become a therapist. This training involves developing a detailed understanding of the neuroscience and evidence base underpinning sensory integration, as well as developing expertise in assessing and providing intervention for people with sensory integration difficulties.

    Want to learn more?

    If you are a qualified occupational therapist, physiotherapist or speech and language therapist and are interested in learning more about sensory integration theory and SI therapy, see our online, UK university-accredited modular SI practitioner pathway. Our Introduction to Sensory Integration Difficulties course is a good starting place.

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