A: Children with sensory issues often need extra help to learn to ride a bike as it involves quickly planning and carrying out movements on an unstable bike. There could be several reasons your daughter is finding cycling challenging: she may experience gravitational insecurity, poor balance, or may have motor co-ordination difficulties associated with sensory integration difficulties. A qualified sensory integration therapist would be able assess and explore with you exactly what is contributing to your daughter’s difficulties and what to work on.

Other simple ways you can help are:

• Introduce a simpler piece of equipment such as a balance bike or a 3-wheeled scooter. These are more stable so she will feel more grounded but will still practice the necessary bilateral movements which will help her when she is ready to move onto something less stable.
• Encourage her to try equipment in playgrounds where her feet come off the ground, eg, swings, zip lines, fireman’s pole, monkey bars, etc. If you can, model feeling nervous and giving it a try yourself so she can see what to do. You can also grade the activity, eg, cross just one monkey bar or go halfway on the zip line first, to ensure she gets a sense of achievement and she’s motivated to have another go.
• When she’s ready to try the bike again, make any adjustments relevant to her needs, eg, replace the saddle with a bigger one that is more padded or covered in a different textured material. Until she’s more confident, reduce the height of the seat so her feet can be flat on the ground when standing.
• Try breaking down the skill of cycling into steps. You could initially remove the pedals and use it as a balance bike while she gets used to the sensation of balancing. Then get her to use the brakes to slow and stop the bike before putting her feet down. Then introduce steering. When you reintroduce the pedals, get her to put her feet on them whilst you push the bike so she can get used the movements and sensations.
• Focus on and celebrate all the small achievements she makes, eg, “Wow, you went really fast on you scooter today!”, so she can build up her confidence. When you feel she is ready for something a little more challenging involve her in discussing it and deciding what to try next.
• Be patient and don’t pressure her: there’s no rush.

Good luck!

Have you got an SI question for us related to ADHD? Drop us an email and your question could feature in the next edition of EmphaSIze.

Physiotherapist at a not-for-profit physio-led organisation promoting good physical and mental health

“Hello, I'm Colette, a physiotherapist living in Manchester, UK.

Prevention has always been important to me, and a number of years ago I set up a charity to encourage people in my community to be more physically active for better physical and mental health. I soon realised that many of the children in the schools I was working with found being physically active a challenge because of sensory difficulties and that, to support them, I needed to expand my learning and skills. I began studying SI Module 1 but didn’t really plan on taking my learning any further. Once I started, though, I couldn’t wait to learn more.

It was a completely new way of looking at things, that made my head hurt a lot (and still does!) but transformed my thinking and practice. I’ve just recently finished SI Module 3 and I’m really excited to begin my journey as an ASI practitioner. I’m learning so much that impacts my work every day.

My original goal around prevention has taken a different turn, but I feel that I’m working so much more effectively now. Of course, being physically active is still a huge part of my work, but I have a much broader view of what it is I’m working to prevent. We run a programme with 2-5-year-olds and their families (in local schools and Sure Start centres) where we play games and talk about how movement supports the children’s development. Working from an SI perspective has added to these sessions, making them more meaningful to the children and their families.

We’ve also recently been awarded a grant to work with families during the first 1,001 days of a child’s life. I’m really excited to be able to incorporate my SI knowledge to support families during this precious time and begin prevention at the earliest possible point. I still feel like I’ve got so much to learn and so I’m looking forward to continuing my learning journey with SI Module 4 next year."

Somatodyspraxia is when a person has problems with praxis AND problems with processing input from the tactile and proprioceptive senses… but what does this mean?

Let’s look at some definitions first.

Praxis is how our brain plans for and carries out movements or activities that are new to us or that we have not done before.

Tactile sensation refers to our sense of touch, specifically the information received from varying pressure or vibration against our skin.

Proprioception is our ability to sense the orientation of our body in the environment. Our muscles and joints have tiny proprioceptive sensory receptors that tell our brain where our body parts are. Your brain then uses this information to plan movements so that you can coordinate your body.

Dyspraxia or motor planning problems are terms used when an individual has praxis problems. Dyspraxia can make movements appear awkward or clumsy.

Dr Jean Ayres, who developed the theory of sensory integration, identified two types of praxis difficulties associated with underlying sensory issues:

• somatodyspraxia; and
• visuodyspraxia (problem with praxis and visual processing).

So, according to Ayres, the term somatodyspraxia describes dyspraxia (difficulties with conceptualising, planning and executing motor actions) that is associated with poor tactile (touch) and proprioceptive (body position awareness) perception and discrimination.

Individuals with somatodyspraxia have decreased body awareness and ability to grade their force appropriately on an object. They may struggle with new (as opposed to habitual) motor tasks but, once learnt, they can perform these tasks with adequate skill. Transitioning from one position to another, or performing a sequence of actions, can be very challenging. Some children with somatodyspraxia can also have problems with oral praxis, which can affect speech and eating.

Somatodyspraxia can impact on the accuracy of a person’s performance and their confidence to perform everyday activities such as dressing, eating, using cutlery, handwriting, typing, playing with toys, ball games, riding a scooter or bike.

Check out the ‘Praxis Problems’ section on pages 349-350 of Occupational Therapy for Children for more information.

This recently published scoping review in the American Journal of Occupational Therapy also gives an excellent overview of somatosensory functioning, its role in child development and its prevalence in the ASD population.

For many people, small adjustments to their environment or the way they are allowed to move at work or school can make a huge difference to how they manage their day-to-day life. Assessment and treatment of sensory integration difficulties should only be carried out by a qualified therapist. Ayres' Sensory Integration intervention (ASI) is a term used to describe intervention developed by Ayres to improve or develop sensory integration for children and adults with sensory integration difficulties. Therapists need specific training to understand the complex reasoning underpinning this therapy.

Visuodyspraxia is when a person has problems with praxis and visual processing.... but what does that mean?

Visual processing refers to the brain's ability to use and interpret visual information from the world around us.

Praxis is how our brain plans for and carries out movements or activities that are new to us or that we have not done before. For children, this could be learning to jump or ride a bike; for adults, this could be learning to drive or use chopsticks. 

Dyspraxia or motor planning problems are terms used when an individual has praxis problems. Dyspraxia can make movements appear awkward or clumsy.

Dr Jean Ayres, who developed the theory of sensory integration, identified two types of praxis difficulties associated with underlying sensory issues:

• somatodyspraxia; and
• visuodyspraxia.

Visuodyspraxia, (verified in studies as recently as 2014),  describes when difficulties with visual perception and discrimination impact on a person’s ability to to plan and organise what to do and when to do it.

People with visuodyspraxia can have difficulty with eye-hand movements, such as ball games; difficulty with positioning self in relation to objects, such as steps or chairs; and difficulty with calculating the speed of their movements relative to other moving objects, eg, other people, balls during a ball game, etc.

Chapter 6 of Frames of Reference for Pediatric Occupational Therapy is a good resource to find out more information, especially table 4 (pages 111-112) which lists the functions of the visual system as well as indications of dysfunctions.

For many people, small adjustments to their environment or the way they are allowed to move at work or school can make a huge difference to how they manage their day-to-day life.  Assessment and treatment of sensory integration difficulties should only be carried out by a qualified therapist.  Ayres' Sensory Integration intervention (ASI) is a term used to describe intervention developed by Ayres to improve or develop sensory integration for children and adults with sensory integration difficulties. Therapists need specific training to understand the complex reasoning underpinning this therapy.

EmphaSIze Newsletter September 2019: SI Therapy in Non-Clinical Settings

Hello {Contact_First_Name}

Over the past few weeks, we've been looking at how sensory integration therapy is delivered outside of a clinical setting, and also environments where sensory integration difficulties can cause challenges... along with some solutions. Here's a round up of our most popular articles, blogs, links and research studies.

Looking ahead to later in September, you might want to participate in two awareness-raising events: World Physiotherapy Day is on 8 September, and from 15 to 21 September, it's Balance Awareness Week 2019.

Best wishes

EmphaSIze Team

PS. A reminder that the latest SIE SensorNet magazine is out now.

If you prefer to read EmphaSIze in your browser, click here. (No need to log in.)

  SI News  

Attending university with sensory integration difficulties

Changes employers can make to accommodate staff with sensory integration difficulties

Have you heard about the Hidden Disabilities Sunflower scheme?

Sensory Integration Education Autumn Conference 2019

Are you part of the SI conversation?

Could you be our next Meet a Member?

Sensory Integration and Balance

Autism Hour: can you get more businesses on board?

  Journals  

Sensory Modulation for People with Anxiety in a Community Mental Health Setting

Effects of Sensory Processing Patterns on Social Skills and Problem Behaviors

The Effects of Sensory Diets on Children’s Classroom Behaviors

Occupational Therapy for Children and Youth Using Sensory Integration Theory and Methods in School-Based Practice

Q: How can I make the transition from one season to the next more bearable for my child?

  International Events  

ISIC 2019: 12 - 13 October 2019, Hong Kong
ISIC 2020: 15 - 18 July 2020, California, USA

  Courses  

Applying SI Therapy Principles with Older Adults

Date: 9am to 5pm, 16 Sep 2019

Venue: London

Participants: Open to all

Fee: £189.05 Early Bird

Postgraduate Certificate in SI

This is your core qualification if you wish to practise as a sensory integration practitioner. After successfully passing all three of the constituent modules, you will gain:

• Knowledge and skills which cohere with those identified at practitioner level in the proposed ICEASI framework
• SIE SI Practitioner status, and a Postgraduate Certificate in Sensory Integration accredited by the UK’s Ulster University.

Total fee: £2699. 12-month interest-free payment plans available.

  Books  

Sensory Like You

The Out of Sync Child Has Fun

Arnie and His School Tools: Simple Sensory Solutions That Build Success

  Resources  

Park Swings: 4 Ways To Use Them Therapeutically

SPD explained and simplified

How to explain sensory processing issues to friends and family

How to create a sensory story

  Apps  

Noisli

Breathe, Think, Do with Sesame Street

  Products  

Splash Swim Goggles

Colour Changing Light Up Shower Head

Coogam Stretchy String Sensory Toys

  Jobs  

Looking for a career change? See our latest Job listings.
Are you looking to recruit an SI professional? Post your vacancy from only £169.

  Share Your News  

PS. Do you have a great piece of news that you’d like to share? Or an app, product, book or article that you’ve been impressed with? Let us know by email at support@sensoryintegration.org.uk.

www.sensoryintegrationeducation.com

Old Breedon School, 8 Reading Road, Pangbourne, RG8 7LY, United Kingdom
SI Network (UK and Ireland) Ltd trading as Sensory Integration Education
Company registration no: 05068304

A: Changes in season mean a change in clothing, daylight hours, temperature, routines, etc, which can be challenging for individuals with difficulties with sensory integration or sensory processing, and co-existing diagnoses such as Autism Spectrum Disorder. Here are some strategies for helping your child manage these changes:

Strategies for changing times and routines due to changes in daylight hours

• Gradually segue into the new time by, for example, making bedtime 15 minutes earlier for a few weeks.
• Share a social story (factual, pictorial step-by-step walk through) with your child about the change in time or daylight hours.
• Create a positive bedtime routine, introducing powering down of electronics an hour before bed and creating a calm, restful environment.
• Use a visual schedule to remind and reassure your child of the bedtime routine elements
• Provide tactile input to support calming in the form of favourite teddy, blanket, pillow, etc.
• Recognise that tired individuals may appear hyperactive and silly and may even get a second-wind after being tired. Allow extra time to wind down.

Changing clothing to match weather change:

Changing clothing type and weight to suit the new season can be distressing for some children, particularly if they are significantly sensitive to touch/tactile input.

• Listen to and respect your child’s preferences on fabric types, no seams or tags, etc.
• Help prepare sensitive skin for heavier clothing on arms and legs which have been bare during the warmer months. Strategies could include body brushing, lotions, and massaging the arms and legs.
• Think about how to make the change in the type of clothing in small steps, for example, offer a soft warm sweatshirt in addition to a t-shirt rather than moving immediately to a single heavier-weight top. Or move from shorts to soft tracksuit bottoms (sweatpants) if possible, rather than direct to long trousers made from stiffer fabric.
• Introduce more weather-proof shoes in short spurts rather than an immediate transition.
• Reduce stress in the morning by agreeing an outfit the night before.
• Changes in clothing type can also present challenges in dressing for children with difficulties with fine motor skills and praxis. Practise these skills and make accommodations where appropriate, for example, poppers instead of buttons, velcro instead of laces, loose clothing that can easily be slipped on and off, etc.

You can find more detailed advice in this article by OT, Kristi Jordan (OTR), at the Indiana Resource Centre for Autism. 

Also, this is a very enlightening blog from an adult with ASD on their experience of coping with the changing seasons and temperatures which might help you understand your child’s experience.

Have you got an SI question for us related to balance? Drop us an email and your question could feature in the October edition of EmphaSIze.

Embarking on a university (college) course is an exciting but challenging time, and more so for a student with sensory integration (sensory processing) difficulties. We’ve looked at some of the advice available for young adults preparing for university life this autumn.

The team at Understood offer six challenges and potential solutions in this article. They suggest these ideas for new students and their parents:

• Carefully consider accommodation options and ask the university (or landlord) if single rooms are available, if quieter blocks are an option, if the student can bring their own familiar furniture from home, etc.
• Familiarise yourself with what the new routine at university will entail. New routines means getting used to a new space, which can be difficult for young adults with proprioceptive issues. Talking about worries and the new daily routine can help to reduce anxiety - as well as planning how to include daily sensory diet activities.
• For young adults with food aversions or preferences, as well as difficulties in coping with bright, noisy crowded spaces, the university cafeteria or dining hall can be overwhelming. Understood suggest talking over dining options and investigating where else on campus you can eat and finding out when these venues are least busy. You could also keep a mini-fridge within your room to keep a stash of favourite foods handy.
• Speak with your institution’s disability office about accommodations that can be made regarding lecture halls and seminar rooms, for example, you may be able to wear sunglasses, earplugs or headphones in class, sit near an exit or the rear, sit in the same place every time, use fidget toys etc. Understood also suggest explaining to your lecturer or tutor that you may need to leave suddenly due to sensory overload and, in that case, would need to arrange to catch up on missed information.
• Talking to friends about your sensory issues and coming up with solutions on how to handle situations together.
• Alcohol and parties are part of the scene at universities but they are only one part of the myriad of campus activities. Explore your options but if you do want to go to bars and parties, practice how to handle peer pressure and how to exit the situation safely.

You can read the full article from Understood here.

All universities should have a function that assists students and looks at potential accommodations that the university can make to best support students with disabilities and additional needs. It might be reassuring to contact them prior to starting university to find out what support will be available to you in advance and to ask how best to inform lecturers and tutors about the accommodations or support that you’ll need. You might also be able to arrange a specific tour of the rooms and facilities that you’ll be using on a weekly basis to help familiarise yourself.

The team at Understood have also provided a very helpful list (appropriate to US and UK universities) explaining which university office to contact to ask for help with specific problems, ranging from tutors not understanding your sensory-related needs, to emotional stresses and health issues.

It’s important to realise that you’re not alone in dealing with sensory integration difficulties as an adult. It might help to read about the experiences of inspiring bloggers, such as Rachel S. Schneider of @Coming2MySenses in the US, or British autism advocate Hannah Molesworth whose posts include her experiences of the sensory challenges associated with autism @doilookautisticyet.

Individuals with sensory integration (or sensory processing) difficulties may experience additional challenges within the workplace.

Melanie Whetzel, Lead Consultant  for the Cognitive/Neurological Team at the Job Accommodation Network (JAN) discusses circumstances that might be problematic for individuals with sensory issues:

“Working in a restaurant or in an adjacent office space might cause a problem because of the pervasive smell of food cooking. Retail areas where merchandise, such as bath and body products or tires are sold, may be problematic.

“Some employers require their employees to wear uniforms, hats, or specific footwear that workers may find difficult or impossible to tolerate. Working in areas of extreme temperatures may also cause problems.

“Our JAN offices are located on a main artery through town. The portion of the street that runs in front of our building is also a state route. We hear the continuous roll of trucks, horns blaring, and the sirens of emergency vehicles. A busy call center with the constant ringing of telephones and background chatter may be troublesome as well.”

It is easy to see why accommodations in the workplace may be essential for individuals with sensory processing difficulties to thrive in their workplace environments. JAN suggests the following accommodations:

Accommodations that employers can make to help employees with sensory integration difficulties:

Fragrance Sensitivity:

• Maintain good indoor air quality
• Discontinue the use of fragranced products
• Use only unscented cleaning products
• Provide scent-free meeting rooms and restrooms
• Modify workstation location
• Modify the work schedule
• Allow for fresh air breaks
• Provide an air purification system
• Modify or create a fragrance-free workplace policy
• Allow telework (home-working)

Situation: An employee in a large office space was having difficulty with the various smells that assailed her on a daily basis. She disclosed and asked for an accommodation.

Solution: The employee was accommodated with a modified workplace policy that allowed her to chew gum in order to help ward off the smells she found difficult to tolerate.

Fluorescent Light Sensitivity:

• Move employee to a private area to allow for personal adjustment to appropriate lighting
• Change lighting completely
• Allow telework (home-working)

Situation: A computer analyst with extreme sensitivity to fluorescent lighting was having great difficulty performing the essential function of his job in an office with overhead fluorescent lighting. The employee asked for an accommodation of telework, explaining how productive he could be when working from home by eliminating all fluorescent lighting.

Solution: The employer agreed to allow the employee to work from home for a two-month trial period. They agreed to meet at that time to evaluate the situation and determine if a more long-term accommodation of telework would be appropriate.

Noise Sensitivity:

• Move employee to a more private area or away from high traffic areas
• Move employee away from office machinery, equipment, and other background noises
• Provide an environmental sound machine to help mask distracting sounds
• Provide noise canceling headsets
• Provide sound absorption panels
• Encourage coworkers to keep non-work related conversation to a minimum
• Allow telework (home -working)

Situation: A new employee who was having great difficulty with the level of noise in a busy customer service location asked if she could work from home.

Solution: The employee’s essential functions consisted of answering phones and assisting customers who came into the busy office. The employer agreed to try accommodations that would limit the employee’s time at the busy customer service counter and allow her to answer phones and do paperwork from a location in the back of the office away from the public and the noise, but denied the request for telework due to the nature of her tasks.

Sensitivity to Touch:

• Modify a uniform or dress code policy

Situation: A new employee was hired by an established consulting firm that required female employees to wear skirts and stockings when meeting with clients. There was no way this employee could tolerate stockings or pantyhose.

Solution: A JAN consultant recommended the employee talk with her employer about her disability and discuss solutions. A modification in the dress code policy as an accommodation would allow the employee to look every bit as professional while wearing a pant suit when meeting with clients.

Temperature Sensitivity:

• Reduce/Increase work-site temperature
• Use cool vest or other cooling clothing / heated gloves or other heated clothing
• Use fan/air-conditioner at the workstation / allow workstation heaters
• Allow flexible scheduling and flexible use of leave time
• Allow work from home during hot/cold weather

Situation: An employee who worked in a maintenance garage in a southern state absolutely could not tolerate heat. Several months out of the year were unbearable and his attendance suffered.

Solution: The employer installed a swamp cooler that dropped the garage temperature significantly. The employee was able to tolerate the environment and attendance was no longer an issue.

Sensory Integration Education would like to thank the Job Accommodation Network (JAN), for its kind permission to repost the above material. The Job Accommodation Network (JAN) is a US-based source of free, expert, and confidential guidance on workplace accommodations and disability employment issues.

I was fortunate to discover Ayres Sensory Integration®(ASI®) during my OT training at McGill University (Canada). There, I had a mandatory course in paediatrics that included an overview of ASI®. I remember how our professor explicitly informed us that we needed advanced post-professional training to use this approach. I was fascinated by the work of Ayres as I recognized many traits in myself; my fear of heights started to make sense!

My lucky streak continued with my first employment. There I met Marie-Josée Tessier, an OT trained in ASI®. I remember my first day on the job when she proudly showed me the recently acquired Sensory Integration and Praxis Test (SIPT). She spoke to me about how the SIPT was helping her better understand children’s difficulties. Marie-Josée was a role model for rigorous evaluation and clinical reasoning. I feel extremely fortunate to have had this methodology drilled into me as young therapist.

I continued to train in ASI® with the WPS-USC program and later opened my own private practice. During this time, I met Dr. Eduardo Ramos, a seasoned paediatric gastroenterologist who became aware of sensory reactivity and perception issues in many of his patients with stool toileting refusal. We started combining OT/ASI® and medical approaches and helped many children overcome chronic defecation disorders that were not responding to conventional treatments.

In 2010, I met Dr. Shelly Lane at R2K, an international sensory integration conference held for more than 10 years in Southern California. Dr. Lane encouraged me to pursue research in the area that I was developing with Dr. Ramos. Since then, Dr. Lane and I have published several papers together and I have earned a PhD thanks to her expert guidance.

Over the years in my work as an OT, hundreds of families have benefited from ASI® and the deepened understanding that this approach brings. In my work as a lecturer of ASI®, I have also witnessed how training in the SIPT and other standardized assessment tools helps young OTs deepen their understanding of children’s difficulties and leads to better interventions that target both underlying issues and participation challenges.

So when asked about ASI®, I am filled with gratitude as I ponder upon a fulfilling career tightly link to the work of Dr. Ayres. Furthermore, my involvement in the International Council for Education in Ayres Sensory Integration (ICEASI) and the data collection efforts for the Evaluation in Ayres Sensory Integration (EASI) is giving me a glimpse of the bright future that lies ahead of us!

Isabelle Beaudry, BSc OT

The latest issue of SensorNet is now available. 

Please login to our website and access it here. 

Please let your friends and colleagues know that they can join the SI Network for FREE to access SensorNet magazine, our monthly EmphaSIze newsletter plus lots more resources.

Some of the features in this summer edition of SensorNet edition include:

• The AOTA Conference & ESIC round-up – We bring all the action to you – reflections, interviews and photos
• Environmental Feature: Sensory Adapted Dental Environments to Enhance Oral Care for Children with Autism Spectrum Disorder by Sharon Cermak
• Practice based Feature: We hear from Stacey Reynolds and Hope Caracci on using an intensive design model of SI intervention in outpatient paediatric settings: How and why to change practice based on evidence
• Assessment Features:The Sensory Processing Measure 2 (SPM-2) with Diana Henry & Assessing the Sensory Environment with Aimee Piller
• ESIC Bursary awards: Three Sensory Integration Education members received a bursary award each to attend ESIC 2019 and present their research
• Research updates - References and abstracts for recent articles related to sensory integration across s number of areas – mental health, diverse populations, ASD and much more.

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