Sensory Integration (SI) therapy: what is it and how does it help?
Since starting at The St Andrews Practice in October last year, Lisa Paxman, our Highly Specialist Occupational Therapist, has quickly become an integral part of our team. She brings with her unique skills and vast experience of working in community and inpatient mental health. Last month Lisa left the NHS after 30 years! For the last 7 of those she has worked in a specialist team for adults with Autism. Lisa has a special interest in how sensory information impacts on us as individuals and is an accredited Sensory Integration Practitioner. Here she talks to us about her move into independent practice, what sensory integration work is and why it’s important. She also discusses her post diagnostic interventions for adults with ASD and ADHD.
Lisa what are your goals for working in independent practice?
I want to provide the best service possible that is responsive to individual needs, to develop links with local services and keep up to date with what resources are available nationally. This will ensure that I can provide useful information to our clients and that I am adding value not duplication.
I want to continue to build on my understanding of sensory experiences, as this is continuously evolving and to keep up to date with developments in other areas such as employment.
I am working to develop stronger links with ASI-WISE/Ayres Sensory Integration – Wales- Ireland-Scotland-England. I am hoping to get involved in their delivery of education and supervision to those that are interested in learning more about sensory issues and others that are practicing in this field.
I would like to provide good learning opportunities to future OTs; we need the next generation to understand how they can use their skills to help the neurodiverse population. I am also hoping we can provide added value to our clients through sessions with OT students at no added cost (supervised by me).
You are a certified sensory integration practitioner. Tell us a bit about how sensory information can be perceived differently in autistic people?
80-90% of autistic people experience sensory differences, both sensory sensitivity e.g. noises are louder, lights are brighter, some types of touch and movement don’t feel good, and sensory-motor e.g. trips, bumps and poorer co-ordination. These differences result in people experiencing high levels of anxiety, difficulties with regulating emotional responses, and impact on ability to do the things they need and want to do.
We’ve seen the significant difference sensory interventions can have in people’s daily lives. Can you explain what these interventions involve and how they help people?
Sensory Integration (SI) therapy is aimed at supporting individuals to develop more successful adaptive responses to environmental and internal cues. This type of therapy is based on the concept of neuroplasticity, which means that we can with the right inputs literally ‘rewire’ the brain. Adults with sensory differences are frequently unaware that their sensory systems are more sensitive or that they are putting in more effort to produce effective movement than most people. Using assessment to work out the specific sensory difficulties, how these may be impacting on everyday life and helping people to understand how our sensory systems work is an important starting point.
People have usually developed strategies and adaptations that they already use to manage sensory differences, however, when stressed or highly anxious they are likely to forget to use them or rely too heavily on avoidance which then prevents individuals reaching their full potential.
What do sensory interventions focus on?
• Building on sensory strategies and an understanding of which strategies provide calming input and which are alerting, and why. Developing sensory toolkits; portable and for in the home.
• Developing awareness of personal indicators of under/over alertness (emotional states) in order to be able to use sensory strategies to regulate emotions. Use of tools such as sensory ladders.
• Use of concepts such as energy banking, balancing demands to reduce incidents of sensory/social overload. Strategies such as weekly planners can also be helpful in ensuring days are balanced out.
• Developing home programmes to work on underlying sensory issues e.g. balance, dizziness, tactile sensitivity, co-ordination.
Are there any other populations that can benefit from sensory interventions?
Recent research highlights that the percentage of people with ADHD who have sensory differences is about the same as in the autistic population (approx. 80%). It is likely that anyone who is considered neurodiverse will experience some level of difference in comparison to the neuro-typical population, this is fundamentally because the structure of the brain is different and therefore operates differently.
People with Post Traumatic Stress Disorder (PTSD) are likely to have developed a level of sensory sensitivity, with flight/fight responses being more easily triggered by sound, visual and touch information perceived as a possible warning of danger. There is evidence that the brain structure, is altered if exposed to trauma early in life, the amygdala (involved in processing emotions and fear-learning) is enlarged. There is also an increasing body of research highlighting the interactions between sensory differences and many mental health conditions.
So, basically, I would say every human being could benefit from learning about sensory differences in order to keep minds and bodies healthy.
You’ve been developing some post-diagnostic interventions for Autism and ADHD. Why do you think this work is important?
When you receive a diagnosis like this it is important that you can access support to make sense of what this means to you as an individual and to learn how to use your personal strengths and skills to limit the impact of any difficulties you experience. It is helpful that the current direction is moving towards understanding neurodiversity as different and not less.