I can help you better understand your child’s development and ways to support it.
My Work as an Occupational Therapist
At the age of 30, I became an OT after receiving a fantastic education at the hands of one of the world’s best OT’s, Kim Hartmann of Quinnipiac University.
I have trained with Winnie Dunn, who developed The Sensory Profile. I have scored and interpreted the Sensory Profile for hundreds of children and am very good at this. For most children I have worked with, I have done the Sensory Profile Report without meeting the child. Families and teams have found this information to be “bang on” and very useful in developing programs and strategies to work with the child. I have an easy time interpreting the standard Sensory Profile (for children ages 3-10). This version includes a Caregiver Questionnaire for parents or other caregivers to complete as well as a Teacher Questionnaire for the teacher or school staff. The questionnaires are in a “sometimes...always...never” format and are not generally felt to be too difficult to fill out. Because they use information from people who know the child well, the results are usually easy to understand. The profile takes your information and interprets it through a sensory framework. This makes it easy for me to develop a ‘picture’ of that child’s sensory processing and help to recommend sensory strategies that will support the child in development and learning. Understanding a person’s unique sensory profile can really help to guide that person into environments and activities that promote self-regulation, or the ability to remain calm and in control. Many children already have a sense of what they need, such as sensory seeking or sensory avoiding behaviours, and allowing adults to understand this will enable us to support self-regulation without making things worse or pushing people in the wrong direction.
It is also essential to consider what kinds of things trigger a stress response in a person. When faced with a significant stressor, many of us revert to sensory strategies to self regulate, and many of us get pushed into autonomic 'fight, flight, freeze' reactions. I use the Stress Survey, developed by the Groden Center in Rhode Island, to help determine what types of things push the child into a stress response. By using their stress survey, I can often see patterns that make a lot of sense in light of an individual's sensory profile. With this information, it can be much easier to help a child to anticipate and prepare for stressors in the environment. I advocate the use of warnings, visuals, and timers in helping children, as well as using social stories and related forms of communication. It is also possible to help to desensitize children to stressors, either through the use of the above or through gradual and therapeutic exposures.
Many of the behavioural challenges that humans face relate to nervous system arousal and the stress response system. By understanding the sensory profile and stress response system of an individual, it is possible to tailor therapy to work within a safe and nurturing environment to support de-sensitization and active engagement in a way which does not trigger a dump of stress hormones. This is true whether we are talking about an adult, a child, or a person with a diagnosis. I start by looking at these areas and integrate this with an individual's life so that meaningful experiences and activities can be more comfortable and more successful for an individual.
Whatever the life activity or goal, working toward mastery can be done by broadening the developmental foundations necessary and then practising component skills and ultimately, the target activity or task. Master occupational therapists can do this in a safe and fun way by providing the "just right" challenge that addresses development and adaptation. The best and most effective way to do this is through play, fun, and meaningful activity. We all define ourselves by what we do, and helping a person to do things successfully supports brain activation and overall development in a very positive way. The focus of many therapeutic sessions may involve precise targets and skills. At other times, however, therapy is aimed and integrating sensory input through various channels without activating stress response system and resulting neurotransmitters. As an integrative therapist, a primary goal is to help the child feel calm and in control in the face of change, demands, unpredictability. When stress responses are activated, helping a child to recover to a calm, positive state of mind is very important and, over time, gives the child the neurological and emotional tools to tackle challenges in a calm manner.
The goals I address maybe motor, perceptual, or functional and all seek to build the ability to face stress and practice areas of challenge while maintaining a calm state of arousal or enjoyment and attitude of fun. A large part of what I do involves helping people to understand how sensory processing and arousal affect performance and development. While people can learn a lot from reading one of my reports, I provide workshops tailored to different ages and different topics, and these are explored more on the “my workshops” page. Because we are not taught this important information in school or university, most of us allow our sensory processing and self-regulation to run on automatic pilot, and this can lead to trouble. Many people attend my workshops more than once. When autism funding first came into being in BC, the NDP government put out a request for agencies to develop EIBI (Early Intensive Behavioural Intervention) programs for young children with autism. From 2001-2005, I worked with an EIBI program set up by the Delta Association for Child Development. I provided training for behavioural interventionists and other professionals who support young children with autism. I developed structured programs to address fine motor and sensory areas. The bulk of my work with that group involved integrated therapy, where I supported interventionists working with young children. We worked together, and I often elbowed my way in to try my own approach with the consumers. We discovered firsthand how integrating sensory activities could help kids stay on task and enjoy what they were doing. Gradually, many of the master interventionists became able to integrate sensory input and sensory principles into ABA therapy and discrete trial training as well as natural teaching, raising the performance and engagement of the child to a new level. Using a sensory-based approach does not have to be an alternative to ABA or “specialized” (i.e. overpriced) forms of intervention. All humans incorporate sensory behaviours and strategies to manage task performance and play, but doing this requires a little more intelligence and cognitive/creative energy than just carrying out a set of memorized instructions or procedures. This integrated form of therapy has proven to be the most valuable form of supporting development, and working in the home allowed families to observe and practise these strategies to build sensory strategies and self-regulation (awareness and activities) into what they do. I do not believe that an OT coming into your home, school, or environment once a week or once a month is the way to support development. It is when each professional is bright and open enough to share their approach and support a truly integrated model that the greatest growth will occur. Just as normal development occurs throughout one’s life, so must the positive supports that are helpful and necessary.
When the EIBI programs were abandoned by the (Liberal) government in lieu of individualized funding, autism in British Columbia became a growth industry. This was led by FEAT, a group of American based entrepreneurs who convinced the autism elite that their approach, based on the fraudulent research of Lovaas, was the only approach that should be allowed. In the past six years, autism treatment in BC has moved into a back room approach where kids are programmed to perform target activities. The strategies, tools, interaction styles, and approaches to working with manifestations of autism need to be based on sound principles of development, rather than classical conditioning, to be valuable. They need to be integrated into the daily life of the child. I have spent many hours observing more traditional forms of intervention and making recommendations to move teams into the first world of integrated therapy. Many traditional interventionists (must be both masterful and open-minded) have learned how to use natural strategies that allow them to access a child’s whole brain and make gains that are not possible with a backroom approach. State of the art intervention is an amalgamation of many different approaches and modalities that can be carried out in treatment sessions and daily life. Transdisciplinary teams need to be willing to learn from each other and learn from working with children rather than learning from fabricated and meaningless research. I support evidence-based therapy. I also recognize that no one reads the professional literature of every professional involved in the autism world, and that is why we have come to a fragmented and less productive approach in British Columbia.
I have helped many teams to move back into the real world with real autism intervention. I tend not to work with “all in one” programs that take all of your autism funding and disclaim any services that they cannot provide in house, profiting their bank accounts. It is truly saddening how many companies have turned autism into a money-making venture that motivates them to discredit meaningful research and intervention approaches and has slowed down the growth of meaningful transdisciplinary interventions.
The greatest teams are driven by educated and open-minded parents who are guided by their hearts and their children.
Of course, we are all sensory beings, and I have worked on my sensory-based approach with many children who do not have autism. Children with many “labels” do best with transdisciplinary intervention based on balancing arousal and attention while targeting specific areas of development. Whether a label is based in genetics, psychometric testing, a psychiatric checklist, or behavioural or functional manifestations, my whole and integrated occupational therapy approach can generate superior results when compared with any other approach.
Please remember that I am not a recent graduate with a masters degree who has been trained to read and produce research. I am a master clinician who has learned and evolved through years of practice tempered with information from master clinicians as well as from fields of neurology, development, physiology, kinesiology, psychiatry, and education.
More to come...