Services

Assessments

I believe that sensory assessment is most important. If I use a standardized assessment with a child, the results are affected by: lighting, visual clutter in the environment, visual and auditory distraction, ability to sit still, maintaining attention with no sensory strategies, distracting thoughts and fears, and stress hormones as they are not familiar with the environment, the activity, or me. SO, if I just walked in and did a fine motor assessment on a kid with sensory needs, my results would be likely to show decreased abilities and fine motor problems that could result from working with a stranger, in a different room, missing classroom time, feeling singled out, stress from being watched carefully, especially on difficult tasks. My testing results might show: how the child handles stress and novelty, how the child functions when not provided movement opportunities or thinking tools (fidgets), how the child works in an overly bright fluorescent environment where some lights buzz, how the child works without visual supports or auditory cues, how auditory distractions affect the child’s attention. So, I do not find this kind of assessment to be very helpful for children with sensory differences as it shows decreased performance almost across the board, because of outside factors! If I start with a sensory assessment, then I might be able to then do a fine motor assessment, taking into account the sensory environment. A simple fidget item or water bottle can affect the child in a positive way, and creative seating can also help, especially if i give the learner a choice of options! I might position us with a window on one side and the lights off. I might even alter the auditory environment with nature sounds, noise reducers, and selecting a better spot for testing. It has been shown that gum chewers do better on tests and assignments when they are chewing (or crunching) something. It’s similar for a multitude of sensory strategies. And just by not correcting little sensory behaviors I build relationship and decrease stress for the child. I’d know to let the child rock in his chair or work in standing, or give a movement break when needed. I’d allow the child to fidget, and allow this more when the learner is facing a challenge. I might note that the child is chewing on her pencil or a piece of paper, but i would not discourage these behaviors, observing the result. My test results, when using good sensory strategies, allows me to assess the child’s true performance abilities rather than the child’s ability to function with no sensory behaviors allowed! Having 34 years of working with children, I can also do less formal assessment. I present fun little tasks that allow me to observe fine motor foundations, posture, pencil grasp, sensory behaviors, as well as visual processing, visual motor integration, bilateral coordination, motor planning, attention, frustration tolerance, etc. BY using a friendly therapy approach, the child does not feel tested but rather engaged. Smiling and laughing as we work make a big difference, as do a couple sensory strategies. After one or two therapy sessions, I have a pretty good handle on what school tasks might be challenging, what kinds of activities will improve foundation skills, and what simple sensory strategies should be embedded into activities. I believe that the best tool for looking at Sensory Processing is the Sensory Profile by Winnie Dunn.

Sensory Profile

I always prefer to start with the Sensory Profile. The Caregiver Questionnaire (ages 3-15) has 86 items and parents rate each one in a “sometimes…always…never” format. Most are very simple, like “does the child put hands over ears when it gets loud” so it usually takes a caregiver about 30 minutes to complete the questionnaire. And I ask caregivers to look at each category and add comments and stories from everyday life. People who know the child BEST answer simple questions. I take that information and feed it through a sensory lens, creating a whole new perspective or way of looking at behaviors. I can easily make suggestions that when this or that is happening, try this or that simple sensory strategy. This becomes intuitive and helps parents to see their own sensory side, so that they can start to encourage sensory strategies that work for them. The School Supplement has 44 items that are related to school performance. These are easy to answer and of course I encourage comments and stories for all areas. While the Caregiver Questionnaire can be used as a stand-alone, the Teacher Questionnaire is intended to be used as a supplement to the Caregiver Questionnaire and is not used alone. Most often, a support worker will complete this questionnaire. It should be the school staff who know the child best who completes this questionnaire. I have had both teacher and support worker do separate questionnaires, and this gives me great insight as I integrate results. For a great summary of the Sensory Profiles, please review this document (Sensory Profile -Why) There is also an adolescent-adult questionnaire and separate questionnaires for children under 3 and under 6 months. A good Sensory Profile assessment will help you to know what things you can do to support performance, and what things you should avoid to keep the child feeling grounded. This will give you ideas of strategies you can try right now, and also things you can try in different situations and different environments. I predict what strategies should be tried right now, and what strategies should be gradually introduced over the next couple years. Parents love the Sensory Profile reports and many tell me it is the first time they have seen a good description of who their child is and what makes them tick. I used to feel really bad when parents would tell me that they cried when they read my report, but they have all been adamant that I should not have left things out of my report or said things differently. It is a great moment in a family’s life when they realize that they, and I, know a child inside out in a way that they never experienced. It begins to make the confusing sensory and behavioral stuff seem like basic common sense! This allows them to support the child and not just scold or take things away. After a Sensory Profile assessment, parents are empowered by their understanding to be confident and effective advocates for their child. Many families and schools have told me that a good Sensory Profile Report was the turning point for a child’s school career, as it encompasses the whole child and looks at things from a different angle than they are used to. A sensory profile that is understood becomes a therapy tool. Anyone who understands it can then begin making small changes that make a huge difference, and this can be more effective and more important than in person therapy.

In Person Therapy

The main benefit of a sensory profile report is derived when people who are important in a child’s life begin to understand a child from a sensory perspective. Common sense strategies can make a huge difference in desk work and indeed performance in all areas. Seeing sensory signs and cues and introducing relevant strategies changes “everything” in terms of a child’s occupations. As a child begins to feel understood and accepted and is not scolded all day but given options, the learner starts to feel better about himself and his school career! This boost in self acceptance and confidence makes a huge difference in a child’s life and in how much energy gets drained away in different environments. I love to do in person therapy to overcome negativity and turn things around. I can make writing and cutting into fun activities that produce improvements in performance, along with visual activities and cognitive activities that become rewarding when one can be successful with them. The main benefit of my therapy is then to integrate myself into the child’s classroom career and home interventions, modeling a “sensory smart” way of addressing goals and objectives. As support workers, teachers, interventionists and parents observe something being done in a positive manner with a smiling and engaged child, they begin to practice some of the same strategies that I do. This is when positive change really starts to happen! Many of our kids are overly “therapized” and experience many different interventions using different philosophies and approaches. This can feel very discombobulated and un-natural. Through sensory profiles, virtual therapy and workshops, you can build a small and effective team where you are able to elucidate goals and priorities in a clear, common sense way. This allows parents to truly be in the driver’s seat and shape a cohesive program where everyone in the child’s life can share a similar perspective and speak the same language. And every professional needs to be able to wrap their heads around who that child is and what makes them tick. Recognizing the sensory side does not mean abandoning any other profession or treatment, although it does affect the approach, activities, and strategies. Through team meetings, the parent can feel confident in being responsible for the team and the team psyche. Often, I will attend early team meetings either in person or virtually and this can help a team to understand a child better and use good strategies.

Virtual Therapy

Once a Sensory Profile report is done and is understood by all, do you really need an occupational therapist to come into your environment every week and work on a few goals? I’d rather have people in that child’s life carrying out my goals in a sensory smart manner. I want my insights and ideas to be integrated into your team approach. By using simple sensory strategies and a good program, anyone can work on printing or writing in a positive and fun way. Occupational therapists work on the whole child and everyone of our target areas should be understood and practiced by all people and professionals. Early on in team development, it might be very helpful for me to attend team meetings and share my perspectives. I can do this via Zoom, Skype, etc. or in person when practical. Once we’ve had a good summary meeting, all your team members will understand me and my work. For a time, being involved in team meetings virtually allows me to shed a little sensory light on everything that comes up! If what I say is grounded and sensible enough, eventually everyone will understand the sensory side of life and will accept and begin to generate sensory ideas and perspectives! When your team achieves this level of enlightenment, then my work is pretty much done, but I can still be available as needed when things come up. I have done virtual therapy via Zoom or e-mail with a person who had a sensory workup years ago. One’s sensory processing does not change that much, but occupations, social situations and task demands do change. So I can guide you into expanding sensory strategies as a child ages, based on sensory assessment and anecdotal evidence. VIrtual therapy is often consultative in nature, but this can change over time. Virtual therapy is most effective after sensory profile assessment and summary meeting. However, a short burst of OT through virtual channels and bring new life to your team as your child grows and develops. I have followed many families over the course of 10 years or more, so I have a pretty good handle on how sensory issues manifest throughout development. My therapy services are most effective when people have participated in my workshops, or had superior sensory training with practical application.

Workshops

Educational workshops have always been a big part of what I do, based on feedback from parents and schools. Often, I do workshops for Pro-D days at a school or group of schools. Several times, doing this has also lead to presenting to Parent groups affiliated with the school or with a community group. So, my workshops have often been sponsored by schools, parent groups, child care centers, resource and referral networks, aboriginal groups. I have also presented at conferences for teachers, counselors, SLP’s, and parents. I love doing workshops, because I can integrate a lot of stories from my practice to help participants understand my material in a very practical and fun way! I tailor my stories and examples to the subject of my talk and to my audience. I used to say that parents are my favorite audience, but I have had awesome experiences with a wide variety of sponsors, and I am often told that I deliver valuable and uncommon information. My workshops are based on fields of neurology, development, trauma/resilience, but because I teach with instruction and stories, I can make these areas understood with practical, real life examples. My workshops are intended to help the audience understand themselves from a sensory perspective, and also to understand their significant others, colleagues. Once you understand what I am saying in terms of you and your world, it is easy to shift thinking to the realm of childhood and development, and have what I am teaching sound like perfect common sense! Understanding the self is key to understanding children and development, given the diversity we experience today. I have done workshops to increase sensory understanding with regard to many “categories” of people. This understanding is very relevant to almost anyone who is a different learner, to anyone who has experienced trauma or significant medical intervention, and to a multiple of man made diagnoses. While my early workshops focused on autism, I have addressed groups focused on ADHD, Prader-Willie Syndrome, FASD, PTSD, Sensory Processing disorder, anxiety, behavior challenges, and a host of learning differences. Doing this has helped me to synthesize sensory processing as a universal human function based on common sense. While some of the strategies I recommend might vary, the underlying sensory basis is simple and universal. I have done workshops over 3 weeks with 2.5 hours a week, or as a full day or two day workshop. I have also presented 2.5 to 3 hour workshops as an overview or focused on one specific area. The areas I cover in my workshops are: The Role of Toxins in Brain Development and Health Basic Brain Differences - Boy vs Girl Brain Differences and How Trauma Changes the Brain As Well As How To Support Function In All Brains! The Stress Response System - How this is activated via sensory and cognitive channels, what happens with Stress Response Activation, the concept of Sensory Stress (brain stem) and how to balance the Stress Response System through common sense strategies Sensory Processing - How we process sensory input and the whole range of sensation and sensory pathways. Individual differences in sensory processing and how this creates a Sensory Temperament. How knowing a person’s sensory temperament helps you understand and interact in a helpful way is key! Self Regulation - How do we self regulate our level of arousal? Automatic means and deliberate strategies. How to support self regulation when involved with brain function, the stress response system, and sensory processing. When someone asks me what I am doing and my answer is “nothing” or “I don’t know” then that is likely a self regulation strategy that can easily be understood. Resilience - How trauma is universal, especially when one’s brain is a little different is critical to understand, and how this trauma affects the brain, the stress response, sensory processing, and self regulation. The teachings of resilience can be woven into each of the above topics to realize that we are always working to build resilience when we are working with Sensory strategies and sensory input. How to use sensory strategies to build awareness, confidence, relationship, and overall resilience I can also tailor workshops to almost any group or category. I believe that Sensory Smarts is what the world is lacking and that this training can help in all aspects of life and relationship. I can build a workshop specific to your group! I have descriptions of workshops covering the above areas (Worshops I do) and an explanation of my life work and self education (workshop Description and Bio).