Sensory Integration Process and Support for School Success

Dr. Virginia Spielmann Author

04/10/2023 Added

15 Plays

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2023 Conference Session

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[00:00:00.000]Help me welcome Dr. Virginia Spielmann.
[00:00:01.860]I'm gonna tell you a little bit about her,
[00:00:03.270]although there's not enough time
[00:00:04.290]to tell you everything about her.
[00:00:06.291]Dr. Spielmann is a well-traveled speaker.
[00:00:09.180]She is a coach and an educator
[00:00:11.850]on topics including sensory integration, DIRFloortime,
[00:00:16.170]child development and infant mental health.
[00:00:18.810]She's conducted trainings in Kenya, in Australia,
[00:00:22.571]in the Philippines, Vietnam, Hong Kong and the US
[00:00:27.330]and leads workshops in international conferences.
[00:00:30.000]So we're really blessed to have her here in Kearney, right?
[00:00:33.030]Clap, everybody.
[00:00:34.029](crowd cheering and applauding)
[00:00:34.862]Yeah, yeah.
[00:00:36.720]She's founder and former clinical director of SPOT.
[00:00:40.555]Did I say that right?
[00:00:41.388]You call it SPOT.
[00:00:42.221]She calls it SPOT.
[00:00:43.575]Which was in Hong Kong.
[00:00:45.480]And she has led a large and widely respected
[00:00:47.730]interdisciplinary team there.
[00:00:50.250]I think that's generally just what you do, right?
[00:00:52.470]Sure, in my sleep.
[00:00:54.900]In her sleep, yes.
[00:00:56.070]She has a BSc in occupational therapy
[00:00:58.920]from Oxford, England.
[00:00:59.880]You will hear that accent.
[00:01:01.890]She has an occupational therapy master's
[00:01:04.320]from the United States,
[00:01:05.430]and then her PhD is in early childhood development
[00:01:08.070]with an emphasis on mental health
[00:01:12.480]with Fielding Graduate University.
[00:01:14.220]Where's that in California?
[00:01:15.240]Santa Barbara. Oh, Santa Barbara.
[00:01:17.340]That's amazing.
[00:01:18.630]Anyway, she's got a vast...
[00:01:20.910]She's got a wealth of knowledge, vast experience,
[00:01:23.399]and you'll hear that throughout
[00:01:25.440]what she has to share with us today.
[00:01:27.270]So will you please help me give Virginia
[00:01:30.240]a warm welcome for our afternoon.
[00:01:32.130](crowd applauding and cheering)
[00:01:34.489]Thank you.
[00:01:38.383]Thank you, it's so nice to be here.
[00:01:42.900]I am British, so if you don't like the content
[00:01:46.710]of what I'm saying,
[00:01:47.543]you can just close your eyes
[00:01:48.540]and pretend I'm your Hogwarts professor,
[00:01:51.450]and that should really help you.
[00:01:54.570]I have lived in all sorts of places
[00:01:56.938]and done all sorts of things,
[00:01:59.310]and they've all sort of come together into my work now.
[00:02:02.864]Very passionate about families and protecting families
[00:02:08.820]and helping individuals
[00:02:10.530]become their favorite self in the world.
[00:02:14.250]I do think that understanding how people are wired
[00:02:18.672]helps us be kinder to one another.
[00:02:21.510]And so this is kind of my...
[00:02:23.543]That's my Miss America platform,
[00:02:27.068]but, you know, I went to kindergarten in Hong Kong,
[00:02:34.410]I went to school in England,
[00:02:36.023]went back to Hong Kong and did high school there.
[00:02:39.312]Before I did my degree,
[00:02:41.055]I was gonna go to and do politics in Russian
[00:02:45.030]at Durham University,
[00:02:47.236]but decided to fail high school instead.
[00:02:50.100]So I didn't do that.
[00:02:51.738]I went a longer route.
[00:02:54.360]I worked in the childcare unit
[00:02:57.810]of an orphanage in Hong Kong.
[00:03:00.690]It was a special needs unit.
[00:03:02.040]And I met this amazing woman
[00:03:03.847]who was an occupational therapist called Drew,
[00:03:07.650]and she changed my life personally
[00:03:10.320]and showed me this amazing career
[00:03:12.990]that I wanted to undertake.
[00:03:15.166]While I was at university...
[00:03:18.540]Well, actually while I was waiting to start university,
[00:03:20.820]'cause I started late,
[00:03:22.260]I was a Lovaas therapist in people's homes
[00:03:26.220]for about five minutes or 10 minutes or something.
[00:03:29.009]It didn't work out.
[00:03:30.150]I wasn't a good fit on the team.
[00:03:32.220]So Lovaas therapy is...
[00:03:34.530]I mean, at that age is me, by the way.
[00:03:37.890]We don't really talk about that anymore.
[00:03:39.420]And this is 25 years ago.
[00:03:43.770]And it's a very, very discreet
[00:03:45.900]child training focused therapy.
[00:03:47.875]And so we would go into the child's home,
[00:03:50.244]the autistic child's home,
[00:03:52.590]and it was paid for by the county council, and a lot was,
[00:03:56.400]and the first thing we would do
[00:03:58.890]is help the child learn to sit in a chair.
[00:04:02.483]I dunno if any of you have ever done this,
[00:04:04.830]but you'd go, "Sit here, sit here,"
[00:04:08.340]and then you'd help the child,
[00:04:09.667]"Sit here," and then you'd give them a Cheerio.
[00:04:13.680]It was Cheerios back then.
[00:04:16.590]Even if they were crying, it didn't matter,
[00:04:18.630]you'd still do it.
[00:04:19.890]And then after they learned to sit in the chair,
[00:04:22.499]even if they were crying,
[00:04:24.210]the next thing we would do
[00:04:26.050]was get them to put a DUPLO block,
[00:04:28.320]you know, the the bigger blocks,
[00:04:30.210]into a stacking cup that was out on the table.
[00:04:33.397]"Do this, do this,"
[00:04:36.600]and then I'd take the hand of the child,
[00:04:38.640]do this, they'd drop it in the cup and I go,
[00:04:40.357]"Well, done.
[00:04:41.370]Good job, good job,"
[00:04:42.660]That's what I'd say,
[00:04:43.493]and then give the Cheerio.
[00:04:45.210]I'm still trying to unlearn good job as something to say.
[00:04:51.840]And what I found was that I didn't really understand,
[00:04:55.970]like it didn't click with me
[00:04:59.130]why we would do it while the child was still crying.
[00:05:02.760]And at the same time,
[00:05:05.000]the reason I got into it
[00:05:06.630]was because of a cousin in a family
[00:05:09.330]and they were so desperate and I was helping them
[00:05:11.520]and that felt really good.
[00:05:12.868]And so I sort of was a bit confused.
[00:05:15.070]But what I found was with my cousin,
[00:05:17.370]if I took the Cheerio and put it on Thomas the Tank Engine,
[00:05:24.450]and then said "Do this,"
[00:05:27.060]and held Thomas and lent forward
[00:05:31.320]and held my breath with excitement,
[00:05:35.910]she would do it and she wouldn't cry,
[00:05:38.220]and then Thomas would deliver the Cheerio,
[00:05:40.500]and then I got fired.
[00:05:43.590]And that's a true story.
[00:05:45.510]So I wasn't doing it properly at the time,
[00:05:48.021]and I know things have changed a lot since then.
[00:05:51.300]And I went into OT
[00:05:52.980]and I knew I always wanted to do pediatrics
[00:05:56.033]and I've been been really fortunate with my career
[00:05:58.290]to have some amazing teachers.
[00:06:00.150]One of the things in my first pediatric placement
[00:06:03.210]was that we weren't really allowed
[00:06:06.210]to talk about sensory integration.
[00:06:08.970]And so my supervisor and I would secretly do
[00:06:14.670]a little bit of sensory integration evaluation
[00:06:16.980]as part of the bigger multidisciplinary assessment.
[00:06:21.090]She was called Maggie Ellis.
[00:06:23.370]And then we'd weave it in in other ways.
[00:06:27.169]Because it was controversial back then, she says,
[00:06:30.390]as if it's not controversial anymore,
[00:06:32.550]I dunno what you think,
[00:06:33.851]but what we are finding now 20 something years later
[00:06:38.940]is that more and more and more research groups
[00:06:44.160]and disciplines, professions, educators
[00:06:48.600]are realizing how important this part of human function is.
[00:06:53.100]And you're gonna see that in some of the research
[00:06:55.050]that I share in this whistle stop tour I'm gonna give you.
[00:06:59.243]But people like Simon Baron-Cohen
[00:07:04.142]whose name you might not have heard for a while
[00:07:06.120]or you might still follow his work,
[00:07:07.740]but he talked about the core deficits of autism
[00:07:10.011]and the triad of impairments,
[00:07:13.590]have published recently saying,
[00:07:16.110]uh, maybe social isn't the main thing, but sensory is.
[00:07:20.280]Maybe sensory's central and social's peripheral.
[00:07:24.120]Maybe the sensory experiences
[00:07:26.310]that are really different for these individuals
[00:07:29.370]shape all these other domains,
[00:07:31.860]and the effort should be in the sensory realm.
[00:07:35.250]And that's called a paradigm shift.
[00:07:38.175]When lots of people with differing opinions
[00:07:41.430]and different research labs
[00:07:43.200]start to realize at the same time
[00:07:46.290]that something needs to change,
[00:07:49.110]that our direction needs adjusting,
[00:07:51.810]and that this is the important thing.
[00:07:53.790]That's called a paradigm shift.
[00:07:55.470]And an author called Coon
[00:07:57.232]wrote about this in a book in the '50s
[00:07:59.518]called "The Summary of Scientific Revolutions."
[00:08:02.880]It is recognized now because of the work of people
[00:08:06.570]like Dan Siegel and and other things like that,
[00:08:09.330]and Edward Tronick and so many researchers.
[00:08:12.240]And this conversation is incredibly current
[00:08:16.620]and a lot of people have been looking at it for...
[00:08:20.820]Like, Gina started looking at this
[00:08:22.590]in the '60s and the '70s,
[00:08:24.360]which is really puts us in a good position
[00:08:26.670]because we have a lot of information
[00:08:28.410]to build on this concept that now people are going,
[00:08:33.637]"Oh, hey we have to think about this.
[00:08:35.790]It's not optional, it's not controversial,
[00:08:38.361]it shouldn't be secret."
[00:08:40.530]That's called underground practice
[00:08:42.810]when you do something kind of against the grain.
[00:08:46.530]And I think like good sensory-informed work
[00:08:49.080]has been an underground practice for a long time.
[00:08:52.590]But I'm telling you now that people are saying
[00:08:55.080]we have to do this, and a lot of them aren't OTs by the way.
[00:08:59.490]So if you're an OT in this room,
[00:09:00.886]I want you to make sure you're at the table
[00:09:03.090]when these discussions are being had
[00:09:05.310]because we need to have like,
[00:09:06.517]you know, the whole conversation,
[00:09:08.550]the comprehensive conversation.
[00:09:10.590]I know if there are at least a few OTs here.
[00:09:14.250]So let's talk about the sensory integration process
[00:09:17.010]just real quick so we're all clear on what it means.
[00:09:22.110]Every living thing processes sensory stimuli
[00:09:27.600]all the time, every day.
[00:09:29.280]It's as real as your heartbeat,
[00:09:32.321]it's as real as your respiratory system.
[00:09:37.920]When you wake up in the morning,
[00:09:40.410]you may not even open your eyes
[00:09:42.543]before you start processing visual data
[00:09:45.600]like the sun being on your face,
[00:09:47.940]and then thermoreceptive data, temperature,
[00:09:51.930]the heat of the sun on your face.
[00:09:53.610]You might smell burnt toast.
[00:09:56.163]Know that your kids are downstairs.
[00:09:58.080]You might hear sounds that tell you
[00:10:00.660]where people are in the house or outside
[00:10:02.910]or that you missed the bin men, right?
[00:10:06.990]You hear all that sensation,
[00:10:08.610]you feel the covers on your body,
[00:10:11.910]and then you have to lift yourself up against gravity.
[00:10:16.230]I don't do that until after my first cup of coffee,
[00:10:19.230]but you have to lift yourself up against gravity.
[00:10:21.570]You generally turn, put your feet on the ground, right?
[00:10:24.390]You feel the ground underneath your feet.
[00:10:26.280]Is it a carpet, is it a hard floor?
[00:10:27.810]Have you stood on something you shouldn't stand on?
[00:10:30.090]Did you just stand on your iPhone?
[00:10:31.650]You quickly pull your foot away, right?
[00:10:33.600]We all process sensation all the time every day,
[00:10:37.350]and it comes from the outside world
[00:10:39.840]and inside our bodies and other people.
[00:10:45.990]And so these sensations occur,
[00:10:48.210]and then we have to, our brain,
[00:10:50.550]the wetware of our computer,
[00:10:53.119]electrical impulses and chemical impulses,
[00:10:56.675]and our body filters, organizes, and defines,
[00:11:01.279]prioritizes what it needs to respond to.
[00:11:04.800]And then, and here's where the money is
[00:11:07.080]and the magic part, we respond,
[00:11:10.230]and that that response action
[00:11:13.350]is based on all that raw material
[00:11:15.985]and your previous experiences.
[00:11:18.990]And it is through the sensory integration process
[00:11:21.270]that you build your perception of the world,
[00:11:25.920]your big picture.
[00:11:28.080]And there are lots of sensory systems
[00:11:30.090]and we can categorize them
[00:11:31.290]in lots and lots of different ways,
[00:11:33.220]and they all talk to each other.
[00:11:35.670]And so one of the things we have to move away from
[00:11:38.130]is thinking of them as units that are isolated.
[00:11:43.680]Everything works together
[00:11:45.390]and the information goes both ways,
[00:11:47.310]And that's just a really important way
[00:11:49.020]of thinking about something like this
[00:11:52.200]when you're trying to create false categories in a way
[00:11:57.450]'cause we need to do that to understand it as humans.
[00:12:00.420]But there's an element of categorization
[00:12:03.030]that is a little bit misleading,
[00:12:04.740]makes you think you can just deal with one thing at a time,
[00:12:07.140]but you can't cause we're humans.
[00:12:10.110]So we've got all these sensory systems.
[00:12:11.730]You learn about five at school,
[00:12:13.680]and every OT mom, you know, the kids come home that day
[00:12:18.330]when they've learned about the five senses
[00:12:20.130]and they wind you up about it
[00:12:22.200]because they know it makes you mad
[00:12:24.060]that we only talk about five.
[00:12:25.620]There are way more than five
[00:12:26.820]and I'm not talking about anything to to psychic or strange.
[00:12:33.955]And then there's more.
[00:12:36.780]There's the vestibular system
[00:12:38.580]which is housed sort of in your inner ear, behind...
[00:13:56.720]In lots of different ways.
[00:13:58.650]There are your in interoceptive sensory systems
[00:14:03.750]and your exteroceptive sensory systems
[00:14:06.030]that tell you about the external world, the outside world,
[00:14:09.300]and they talk to each other,
[00:14:10.930]and some of them go in both categories.
[00:14:14.220]So that open systems thinking is really important
[00:14:16.980]when you're learning about the sensory integration process.
[00:14:20.430]So I just wanna talk a little bit more
[00:14:22.110]about that action response
[00:14:25.980]and how we use sensation to produce action.
[00:14:28.789]And we are going to watch this,
[00:14:33.120]I think it's a young lady but I can't remember.
[00:14:35.340]We're gonna watch this video.
[00:14:37.080]Whoa, no we're not.
[00:14:37.920]Can you press play on it?
[00:14:50.783](skateboard clacking)
[00:14:53.568]Whoo!
[00:14:54.620](kid mumbling)
[00:14:58.383]Almost.
[00:15:01.522]Oh!
[00:15:03.791]Whoo! Whoo!
[00:15:11.062]Whoo!
[00:15:12.200]You got that.
[00:15:14.883](metal clacking)
[00:15:19.959]This is my kind of rail right here.
[00:15:22.107]Yeah, actually, you should probably get in.
[00:15:24.121]That should get on...
[00:15:25.795](skateboard clacking)
[00:15:31.588]Oh!
[00:15:34.132]Oh! Oh, yes.
[00:15:37.093]Well, you got me on a (indistinct).
[00:15:39.110]That's true.
[00:15:40.519](wheels grinding)
[00:15:45.829](skateboard clacking)
[00:15:48.598]Whoo!
[00:15:53.258]Oh! Oh!
[00:16:00.519]So, can we turn the volume down on the video a bit?
[00:16:03.540]Thanks.
[00:16:04.620]Okay, so what we've got here...
[00:16:06.450]It's a boy, I dunno,
[00:16:08.110](indistinct) gender bias or something.
[00:16:09.660]But what we've got here is this very young child
[00:16:14.430]who is using the information from their sensors
[00:16:18.238]to produce exquisite motor outputs.
[00:16:22.620]So from a strength-based perspective,
[00:16:24.480]we can really celebrate the differences
[00:16:26.820]in the sensory integration process
[00:16:28.560]in this young child, right?
[00:16:30.450]Because it's helping them really excel at something.
[00:16:35.520]What they're doing is they're moving through space and time
[00:16:39.150]and making predictions based on sensory data and experience.
[00:16:44.640]And those predictions are how far I have to jump, right?
[00:16:51.102]When they...
[00:16:52.350]I tried skateboarding for about 30 seconds
[00:16:55.296]when I was a teenager and the group of boys
[00:17:00.528]that I was hanging out with at the time,
[00:17:02.297]'cause that was just me, I was always that person,
[00:17:06.930]were very kind to me,
[00:17:08.790]but it didn't work out.
[00:17:10.057]It wasn't a good fit for me.
[00:17:12.990]But when you lean down on the skateboard to jump
[00:17:16.290]and you bring the board up with your foot,
[00:17:18.810]that's a lot of proprioceptive and tactile data
[00:17:22.710]that you are using.
[00:17:23.880]And then all that vestibular information
[00:17:26.400]about where you are to stay upright,
[00:17:29.700]those tiny little postural adjustments,
[00:17:32.083]the tiny little adjustments in the ankle to stay upright,
[00:17:36.390]all of these different pieces working together
[00:17:39.540]so that you can predict, predict, predict,
[00:17:42.300]and then the information from your body as you move
[00:17:45.260]so that you can adjust, adjust, adjust
[00:17:48.600]to produce this outcome.
[00:17:50.910]So the sensory integration process,
[00:17:52.840]if we think about some of our Olympic gymnasts,
[00:17:56.730]can produce exquisite motor outputs.
[00:18:00.690]And just like any part of human function,
[00:18:04.613]the neurophysiological potential for it
[00:18:08.520]to go a little bit awry is also there.
[00:18:12.120]And then the main thing it impacts is these motor outputs.
[00:18:15.755]But what do we do?
[00:18:16.800]We tend to call them behaviors when we see them in children.
[00:18:20.700]And so we are gonna go into that a little bit more.
[00:18:22.710]Does anyone have any thoughts about that video
[00:18:24.690]that you wanna yell out at me or anything I missed?
[00:18:29.790]See hopefully what you could see there
[00:18:31.680]was how that child was moving in space and time,
[00:18:35.507]'cause that's a big part of this as well.
[00:18:38.250]Our understanding of space and time
[00:18:40.080]is really based on motor mastery
[00:18:43.980]that we experience in the early years.
[00:18:46.290]And when I can predict,
[00:18:47.970]when I can make something happen,
[00:18:49.560]not just in the immediate future but in the future future,
[00:18:54.570]and it happens reliably,
[00:18:56.880]I'm gonna be ready to start developing abstract thought
[00:18:59.755]and learning more academic cognitive principles
[00:19:02.238]'cause I've learned it first in my body.
[00:19:06.153]And that is one reason,
[00:19:08.340]I just wanna make a connection there,
[00:19:10.200]why praxis and and motor planning outputs
[00:19:13.710]and successful motor mastery support transitions.
[00:19:18.480]For a child to transition from this room to this room,
[00:19:21.630]out the house, in the house, school to this.
[00:19:23.607]And how many of you have ever met a child
[00:19:25.830]that struggles with transitions?
[00:19:28.410]Yeah, none of us, right?
[00:19:29.670]Like, it's never happened.
[00:19:32.490]And so often that's because they're not ready
[00:19:36.240]because they don't have the raw materials
[00:19:38.220]of understanding space and time,
[00:19:40.050]they haven't experienced that in their body first.
[00:19:43.560]And this is, again,
[00:19:44.393]this is why people keep coming back to this topic.
[00:19:46.770]This is why this paradigm shift is happening,
[00:19:49.110]and we call it embodied cognition
[00:19:50.686]or we call it somatic learning.
[00:19:53.100]And a lot of what we're talking about
[00:19:54.990]is the sensory integration process.
[00:19:58.980]So I'm gonna quickly just take us through very quickly
[00:20:02.306]a couple of articles,
[00:20:04.500]and I've given them to you so that you can read them.
[00:20:07.484]I'm sorry that you don't have the handouts.
[00:20:09.930]You will.
[00:20:11.304]They're too big and they keep refusing to send.
[00:20:14.040]So I'm gonna take the video out of the child
[00:20:17.010]and put a YouTube link in,
[00:20:18.900]and then I'll resend it immediately after this.
[00:20:20.766]I apologize.
[00:20:23.109]So this article, not just sharing 'cause my name's on it,
[00:20:27.847]but we are gonna talk a little bit about this today.
[00:20:31.560]So if you wanna read more,
[00:20:33.360]this is the place to go where we've talked about
[00:20:35.910]how you can have sensory-informed classrooms
[00:20:39.094]and the difference that it makes within MTSS.
[00:20:44.090]But then here are some examples of these articles
[00:20:46.939]that are saying, "Huh, maybe sensory is the thing."
[00:20:52.987]"Maybe sensory is the piece that's going to help
[00:20:58.320]our children achieve autonomy and psychological wellbeing."
[00:21:03.809]And when we start thinking this way,
[00:21:07.457]we are building classroom citizens
[00:21:12.060]instead of children who can be socially appropriate.
[00:21:15.540]I really like Alfie Cohen talks about how so often...
[00:21:21.660]He says what we need to do is cultivate reflective rebels
[00:21:25.620]in our schools.
[00:21:26.850]Or children who learn for learning's sake
[00:21:29.220]and are lifelong learners and question things.
[00:21:32.580]But so often, he says,
[00:21:34.027]"We choose to prioritize the child of least resistance,"
[00:21:39.630]convenience in the classroom.
[00:21:42.204]When we start thinking about how
[00:21:44.188]this sense of mastery in myself and my body
[00:21:47.978]really supports my psychological wellbeing,
[00:21:51.300]we move way beyond the chart of least resistance.
[00:21:54.090]And we're building classroom citizens
[00:21:55.740]who are in the classroom because they want to,
[00:21:58.530]because they get it, and because they enjoy other people.
[00:22:01.410]And then that changes our goal writing,
[00:22:03.179]it changes our report writing, everything.
[00:22:07.380]And so this article was really interesting
[00:22:11.310]because it was talking about older children
[00:22:14.010]and how challenging high school spaces are
[00:22:18.450]from a sensory perspective
[00:22:20.520]and the potential for the sensory perspective
[00:22:24.060]to be used proactively to support function
[00:22:28.020]and support meaningful participation
[00:22:31.458]and helping this child become their favorite selves
[00:22:36.000]and ready for adulthood.
[00:22:38.070]And we get stuck sometimes when we talk about schools
[00:22:40.470]and we forget that we're really trying to help this person
[00:22:43.860]become an adult in the long term
[00:22:45.960]who has healthy relationships
[00:22:47.362]and can self-organize in the world.
[00:22:50.101]And I think this perspective really helps us
[00:22:52.410]come back to that.
[00:22:55.200]And this was very similar as well.
[00:22:57.480]And, you know, the language in these research papers
[00:23:00.162]is still very pathologizing and deficit-based.
[00:23:02.970]Research needs to catch up.
[00:23:05.550]But again, it was this idea of how central
[00:23:09.750]the sensory integration process is to success at school,
[00:23:15.956]to success in occupations.
[00:23:20.567]'Cause I'm just gonna...
[00:23:21.400]I feel like I've said that.
[00:23:22.233]And then there's some more reading for you there.
[00:23:24.630]And so from our perspective at STAR Institute,
[00:23:28.110]and we do research, provide therapy,
[00:23:30.524]and educate professionals, parents,
[00:23:35.070]and self-advocates and so on,
[00:23:39.030]we really think of the sensory integration process
[00:23:41.280]as integral to human development
[00:23:44.190]and inseparable from relational health and state regulation.
[00:23:51.990]And so when you're trying to support children
[00:23:54.540]to be successful in a school setting, you've gotta...
[00:23:57.480]We are gonna talk about the sensory piece,
[00:23:59.220]and you've gotta really be thinking
[00:24:00.540]about all of these sensory systems
[00:24:02.141]and how they work together.
[00:24:04.530]And we've gotta think about regulation.
[00:24:07.290]And so what is regulation?
[00:24:09.270]Regulation is your state.
[00:24:11.942]Your energy state right now, your energy outputs.
[00:24:14.658]How much work are you having to put into
[00:24:18.240]at the end of a two-day conference listening,
[00:24:20.850]even if you pretend I'm from Hogwarts, right?
[00:24:22.830]How much effort are you having to put into that?
[00:24:25.890]And for some of you, it's easier than others,
[00:24:27.360]and that's differences in your state regulation
[00:24:29.306]among other things.
[00:24:31.170]And so the demands of the environment,
[00:24:33.896]we wanna be able to meet them with the appropriate energy
[00:24:38.040]that enables us to calm and alert and available.
[00:24:42.857]And it's not just about sensory regulation.
[00:24:46.920]So something that sort of happened in OT for a while
[00:24:49.470]was that we sort of used those words interchangeably,
[00:24:52.290]sensory modulation and regulation, and they're different.
[00:24:54.750]There's lots of things that contribute
[00:24:57.060]to my ability to be regulated.
[00:25:01.020]Motor learning usually is very taxing
[00:25:05.079]and can cause dysregulation very easily.
[00:25:08.553]I remember learning to drive quite late, and my fiance...
[00:25:16.410]We are still married, so it's a good ending.
[00:25:18.600]But he was my driving instructor for a while.
[00:25:22.470]He wasn't my drive...
[00:25:24.180]That didn't work out, but the relationship did.
[00:25:28.451]So I was an older person to learn to drive.
[00:25:33.450]I think I was like maybe 20, I dunno, something,
[00:25:37.020]and little anxious,
[00:25:39.570]not really sure I wanted this guy I fancy
[00:25:41.910]to be my instructor, but okay.
[00:25:43.950]And he's telling me to do this and do this and do this,
[00:25:47.220]and I couldn't talk about anything else.
[00:25:49.260]Do you remember that stage of driving?
[00:25:50.820]And you're even saying out loud like,
[00:25:53.040]in England we say mirror, signal, maneuver,
[00:25:56.070]mirror, signal, maneuver,
[00:25:57.330]so that you don't maneuver before you signal, right?
[00:25:59.970]It's generally a good idea.
[00:26:02.130]And so we're saying it out loud, I can't do anything else.
[00:26:04.710]And then I'm not saying it out loud anymore, it's internal,
[00:26:08.940]but that self speech is still happening,
[00:26:11.100]it's just an internal monologue.
[00:26:12.600]And woe betide my husband
[00:26:14.340]if he tried to talk to me at that stage.
[00:26:15.837]No, no, no.
[00:26:17.580]And then it's starting to get a bit easier
[00:26:20.340]and we're occasionally talking about other topics
[00:26:23.610]because my regulation is in a better place
[00:26:26.490]and I'm more available,
[00:26:27.480]my motor learning has progressed.
[00:26:29.880]And we're driving along and he says,
[00:26:32.744]"You're gonna go straight through this red traffic light."
[00:26:36.060]And I went, "Really?"
[00:26:37.890]And he went,
[00:26:38.723]"Yeah, go straight through the red traffic light."
[00:26:40.500]So I did, and he went, "After it turns green."
[00:26:45.000]He was giving me directions
[00:26:46.530]and teaching me to drive at the same time,
[00:26:48.660]and it did not work out.
[00:26:51.315]Everything was fine.
[00:26:52.890]I actually slammed the brakes on,
[00:26:54.600]but I wasn't in my...
[00:26:58.804]I wasn't operating to my full capacity.
[00:27:02.160]I wasn't completely available.
[00:27:03.807]My upstairs brain wasn't fully analytically available
[00:27:08.520]because I was strung out by the motor learning process
[00:27:11.700]of learning to drive.
[00:27:13.110]And so there are lots of things
[00:27:15.090]that can impact our state regulation,
[00:27:18.360]and one way that we conceptualize this at STAR
[00:27:21.990]is with the coffee cup.
[00:27:24.780]And so when I'm functioning,
[00:27:27.360]my coffee cup is just full enough,
[00:27:30.300]but when I'm dysregulated or overaroused,
[00:27:32.995]my coffee cup is too full.
[00:27:36.240]And these are some of the different things
[00:27:37.650]that could go into my coffee cup.
[00:27:39.977]So biological differences.
[00:27:43.080]And this is from Stuart Shanker's work.
[00:27:45.885]Emotional experiences.
[00:27:47.730]And he even talks about like perfectionism,
[00:27:50.571]peer pressure, social responsibility, pro-social pieces,
[00:27:54.270]all of these things can push us into dysregulation,
[00:27:57.965]and it's hugely sensory as well.
[00:28:01.050]And so one of the things we always say is,
[00:28:02.977]"You have to start with regulation,
[00:28:04.860]You have to understand regulation."
[00:28:06.780]And in autistic populations,
[00:28:09.120]regulation does not come easily
[00:28:11.610]and it tends to be more weighted towards fight or flight
[00:28:16.380]or fight or flight readiness.
[00:28:18.930]And so it's quite effortful,
[00:28:20.970]it's more effortful to stay regulated.
[00:28:22.890]And part of the reason for that is 'cause the world
[00:28:25.620]isn't really built for autistic bodies and brains
[00:28:28.391]and neither are school environments.
[00:28:30.540]They rarely, rarely are.
[00:28:32.287]And so just operating in this space
[00:28:35.550]that isn't really accessible for me,
[00:28:37.530]isn't really designed for me,
[00:28:39.480]is already gonna weigh me towards vigilance
[00:28:44.459]and defensiveness at a nervous system and body level.
[00:28:48.870]So we always start with regulation,
[00:28:51.270]and it's really inextricable from the sensory piece.
[00:28:53.940]And again, that's why I did that open systems piece.
[00:28:57.300]'Cause if I'm not regulated, I'm not learning.
[00:28:59.760]And if I'm not regulated,
[00:29:01.290]I'm gonna look like I have sensory integration differences
[00:29:04.050]coming out my ears.
[00:29:06.690]There was a boy that I evaluated in Hong Kong, and he was...
[00:29:13.050]They tried everything, and he was failing school,
[00:29:16.860]and I think he was eight,
[00:29:19.020]I mean, eight years old and failing school
[00:29:21.090]and we blame it on the child?
[00:29:22.440]Like, that's just a curiosity to me.
[00:29:24.300]Anyway, I went in and did the evaluation
[00:29:27.900]and he scored as what we call
[00:29:32.757]global sensory integration dysfunction
[00:29:35.160]in the (indistinct), right?
[00:29:37.237]It's called global I think, or generalized.
[00:29:38.670]It means everything.
[00:29:40.200]He scored as having challenges in every single test,
[00:29:45.750]which is actually a little bit illogical
[00:29:47.970]'cause it means you can't find a pattern, but it happens.
[00:29:51.870]So I'm like, "Okay, I have to get some more information."
[00:29:55.330]I do a classroom visit
[00:29:57.780]and he's like all up in everyone's faces at each table.
[00:30:01.410]Like, making sure everyone else is following the rules,
[00:30:03.480]but by doing that, not really following the rules himself.
[00:30:07.050]But like not logically available
[00:30:09.226]to have that discussion because why?
[00:30:12.750]Because he was dysregulated.
[00:30:15.150]And so all of the behavioral supports
[00:30:17.640]at the traffic light and everything wasn't landing for him
[00:30:21.690]because he was in a state of dysregulation all the time.
[00:30:24.861]And the penny really dropped for me,
[00:30:27.330]which is very Hogwarts thing to say,
[00:30:29.878]I really realized it at this particular stage
[00:30:33.420]when there was gonna be a transition in the classroom,
[00:30:36.630]and so tidy up time was happening,
[00:30:39.030]and the teacher played a countdown animation
[00:30:42.480]on the interactive whiteboard, and it was a ticking...
[00:30:45.870]No, it wasn't ticking, it was...
[00:30:47.340]Yeah, it was a ticking time bomb.
[00:30:49.740]It was a ticking time bomb that was going, tick, tick.
[00:30:51.750]Everyone had to tidy up before the bomb exploded.
[00:30:54.268]And this boy went like this.
[00:30:58.530]And she's like, "See, he doesn't tidy up.
[00:31:01.980]So non-compliant."
[00:31:03.570]And I was like, "He thinks he's going to die."
[00:31:06.156](crowd laughing)
[00:31:07.417]"He thinks the bomb's going to explode
[00:31:09.780]and he's going to die.
[00:31:11.940]And can I suggest that one of the things we change
[00:31:15.121]is your countdown timers?"
[00:31:18.000]It was the funniest thing.
[00:31:20.100]It was the funniest thing.
[00:31:21.060]I mean, his pupils were blown,
[00:31:22.920]like, this body had taken over this brain, right?
[00:31:26.490]And he'd gone past the point of fight or flight
[00:31:29.310]to immobilization, and that was happening every day.
[00:31:33.420]So his baseline had become a baseline of dysregulation,
[00:31:38.460]but everyone was looking at him through the lens
[00:31:40.860]of being a controlling busy body.
[00:31:43.725]But until we could get him regulated,
[00:31:48.153]there wasn't anything else worth doing.
[00:31:52.200]They ended up actually moving out of Hong Kong.
[00:31:54.720]They couldn't find a school...
[00:31:55.770]They were Australian family.
[00:31:56.910]They couldn't find a school that fit him in Hong Kong
[00:31:59.370]and they moved to a suburban area of Australia
[00:32:02.730]and he went to a small country school.
[00:32:05.250]And they wrote to me
[00:32:06.083]about how well he was doing, amazingly well.
[00:32:10.140]And then an OT did a reevaluation on him
[00:32:12.900]and he scored within typical range for everything.
[00:32:16.860]So his regulation had put him into this state of vigilance
[00:32:21.900]and he probably had some vulnerabilities
[00:32:25.380]in the sensory integration process,
[00:32:28.980]but it wasn't the main thing,
[00:32:31.200]it was the state of utter terror
[00:32:33.480]that he was living in all the time
[00:32:35.820]because of these mild differences in sensory integration
[00:32:39.240]and the mismatch between him and the environment he was in
[00:32:42.930]and the expectations he was being given,
[00:32:45.510]and the fact that he was cast in the role
[00:32:47.550]of the problem child, which he decided to live up to.
[00:32:50.117]'Cause if you tell a child who they are,
[00:32:52.380]they'll be that person, right?
[00:32:54.150]So all sorts of things were going on.
[00:32:56.430]Okay, regulation enough.
[00:32:58.017]Okay, so let's talk about what this means in schools.
[00:33:01.194]Hopefully you are all familiar with the idea of MTSS,
[00:33:04.234]but that there are whole school level school supports,
[00:33:07.381]classroom supports, and then individual supports
[00:33:10.200]that we give and we can offer our children.
[00:33:14.460]And I'm not gonna go,
[00:33:15.420]that's not what this lecture is, right?
[00:33:17.280]But the idea is,
[00:33:20.220]that we can offer help at every single level,
[00:33:24.041]and a sensory-informed school environment
[00:33:28.050]is relevant for every single child.
[00:33:30.999]You know, historically, when we used to talk
[00:33:33.660]about SPD as the main thing, sensory processing disorder,
[00:33:39.930]sensory processing disorder was a big...
[00:33:42.540]It's a big...
[00:33:43.530]It represents a big group of people.
[00:33:45.900]And if you didn't meet criteria for another diagnosis
[00:33:50.250]and you just met criteria for SPD,
[00:33:53.310]then that wasn't recognized
[00:33:54.900]as a formal diagnosis in the DSM.
[00:33:56.970]And so you wouldn't get insurance coverage,
[00:33:59.490]you wouldn't get the accommodations and supports.
[00:34:02.610]So there was a really big movement
[00:34:04.230]to get it recognized as a diagnosis.
[00:34:06.330]It was unsuccessful,
[00:34:08.280]but it did get it recognized as part of autism in the DSM
[00:34:12.240]which led to a lot more research being done,
[00:34:14.340]which is a cool outcome.
[00:34:16.282]And it's also led to a lot of misunderstandings.
[00:34:20.730]when we talk about SPD,
[00:34:21.870]we used to say 16% of the children in the room.
[00:34:25.260]And then we talk about how many autistics
[00:34:27.420]have differences in sensory integration.
[00:34:29.160]Well, actually, the research says anything
[00:34:30.780]from like 66% to 93%,
[00:34:33.870]and I'm more of the like 100% leaning,
[00:34:38.383]and there are reasons for that.
[00:34:40.860]A lot of the research only looks
[00:34:43.230]at sensory overresponsivity.
[00:34:45.492]Where's that gone?
[00:34:47.670]I'm gonna have to come back to that.
[00:34:49.650]Only looks at sensory overresponsivity, right?
[00:34:53.063]Everything's too loud, too much, too intense.
[00:34:57.540]There's also sensory underresponsivity,
[00:34:59.460]which is much less researched but very prevalent.
[00:35:03.510]And then there's your motor planning differences
[00:35:06.565]which don't always get counted in
[00:35:09.060]when we do the statistics
[00:35:10.380]of how many people have these differences.
[00:35:12.180]And then there's your postural differences
[00:35:14.190]and so on and so on and so on.
[00:35:16.320]When we talk about sensory health,
[00:35:18.660]when we look at it from a strength-based perspective,
[00:35:20.820]like the child on the skateboard, like our Olympic gymnasts,
[00:35:24.090]it benefits a hundred percent of the people in the school,
[00:35:27.120]and I say that with confidence that my researcher is sound.
[00:35:30.360]Because everyone in the school I'm hoping is human,
[00:35:34.860]and therefore having this approach
[00:35:38.040]that really takes into account the whole person
[00:35:40.290]is going to benefit them.
[00:35:41.970]And they're gonna come out of that school environment,
[00:35:44.280]the sensory-informed school,
[00:35:46.110]understanding their regulation
[00:35:48.360]better than at my generation ever did.
[00:35:51.000]You know, this concept that now might not be a good time
[00:35:56.100]to talk about the family budget.
[00:35:58.800]I mean, that's always with me, but, you know.
[00:36:00.941]Because I'm more stressed than I am on another day.
[00:36:04.440]Like, those sorts of things,
[00:36:06.067]they're really important to know.
[00:36:07.680]So when we provide sensory-informed supports
[00:36:11.230]at a whole school level, everyone benefits.
[00:36:14.580]Everyone benefits.
[00:36:15.600]The teachers, especially, benefit I think.
[00:36:19.080]Because if I'm taking the time to think about my regulation
[00:36:23.925]as an adult in this space,
[00:36:26.670]because that's a learning strategy for my students, right?
[00:36:29.670]When they see it, they do it,
[00:36:32.040]I'm also going to be a happier, healthier teacher.
[00:36:36.390]We'll, let's all...
[00:36:37.410]I'm noticing that we all need to take a minute.
[00:36:40.290]Let's all take a minute.
[00:36:41.850]And we create these dynamic understanding environments,
[00:36:44.640]and what does that do?
[00:36:47.280]Absolutely amplifies the social emotional development
[00:36:52.140]of the children in that classroom and the whole school.
[00:36:55.680]The whole school nervous system benefits
[00:36:59.340]when we take a sensory-informed approach.
[00:37:03.339]And so there are things that we can do.
[00:37:05.760]Like, I've done a lot of parent trainings,
[00:37:07.774]teacher trainings,
[00:37:10.111]but then also like looking at the school environment
[00:37:13.211]and making some simple changes.
[00:37:15.255]And my favorite thing,
[00:37:18.060]normalizing accommodations instead of normalizing people.
[00:37:22.830]And so we start to have these dynamic spaces
[00:37:25.495]with multiple seating options, standing desks,
[00:37:29.976]noise reduction headphones,
[00:37:32.610]and it's okay for this child to listen to music today.
[00:37:35.730]And I, as the teacher, I'm even gonna say,
[00:37:38.340]I'm gonna put my Vibe...
[00:37:40.080]No, I'm not sponsored by them.
[00:37:41.700]Earplugs in or whatever
[00:37:43.227]and just use some noise reduction strategies today
[00:37:46.205]'cause it's a lot of noise at the moment, right?
[00:37:48.960]And we start realizing
[00:37:50.610]that the way we've understood accommodations
[00:37:52.800]is a little bit skewed.
[00:37:54.310]Sitting at the front right next to the teacher,
[00:37:58.260]it's not always gonna support regulation.
[00:38:00.990]Sometimes sitting at the back is better,
[00:38:02.580]and I'm using my sensory-informed lens
[00:38:05.610]to understand what this child needs.
[00:38:08.190]And then that way we appreciate
[00:38:11.729]the diversity in the room and benefit from it
[00:38:16.769]rather than just trying to cultivate
[00:38:20.070]lots of little children of least resistance
[00:38:22.814]and that classroom convenience,
[00:38:25.642]over dynamic learners and reflective rebels.
[00:38:33.060]And so we're we're sort of starting,
[00:38:35.340]at that whole school level,
[00:38:37.530]try to normalize accommodations
[00:38:39.390]instead of normalizing people.
[00:38:42.540]And then our practice becomes neurodiversity affirming
[00:38:45.420]almost incidentally.
[00:38:47.280]I do believe that sensory-informed approaches
[00:38:50.310]are neurodiversity affirming approaches
[00:38:53.100]when they're done right.
[00:38:56.520]And so the other part of doing this
[00:38:58.811]at that whole school level is how much...
[00:39:02.250]It really relies on the whole team,
[00:39:05.130]the whole interprofessional team.
[00:39:06.960]And I include parents and the interprofessional team
[00:39:09.900]and I hope you do too.
[00:39:12.450]And so really working together to support regulation
[00:39:18.510]and to have a sensory-informed space
[00:39:20.280]and sensory-informed approaches
[00:39:22.620]can be tremendously beneficial.
[00:39:24.360]And Colleen Whiting,
[00:39:25.440]who was the first author on that paper I just showed you,
[00:39:28.740]she's actually responsible
[00:39:29.790]for a lot of the content in this presentation.
[00:39:31.830]She's a school-based OT at...
[00:39:34.691]I wanna say Massachusetts.
[00:39:36.990]I hope I'm right.
[00:39:39.210]And what she'll do
[00:39:41.160]is she'll build sensory-informed strategies
[00:39:44.430]into the curriculum.
[00:39:45.960]So like this week we are teaching this,
[00:39:47.912]the teachers told her that six weeks ahead of time,
[00:39:51.270]and she's gonna do this, this, this, this and this,
[00:39:53.100]and they're all whole body
[00:39:54.210]immersive multisensory experiences
[00:39:57.150]that support the learning of the students,
[00:40:00.060]but not just the learning of the students
[00:40:01.980]as in the retaining of information,
[00:40:04.140]their ability to be attentive is improved
[00:40:07.530]because of this sensory-informed approach.
[00:40:09.750]So lives start to get easier and more joyful.
[00:40:13.735]Okay.
[00:40:16.110]And so one of the things I really like
[00:40:18.690]about this idea of like multiple service users
[00:40:21.690]being interested in this,
[00:40:22.860]it's not just the domain of the OT,
[00:40:23.853]is because, as I said, it benefits the team.
[00:40:30.630]If you can get your leadership of the school
[00:40:33.240]into it as well, it's really, really powerful.
[00:40:37.260]And once they start experiencing in their body the benefits,
[00:40:41.086]the buy-in's gonna increase,
[00:40:43.800]and then hopefully we'll have an upstream effect.
[00:40:46.770]I like this rubric.
[00:40:48.330]I've kept it in.
[00:40:49.290]It's really sort of more for the OTs here
[00:40:51.720]who are thinking about,
[00:40:52.553]how can I do this in my end interdisciplinary team?
[00:40:55.890]So you are welcome,
[00:40:57.600]and I really like looking at the competent
[00:41:00.881]and mastery columns of this rubric because,
[00:41:03.893]and I can't read it from that small screen,
[00:41:08.280]but they're talking about assertiveness,
[00:41:11.670]and responsiveness, conciseness, initiative.
[00:41:20.610]There's nothing in there about like
[00:41:25.560]whole body listening or sitting still or compliance, right?
[00:41:27.917]So when we are looking at the adults in the school,
[00:41:31.350]the things that we value
[00:41:33.030]are things I hope we can also value in our children.
[00:41:35.610]And again, we come back to that idea
[00:41:36.930]of like the reflective rebels and classroom citizens
[00:41:39.983]and how this whole body-brain approach
[00:41:43.050]can really support that piece.
[00:41:47.520]And so we look at these three domains
[00:41:50.040]as a way of supporting wellbeing,
[00:41:51.750]as a way of supporting sustained attention
[00:41:54.030]and learning at school,
[00:41:55.440]and learning starting in the body,
[00:41:57.090]and then moving to that academic space.
[00:41:59.970]And so we have to look at the environment.
[00:42:04.140]There's that classic example
[00:42:06.060]of the building with the stairs, and...
[00:42:13.170]Well, the child in the wheelchair can't get in but...
[00:42:16.140]Okay, I can put the ramp down
[00:42:19.320]for the child in the wheelchair,
[00:42:20.550]but let's let everyone who can walk up the stairs go first.
[00:42:24.660]And the question is, everyone can use the ramp.
[00:42:27.540]Why aren't we starting with the ramp?
[00:42:30.570]Right?
[00:42:31.403]Like, why are we even still building stairs
[00:42:33.900]if we can build ramps?
[00:42:35.760]And it's a similar sort of principle
[00:42:37.410]when you're thinking about sensory-informed spaces.
[00:42:40.650]It's like, don't make it about the like exception
[00:42:43.737]to the rule, make it about universal design.
[00:42:47.610]Everyone will benefit
[00:42:49.650]if we start normalizing accommodations, if we...
[00:42:53.940]And here's a controversial thing.
[00:42:56.889]There is evidence that really strongly shows
[00:42:59.640]everyone in the classroom benefits
[00:43:02.279]when there's no artwork on the walls
[00:43:05.310]or hanging from the ceiling.
[00:43:07.502]Ah, I've never met a teacher who likes it when I say that.
[00:43:12.840]But there's really overwhelming evidence that if you remove
[00:43:15.900]all the visual distractions in a classroom,
[00:43:18.570]the children can pay attention for longer
[00:43:21.000]and hold onto their learning for longer.
[00:43:24.780]But because that clashes with our cultural expectations,
[00:43:27.390]it hasn't really gone anywhere, right?
[00:43:29.250]But sensory-informed space is benefit everybody.
[00:43:33.413]And again, there's like overwhelming evidence
[00:43:36.270]that where if we move when we are learning,
[00:43:39.600]if we move to learn,
[00:43:41.835]that again, like, we learn more robustly.
[00:43:46.230]I'm sorry, I apologize.
[00:43:49.439]And in fact, there's even some wacky evidence
[00:43:52.410]about like learning your timestables.
[00:43:54.750]And if you move to the right when you do the thing,
[00:43:57.281]you learn it better than if you move to the left.
[00:44:00.000]I'm not suggesting we all start doing that,
[00:44:01.920]seems really complicated, but the point is,
[00:44:06.330]moving to learn not as incidental to learning,
[00:44:08.573]not sitting still to learn, is way more powerful.
[00:44:15.420]And when we ask the little bodies in our classrooms
[00:44:20.010]to sit still to learn,
[00:44:22.530]sometimes the sitting still is the only part they can do.
[00:44:26.250]And so what we are doing is we're actually failing them,
[00:44:28.590]and we're failing them at a level
[00:44:29.820]that would be identifiable under IDEA if you ask me.
[00:44:33.690]Like, my priority of you sitting still
[00:44:36.699]and looking like you're listening to me
[00:44:39.390]is completely disrupting your ability
[00:44:41.730]to actually access the curriculum.
[00:44:45.150]So that's, I've just created a barrier for you to learn.
[00:44:48.990]But if I can let you stand up to learn
[00:44:51.510]and normalize moving around to learn
[00:44:54.150]or chewing or fidgeting or whatever,
[00:44:57.540]you are gonna be able to learn a lot better.
[00:44:59.520]And this is a strange phenomena I experienced
[00:45:02.072]when I did finally start going to university.
[00:45:04.350]But seeing like adult learning spaces
[00:45:06.810]where people could get up to listen
[00:45:09.750]or it was just acceptable to sort of be a human,
[00:45:13.562]not be dead still in your chair.
[00:45:17.460]It was very strange to me
[00:45:18.570]why do we have these higher expectations
[00:45:20.497]on our younger learners than we do on our older learners?
[00:45:26.340]And then on top of that,
[00:45:28.800]despite everything we know about autism,
[00:45:32.100]even higher expectations on our neurodivergent learners
[00:45:36.330]than on our neuro majority learners.
[00:45:42.690]I've done so many school visits
[00:45:46.680]and watched the children on the carpet
[00:45:49.380]and the autistic child who can't sit still
[00:45:54.300]and leans and touches the other children
[00:45:57.810]is the reason I'm there, right?
[00:45:59.277]And and they do it,
[00:46:00.510]they do those things.
[00:46:02.340]But so does everybody else in that classroom.
[00:46:04.200]They just don't look autistic when they're doing it.
[00:46:06.930]Like, so I sit there time and time again like, "Huh?"
[00:46:12.120]And then we've got all these expectations
[00:46:14.850]on whole body listening.
[00:46:16.650]Not a single one of you in here,
[00:46:18.780]and I love you, you're amazing to talk to,
[00:46:21.000]but none of you are doing whole body listening.
[00:46:24.150]And if I demanded it of you, you would either leave
[00:46:28.500]or do so you'd get your phone out
[00:46:31.320]or you'd be working so hard to sit still
[00:46:35.097]and look like you're listening
[00:46:36.960]that you'd do the Hogwarts strategy I suggested
[00:46:39.636]and you wouldn't know any of the content.
[00:46:42.840]We have higher demands on our young learners
[00:46:45.450]and even higher demands
[00:46:47.700]on our neurodivergent young learners,
[00:46:49.680]and it doesn't make sense.
[00:46:51.030]We are creating barriers to them accessing the curriculum,
[00:46:54.937]and then we are blaming it on them
[00:46:58.123]when they show distress behaviors,
[00:47:03.360]even though there's this tremendous mismatch
[00:47:06.300]between what they're capable of
[00:47:08.040]and what we're asking of them.
[00:47:12.180]And so what can we do?
[00:47:14.160]That's what I'm supposed to be talking about.
[00:47:16.196]We are gonna go back to regulation,
[00:47:20.520]we are gonna start talking about how our body feels,
[00:47:24.360]we're gonna model it,
[00:47:25.950]we're gonna make space and time for that,
[00:47:28.170]we're gonna get really good
[00:47:29.700]interdisciplinary team evaluations
[00:47:31.980]with lots of information in them,
[00:47:33.783]and we are going to use relationships
[00:47:37.615]in a way that is supportive and respectful
[00:47:41.040]for the children in our classrooms.
[00:47:44.160]And so one example of what it might look like
[00:47:46.650]in a sensory-informed environment, but not really,
[00:47:49.710]something very practical
[00:47:52.110]is like just thinking about the nurse and injections.
[00:47:55.860]And actually this has become even more relevant,
[00:47:57.600]of course, hasn't it?
[00:47:58.433]Since immunizations.
[00:47:59.970]And some of the...
[00:48:00.810]There are schools in Colorado
[00:48:01.980]where the immunizations are done at the school.
[00:48:04.350]Does that happen here as well?
[00:48:07.890]Okay, I don't what you've said, but that's fine.
[00:48:12.106]But if you've got this like...
[00:48:14.297]If you are living and breathing
[00:48:16.260]this sensory inform culture,
[00:48:18.900]the approach to needles at school might look like this,
[00:48:23.564]and it would be supportive of the nurse.
[00:48:26.647]This example was very easy for me
[00:48:29.520]'cause I have two children with type 1 diabetes.
[00:48:32.130]And you meet so many people,
[00:48:33.844]even nurses in the emergency room,
[00:48:36.840]they have no clue how to support type 1 diabetes.
[00:48:39.966]And they, even in the children's hospital,
[00:48:42.484]have no clue about sensory-informed strategies.
[00:48:45.409]And there are so many that are available.
[00:48:48.690]So you can get this little yellow piece of plastic.
[00:48:53.100]It's got tiny little nubs on the other side.
[00:48:55.260]You put it on, and that sensory input
[00:48:58.740]helps to mute or dull the sensation of the needle going in,
[00:49:03.504]and then it's harder to hyperfixate on that, right?
[00:49:06.628]That's a sensory-informed approach.
[00:49:08.700]That's what that is.
[00:49:10.440]There's a vibrating ice pack that looks like a bee,
[00:49:13.800]you know, very, very similar,
[00:49:15.150]and then the numbing of the ice.
[00:49:17.250]You can find out a lot about these ideas
[00:49:20.434]from this free resource and from the Meg Foundation,
[00:49:23.926]and she did that talk for us on this.
[00:49:27.790]But like, that's an example of what I'm trying to talk about
[00:49:31.080]with sensory health in schools,
[00:49:32.464]sensory-informed environments.
[00:49:36.510]Okay, and then, this supports then
[00:49:41.203]our relational understandings
[00:49:45.630]and starting to understand
[00:49:47.400]how the sensory integration process intersects
[00:49:50.790]with socio-emotional development becomes really important.
[00:49:56.430]And then if we had another day together,
[00:50:00.927]we could get onto how this supports the idea
[00:50:03.840]that play for play's sake,
[00:50:06.960]especially whole body play, is really important in schools.
[00:50:13.650]Okay.
[00:50:16.350]So you couldn't look at that in your own time.
[00:50:20.970]Tier two would be working more indirectly
[00:50:25.440]in the classroom in context.
[00:50:28.920]And so you are gonna start doing those...
[00:50:30.810]You're gonna start sort of stepping in
[00:50:32.580]and looking at what's going on in that environment
[00:50:35.040]and paying attention to the dynamics of that space
[00:50:37.384]in that room.
[00:50:38.850]A very simple example of that
[00:50:40.920]was one classroom that I visited
[00:50:42.720]in a very large international school,
[00:50:46.140]and they used...
[00:50:47.520]And I'm gonna probably use the wrong word.
[00:50:49.200]They had like a (indistinct) system.
[00:50:52.059]They had like, every classroom had speakers in it,
[00:50:54.150]and then they could make the announcements.
[00:50:57.090]And the speaker in this child's classroom
[00:51:01.050]had a very, very, very faint static hum all the time,
[00:51:06.960]and everyone else had tuned it out.
[00:51:08.910]But I was a visitor to the classroom
[00:51:10.553]and I'm sensory over-responsive, thank you,
[00:51:13.410]and so I noticed this immediately
[00:51:17.160]and realized that the young man I had gone to visit
[00:51:21.270]was aware of it all the time,
[00:51:23.100]had never habituated to it.
[00:51:25.590]So it was constantly calling his attention
[00:51:28.980]away from what he was supposed to be doing.
[00:51:32.100]And so we fixed the speaker, right?
[00:51:35.220]Like, that's just a really simple example
[00:51:36.899]of this kind of thinking and problem solving.
[00:51:40.080]It's really not that revolutionary, some of these pieces,
[00:51:45.600]helping everyone understand themselves
[00:51:47.640]and what they need to learn.
[00:51:48.990]And those of you that are like looking
[00:51:50.460]at what on earth is happening in the picture,
[00:51:53.280]these are exactly what they look like.
[00:51:56.280]Plastic storage boxes that have been turned into vehicles
[00:52:00.600]with cushions inside them
[00:52:02.580]for children who have not yet learnt
[00:52:05.430]the boundaries of their own space for circle time,
[00:52:07.980]which is most children in preschool.
[00:52:10.954]And so this is how they start learning
[00:52:13.282]to be in the classroom space
[00:52:15.300]with a physical sense of safety and containment.
[00:52:20.370]And then as they're ready,
[00:52:21.600]they actually tell us
[00:52:23.340]and we move them into a like a yoga floor chair
[00:52:27.060]that has a back,
[00:52:28.200]but still gives them a sense of containment.
[00:52:30.930]And then as they're ready to provide
[00:52:32.580]that sense of containment themselves,
[00:52:34.770]they just sit on a spot.
[00:52:36.510]And that's one example of supporting development
[00:52:39.210]in a sensory-informed manner.
[00:52:43.170]And then the other thing that's...
[00:52:46.135]Oh, that's the next slide, okay.
[00:52:48.030]And so then what we've got is,
[00:52:50.640]again, now at the classroom level,
[00:52:53.010]learning about how our nervous system fluctuates
[00:52:58.320]through the day, our state regulation,
[00:53:00.420]what we can do to support our attention spans and so on.
[00:53:03.766]And so we all...
[00:53:05.400]Brain gym as an example, right?
[00:53:07.021]Like, let's all get up and do da, da, da, da, da,
[00:53:10.035]and then we sit down and we learn again.
[00:53:12.450]And like reading the room
[00:53:13.958]and being responsive in real time,
[00:53:18.150]having your pulse on the nervous system of the classroom
[00:53:21.720]is going to help develop this community of learners
[00:53:28.950]who are together because they get it and they want to be
[00:53:31.860]and feel safe in that space.
[00:53:35.794]And so a lot of what we're doing is like,
[00:53:38.773]trying to support this in the moment responsiveness
[00:53:44.010]to our humanity as individuals, as a classroom and so on,
[00:53:49.501]and that means that we change what we're doing.
[00:53:52.680]And if regulation's harder today than it was yesterday,
[00:53:56.730]we let go of our own agenda and we start with regulation,
[00:54:00.048]and then we can get back to the learning again,
[00:54:02.820]and that can be really hard as adults.
[00:54:05.190]Because yesterday we had this amazing,
[00:54:07.931]sophisticated interaction, and I really wanna do that again.
[00:54:10.830]But if the child's not ready, they're not ready.
[00:54:13.638]And we really become partners and collaborators
[00:54:16.830]with the teachers and educators.
[00:54:20.820]And we are not just talking about
[00:54:22.560]moving for movement's sake,
[00:54:23.970]we're talking about a very intentionally pluggingness
[00:54:27.810]this into our classroom culture.
[00:54:32.340]So we've talked about regulation
[00:54:34.110]and I wanna share this resource with you
[00:54:35.940]by Heather Spann and Amy Lewis.
[00:54:38.190]It's at powerfullyyou.org,
[00:54:41.070]and it's a really lovely kind of curriculum
[00:54:44.730]for learning regulation that's embodied.
[00:54:47.042]It's whole body.
[00:54:48.900]A lot of times we find these curriculums are very cognitive,
[00:54:52.950]and that doesn't work
[00:54:54.210]if we're trying to really help the whole brain and body.
[00:54:57.222]We can't just talk about it.
[00:54:58.980]We already have hundreds of little scientists
[00:55:02.250]walking around the school who are very good at talking
[00:55:04.440]and not very good at being in their bodies.
[00:55:06.060]So this approach is really nice.
[00:55:09.010]They offer trainings with the approach.
[00:55:13.500]Sorry, that's really small.
[00:55:14.880]I don't know how that happened.
[00:55:17.010]But there's this body-based awareness,
[00:55:18.878]and what I really like about Powerfully You
[00:55:21.570]is that they don't use language that insinuates judgment,
[00:55:28.837]insinuates good or bad.
[00:55:31.170]One of my concerns with like the Zones of Arousal,
[00:55:34.590]which is an excellent program,
[00:55:36.342]but the way that it's used when we talk about the red zone
[00:55:39.762]suggests that the red zone's not okay.
[00:55:42.960]We call that valence.
[00:55:44.130]There's kind of a judgment insinuated in it.
[00:55:47.400]Oh, you know, when your body's in the red zone
[00:55:49.530]and da, da, da, da, da.
[00:55:50.370]And they've really tried to avoid that
[00:55:52.534]and their language is really designed
[00:55:55.889]to support this judgment-free understanding
[00:55:59.665]of how people are doing.
[00:56:02.160]And so one way that that looks,
[00:56:04.170]this is a inner school
[00:56:05.760]where they have like a little regulation corner
[00:56:09.330]and they have the powerfully you resources up.
[00:56:13.740]And the children can visit it
[00:56:15.750]when they need to take a break, check in,
[00:56:18.150]do some of the exercises,
[00:56:21.030]start to become aware of their own state regulation
[00:56:23.131]and so on.
[00:56:25.507]And so that...
[00:56:26.580]It's just a really nice piece to build into your environment
[00:56:30.570]and it really supports at that classroom level.
[00:56:34.446]And so when my battery's flat and when my battery's full
[00:56:37.710]and what fills my battery,
[00:56:40.050]it becomes part of the conversation.
[00:56:42.060]There's another resource called Autism Level UP.
[00:56:44.880]Autism Level UP is designed
[00:56:47.467]by doctors Jacquelyn Fede and Amy Laurent.
[00:56:51.630]Jacqueline is autistic and brilliant
[00:56:58.290]and very angry with pathologizing autistic children.
[00:57:04.170]And so what they've created is a suite of resources
[00:57:07.648]that again, like are judgment-free resources,
[00:57:11.760]and really are coming from that strength-based
[00:57:14.070]non-athologizing perspective.
[00:57:15.900]And so this is how they talk about...
[00:57:18.540]This is one of the ways that they talk about
[00:57:21.450]checking in with your body.
[00:57:22.650]So instead of like red, blue, green or too high or too low,
[00:57:27.270]they're saying, which of these does it feel like?
[00:57:30.300]And you find the abstract representation
[00:57:33.748]that works for that child
[00:57:35.626]and it might be a sound
[00:57:39.690]rather than an emotion or a color or those sorts of things.
[00:57:44.310]And then they also do it with...
[00:57:46.440]I think they've done it with "Star Wars" characters
[00:57:49.246]and I'm sure "Harry Potter" and other things like that.
[00:57:53.550]Okay, and then this is another example
[00:57:56.790]of how they talk about different states of regulation
[00:58:00.504]and really trying not to say one's better than another.
[00:58:05.250]So how are you, where are you at?
[00:58:08.010]And a lot of it is free on their website, so...
[00:58:12.360]And then there's other resources you can look at.
[00:58:14.797]Self-reg.ca is Stuart Shanker's group,
[00:58:18.330]and they've got trainings and books coming out their ears.
[00:58:21.840]So a massive resource there.
[00:58:27.210]And here are some other programs
[00:58:29.105]that you've probably heard of before.
[00:58:31.440]I think I wanna call your attention most to Kelly Marlas.
[00:58:34.470]Kelly's really helping us tune
[00:58:37.230]into our interoceptive sensations
[00:58:39.780]and figure out what that means for us.
[00:58:42.480]So I feel this and it means I need to do some self-care
[00:58:46.230]or I need...
[00:58:47.063]You know, those sorts of things, and it's very practical.
[00:58:51.450]Okay.
[00:58:52.320]So all of this is, it intersects with these other pieces.
[00:58:57.085]And I think one of the main things
[00:58:59.220]I want to point out just now
[00:59:00.900]is the caregiver's sensory profile.
[00:59:05.400]The teacher's sensory profile.
[00:59:07.140]And so when you are supporting at the classroom level,
[00:59:09.836]let's support the teachers and the educators too
[00:59:12.690]and help them understand their sensory preferences
[00:59:15.150]and strengths and so on.
[00:59:17.400]Okay, let's see what we haven't covered yet.
[00:59:23.700]So one of the things that we can do at this level as well
[00:59:27.562]is like really help the whole team,
[00:59:30.450]the education team and the therapists,
[00:59:32.490]understand that everything's a therapeutic opportunity
[00:59:36.390]and you don't have to be and pull out OT to get that.
[00:59:39.926]And we can give away these magic pieces of information
[00:59:43.104]that we have as OTs and not be scared.
[00:59:47.730]We are not gonna run out of children who need our help.
[00:59:50.520]We can really give away our information.
[00:59:55.680]And so as we go down this journey,
[00:59:59.130]we are gonna be finding out more and more and more
[01:00:01.230]about the child's individual differences and their profile,
[01:00:03.980]and that might mean at this stage
[01:00:06.120]that you are gonna get a full evaluation.
[01:00:08.460]And I want you to know that not all OTs
[01:00:11.340]provide the same level of sensory integration evaluation,
[01:00:15.150]and so you really wanna look for someone
[01:00:16.860]who has had 50 to 120 hours of post-professional training
[01:00:22.181]in sensory integration ideally,
[01:00:25.590]or they're supervised by someone who does.
[01:00:28.320]That's really hard,
[01:00:29.970]especially when you're in rural areas or whatever.
[01:00:32.856]But what happens when people just use one tool
[01:00:37.830]or have just done a weekend training
[01:00:39.450]is that everyone tends to just fall into the category
[01:00:42.330]of sensory over-responsive,
[01:00:44.010]and we don't get the differentiation
[01:00:46.140]that's really important.
[01:00:47.880]We need to really understand the profile of the child
[01:00:50.730]to provide the tailored supports
[01:00:53.190]that are gonna help them to be precise.
[01:00:56.700]And so what you want is a report
[01:00:58.410]that covers all of these areas and make sense
[01:01:01.230]and is connected to function.
[01:01:03.810]And you should be able to read your OT report
[01:01:06.210]and get really good complex information
[01:01:08.550]that is relatable and connected to the reason for referral.
[01:01:14.280]The evaluation shouldn't just give you
[01:01:16.770]a report measure only,
[01:01:18.630]it should be a report measure and...
[01:01:20.430]That's a questionnaire, right?
[01:01:23.130]We wanna do those and we wanna do,
[01:01:25.650]if possible, a standardized assessment,
[01:01:29.040]which should be possible,
[01:01:30.390]and clinical observations
[01:01:32.160]and discussions and interviews and so on
[01:01:34.980]and wherever possible, including the child in that.
[01:01:39.120]And then we're asking the question is,
[01:01:40.800]does this child sensory integration differences
[01:01:45.450]contribute to their challenges accessing the curriculum?
[01:01:50.430]And I think you can tell already
[01:01:52.350]from the way I've been talking
[01:01:53.370]that a lot of the times,
[01:01:54.840]it's the mismatch
[01:01:56.220]between that child sensory integration differences
[01:01:58.860]and the environment, that other barrier,
[01:02:01.290]not the child themselves.
[01:02:02.700]And so we wanna try and really move
[01:02:04.492]towards that kind of thinking.
[01:02:08.010]I'll leave that in there for you
[01:02:08.880]to look at on your own time.
[01:02:11.850]And then the other thing about schools
[01:02:13.740]is being really creative about the use of space.
[01:02:17.130]And it's funny how I needed permission for this.
[01:02:20.400]So a lot of OTs work in a cupboard,
[01:02:23.927]but if you can get the whole school on board
[01:02:27.300]as a sensory-informed community,
[01:02:28.710]you can start using hallways, the asphalt,
[01:02:32.220]the playground, the gym, the stage, when it's not in use,
[01:02:35.910]those sorts of things.
[01:02:37.290]So life outside the cupboard becomes accessible
[01:02:42.377]for sensory-informed communities.
[01:02:47.790]Okay, we were gonna meet Matthew,
[01:02:49.800]but we are running out of time, aren't we?
[01:02:52.517]Matthew is in grade one,
[01:02:59.550]and I was gonna share his impact statements with you all.
[01:03:04.260]I'm gonna let you read those in your own time.
[01:03:06.840]The way we write our reports at STAR Institute
[01:03:09.630]is that you get these impact statements where we say,
[01:03:13.507]"Here's the factor that we've identified the difference
[01:03:16.769]in sensory integration
[01:03:18.930]and here's how it connects to function."
[01:03:22.320]And this is...
[01:03:25.440]This is an advocacy tool.
[01:03:27.510]This is an advocacy document.
[01:03:29.640]You are seeing an emotional response,
[01:03:32.160]I'm gonna explain what's happening in this child's body
[01:03:34.617]that's causing it.
[01:03:36.750]And we go through that whole sort of trees or that diagram,
[01:03:40.977]which we call the nosology,
[01:03:43.374]as we try to explain those pieces.
[01:03:46.170]And so if those aren't readable,
[01:03:48.090]which they're probably too small on the handout,
[01:03:50.010]I'll send a bigger version of those for everyone to see.
[01:03:53.640]I think we've got some questions
[01:03:55.290]and a tiny bit of time for questions.
[01:04:00.840]I know we had one earlier that was about...
[01:04:04.706]Oh, gosh, I can't even remember it now, Jamie.
[01:04:07.140]The one from online that I didn't answer.
[01:04:12.150]Yeah, it's okay.
[01:04:14.070]It doesn't matter.
[01:04:15.150]Yeah, does anybody have a question that you'd like to ask?
[01:04:18.219]I know it's the end of day two,
[01:04:20.210]so question time is like,
[01:04:24.330]it's challenging at the best of times.
[01:04:29.605]Yeah.
[01:04:30.678](attendee faintly speaking)
[01:04:43.287]So the question is,
[01:04:44.449]the debate on sensory rooms as a use of space
[01:04:48.120]and functional activities
[01:04:51.948]that are like multi-sensory
[01:04:54.720]and what are my thoughts on that.
[01:04:56.400]One of the...
[01:04:57.420]i think you have to understand why we have sensory rooms.
[01:05:01.380]They're not just so we can like keep a child busy
[01:05:05.670]who's difficult to have in the classroom
[01:05:07.812]or like so that they can do 10 swings.
[01:05:10.772]We have sensory rooms.
[01:05:12.900]They're designed very specifically to provide intense
[01:05:15.740]and novel experiences for the whole body
[01:05:19.950]that the child didn't use successfully earlier in life
[01:05:24.407]because of their sensory differences.
[01:05:27.000]So just bear with me for a second,
[01:05:28.710]but, you know, my oldest who's neurodivergent,
[01:05:32.550]it took us a little while,
[01:05:33.630]but we figured out eventually that to soothe him,
[01:05:37.830]my husband did it,
[01:05:39.420]he had to like drop him almost.
[01:05:43.020]He had to like really do this intense movement sometimes
[01:05:47.526]when our boy was really beside himself,
[01:05:50.700]and that was the thing that soothed him.
[01:05:53.250]And then as we got to soothe him,
[01:05:55.110]we could get him back to learning
[01:05:56.610]and engaging with us as a family.
[01:05:58.380]If we hadn't been able to problem solve
[01:06:00.660]that intense movement,
[01:06:03.300]he might not have been able to access
[01:06:05.790]all the opportunities available to him, right?
[01:06:07.855]Like, he wouldn't have had organized...
[01:06:12.303]What's the right word?
[01:06:14.233]Safe and connected childhood as much.
[01:06:19.215]And it might be that like his friend
[01:06:21.960]who I ended up seeing when he was 9, 10, 11,
[01:06:24.783]that we had to figure out this sensation organized him
[01:06:29.040]when he was 9, 10, 11.
[01:06:30.720]My husband's not doing that, right?
[01:06:33.570]But if I can get a decent swing with bungee chords
[01:06:37.470]and those sorts of things,
[01:06:38.820]give him the sensation in that bigger body
[01:06:42.360]that organizes him,
[01:06:44.070]that's gonna help his brain
[01:06:46.050]start to learn the things that he's missed,
[01:06:49.590]then the sensory room becomes really important.
[01:06:53.676]So it's how we use these spaces.
[01:06:56.010]In a perfect world, we'd absolutely have both.
[01:06:59.280]And in a perfect world,
[01:07:00.240]swings wouldn't be outlawed in England.
[01:07:02.620]There are hardly any swings on the playgrounds
[01:07:05.010]'cause they're too dangerous.
[01:07:08.460]So like, you know, we need that whole range of experiences,
[01:07:12.362]and the sensory room is important
[01:07:15.090]when it's used intentionally.
[01:07:17.460]It's not supposed to be something
[01:07:21.510]that you just take the kid who's having a meltdown to
[01:07:23.730]as a way of managing them.
[01:07:24.900]It's supposed to be used to support learning and attention
[01:07:27.708]and all of those pieces.
[01:07:35.928]I can see a hand up at the back,
[01:07:37.260]but I'm not gonna be able to hear that person,
[01:07:40.320]and they've disappeared now.
[01:07:42.240]Does anyone else have a question?
[01:07:44.940]I think we're good then.
[01:07:48.383]Okay, thank you. (crowd applauding)

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Sensory Integration Process and Support for School Success

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