Tuesday, October 9, 2018

Sensory Processing Disorder - the diagnosis that doesn't exist

It is so difficult to explain sensory processing.  I've been trying and sometimes succeeding for almost 20 years.  Most of the time I talk about the 8 sensory systems and that they need to have a "balance" to work properly.  The children I see are "out of balance" with some sensory systems over responsive and others under responsive.  OT treatment seeks to regain this balance and improve functional outcomes.  My frustrations were supported by this recent blog post form the Anonymous OT (on of my favorite blogs.


As lots of professions are jumping on the sensory bandwagon I find there is more and more misinformation out there.  I've gotten prescriptions from physicians with a diagnosis of SPD and recommending OT for it.  I've had other professionals - counselors and psychologists usually - talk about sensory regulation as though that is the same as sensory integration treatment.  When I first starting working in pediatrics if you mentioned "sensory" everyone looked at you as though you were crazy.  Now it is part of the diagnostic criteria of Autism in the DSM-V.

SPD is not an officially recognized diagnosis.  The SPD foundation attempted to get it added to the DSM-V, but they were unsuccessful.  At the same time awareness and prevelance of sensory issues have exploded.  Parents and professionals are left in a diagnosis limbo. 

It's no wonder the public is confused.  I like to point my parents or colleagues to these fact sheets from the Spiral Foundation. Its a good place to start the conversation. 

Parent Factsheet

Educator Factsheet

Physician Factsheet

In Texas, Medicaid came out with a statement that they will not reimburse for auditory integration treatment or sensory integration treatment because these are not evidence based.  I could argue the opposite point, but it doesn't really matter.  As an OT, I focus on function.  My goals ALWAYS address functional outcomes.  "Sensory processing" isn't a goal.  Going to a public restroom without increased anxiety is a goal.  How I get my clients to reach that goal is up to me.  Results speak volumes. 

There is SOOOO much to know about sensory processing.  It is a complex and not fully understood process.  Don't get discouraged, but keep seeking out good information from reputable sources. 

Friday, April 13, 2018

Workload vs. Caseload

It's 2018, and we need to move away from thinking about productivity as a function of caseload - especially us school based therapists.  SOOOOOO much of what we do is not accounted for in just the IEP minutes.  AOTA has been relatively silent on this issue that has plagued the therapy world for all the 20 years I've been practicing. 

I took it upon myself to put together a calculator to help me see how "productive" I am throughout the week.  Once I sat down and wrote out all I did in a week - I was exhausted.  =)  This will give you some much needed numbers with which to go to your administrator to show them that you need more help. 

Click picture for access to the calculator

Thursday, April 12, 2018

Interoceiption - Listening TO your body


I have a social skills group I lead once per week.  It consists of Kindergarten and 1st graders.  We have worked through all the Wee Thinkers from Social Thinking, so now as the school year is winding down, I'm adding in some other sessions.  Today we talked about INTEROCEPTION.

You've never heard of this "sense?"  Well, it's all the rage now in the therapy world.  It is the ability to notice physical sensations coming from inside your body.

In the past we have done a lesson on Whole Body Listing (see previous post), and one of my smarty smartersons in the group raised his hand and said we already learned how to listen WITH our bodies.  He was right, of course.  But I explained to him that today we were going to learn how to listen TO our bodies.

I have broken up this lesson into three parts.  Lesson 1 - watch a video and introduce the idea of listening TO your body.  Lesson 2 - Discussing what different body sensations are and where we might feel them in our bodies when having different emotions.  Lesson 3 - Discuss how everyone feels feelings differently and in different parts of their body.  We will also connect this with a previous lesson on coping skills (see previous post).

Click on the picture below for the lesson plan and worksheets:

For more information about interoception check out this book:  
click for link to Amazon

Friday, February 2, 2018

PAPERWORK!  It's the bane of my existence.  I LOVE working with kids, talking with teachers, and finding solutions to difficult problems.  But taking the time to then write what I just said, or find a way to quickly take data in order to prove my students are making progress has always been hard for me.


This is the best solution I've found so far to show progress and keep me on track when treating students.  Especially in the school system where time is at a premium.  Check out these files I've created as examples of how to use rubrics to document treatment.

This method is very flexible and easy to see progress on goals easily when it comes time to write progress reports.

Click on the link to get access to my examples of how I use rubrics in my daily OT practice.  Directions on how to download and change to your needs are included.


This is a lot of set up in the beginning, but I'm telling you it will be worth it!  Let me know how it works for you in the comments below.

Friday, September 22, 2017

I created this file so that teachers could adapt writing paper for spelling tests.  The file includes instructions on how to change the length of the word.

Click on picture for file access

Tuesday, September 27, 2016

Cut, Rip, Crumple, and Throw

This is one of my favorite activities to do with students.  People forget how hard ripping can be.  It is a GREAT fine motor tasks.  I also love how this activity gets kids to use the tips of their fingers and strengthen the in-hand muscles.

Friday, August 26, 2016

Classroom Supports for Focus, Attention, and Emotional Regulation

I find that many students benefit from some sensory supports to help maintain focus.  Visual prompts are extremely useful to help students manage their behavior.  Click on this picture for a downloadable file.

Click on picture to download file.