One of the “benefits” that I have experienced as a result of the Covid-19 Pandemic is an increased presence in the online world of support networks that are available for parents of young people with additional learning needs/special educational needs. I am often asked if I can provide reports that cover sensory needs as part of the EHCP/Statement of SEN assessment process.
Unfortunately, I am not able to help every person who comes to me, be that where face to face appointments would be more appropriate (I tend to travel within 2 hours of Bridgend in South Wales) or perhaps the young person may not be well suited to a virtual assessment. There is also the case at times where I do not have capacity to take on new families within the timescales that they require a piece of work to be completed.
Because of this, I have put together this post which I hope will help families to understand a bit more about the assessment process, training options, and to also locate other OTs who may be able to support them.
What is the Occupational Therapy process?
To begin the process, a thorough assessment is required to really understand the young person and their strengths and challenges. A therapist will use a multitude of assessment materials to gather the information that they require, as well as taking a full medical and developmental history. The therapist will be interested in the activities that the young person wants and needs to do, and also the views of their families, educators, etc.
This assessment enables the therapist to use their clinical reasoning and knowledge of neurology and sensory processing to ensure that they can form a hypothesis about the impact of the child’s strengths and challenges on their ability to engage in the things that they want and need to do throughout their daily lives (their occupations).
Following assessment and creation of the hypothesis, the therapist then needs to identify goals for the young person. These goals should be occupation focused overall, with consideration also for developing the underlying skills where the young person is experiencing difficulties (e.g. perception of body awareness, managing tactile sensations, etc.). Therapists will aim to use the young person’s strengths to support the development of the areas of their challenges.
Once goals have been created, the therapist will identify outcome measures that will be used to measure the baseline skills and then to review the young person at set intervals.
The next step is intervention or treatment.
“ASI intervention is based on the concept of neuroplasticity, that is, that the nervous system changes in response to experience. Thus, through guided participation in sensorimotor activities targeting a child’s individual needs, ASI intervention is hypothesized to improve function, skill, and behaviour as a basis for participation in everyday activities. More specifically, ASI proposes that active engagement, in individually tailored sensorimotor activities, contextualized in play, at the just-right-challenge, promotes adaptive behaviours via neuroplastic changes that occur in response to these experiences.” (Lane et al 2019)
Therapists may sometimes recommend sensorimotor or sensory based strategies as opposed to a formal Ayres Sensory Integration approach.
The intervention will be conducted and the therapist will then review the progress and adapt their goals as required.
If your young person is receiving an Occupational Therapy assessment as part of the EHCP/Statement of SEN assessment process, you are likely to receive a service up until the end of the goal planning section of the above description. The Occupational Therapist will need to write their report with clearly specified goals and quantified provision as well as specifying the levels of training that an OT would require to continue with the provision recommended.
Providing the Local Authority (or Tribunal when required) agree to these recommendations, the likely outcome will be that a new OT will be introduced once the EHCP/Statement has been finalised and they will then take over with provision of the service. This OT will need to complete their own baseline measures of the young person’s skills and ensure a good understanding of their needs before commencing the intervention process.
There is a variety of training available worldwide for OTs to train in Sensory Integration, from basic awareness through to Masters level postgraduate studies in the area. A therapists’ training and qualifications may vary depending on when they completed their training and through which programme they did this. In addition, there is a branch of Sensory Attachment Intervention, which is typically used more in cases of childhood trauma and adverse childhood experiences.
Because of the variety of training available, it can be difficult to understand the qualifications of the therapist that you are looking to work with (or what may have been recommended as part of an EHCP/Statement of SEN). As all therapists learn and develop at their own pace, it is important that they are confident at whatever level they have reached to provide the service that they are offering. It is also generally recognised that the therapist should have access to regular group or individual clinical supervision to support further skill development.
Qualifications you are likely to see when a therapist has completed a modular pathway are “Certificate in Ayres Sensory Integration”, “SI Advanced Practitioner Status (with/without SIPT)” or “Post Graduate Certificate in Sensory Integration”.
It is always beneficial to discuss the level of training a therapist has with them. It can take many years to work through these modular pathways and also a significant financial investment. Not having the final qualification does not mean that a therapist cannot practice in Ayres Sensory Integration. If you want a therapist to work with you using an Ayres Sensory Integration frame of reference though, they must at least have a secure grounding in the neuroscience and theory, the thorough assessment and observational skills and in depth clinical reasoning skills.
Directories (searching for an OT)
There are currently two online directories that list those therapists who have completed modular pathways.
CLASI Certificate in Ayres Sensory Integration: https://www.cl-asi.org/directory
Association of SI Practitioners’ Register – MSc Pathway: https://www.sensoryintegration.org.uk/ASIP-Register
There is also a directory for searching Independent Occupational Therapists in the UK, although only therapists who choose to pay for this service are included in the directory.
Royal College of Occupational Therapists – Independent Practitioners Profiles: https://rcotss-ip.org.uk/find
Its always a good idea to check that your therapist is HCPC registered too: https://www.hcpc-uk.org/check-the-register/
I am a HCPC registered Occupational Therapist based in South Wales. I specialise in working with children and young people from 0-25 years of age, both in person and online when in person sessions aren’t possible. I provide support to the Operation Diversity Academy.
I have gained and collated this knowledge as I too am working my way through the modular pathways! Having completed two modules of sensory integration training with the Sensory Integration Network before having children, I have then completed Modules 1-5 with CLASI, with the live training of Module 6 completed in October 2020 and am one case study away from receiving my Certificate in Ayres Sensory Integration.
I’m not listed on the websites yet because of this, but its my goal for 2021!
If I can help anyone with their understanding, please don’t hesitate to contact me via email@example.com.
Lane, S.J.; Mailloux, Z.; Schoen, S.; Bundy, A.; May-Benson, T.A.; Parham, L.D.; Smith Roley, S.; Schaaf, R.C. Neural Foundations of Ayres Sensory Integration®. Brain Sci. 2019, 9, 153.