Category Archives: Therapist Resources

Comprehensive resources, strategies, and tools designed to support therapists in delivering effective care and ongoing professional growth.

ASH vs ASPS: Comparing Sensory Assessment Tools

December 15, 2018Assessments, Events & Conferences, Sensory, Therapist Resourcessaturday seminar recaps, therapist resourcesTherapro

Teresa A. May-Benson, ScD, OTR/L, FAOTA, is a pillar in the field of sensory processing disorder (SPD). She is the Executive Director of the Spiral Foundation (Sensory Processing Institute for Research and Learning), whose stated mission is “To
Increase Understanding and Acceptance of Sensory Integration and Sensory Processing Dysfunction through Education and Research.” Dr. May-Benson is an esteemed educator and researcher as well as a clinician at OTA The Koomar Center in Massachusetts. At today’s Saturday seminar entitled: ASHs to A/ASPs: Comparison of Assessment Tools for Adolescents and Adults with Sensory Processing Disorder, she provided a comprehensive review of available assessments for the adolescent and adult populations with accompanying research, as well as a detailed overview of her tool, Adult/Adolescent Sensory History (ASH), published in 2015.

Dr. May-Benson reviewed research studies conducted on adults with SPD and concluded that there is a paucity of research and more is needed. She outlined what we currently know about SPD in adults, including how it impacts all aspects a person’s life. A poignant example she described was a mother who is sensory defensive who had difficulty maintaining a family relationship with her child who is a sensory seeker. The challenge for therapists during the process of assessment is to explore what things are affecting the person’s ability to engage in life activities. Dr. May-Benson also cited the problem of an apartment dweller who is auditory defensive and lives in an apartment in between two apartments. Moving to an apartment end unit that has extra insulation from noise may be a good solution to explore with this client. These examples demonstrate the value of an interview as part of the assessment process because it helps the therapist gather information about the individual’s daily life experience, along with formal screening and direct assessment.

There are a number of tools available to assess SPD that Dr. May-Benson reviewed, discussing their positive aspects and their limitations. She cautioned that screening tools should be used only to determine whether a sensory-based problem is present that warrants further testing.

According to the Spiral Foundation, “The Adult/Adolescent Sensory History is designed as a self-report assessment of sensory and motor behaviors commonly observed in individuals with difficulties processing and integrating sensory information. The purpose of this assessment is to help identify adults and adolescents ages 13 to 95 who experience problems in sensory processing and integration as well as assist therapists in clinical reasoning when creating interventions for these individuals. Based on the conceptual model of sensory processing and sensory integration proposed by A. Jean Ayres, this measure is designed to identify difficulties in five key areas of functioning: Sensory Discrimination, Sensory Modulation, Postural-Ocular Skills, Praxis, and Social-Emotional Functioning.” The ASH has performed strongly on tests of reliability and validity. It is available at the Spiral Foundation www.thespiralfoundation.org This website offers many resources including webinars, courses, and free SPD education toolkits.

In her presentation, Dr. May-Benson provided the following implications for practice:

Assessment of adults with SPD is complex and should be comprehensive.
To determine sensory integration difficulties, assessment must include more than questionnaires.
Be aware that different measures emphasize different aspects of sensory
integration; be aware that we may miss vital information if we use one
measure over another.
Select measures with the particular client’s needs.
Recognize that all measures are not created equal: some measures can provide
better functional performance information than others and others may
provide better psychometrics than others.

We were honored to present Teresa May-Benson’s seminar to spotlight her diligent work over the past 15 years to develop the ASH, which is a comprehensive, valid, and reliable adolescent/adult assessment of SPD. Her research has illuminated the issues that clients with SPD as well as their families and practitioners, face. Her research is ongoing and crucial.

Here is a sample of positive reviews about Teresa’s seminar:

“Excellent overview of Sensory Assessment tools.” – Teri B., Occupational Therapist

“I would recommend this seminar to a colleague if they work with an
adolescent or adult population. The ASH appears to be a useful tool.” – Anonymous, Occupational Therapist

“Thank you for a well-organized and comprehensive seminar about the tools
available for adolescent and adults with SPD. Teresa’s new assessment
tool has great potential!” – Maria K., Occupational Therapist

Thank you, Teresa!

Filomena Connor, MS, OTR/L
December 15, 2018

The Value of Therapy Balls and How Best to Store Them

March 26, 2018Therapist Resourcesoccupational therapy (OT) tools, physical therapy (PT), therapist resourcesTherapro

I’ve had the joy of working in four different countries and across a variety of clinical settings. No matter the environment or the age of the client, certain tools remain universally valuable—and therapy balls are one of them. I’ve successfully used therapy balls with individuals recovering from head injuries or strokes, as well as with children with learning challenges and even clients with visual impairments.

I think balls of various sizes, textures, and shapes are a tell-tale sign that you have stepped into an OT room or department. Therapy balls are valuable in meeting so many goals and certainly show how dynamic OT is and how creative we need to be with every treatment plan and session. Let’s face it, balls are fun for most ages. They are colorful and versatile. Being round means that they are dynamic, resulting in the ability to grade therapy sessions by working on an unstable surface.

Therapy balls are valuable for improving:

motor control
muscle tone
trunk control or strengthening core muscles
upper limb function for clients with orthopedic or neurological disorders
introducing fun games and exercises into therapy
eye-hand coordination
righting and balance reactions
weight shift

Balls can encourage a child to feel excited to come into a treatment room or to prepare a blind child for hippotherapy. Balls can be just as important to an older woman needing to reduce internal scarring from repeated abdominal surgery.

There is one problem with therapy balls: storage. Without due care, your therapy room can quickly become messy, cluttered, and a potential safety hazard. We don’t want our clients tripping over equipment!

If you’ve ever worked in an OT department or been involved in developing a therapy department in limited space, then you can appreciate the need to organize physio/Gymnic balls. There are times that facilities will look into securing a suitable shelf, setting up a hammock specifically for therapy balls, or acquiring an array of other wall or ceiling fittings.

But what can do you do if your practice is in rented space that doesn’t permit attaching anything to the walls or ceilings? Or if your OT room is in a building with prefabricated walls and ceilings, reducing the strength and stability of the internal structure?

When I started in private practice, one of the first pieces of equipment I obtained was a large therapy ball with bells inside. Amongst my first private clients was a child who was blind from birth and severely sensory-deprived, hence the bells within the ball. It was wonderful to introduce a ball game in which he could participate because he could hear where the ball was.

The problem was how to store the therapy ball. I grappled with this dilemma until I discovered the wonderful Ball Stacker. It looks professional and neat and makes a good impression when a parent comes into the therapy room for the first time. Now you can use therapy balls even if you can’t attach brackets, shelves, or hammocks to the wall or ceiling.

Another valuable accessory to the therapy ball, is the Ball Handpump which offers the freedom to alter the pressure in the ball according to the goals of your client.

Guest Blogger: Shoshanah Shear

Shoshanah Shear Occupational Therapist, healing facilitator, certified infant massage instructor, freelance writer, author of “Healing Your Life Through Activity – An Occupational Therapist’s Story” and co-author of “Tuvia Finds His Freedom”.

Do Gifted But Non-Disabled Children Need Occupational Therapy?

November 15, 2017School-Based Practice, Therapist Resourcesoccupational therapy (OT) tools, therapist resourcesGuest Blogger

School-based occupational therapists are familiar with receiving requests for assessments or interventions for children with delays of all kinds. What happens when the service request is for a child that has been identified as gifted or talented, but has no diagnosed disorders (non-disabled)? Will OT treatment help a child whose brain is globally and permanently wired for intense responses?

Some common behavioral characteristics of the gifted often suggest that sensory processing difficulties could be present:

Sensitivity to lighting, fabrics, and other sensory stimulation.
Seeking strong sensory-motor input throughout the day.
Difficulty tolerating school rules such as taking turns or sharing the spotlight in discussions.
Pursues interests in isolation or with adults rather than with peers.
Resistance to complete assigned projects; pursues personal interests.

Theorists such as Kazimierz Dabrowski have attributed these and other behaviors to multiple “overexcitabilites.” He identified five primary areas of over-excitability in gifted individuals: psychomotor, sensory, intellectual, imaginational and emotional. Not considered to be signs of neurological disorders, they are thought to be the result of a brain that is wired differently than children of average abilities. Brain imagining studies suggest that the gifted make faster and more complex associations between stimuli. They perceive experiences and interactions with more depth and intensity than other children, and have an inborn drive to follow their passions.

These brain characteristics are not necessarily problematic for every gifted child. When teachers and parents know how to support children who learn differently, the gifted child can become a positive force and even a leader in the classroom. Although scores on the Sensory Profile or on other sensory-based assessments may suggest an SI diagnosis, there are gifted children that manage successfully in school and at home without intervention. They may even come up with their own sensory diet, having identified activities that provide what they need. For example, a child that seeks sensory input could engage in complex art projects or specific sports activities that provide visual, tactile, vestibular or proprioceptive input. A sensory-sensitive child may happily use an unoccupied corner of the room with indirect light for free reading time.

Some gifted children will have difficulty in class, especially when their behavior is at odds with school routines and social norms. A child that takes over discussions or refuses to work on a group project may disrupt a classroom or be unable to complete assignments even though their academic abilities exceed their peers. A child that refuses to wear a tie or participate in music class may need help to handle the demands of school.

Anne Cronin, OTR, FAOTA has recommended that gifted children can benefit from sensory diets and modulation strategies found in programs such as “ It is worth noting that gifted children may be able to comprehend and implement programs at earlier ages and stages than typical children. Children who were reading at 3 or creating complex imaginary civilizations at 5 may learn and incorporate a sensory diet almost immediately on accepting its value. Such students may even improve on your suggested activities with one of their own creation! This is the time to collaborate with them and provide them with the positive feedback they may need in order to try new ways of responding at school and at home.

Patterned Fluorescent Light Filter, a resource for Gifted but Non-Disabled Children — Patterned Fluorescent Light Filter

Fluorescent Light Filter, a resource for Gifted but Non-Disabled Children — Fluorescent Light Filter

The same sensory-based equipment that we recommend for other children with sensory processing problems could help gifted children as well. Fluorescent Light Filters effectively dim harsh lighting, and fidgets for feet and hands can be effective tools that don’t disrupt productive work. Because gifted children need to learn to manage and modulate their intense and complex responses, there are many ways that OTs could be helpful to these children.

Gifted children may need a wider variety of tools to give them the desired novelty they crave, or they may reject many ideas rapidly. Always ask for an explanation and be ready with alternatives. A gifted child may be able to project many steps ahead of you and identify roadblocks that you don’t anticipate…yet!

Cathy Collyer, OTR, LMT, PLLC

Cathy Collyer, OTR, LMT has treated children with neurological, orthopedic and sensory processing disorders for over 20 years. She is the author of The Practical Guide To Toilet Training Your Child With Low Muscle Tone.