Spiral Foundation’s NEW!! Book Club

In our ever-growing attempts to provide resources and materials to professionals and parents, the Spiral Foundation has partnered with Amazon to bring you our NEW! A-Store.  In our A-store/ Book Club you will find recommended reading for parents, professionals and children.  By purchasing your books…paper or Kindle versions alike!…through our store, you not only get a great recommendation, but also help support research and education activities in sensory integration.  So make us your first stop for your sensory-related resources!

Today for professionals we would like to highlight two wonderful MUST HAVE resources by Dr. A. Jean Ayres.  If you want to know more about praxis pick these up today!  Click on the pictures to go to our store.

 

Ayres Dyspraxia Monograph, 25th Anniversary Edition

Ayres Dyspraxia Monograph

This monograph is THE resource on beginning to understand the complexities of praxis.  This updated version includes bonus information by praxis expert, occupational therapist, Dr. Sharon Cermak as well as a new extensive bibliography of praxis references.

The Adaptive Response

The Adaptive Response

This classic DVD is the only resource from Dr. Ayres fully explaining adaptive responses in sensory integration intervention and detailing the various levels of adaptive response.  This resource is a MUST HAVE for every therapist practicing in the area of sensory integration or mentoring other therapists or students in sensory integration.

Happy reading and viewing and watch this blog as well as our Facebook page for more great resources.

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In Memorium – Jane A. Koomar, PhD, OTR/L, FAOTA

Jane KoomarMany people are already aware that our beloved friend and colleague, Dr. Jane A. Koomar, passed away this year on February 23, 2013 after a three year battle with breast cancer.  Jane was the heart and soul of her private occupational therapy clinic, OTA The Koomar Center (previously known as OTA-Watertown).  She was an icon in her field and changed for the better the lives of thousands of children, parents and therapists.  The Spiral Foundation deeply mourns her loss but endeavors to continue her work with our research and education activities.

To see  a lovely memorium written by OTA and Spiral Foundation staff please visit our website, http://www.thespiralfoundation.org, or by clicking here.

Donations in Jane’s honor may be made to the Spiral Foundation to support research in sensory integration.

What’s the relationship between DCD and dyspraxia?

Many are understandably unsure of the relationship between Developmental Coordination Disorder (DCD) and dyspraxia. Though I’ll try to clear the issue here, I admit, it’s complicated.

First, the definition of “dyspraxia” is not always very clear and its current usage is not exactly synonymous with conceptualizations of praxis in general. I actually try to avoid the term dyspraxia altogether these days because it is not a terribly useful term due to its lack of clear definition. I prefer the term “praxis deficits,” which is more accurate. Praxis deficits may include problems with ideation or motor organization issues of motor planning, bilateral coordination, sequencing, or projected action sequences – all of which are aspects of praxis. Dyspraxia tends to refer only to motor planning problems and depending on the profession, can be even more restrictively defined as only problems with imitation of gestures. This is far more restrictive than our current understanding of praxis in general which can include problems with tactile-based motor planning, vestibular/prop-based bilateral coordination and sequencing problems, and ideational deficits.

The term was originally developed to try to standardize identification of motor performance problems (including praxis issues) in children so there was some uniform terminology and assessment for researchers. DCD was eventually included in the DSM as diagnosis. As a diagnosis, DCD is used very broadly and is usually perceived as an umbrella term that encompasses praxis deficits. The problem with the research and the hard core DCD people is that the gold standard assessment of DCD is the Movement ABC which, from a sensory standpoint, only taps into vestibular issues and does not address tactile-based motor planning. So, the majority of children identified in the DCD literature, if they only use the M-ABC, will be those with bilateral coordination and sequencing problems and not those with tactile-based motor planning. The hard core DCD people tend to make a distinction between “motor coordination” problems (which they usually identify as issues of balance, running, ball skills, etc. – what we identify as bilateral coordination and sequencing and projected action problems) and “motor planning” or “dyspraxia” problems (which they identify as problems of imitation of gestures).

So long answer to the question – the answer is not clear. DCD is generally perceived by OTs as a larger umbrella diagnosis with praxis deficits such as motor planning problems (dyspraxia) falling under the umbrella. However, your hardcore DCD people, including many in Canada and the UK, can be quite adamant that they are different issues. The DCD research literature will capture problems with praxis but they will largely focus on children with more vestibular/ bilateral coordination/ sequencing problems; though you have to read carefully as an OT will use the DCD term but may make a point of capturing kids with tactilebased issues as well.

There is amazingly little research specifically on praxis and even less recent research. Most current articles are in relation to imitation skills in children with autism. I think it is most important to realize DCD research will reflect mostly skill-based vestibular activity and, unless done by an OT, will not reflect specific problems in tactile-based motor planning.

For more stories, info, resources, facts and tips, go to www.thespiralfoundation.org

 

 

Remembering Jean: AOTA’s 2011 A. Jean Ayres Award-Winner Jane Koomar Reflects On Her Mentor

In April I was honored to receive the American Occupational Therapy Association’s 2011 A. Jean Ayres Award, which aJane Koomar & Ellen Cohnccording to AOTA, is given annually,

(T)o recognize occupational therapy clinicians, educators, and researchers who have demonstrated sustained commitment to the application, development, or testing of theory in occupational therapy. The award is given in honor of A. Jean Ayres, PhD, OTR, whose concentration on developing theory in support of practice was of great significance to the profession of occupational therapy.

I was delighted to be so honored by my colleagues and peers, and what makes this award even more special is the fact that Jean Ayres was both my mentor and a cherished friend. It is not often that one can say both things about someone who shapes their professional life, but I am fortunate to have both worked with her and known her personally. Ayres was an occupational therapist, psychologist and neuroscientist who developed the sensory integration theory, assessment and intervention, now known as Ayres Sensory Integration (ASI) Intervention, which is practiced at OTA-Watertown and other SI-based OT clinics around the world.

Ayres started her work in the University of Southern California’s Brain Research Institute in the 1950’s, developed her theory of sensory integration in the 1960’s, and published her landmark book, Sensory Integration and Learning Disorders, in 1972. In the late 1970’s I was in Cincinnati and fortunate to be working with Virginia Scardina, who is also well-known to folks in the SI community. I had completed my fieldwork with Ginny and then worked in Cincinnati where I assisted in Ginny’s three week and three month sensory integration training program for OTs. Ginny was a big supporter of Jean’s work and, when Jean came to speak in Dayton at Ginny’s behest, I met her and was completely inspired. In the early 1980’s, a faculty was developed to certify therapists in sensory integration, and I was honored to be selected by Ginny, then accepted by Ayres to be a faculty member and help shape the first, formalized training in the field. What an amazing group of women, and all were—or went on to become—leaders in our field.

In 1984, I graduated from one of Ayres’ final four-month training classes at USC, just before she retired. And despite her dislike for traveling, I persuaded her to come to a conference at Boston University in September 1985, exactly when Hurricane Gloria hit the region. Thanks to my coordinating the conference successfully under duress, the executive director of Ayres’ non-profit suggested that I be added as a board member. This allowed me to visit California for board meetings four times a year, and each time I shared Friday night dinners with Jean and her husband Franklin. These dinners hold some of my most treasured memories of them.

Colleagues ask me what it was like to study directly with Jean. The closest I can say is that I felt like I had been knighted. There is nothing to compare with having Jean Ayres pause in the midst of a meeting on the SIPT development, to look out the doorway onto a treatment session of a particularly challenging child where I had been able to “turn the corner” with the child, and receive an affirmative sign showing she was well pleased with the transformation. Ayres was a sensitive person, very sensitive to criticisms from inside and outside the field. In so many ways her ideas were ahead of their time: the contributions that sensory stimuli make to other parts of our nervous system, to development overall, and our emotional well-being, to name a few.

To this day I still see the revolutionary aspect of her thinking. My recent work combining SI with psychological treatment for children with trauma and attachment issues has opened her ideas to a new audience of people, who see how much more effective their work with these children can be with the addition of SI-based interventions. When sensory processing disorder (SPD) becomes part of the fifth edition of the APA’s Diagnostic and Statistical Manual of Mental Disorders (DSM) as we expect it to in 2013, this will further open the way for cross-disciplinary education and research to further Jean’s incredible work.

I was doubly delighted to share the Ayres Award with Ellen Cohn, ScD, OTR/L, FAOTA, who is also a dear friend and member of the Spiral Foundation board. Ellen has contributed significantly to occupational therapy: she launched the development of the Fidelity Measure for use in research on the effectiveness of ASI, which is now a highly regarded tool for use in all intervention studies involving ASI. As part of the Sensory Integration Research Collaborative, Ellen contributed to the development of Goal Attainment Scaling and studies on physiological measures and sensory modulation. Most recently, she conducted research on the parents’ sense of competency for those raising a child with a sensory processing disorder. You can read more about her outstanding research and teaching at Boston University’s website.

In this photo with Ellen, I’m wearing a magenta scarf. It was Jean’s favorite color, and anyone who visited her clinic was greeted by magenta paint on her clinic walls. Magenta also reminds me of Jean’s legacy, and the number of lives touched by people in our field thanks to Jean Ayres’s courage, creativity and passion.

Helping Holly: Sensory Integration In A Captive Chimpanzee

In June 2009, I received one of the most unusual requests in my career as a sensory integration-based occupational therapist. The St. Louis Zoo had a chimpanzee named Holly, who was exhibiting behaviors different from other chimps: among other things she was neither grooming other chimps nor allowing herself to be groomed in a typical way. She plucked her hair excessively. She displayed body rocking movements and was seemingly fearless in situations where other chimps were more cautious. They hypothesized that Holly may have a chimp form of autism

Our colleague Dr. Margaret Bauman checked out Holly, and after careful review of the evidence she suggested instead that Holly had a form of sensory processing disorder (SPD). The Spiral Foundation was contacted, and I joined a team of experts bridging human and animal health disciplines to look into Holly’s condition.

I jumped at the chance to help, and started adapting some of our pediatric sensory integration checklists for use with chimps. Once the zoo staff administered the checklists to all of their chimps as a baseline, we administered additional tests to ensure that Holly’s differences were not simply personality traits.

With the combined data, I created a phased intervention program to address Holly’s particular needs. Phase one emphasized tactile and proprioceptive inputs to help her build body awareness and motor planning skills. The second phase was intended to strengthen her vestibular system and address deficiencies in her higher-level motor skills, with additional heavy work to solidify her proprioceptive gains from phase one. Happily, we found that after the treatments she demonstrated significant reduction of atypical and stereotypic behaviors, while increasing time spent in positive occupations such as resting and interacting with others.

From a researcher’s perspective, this unusual request holds interesting opportunities. In the short-term we have the opportunity to improve the life of an animal that was clearly out of sync with her environment. Longer term our work may help develop a chimp model of SPD, which could have far-reaching benefits for the welfare of chimps and other animals in captivity. Lastly, establishing a strong model and treatment for SPD in chimps and other non-human primates can help inform and advance diagnosis and treatment models in humans.

I have had a wonderful experience working with the St. Louis Zoo staff, the team working on Holly’s condition, and Holly herself. While I may never again get such an unusual request, this experience has opened my eyes to the universality of sensory experiences, regardless of age, gender, race, and now, species.

For more stories, info, resources, facts and tips, go to www.thespiralfoundation.org

Creating A SAFE PLACE For Attachment | 2011 Boston Symposium: Sensory Processing, Emotion & Behavior

On March 24, at Microsoft’s offices in Waltham, MA, the Spiral Foundation will present “Utilizing SAFE PLACE for Professionals.” Attachment (the affectionate relationship that binds a child to a parent or caregiver) and sensory processing (the ability to take in information from our worlds and stay regulated and able to perform our daily activities) are critical for building a foundation for subsequent emotional development in children. Over the last few years, Spiral Foundation President Jane Koomar, Ph.D, OTR/L, and clinical psychologist Daniel Hughes, Ph.D., have worked together to increase awareness of the importance of these dynamics in early childhood.

With additional work by their Boston-based colleagues Deborah Rozelle, Psy.D., and Stephanie Shellie, LMSWC—who trained with Dan in his Dyadic Developmental Psychotherapy (DDP)—and Jane’s occupational therapy colleagues at OTA-Watertown, there is growing evidence that a combination of sensory occupational therapy and psychological counseling can best address the needs of a child who has experienced attachment issues due to abuse, neglect or multiple foster placements.

To provide an overview of their work, Jane and Dan developed a two day course for parents titled “SAFE PLACE.” While the intention of this model is to create a literal “safe place” for children, the name stands for additional concepts. Sensory Attunement Focused Environments or Sensory Attunement Family Enjoyment derive from the OT’s fun and physically stimulating sensory integration work. PLACE stands for Playfulness, Love, ACceptance and Empathy, the core concepts of Dan’s DDP model. In the SAFE module parents learn how to create environments and activities at home to help their child with sensory regulation, and to stimulate rhythmic, mutually enjoyable interactions. The PLACE module offers the ability to develop strong interconnected relationships as the basis for all other parts of development.

SAFE PLACE works best when mental health professionals and occupational therapists work together with parents and children, providing co-treatments when possible, and sharing their observations with the family. This weaving-together of support for the child and parent in multiple developmental areas creates support and respect for what can often be felt as deep pain when working to parent a child who has trauma and attachment difficulties.

An introduction to SAFE PLACE is available on DVD for $25.00, and contains excerpts from the one-day workshop presented by Dan Hughes and Jane Koomar. The event on March 24 is the pre-conference institute for Spiral’s 2011 Boston Symposium titled “Sensory Processing, Emotion & Behavior: Clinical Innovations & Research.” The symposium gathers nationally recognized speakers on SPD, attachment, trauma, bullying and sensory integration-based therapeutic interventions. In addition to Dan and Jane, speakers include Spiral Research Director Teresa May-Benson, Dr. Marty Teicher, Tina Champagne and Deborah Rozelle.

For more information on the video or events please contact the Spiral Foundation at (617) 923-4410, ext 102.

Becoming OT Innovators

By Jane Koomar, PhD, OTR/L, FAOTA, President of the Board of the Spiral Foundation

One of my greatest joys is teaching, but over time clinical work and research increased to the point where I had less time to mentor students. Fortunately, this past year I was invited to join the Boston School of Occupational Therapy at Tufts University as their Professor of Practice. The appointment has been personally rewarding because I have had the opportunity to work with outstanding faculty as well as with truly excellent and dedicated future OT practitioners. Professionally it was an opportunity to share with the students some of the great work we have going on at the Spiral Foundation and our sister clinic, OTA-Watertown.

The group’s enthusiasm was especially evident when we visited the clinic for a hands-on lab. The wide variety of equipment—especially suspended equipment—is something OTA prides itself on. Seeing my students try some of the equipment themselves, reminded me of the importance of continued training and education for all OT practitioners, wherever they may be in their careers. Getting back into the classroom on a regular basis in 2010 also reminded me that teaching is often the best way to learn, and I learned a great deal from my students. To this end, the Spiral Foundation and OTA are planning to resume our intensive practical trainings for OT practitioners

When we have students or practitioners in our clinic, I like to share with them the Sensory Challenge Protocol Lab, designed by Dr. Lucy Jane Miller of the SPD Foundation. In it a subject—either a child or adult—is presented with a series of sensory experiences while we monitor his or her heart rate and skin conductance response. This unique space has been used in my own research through the Spiral Foundation, and by Dr. Roseann Schaaf at Thomas Jefferson University in Philadelphia.

The clinic and the lab represent two important aspects of our work: the clinic at OTA-Watertown is already well recognized as a place where children and adults with sensory processing challenges can find caring, dedicated and skilled therapists to help them make sense of their senses.

Spiral, while less known, is no less important. Research Director Dr. Teresa May-Benson, statistician Alison Teasdale and I are engaged in numerous research and educational projects to help push the boundaries of treatment for SPD. Our work, combined with that of research colleagues from around the world, is put into practice at the clinic.

The convergence of research and clinical practice is the truly unique aspect of the relationship between OTA-Watertown and the Spiral Foundation. My hope for my students at Tufts, as well as for others who train with us, is that they take away from their visit what we strive for every day in the clinic and the foundation: the enthusiasm for developing the creativity and dedication involved in becoming an OT innovator.