I now spend some time in a multidisciplinary clinic where sensory
integration (SI) is one of the therapeutic approaches on offer as part of
the occupational therapist toolkit, not exclusively but dependent on the
child's 'sensory' and other profiles (yes, the roots lie in Jean Ayres
work). In the UK SI assessments and management are frequent within the state
NHS system (but treatment is rare unless independently funded by
charities/parents). I have researched the literature and the reports remain
equivocal (much as for many forms of SLT!) but many reports are focussed
predominantly on ASD and behaviour not speech or quality of communication.
I had never thought about the approach until last year but now see a number
of children who appear to benefit from these 'move to learn' approaches and
at the very least a different perspective on their needs, states of arousal
and focus etc. Many parents report (indeed only yesterday with a dyspraxic
teenager) that there are changes in performance after physical exercise such
as the trampoline, including raised volume (which might not surprise any
mother!) quantity of verbal output, less hypernasality, clarity of
articulation per se? not sure. I would not dismiss it completely because
these reports are unprompted and quite frequent. Having observed the SI
therapists at work I would say a lot of skill lies in the hands of the
sensitivity of the therapist to the client at the interactional and physical
level on a turn by turn basis and moment by moment basis, much as in the
skill of an SLT. We now have group narrative sessions with a lot of movement
based work interspersed/integrated into role play. Perhaps it is the
therapist not the 'therapy' that is the important factor here but it would
be great to see some larger scale research across other types of difficulty
than just asd. Whether that answers the question regarding
trampolines/vestibular systems I don't know, but there is a neuroscientific
basis to increased efficiency in learning regimes if they are broken into 15
minute chunks with physical movement inbetween (and then learning the same
thing three times in different ways). There is now at least one state school
in the North of England that is following this lesson pattern following the
research report. IN SI in particular the occupational therapists recommend
'sensory diets' for children throughout the school day (and at home) to help
children regulate their sensory seeking behaviour and this may optimise
'state of arousal' (calm/alert) for learning but I doubt they would claim
there are direct effects here on speech, only that the child might attend
better and 'optimise' learning . There will probably be a clinic running
when you are staying in York next year for your workshop Caroline, and you
(or anyone else) would be more than welcome to come and meet the team for a
lively debate! They are already involved in research projects around other
fine motor movement development, dyspraxia and dysgraphia and take EBP
seriously.
Kind Regards
Hilary
_____
From: phonologicaltherapy@yahoogroups.com
[mailto:phonologicaltherapy@yahoogroups.com] On Behalf Of Caroline Bowen
Sent: 04 August 2010 00:23
To: phonologicaltherapy@yahoogroups.com
Subject: RE: [phono-tx] Re: Impaired vestibular system?
Lucy,
RE: "Interestingly I noticed his speech was much clearer when he come in
from playing on the trampoline. My question is, am I missing an underlying
link such as an impaired vestibular system? Should input be a big(ger than
usual) part of therapy?" from your initial post in this thread.
This combination of ideas - the vestibular system and trampolines - takes me
back to the mid-1980s to Jean Ayres' work and a time when spinning and
swinging (children) in nets and having them bounce on trampolines was the
cure-all for everything from ADHD to agoraphobia to autism to zits. The
children were supposed to have a *vestibular dysfunction* or *sensory
integration disorder* (SID) that accounted (MYSTERIOUSLY) for, or underlay
difficulties in speech, language, hearing, behaviour, social engagement,
motor coordination and a host of other issues. A quick google of *vestibular
system + trampoline* shows that businesses based around treatment for
*vestibular dysfunction* continue to operate.
Jean Ayres: http://www.siglobalnetwork.org/about.htm
It is interesting that you noticed that the boy's speech was clearer after
playing on the trampoline. But perhaps it is important not to think in terms
of the trampoline exercise specifically having a beneficial effect. If you
rephrase the statement, "I noticed his speech was much clearer when he come
in following vigorous exercise outside" - you might then consider what the
factors associated with this improvement might have been. Did he clear his
nose so that he could breathe more easily while he exercises, for example?
RE: " No one posted any answers regards my question about an under developed
vestibular system so i'm picking theres nothing obvious underlying
that i am missing."
SID is a *controversial diagnosis* and is not a recognized diagnosis in the
DSM-IV-TR or the ICD-10.
Best wishes,
Caroline
"The Vestibular system is located in the inner ear. It responds to movement
and gravity and is therefore involved with our sense of balance,
coordination and eye movements. Therapy can include hanging upside down,
rocking chairs, swings, spinning, rolling, somersaulting, cartwheels and
dancing. All these activities involve the head moving in different ways that
stimulate the vestibular system."
http://en.wikipedia.org/wiki/Sensory_integration_therapy
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