Sensory Integration Education

Emer Broderick discusses how she employs a sensory integration informed approach into her practice as a paediatric occupational therapist.

SensorNet: Tell us about your current role and your area of practice. 

Emer Broderick: I am a Children’s Occupational Therapist working in Independent Practice. I work with children of all ages but mainly pre-school and primary school-aged children. I also work with Sensory Integration Education (SIE) as an E-Mentor, Clinical Mentor and E-facilitator for ASIP (Association of Sensory Integration Practice). 

_{Emer Broderick}

SN: What does your typical day in clinical practice look like?

Emer: I think, like most clinicians, every day can be very different. In general, though, I tend to see children either in their homes or in their school setting. I am fortunate that many of the schools I work in have great spaces for me to work with lots of equipment that I can use. 

SN: Why did you seek out additional training in SI? What were you seeing in practice? 

Emer: I started my SI learning journey back in 2013. I was working in the NHS in a community service at the time. The OT department was getting so many referrals for children who were presenting with sensory processing difficulties that my manager offered me the opportunity to complete SI Module 1 training with SIE. I loved it straight away and knew I wanted to continue the training as soon as possible. It just made so much sense in relation to the children that were coming to our clinic. I completed the four modules with SIE and then completed my Masters in SI in 2018. 

SN: How has the SI training through SIE shaped and influenced your practice to date? 

Emer: The SI training has had a strong influence on my practice. I do not use ASI with every child I work with - it’s not always the most appropriate intervention for everyone - but having a deeper understanding of sensory processing impacts how I work with all of the children I see. From a basic perspective, just understanding how to support a child to get to a calm, alert and regulated state is vital to get the most out of therapy sessions for all children. Considering the sensory environments in a child’s life can also impact therapy and how effective it may be. 

SN: What is the most significant thing that has changed in your practice since completing the training? 

 Emer: To be honest I think one of the main ways it has impacted my practice is that I have become much more confident in critiquing literature and I am much more inclined now to review the evidence of any type of interventions that I am considering for the children I work with. I also make it a priority to keep up-to-date with research – it's not always easy to find the time but it's important. 

SN: How do you use Ayres Sensory Integration or the principles of ASI in your practice currently? How does this approach inform your work with your current client caseload? 

Emer: I use ASI with many children that I work with. I have to be creative to be able to do this in a non-clinic environment but it is possible. It involves bringing lots of mobile equipment to people’s homes – therapy balls, scooter boards, wobble boards, tunnels etc. Making sure parents are very well informed about what ASI is and what it looks like, is very important in these situations so that they understand why I am bringing such a range of equipment into their homes. 

With other children I work with, I use a sensory integration informed approach where I use the principles of ASI in my work. I would use this approach more often in schools – trying to meet a child’s sensory needs within the school environment, through both individualised programmes and strategies as well as classroom or school based strategies. 

With both approaches, education is key so I spend a lot of time educating the family and/or school about sensory processing and its impact on function in general, as well as the specific sensory processing needs of the client. 

SN: Tell us about how your training has influenced your work as a clinical mentor.

Emer: I love working as a clinical mentor – mainly because I get to discuss sensory integration with a clinician for an hour at a time! I love hearing about how other therapists and settings are using ASI in practice. 

When I was doing my training, it was certainly a steep learning curve for me. There were so many 'aha' moments in my training that I still remember clearly. The child I did my case study for SI Module 4 on, for example, really taught me how powerful the vestibular system is and how reactive it is. 

I felt really supported throughout my training by Sensory Integration Education – by the mentors/lecturers and other students, which is why I continued each time to the next module. I really want the students I work with to feel supported in the way that I did. 

My SI training also made me a more reflective practitioner which is helpful for my role as Clinical Mentor. Reflective practice is very much encouraged as part of SI training, and I try to encourage it as a mentor. I think many of the students I have worked with as a clinical mentor probably became sick of me saying ‘write a reflection on that’. 

SN: Growing a community of practice is an important way of continuing professional development. How can we ensure we are part of this as clinicians? 

Emer: As clinicians we need to prioritise time in our busy working lives to engage in things like peer supervision and mentorship and journal clubs. Reflecting on our practice and finding opportunities to share this with the people we work with is important. There are more opportunities for this now, I think. The Association of Sensory Integration Practice (ASIP) which has been developed by SIE, is a great way to engage in CPD within a growing community of practice. 

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SN: What excites you within the field of SI at the moment? 

Emer: I am very interested in the link between sensory processing and anxiety – I think this is becoming increasingly more important considering the mental health difficulties that many children and young people are experiencing today. 

I also find the research coming out regarding the sensory systems of babies born prematurely very exciting. Additionally, and linked to this in a way, I find the research around sensory processing, attachment and trauma really fascinating and also how that links to mental health in older children. In practice, I am seeing the impact of attachment difficulties in children’s sensory processing skills and am keen to learn more about this. 

SN: We know you have completed your own research in the area of anxiety and SI as part of your masters. Tell us more about your work in this area. 

Emer: Yes - for my SI Masters thesis I completed a systematic review on anxiety and sensory over responsivity in ASD – the title was 'Sensory Over Responsivity and Anxiety is ASD: Is there a causal relationship?'. I chose this topic because it was what I was seeing in practice. I was getting so many referrals for children with sensitivity to sensory input who were also presenting with a lot of anxiety. I was interested to know if there was any research regarding a causal relationship between the two – and if so, could the impact of anxiety be reduced by addressing sensory over responsivity in young children. The systematic review found that while there is a definite link between the two, there was not sufficient evidence to determine causality. There does seem to be more and more research coming out in the area though, so I’m keeping an eye on that. 

SN: Have you any advice for those currently thinking about embarking on the modular pathway or who are currently going through it?

Emer: To anyone thinking of embarking on the training I would say – do it. Sensory integration plays such an important role in function and I continue to be amazed at the impact ASI can have on a child’s functioning – and how much fun it can be.

The training also offers more than just learning about ASI – it helped me to become a more reflective, evidence-based practitioner. 

And for those currently on the modular pathway, I can remember how overwhelming it can be at times – balancing the clinical hours, the course content and the assessments with work and family life. But it’s short term and it will definitely be worth it in the end so keep with it.