Sensory Health with Dr Virginia Spielmann
By Sensory Integration Education, 15 March 2022
Virginia Spielmann MS OT, Executive Director of STAR Institute for Sensory Processing, Affiliate Faculty at Colorado State Department of Occupational Therapy, ICDL Clinical Consultant
In this interview, we speak to Virginia Spielmann, PhD, OTR/L and Executive Director of STAR Institute for Sensory Processing to find out what she has been working on currently. At SensorNet, we are keen to bring you the most up-to-date developments across the field of SI and we are always looking to report news, events and information which you can take and translate across your own practice and services.
Virgina Spielmann
Virginia Spielmann is an Occupational Therapist. She obtained her PhD in Infant and Early Childhood Development in August 2021 and is Affiliate Faculty at Colorado State Department of Occupational Therapy. She co-founded and authored the Critical Core therapeutic role-playing game and co-developed the Palaana sensory lounger with SLACK Lifestyle. Virginia’s therapeutic emphasis is on psychological well-being and flourishing, and enabling clients of occupational therapy to reach their full potential. Her extensive clinical experience includes autism, differences in sensory integration/processing, infant mental health, adoption, developmental trauma, and physical disabilities. In relation to SIE, Virginia has worked in collaboration with us to deliver a masterclass on Sensory Integration Therapy and DIR/Floortime.
In December 2021, Virginia presented “Your Sensory Health Matters: Here’s Why” at the TEDxMileHigh. This is a non-profit event that exists to spread big ideas and elevate inspired citizenship in Colorado. It is a community of thinkers and doers, ideators and creators, activists and enthusiasts. This provided Virginia with an opportunity to disseminate and share more about sensory integration to a wider audience.
SensorNet: Can you tell us the take home message from your TEDx talk? For those who may not have seen it yet, we recommend our readers to check it out here.
Virginia Spielmann: TEDx is all about “Ideas Worth Spreading” and choosing one crucial concept to share. This meant drilling right down — did I want to talk about Occupational Therapy? The work of Dr A. Jean Ayres? The sensory based motor aspects of sensory integration and processing?
Ultimately, we decided the critical idea we needed to share was that understanding the sensory aspects of life improves wellness. The idea worth spreading is “sensory health”. We believe that the better every person understands the importance of sensory health, the more likely they are to understand the need for sensory accommodations, evaluations and more.
SN: You speak about differences in sensory integration and disordered sensory processing in your talk. Where are we at using a common shared language that we all understand both within and outside the field of SI?
Virginia: At STAR Institute we follow the AOTA guideline and talk about Sensory Integration and Processing. Ultimately, this terminology is an accurate representation of what we are discussing, and we believe it supports multi-disciplinary and supra-disciplinary understanding. Our organisational values include collaboration and shared progress towards a mainstream understanding of sensory health.
“A rising tide raises all ships.” If mothers talk about sensory health over coffee, teachers teach the full story of our sensory systems in the classroom, and CEOs understand the impact of sensory differences in the workplace—then exact terminology debates will become peripheral to our work. Promoting understanding is key, it’s the main thing. I don’t want to hear another person say “I don’t believe in sensory processing” for the rest of my life!
SN: TEDX talks are internationally recognised and are generally well received. What was the aim for your talk on sensory health?
Virginia: The purpose of a TEDx is to inform and educate global audiences in an accessible way. This is something we have been working on at STAR Institute for the last four years – raising awareness of the sensory domain in the mainstream. We want to help people understand the sensory aspect of day-to-day life in relatable and meaningful ways.
Stories are a tool we have been using for the last two years. It started with our sensory stories (you can find them here) in Sensory Awareness Month 2021. This was the most successful awareness campaign we had run at STAR Institute.
Since the TEDx talk, it has been so exciting to receive messages from people stating that they get it, that they “never thought about wellness this way before”. We even heard from the partner of a long time SI OT that they finally felt the message was relatable and “for them”.
Virginia speaking at TEDx
SN: Sensory informed living and sensory health are two important pillars you speak about. Do you feel these are becoming more recognised?
Virginia: I really do believe that the time is now. You see the work of Mona Delahook, Lori Desautels, Tina Payne Bryson – fantastic, sensory informed and relationship-based approaches to parenting and education. These brilliant theorists are gaining momentum in the mainstream, and they are all intentionally utilising a sensory informed approach. Even the work on embodied cognition and somatic trauma care recognises that it’s time to tune into the wisdom of the body.
In answer to the question – it is not recognised yet, but if we are intentional as a field, as a discipline, then very soon I do believe the tide will turn.
SN: As clinicians we play a significant role in being able to explain the complex neurophysiological process of sensory integration and how this may impact on individual's participation within their everyday lives. Are there any tools, resources or methods that you can recommend to guide us in this?
Virginia: After my initial certification in the SIPT I felt that communicating about SI was about honoring the whole picture, the complexity of the principles. However, I was making a critical error; I wasn’t meeting people in relatable space. I was expecting them to do all the work and come and meet me in my jargon-heavy, scientific, and highly cognitive space. That’s not how to educate people.
Health literacy principles are a well researched resource:
- Health literacy ‘how to’ guide by NHS Education England
- Presenting Your Information by NIH (National Institutes of Health)
- Using Stories to Teach About Health by HealthLiteracy.com
The way we have interpreted this at STAR Institute is a layered approach to sharing the message. By starting with something relatable, we take that labour out of the equation, and nothing is more relatable than a story. Once you have had that moment of recognition, then you can add the next layer, and the next and so on. I think it’s key not to be in a rush and to be selective. What is the most important take away for the group or individual you are talking to? Don’t over complicate it.
SN: In other news, STAR has recently started neurodiversity firesides. Tell us about the aims and objectives for this and what we can expect to learn?
Virginia: Oh, these are just some of the most fun I have had in years! These are very much discussion-based Zoom meetings where we discuss topics related to the provision of neurodiversity affirming therapeutic supports. We only charge US$10 per person (which means there are no Continuing Education Units) because we want to make them accessible to as many people as possible. Topics so far have included goal setting, the double empathy problem and neurodiversity-affirming Sensory Integration Therapy. Mostly it’s about identifying systemic ableism and unlearning our internal biases. Follow this link to find out more about the various topics covered and how to register your attendance.
Ableism refers to the baked-in cultural values we have that marginalise the differently bodied, neurodivergent processors, those with mental wellness differences. It’s embedded in our university curriculums, town planning, building design, policy, classroom design, pedagogy, language, socialisation, health care provision and more. It is alternatively referred to as “disability oppression”, or the “normalisation agenda”.
To help introduce some of the health implications of ableism on neurodivergent populations and to learn more about the topic, refer to Clairy, K., Ochsenbein, M. et al. (2021) Trauma in Neurodivergent Populations. In Lynch, A., Ashcraft, R., and Tekell L., (Eds.).Trauma, Occupation and Participation: Foundations and Population Considerations in Occupational Therapy. AOTA Press.
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SN: Can you summarise some of the key learning points from the January Firesides session on “Goal Writing as Advocacy - Writing Neurodiversity Affirming Goals Using Goal Attainment Scaling”?
Virginia: That was a fun one. We used Goal Attainment Scaling – I do believe it’s the best format for goal writing and outcome measurement. It also works well as part of the therapeutic process and as a client centered approach because of its collaborative nature. The main take-aways centered around affirming the authentic nature of our clients, honouring them, and enabling them to become self-determined agents of change in their own lives. This means questioning some of the expectations placed on them. Instead of compliance in “non preferred activities” what about engaging in activities because they want to, because they get it, and in a way that brings the client joy. Instead of social skills, what about social confidence and flourishing on their own terms? As Occupational Therapists particularly, participation was always supposed to be meaningful, and Ayres talked about the self-organised child—not the convenient compliant child.
SN: You speak about how to deliver Neurodiversity-Affirming Sensory Integration Therapy – tell us more about this.
Virginia: I think Ayres was an early advocate for neurodiversity, while the language is sometimes awkward the principles are all there. “The child must organize his own brain; the therapist can only provide the milieu conducive to evoking the drive to do so.” (Ayres, 1972, p. 256).
If you look at the fidelity measure for ASI (and work hard on your own internalised ableism) the ingredients are there. Honour the child’s authentic nature, trust the pacing of their nervous system, always (always) seek consent and respect when consent is not given. The principles of self-determination theory (Deci & Ryan, 2000) are very useful tenets to use a litmus test for your own practice. Is your client supported to be autonomous, competent, and related? On whose terms? Yours or theirs? If it is on yours then they aren’t experiencing authentic autonomy. Do you celebrate their play ideas even if you feel this is a “hyper focus” of the child’s? If you are trying to move them on to other topics, they aren’t experiencing competency. Do you work hard to attune to their neurodivergent communication style? Or do you demand that they become “socially appropriate”? Relatedness requires two communication partners equally respectful and interested in one another.
SN: There were some practice guidelines published from a recent research publication you were involved in on a Multi-Tiered and Multi-Dimensional Approach to Intervention in Schools: Recommendations for Children with Sensory Integration and Processing Challenges. How can these guidelines support our SI therapy?
This article is a great step towards the provision of sensory-informed services in schools. The multi-tiered approach in the USA refers to 1) whole school/community, 2) in classroom support, and 3) individualised support. Utilising a sensory health perspective, you can really see that everyone in a school can and should benefit from sensory-informed education and support. This article outlines some lovely, and very practical, strategies that practitioners can employ. I was honoured to be a part of it.
SN: Any current research or projects that you are currently working on which we should keep a lookout for?
Virginia: I have just submitted a chapter on Sleep and Sensory Processing in Autism that is based on a systematic review completed with Shelly Lane, Marco Leao and myself. It is for a Jessica Kingsley Publishers' book edited by Edelson called “Sleep and Sensory Processing”. We will also be submitting the formal review for publishing soon. There’s lots of work to do in this highly neglected area of occupation.
I am also working with Shelly Lane, Hannah Burke, and the UK-based group Autistic Empire on their Grand Sensory Survey results. That was a truly fascinating survey with eye-opening data.
Finally, I am in the process of formalising a practice guideline on the identification of trauma in neurodivergent populations. The aim is to provide a framework that practitioners can use to identify classic and unconventional forms of trauma, which is a necessary first step in the provision of truly trauma informed care. I will be presenting on this at the STAR Annual Sensory Symposium in October 2022 which you can join live or online.
It was a pleasure to speak with Virginia Spielmann, and we will continue to follow and learn from the important work she is leading on.
References:
Whiting, C. C., Ochsenbein, M., Schoen, S. A., & Spielmann, V. (2021). A Multi-Tiered and Multi-Dimensional Approach to Intervention in Schools: Recommendations for Children with Sensory Integration and Processing Challenges. Journal of Occupational Therapy, Schools, & Early Intervention, 1-14.
