Sensory Pathway

Greater Glasgow and Clyde

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Sensory Pathway

Population

What type of child/young person would it be appropriate to see within this pathway?

Any child or young person (0-18 years) who’s occupational performance is being affected due to a sensitivity in processing sensory stimuli. This can include children with Autism Spectrum Disorder (ASD), Learning Disability, Neurodisabilities, Developmental Co-ordination Disorder (DCD), Attention Deficit Hyperactivity Disorder (ADHD), Global Developmental Delay. 

How would these children/young people and their families access the Occupational Therapy Service?

These children and young people would mainly come to the service through the Disability Pathway or through uni-professional referral from parents/carers, education, and other professionals. They may also come through the Vulnerability Pathway or Post Diagnostic ASD pathway.

Reason for Pathway

A high proportion of referrals made to the Occupational Therapy service are for the investigation of sensory sensitivities affecting daily Occupational performance.

We want families to be able to access the service at a targeted level and then if required to access specialist services for specific support for children/young people who have more severe responses to sensory stimuli impacting on their well-being needs and participation levels therefore a staged model of care is required.

Staged Journey of Care

Ready to Act advocates nationally for a tiered model of service delivery. As such the focus for this population is on developing self-management skills and it is essential to empower families with the skills they need to support their child into adulthood.

For this population assistance will be offered at a targeted level in the first instance and progression onto specialist if required. Targeted information will be provided primarily via the KIDS Scotland Platform and through parent sensory workshops.

 

Targeted Level

Resources available at a Targeted level can be accessed by families of professionals working with children/young people with a sensory processing difficulty they include:

  • KIDS Scotland Platform.
  • Sensory Workshop for parents/carers.
  • Workshops for Educational Establishments (in development).

 

Specialist Level

Specialist level intervention will be accessed on an individual basis with a focus on functional outcomes. Parents/carers of those children/young people requiring specialist level intervention can also access the Sensory Workshop.  Individual therapist can request support with clinical decision making and implementation of evidence based practice for this population by contacting the Advanced Practitioner for this pathway.

Sensory Pathway Stages

Evidence Base

Current Best Practice

This pathway was developed following bench marking of local, national services and review of the literature.

Occupational Therapy works with children with significant sensory modulation difficulties that are impacting on their occupational performance.  Current best practice suggest up-skilling the adults working in closest proximity to the child/young person to understand and recognise their sensory preferences and enable them to look at adapting the environment. For example changing the sensory environment to enable the child/young person to participate in the activity, i.e. alter the temperature, reduce visual clutter, noise level, and lighting in the environment (College of Occupational Therapists 2015).  Moreover supporting the parent/carer to manage sensory needs and to improve participation of children in their chosen occupations through using coaching principles has shown evidence of effectiveness (Dunn et al 2015; Graham et al 2015; Graham et al 2009; Schaaf et al 2015).  Most scholars recommend use of sensory based interventions as one component of a comprehensive intervention that uses a variety of methods to promote performance.

There is not enough evidence to validate use of Sensory Integration for this population at present (College of Occupational Therapists 2015).

 

The Sensory Pathway in Depth

The pathway is accessed in a staged model

KIDS Scotland Platform

  • If parent/referrer feels child has a sensory issue(s) they can directly access the portal where sensory resources such as questionnaires and strategy booklets are available.
  • Sensory questionnaires are separated out into 6 different checklists covering the 7 senses.  Each checklist is divided into 3 different age ranges (2-5, 5-12, 12-18 years).
  • Parent/referrer can complete the questionnaire related to specific sensory concern which will produce individualised sensory strategies.
  • Parent/carer tries these strategies for 3 months. Rationale of 3 months as parents/carers need to try consistently for this length of time so then know that the strategies work and therefore it is a behavioural response.
  • If the sensory concern is not resolved, i.e. despite trying the strategies the child/young person continues to have sensory difficulties impacting on their participation in everyday activities parent/carer can make a self-referral to OT or return to referrer to seek further support and advice which may result in both of these options.

First Contact Appointment

If a referral is received into the service the Occupational Therapist conducting First contact appointment will ask parent/carer if they have gone through the process described in stage 1 i.e. gone onto KIDS Scotland Platform and completed sensory questionnaire(s) related to specific sensory concern. Where possible the date of the Sensory Workshop will be provided at First Contact Appointment.

The therapist will ensure the parent has visited the portal and completed the questionnaire(s) and tried strategies.

If parent/carer has not known or been previously directed to the Platform the Occupational Therapist will complete these steps at First Contact appointment.  Following these steps if the concerns are not resolved the family’s needs are reviewed and the following options are available:

  • Family attend a sensory workshop with a telephone review.
  • The family meet with a therapist in a 1:1 setting to set functional goals and complete an episode of care.
  • Families can have both options.

Sensory Workshop

The Sensory Workshop titled “Taking Part in Everyday Activities Living with Sensory Differences” is an evidence based Occupational Therapy intervention for parents/carers of children/young people referred to the service with sensory issues. Children/young people can have sensory sensitivities, movement and co-ordination difficulties, reduced concentration, low self-esteem impacting on their function and participation levels in occupations of self-care, education, play/leisure.

The Workshop will be conducted by Band 6 staff.  Band 3 and 4 staff will assist in the setup of the room and preparation of workshop forms, and elements of workshop such as equipment demonstration etc.

The child/young person will have a named therapist.

The Workshop is run on a regular basis throughout Greater Glasgow and Clyde sectors of North East, North West, South, Renfrewshire and Inverclyde, West Dunbartonshire. The Workshop venues are currently run in Health buildings during the day and last for 90 minutes. Families will have access to the same workshop content regardless of where they attend the workshop.

The Workshop is a practical approach where parents/carers come to the workshop to increase knowledge of sensory processing, to help the child/young person’s participation and function. This consists of interactive sessions with parents/carers using a video to explore sensory systems, interactive activities using sensory equipment and discussion with therapists, also networking opportunities for parents/carers, utilising a coaching role from therapists to encourage self-management as evidence shows that this approach is an effective occupational therapy intervention (Dunn et al 2012). Qualitative evidence has been gathered from parents/carers through positive parent feedback from current workshop evaluation forms some examples of feedback are as follows:-
“I found this really helpful and got some sensory issues discussed and techniques to cope with these”.
“fantastic workshop very understandable in all aspects from start to finish”.

The added value of the workshop is further information on sensory development and sensitivities, parental networking, speaking to a therapist, further strategies, equipment demonstration, specific advice, support in making a plan and goal to support the child/young person’s participation levels.