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 differences 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/Developmental Impairment.  It can also include children/young people without a diagnosis.  Children/young people may present with sensory differences impacting on their behaviour, movement and co-ordination,  concentration, self-esteem which all impacts in their participation in the occupations of self-care, education and play/leisure.

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 a uni-professional referral from parents/carers, education and other professionals or through the Disability Pathway. They may also come through the Vulnerability Pathway or ASD pathway.

 

Evidence Base

Current Best Practice

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

Occupational Therapy works with children with significant sensory processing 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/young people 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).  The evidence recommends the 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 Intervention for this population at present (College of Occupational Therapists 2015).

 

Reason for Pathway

A high proportion of referrals made to the Occupational Therapy service are for the investigation of sensory differences 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 therefore 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 Website and through parent sensory workshops.

 

Targeted Level

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

  • KIDS Website - information video and interactive sensory questionnaires and hand-outs/resources.
  • Sensory Workshop for parents/carers.
  • Workshops for Educational Establishments.

 

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 information and resources on the KIDS website and the Sensory Workshop.  Individual therapists 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

The Sensory Pathway in Depth

The pathway is accessed in a staged model

KIDS Website

  • If a parent/carer or referrer thinks a child/young person has  sensory differences they should access the Joining in with Sensory Differences section of the KIDS website.
  • The parent/carer should watch the video first.
  • The parent/carer with the support of the referrer, if necessary, then completes the relevant sensory questionnaire(s) related to the specific sensory concern(s). The 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).  On completing the questionnaire(s) individual strategies are generated which can be downloaded and then saved or printed.
  • The parent/carer tries these strategies for 3 months. 3 months is long enough for  parents/carers to try the strategies consistently so that they know whether or not the  strategies work and that there has been a behavioural response.
  • If the impact of the sensory difference on the child/young person's participation in every day activities has not resolved despite trying the parent/carer should contact their local occupational therapy team to discuss the need for further support.

First Contact Appointment

If a referral is received into the service the Occupational Therapist conducting the First Contact appointment will ask the parent/carer if they have gone through the process described in stage 1 i.e. gone onto KIDS website, watched the video and completed the relevant sensory questionnaire(s) related to specific sensory difficulty.

If the parent/carer has completed the process the Occupational Therapist will work through these steps at the First Contact appointment.  

Families can also be invited to attend a Sensory Workshop either after or alongside trying the strategies identified when completing the Sensory Questionnaires.  Where possible the date of the Sensory Workshop will be provided at First Contact Appointment.

The family attend a sensory workshop with a telephone or email review, ideally within 3 weeks.

Individual Intervention

If further issues are identified or if the plan set at the sensory workshop has not been effective then further intervention may be required. 

The family will meet with a therapist in a 1:1 setting to set functional goals and complete an episode of care.  Intervention options could include:

  • More specific advice and strategy provision to family.
  • Liaison with Education regarding adapting the sensory environment to improve participation.

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 differences.

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.

The Workshop is run on a regular basis throughout Greater Glasgow and Clyde sectors: North East, North West, South, Renfrewshire and Inverclyde and West Dunbartonshire. The Workshops run 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 increase their knowledge of sensory processing and identify strategies to help the child/young person to join in with every day activities despite their sensory differences. The workshop is interactive with parents/carers watching a video to explore sensory systems, followed by further discussion of the sensory systems and the impact that sensory differences may have on children/young people.  There is also opportunity to experience the use of sensory equipment, discussion with therapists and other parents/carers about what has worked and their own experiences of supporting a child/young person with sensory differences.  The therapists use a coaching approach 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 differences in processing, parental networking, speaking to a therapist, further strategies, equipment demonstration, specific advice, support in setting goals and making a plan to support the child/young person’s participation levels.