iLs Newsletter 

March

2010

Issue 1

Vol 2

In This Issue

* Interview: Dr. Lucy Jane Miller
* Accessing School Federal Stimulus Funds: A Success Story!
* Updated iLs 2010 Training Schedule
* iLs Announcement: New iLs Playbook - more visual tracking, new layout
* Interesting Research in the Field

iLs Interview: Dr. Lucy Jane Miller, OTR/L, Ph.D., Director of SPD Foundation,  Founder of The STAR Center and author of "Sensational Kids."

What kind of clients does STAR see?
We see a broad variety of clients, from 5 months up to age 35.  Almost all of the people that come to us have some kind of Sensory Processing Disorder.  I’m not a fan of using labels to describe people, but to give you an idea of who we see, most of them come with diagnoses of autism, ADHD, anxiety disorder, learning difficulties.  As a group, the types of problems that our clients bring seems to be shifting over time.…  When I started as an OT back in 1980 kids were more learning disabled, but now we’re starting to see a lot of children with various kinds of emotional challenges as well. There are also so many children with multiple diagnoses.  These are complex issues, not as easy to resolve as the more “pure”  Sensory  Processing Disorder that we used to see.

What interventions do you use at STAR?
First of all we want parents to be very engaged in the program, and by engaging parents in an intensive intervention model (3 to 5 times a week) we get a commitment from them to make other activity sacrifices for about 30 sessions or 2 ½ to 3 months if they live in-town, or 3 weeks to 1 ½  months if they are from out of town.  So, for example, instead of going to soccer, piano or gymnastics, they put all that time and energy into working with their child for that time period and when done they return to natural settings and activities in the community.  We have a broad menu of interventions, with the objectives based on the family’s priorities.  After the evaluation and feedback we take a whole session to work with the parents (no children at this meeting) to help the parent establish measurable goals for their child’s program.  That way we can evaluate if the treatment is working for that child. 

The interventions we use include OT, iLs and DIR Floortime, and other sensorimotor stimulation techniques such as Interactive Metronome, Wii and Makoto.  The main thing is that we focus first on relationship and engagement.  Many of the kids coming to us seem unable to make the kinds of interpersonal connections needed to develop normally.  So we need to take a step back from any specific intervention and establish a special relationship with the child and with his/her parents.  Sometimes this takes several sessions.

In terms of labeled intervention approaches we combine in different amounts as indicated by the child’s needs: occupational therapy with a sensory integration approach, DIR/Floortime, iLs and a host of other methods.  The way in which we combine these different interventions is based on clinical reasoning, which is the process of determining in the moment what will challenge the child while still providing enough support that he/she will be successful.

You know, Dr. Ayers always saw children intensively, but because of managed care, insurance scheduling, etc, the 1x a week model developed.  In my opinion, once a week therapy can be used to work on changing some environments, task requirements and perhaps behaviors but it’s not enough to actually change the brain. 

What does iLs bring to the table in terms of results at STAR?
We have seen tremendous developmental growth spurts using iLs in combination with OT.  We use it with most of our children.  iLs combined with OT seems to accelerate or “jump start” many of the children’s developmental changes.  It also can have a calming effect on some children which makes it easier for our therapists to work with the child.  In general, we see accelerated gains by adding iLs to OT. 

Can you tell me about a recent client who is a good example of the changes you see in your practice combining OT with iLs?
2 weeks ago we had a little 4-year old boy who came in for just 1 week of therapy.  We asked him to draw a picture of himself during his pre-test when he came in.  He drew a long arm-type shape on one side of the paper and then he turned the paper over and on the other side he drew the other arm-type shape.  He was carefully treated with extensive discussion of his needs by the whole team.  His intervention was OT and iLs with suggestions for home, for 5 days in a row.  On the fifth day before he left he was again asked to draw a picture of himself.  He drew a recognizable figure of a head, eyes, smile, a sort of vague body, and yes (of course!) arms.  That was after only 5 sessions.  We also saw behavioral and other gains but the difference in the pictures impressed us all . . .  and his mother had tears in her eyes when we showed her the gains her child had made.

What kinds of training options are you offering through the Sensory Processing Disorder Foundation?
Right now we have 3 major programs: national conferences, e-learning campus and intensive mentorships for professionals, Level 1 and Level 2. 

In Level 1 Mentorship, a small group of 8-10 therapists come together to learn to really understand Sensory Processing Disorder and all its subtypes.  We look in depth at each subtype of SPD--one subtype per day, e.g., on day one, we focus only on modulation disorders;  on day two we focus only on postural disorders, and so on for dyspraxia and discrimination.  And we talk about treatment options for each of the subtypes.  The mentees leave with a much more in depth understanding of what SPD is and is not, and how to differentiate the subtypes.

In Mentorship Level 2, each trainee works individually with a client for the week.  The mentees get one-on-one supervision from the STAR OT who is present for their entire session, and we video tape each mentee for each session on each day.  Then in the afternoon, Dr. Sarah Schoen and I review the tapes with the mentees and provide training on relationship building, clinical reasoning, integrating cognitive behavioral approaches into OT, when to use iLs and more.  

We have an e-Learning Campus on the internet also.   We have several new e-learning modules about to launch and expect to continue launching new segments about two or three per semester. 

You had a Sensory Processing Disorder Foundation conference last week and just before that, the word was released that SPD made the DSM short list.  You’ve devoted a big part of your life to this effort – how’s it going?!   It really does feel like a big victory for us.  After 35 years… you can imagine.  Sensory Processing Disorder is 1 of only 12 diagnoses that were submitted by “outside sources” [that’s what they call us!], that made the short list for possible inclusion in the DSM-V. The DSM-V committee is taking comments from the public until April 20th.  We really need people who have worked with children who have SPD or who have children with SPD to write a short letter and post it on the DSM-V website. For more information about how to write the letter and where to submit it, please visit us at www.spdfoundation.net/dsmv.html  

In 2011 the committee will make the final decisions and the DSM-V book will be published in 2013.  We will submit to the DSM committee whatever research gets completed by all the scientists on our scientific work group by the end of this year. . . and then, that’s it!

Accessing Fed Stimulus Funds: A Success Story
An interview with Jackie Taylor, OT in Adams 12 School District, Colorado

How were you successful in receiving federal stimulus grant money?
The district applied for a number of things with the state which is applying for federal stimulus funds (ARRA Funds). I applied in Dec using a simple form plus the support materials – explanation of iLs from web site, research results, and a CD with interviews of teachers (the pilot study, research, and CD with interviews are on the iLs web site). We also applied for PT, OT and other equipment. Everything came through in March, including funds for 15 iLs Total Focus systems.

How do you implement iLs w/o losing class time?
We talked to the lawyer for our district to get his approval for using iLs during school hours. He said it’s been demonstrated to be effective with students so we can use it during the day.

We use it with kids with IEPs so they are pulled out of class anyway. The special ed teacher, or aid, typically does iLs sessions. Formally, we have to do it with children who have LD or autism because that’s what the grant was for. But we can use iLs informally after school with any kids (with parent permission).

Who monitors the iLs sessions?
Each school is different. Aids are often doing the program with the Special Ed teacher in the room at the same time. In other schools parents and para-professionals are helping monitor the program.

May we post your application for others to see?
Of course! (Note: Ms. Taylor’s ARRA application is now posted in Forms & Documents in the Professional Resources section of the iLs web site)

Upcoming Training

PRACTITIONER 1-DAY CERTIFICATION

PROFESSIONAL 4-DAY CERTIFICATION

Lean more and register for a training session at www.integratedlistening.com/training

iLs announces the new Playbook & Integration Kit:

• The new Playbook format is larger and uses pictures to guide each session, so it can be viewed at a distance.

• New equipment and activities include hanging and bouncing balls; a video demo of each activity is now loaded on iPods.

• Playbook now includes a separate Early Developmental Program of activities.

• Playbook and equipment additions - hanging ball, bouncing ball and Playbook - are available to iLs Associates at our cost: $30, including shipping.  To have video demos loaded on your iPod add another $10.

Interesting Research in the Field

Ringing in the old ear - Whooshing, whirring, roaring, whistling… all descriptions of “ringing in the ears”… provide millions of people with a not-so-welcome soundtrack for their lives...
University of Florida, Health Science Center News

Will iodine fortification solve Australia's iodine deficiency dilemma? - A recent study called the Australian Total Diet Study showed 70 per cent of women aged 19 to 49, covering most of their childbearing years, were not getting enough iodine from their diet.
www.blackmores.com.au

iLs is now on Facebook & Twitter!

Contact Us: info@integratedlistening.com 925 S. Niagara Street, Suite 660 Denver, CO 80224 www.integratedlistening.com