Sensory Integration Education

Alison Dear is a Speech and Language Therapist who has worked exclusively in special schools for fifteen years. She qualified as an Advanced Practitioner in 2015 before being awarded her Masters of Science in Sensory Integration in 2017. Her current role at Woodlands Secondary School in Luton has included developing a curriculum, underpinned by Ayres Sensory Integration Theory, for students who are predominantly non-verbal and who can present with significant levels of challenging behaviour. Alison is an SIE Clinical Mentor, a member of the committee of the National Sensory Integration Speech and Language Clinical Excellence Network and co-author of its first position paper on the use of ASI within Speech and Language Therapy.

_{Alison Dear}

Background of the Clinical Excellence Network

The Royal College of Speech and Language Therapists (RCSLT, 2021a) describe the role of a Speech and Language Therapist (SLT) as “Providing life-improving treatment, support and care for children and adults who have difficulties with communication, eating, drinking or swallowing.” Sensory Integration (SI) underpins the motor control required for speech; alternative means of communication such as gesture, using a picture communication system or signing; the actions and interactions of play and the processes of eating and drinking. Sensory processing is also integral to our abilities to understand the verbal and non-verbal communication of others (Ayres, 2005). An increasing number of SLTs are recognising the implications of sensory processing and integration challenges for their service users and are undertaking postgraduate study in the field of Ayres Sensory Integration (ASI).

A Clinical Excellence Network (CEN) for SLTs undertaking or considering postgraduate study was the brainchild of Amy Stephens, RCSLT SI Advisor. This national CEN, known as the SI-SALT CEN, is registered with the RCSLT and in common with all CENs, has a role in producing and sharing the evidence base (RCSLT, 2021b). The first national SI-SALT CEN took place at the RCSLT offices in October 2019. At this event, I joined the committee along with Advanced Practitioners Amy Stephens and Judy Goodfellow PG. Dip. Sensory Integration. The fourth member of the committee, Sarah Pendelton, gives the very valuable perspective of a Speech and Language Therapist beginning their SI studies.

Developing the Position Paper

Membership of the CEN continues to grow as do the variety of opportunities for professional development. Members have enjoyed presentations from a number of guest speakers including Professor Pam Enderby, SIE Director Dr Sylvia Taylor-Goh and RCSLT Research Manager Katie Chadd. In addition, a website, si-salt-cen.org.uk developed by Amy Stephens, enables members to connect, share experiences and find out further information. However, in its first year, the main focus of the CEN was to take the significant step of developing the UK’s first national position paper in relation to the use of ASI within the profession of speech and language therapy.

Discussion at the first CEN revealed that many members were communicating the relevance of ASI within the profession during face-to-face meetings, but had more difficulty in doing so outside these forums. A number of common issues emerged and it was agreed that a document which could be used as an initial point of reference would be of benefit.

The process began by the committee identifying ten questions that they felt would be most relevant to a range of readers. These readers were anticipated to be SLTs who had undertaken postgraduate training or were considering doing so; Occupational Therapists and Physiotherapists, other health professionals; education professionals; commissioners of services and also service users themselves. Discussion resulted in agreement on a range of issues which included a broad outline of ASI theory and its relevance to a SLT; potential benefits of SI-SLT assessment; boundaries of practice and consideration of ASI Therapy in relation to evidence based practice. These questions and answers were then shared with all CEN members. In December 2020, after receiving final comments and suggestions, the full position paper was shared with members and published on the SI-SALT website. Key messages of the paper are:

• That ASI is highly relevant to speech and language therapy.
• The work of an SI-SLT is distinct from an SI trained Occupational Therapist or Physiotherapist.
• As with any therapy, the decision to use an ASI framework to support communication, eating or drinking is driven by the clinical reasoning of an SLT. 
• The importance of post-graduate training for SLTs wishing to use ASI in their practice.

The Future for the SI-SALT CEN and the Position Paper

Feedback from SLTs in relation to the position paper has been very positive and the CEN plans to continue with its work of supporting those SLTs using an ASI frame of reference. In particular, there will be a focus on the development of a journal club to explore the literature and critique relevant papers with this process benefitting from the literature collection established by Judy Goodfellow. The work of the journal club will undoubtedly facilitate a review of the position paper which is expected to evolve over time. The purpose of a review will be to support SLTs who use ASI to continue to deliver evidence-based practice to children and adults in their care who experience difficulties in communication, eating or drinking.

New SI-SALT CEN members are always welcome. Visit the website to find out more!

References

_{Ayres, A.J. (2005) Sensory integration and the child. Western Psychological Services.}

_{Royal College of Speech and Language Therapists. (2021a). What is Speech and Language Therapy?} 

_{Royal College of Speech and Language Therapists. (2021b). Clinical Excellence Networks.}