Copyright © 2007–2013 by Western Psychological Services. Not to be reproduced, adapted, and/or translated in whole or in part without prior written permission of WPS (rights@wpspublish.com). All rights reserved. SPM Quick Tips and SPM-P Quick Tips version 1.0.

Companies and products or services mentioned in the SPM Quick Tips, SPM-P Quick Tips, and this user guide may be trademarks, service marks, or registered marks of their respective mark owners. WPS does not necessarily make any claims with respect to those marks.

Diana A. Henry, MS, OTR/L, FAOTA

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Acknowledgments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . iv

Foreword . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vi

SPM Quick Tips User Guide

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

What the SPM Quick Tips Is . . . . . . . . . . . . . . . . . . . . . . . . 1

What the SPM Quick Tips Is Not . . . . . . . . . . . . . . . . . . . . . . 2

Goals of the SPM Quick Tips . . . . . . . . . . . . . . . . . . . . . . . . 2

Who Can Use the SPM Quick Tips? . . . . . . . . . . . 3

SPM and SPM-P Assessment Raters . . . . . . . . . . . . . . . . . . . 3

SPM Quick Tips Users . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

Using the SPM Quick Tips: From Initial Test to Retest . . . . . . . . . . . . . . . . . . . . 4

Additional Assessment and Intervention . . . . . . 7

Components of a Comprehensive Evaluation . . . . . . . . . . . . . . 7

Referral to Other Health Care Professionals . . . . . . . . . . . . . . 7

Intervention in Other Contexts or Environments . . . . . . . . . . . 7

Additional Options for Intervention . . . . . . . . . . . . . . . . . . . . 7

SPM Quick Tips Strategies . . . . . . . . . . . . . . . . . . . 8

Guided by Clinical Reasoning . . . . . . . . . . . . . . . . 9

Types of Clinical Reasoning . . . . . . . . . . . . . . . . . . . . . . . . 9

Considering the “Big Picture” . . . . . . . . . . . . . . . . . . . . . . . 9

Interpretation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

Choosing Strategies That Meet Objectives . . . 10

Recording Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

Guidelines for Using the SPM Quick Tips Record Form . . . . . . . 11

The SPM Quick Tips Team . . . . . . . . . . . . . . . . . . 11

Team Meetings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

Unifying Principles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

Preparing for the Initial Team Meeting . . . . . . . . . . . . . . . . . 12

Conducting the Meeting . . . . . . . . . . . . . . . . . . . . . . . . . 12

Initial Team Meeting Follow-Up . . . . . . . . . . . . . . . . . . . . . 13

Retest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

Retest Team Meeting . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

Contents

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SPM Quick Tips

Home Form . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29

Main Classroom Form . . . . . . . . . . . . . . . . . . . . . . 57

School Environment Forms . . . . . . . . . . . . . . . . . 82

Art Class . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82

Music Class . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90

Physical Education Class . . . . . . . . . . . . . . . . . . . . . . . . . 94

Recess/Playground . . . . . . . . . . . . . . . . . . . . . . . . . . . 100

Cafeteria . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105

School Bus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110

Products and Other Resources Mentioned

in the SPM and SPM-P Quick Tips . . . . . . . . . . . . . . . . . . . . . 114

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 132

SPM Quick Tips User Guide (continued)

Case Examples Following Use of the SPM or SPM-P . . . . . . . . . . . . . . . . . . . . . . . 14

Case A: Amelia (modulation disorder) . . . . . . . . . . . . . . . . . 15

Presenting problems . . . . . . . . . . . . . . . . . . . . . . . . . 15

SPM results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

Contributing SPM items . . . . . . . . . . . . . . . . . . . . . . . 15

Suggested approaches (from SPM Quick Tips) . . . . . . . . . 15

Case B: Benjamin (aggression) . . . . . . . . . . . . . . . . . . . . . 17

Presenting problems . . . . . . . . . . . . . . . . . . . . . . . . . 17

SPM-P results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

Contributing SPM-P items . . . . . . . . . . . . . . . . . . . . . . 17

Suggested approaches (from SPM-P Quick Tips) . . . . . . . . 17

Case C: Charlie (postural control) . . . . . . . . . . . . . . . . . . . . 19

Presenting problems . . . . . . . . . . . . . . . . . . . . . . . . . 19

SPM results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

Contributing SPM items . . . . . . . . . . . . . . . . . . . . . . . 19

Suggested approaches (from SPM Quick Tips) . . . . . . . . . 19

Case D: Danielle (autism/praxis) . . . . . . . . . . . . . . . . . . . . 21

Presenting problems . . . . . . . . . . . . . . . . . . . . . . . . . 21

SPM-P results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21

Contributing SPM-P items . . . . . . . . . . . . . . . . . . . . . . 21

Suggested approaches (from SPM-P Quick Tips) . . . . . . . . 21

Sample Evaluation Reports . . . . . . . . . . . . . . . . . 24

Following administration of the SPM . . . . . . . . . . . . . . . . . . 24

Following administration of the SPM-P . . . . . . . . . . . . . . . . 27

Sensory Safeguards and Guidelines for Using Sensory-Based Strategies . . . . . . . . . . . . 28

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AcknowledgmentsMelinda Spring, Sarah Cotton, Margie Taylor, and Ann-Christin Hyatt at the Cave Creek School District, for participating in SPM and SPM-P Quick Tips case studies during 2010, 2011, 2012, and 2013.

The SPM team at WSWHE BOCES in Saratoga Springs, New York, for acting as a focus group during 2009 and 2010. Team members included Jim Spears, Katie Jones, Sue Loomis, Cathy Keenan, and Julie Lafountain.

Terry Beagle, for sharing her Sensory Safeguards.

Workshop attendees who participated in “Lunch with Diana” SPM Quick Tips focus groups from 2004 to 2013 in the U.S., Canada, U.K., Ireland, and Australia. Special thanks to JoAnne Vindigni, OT in New York, and Judie Hind-Roff, social worker in Australia.

Deb Hopper, Virginia Lawson, and Mariane Judd (in Australia); Ingelis Arnsbjerg, Julie Wolf Broges, and Birte Engmann (in Den mark); Christel Seeberger (in Canada); and Kath Smith (in England), for the interna-tional flavor they added with their reports and reviews.

Cristy Mendoza, Thomas Passerino, Cheryl Domino, Deb Wilson, Rena Baxter, Debi Hinerfeld, Jennifer Brady-Johnson, Sarah Johnson, Monique Taylor, Victoria Nackle, Pat Hageman, Regina Stovall, Julie McCrea, Samantha Couzens, and Kathy Barrett, for their caring reviews and suggestions.

Therapy team collaborative reviewers in Dayton, Ohio, including Kathy Sanders, Laura Always, Tracey Jackson, Norma Hostetler, Denise Campbell, Ashley Banias, Audra Moore, Jennifer Kemmer, Megan Kreill, Christine Urig, Jacqueline Renegado, Kara Hartke, Georgia Jewell, Karen Stevens, Paula Pleiman, Amy Dauber, Julie Chimenti, Tina Snyder, Susan Aebker, and Sue Voisard.

Day care providers, teachers, and therapists on South Padre Island in 2011, for providing important feedback. These included Mari Naua, Amanda Gonzales, Minerva Vargas, Laura Martinez, Veronica Mon-tes, Larry Cadera, Michelle Garcia, Nora Sailor, Blanca Morin, Matty Arroyo, Eileen Rodriguez, Adela Rodriguez, Gloria Chapa, Jona Garza, Sahaila Nieto, Lily Lugo, Alicia Gomez, Lourdes Jimenez, Yvonne Luna, Ruby Gonzales, Edna Diaz, Elena Degges, and Eilu Rod.

I would like to offer my sincere thanks to the following for their contri-butions to this project:

SPM and SPM-P coauthors Heather Miller Kuhaneck, Tara Glennon, Diane Parham, and Cheryl Ecker.

David Herzberg at WPS, for his patience and perseverance throughout this journey, as well as others at WPS who played major roles in this effort, including Kartik Chandar, Ken Gong, Janet Lam, Eric Atallah, Dane Yang, and Sal Velasco. Thanks are also due to the rest of the IT team; Stacy Messerschmidt, Michael Hyatt, and the art and production team; Amanda Wynn and the marketing team; Glady Lim and the cus-tomer service team; Jaymi Nau, Susan Weinberg, and Lisa Bouyer; and finally, Jeff Manson, for believing in this project.

Danette Rowley, OT, and Barbara Tien, Executive Director of The Prep Program in Calgary, Canada, for giving permission to use the seed they had planted.

Colleen Basaraba in Calgary, Canada, for her reviews and work on case studies linking Ayres Sensory Integration in her Kids Can clinic with the SPM Quick Tips via a school team empowerment approach.

Carol Olson, her 2012–2013 OT students (Meagan Chapman, Jane Charley, Ashley Peck, and Jessica Walworth), her 2013–2014 OT stu-dents (Katherine Roth, Chelsay Tysver, Lacey Wagner, Chelsea Munson, Alissa Kyllo), and the team at the Exploring Minds Development Center (Michelle L. Dressler Johnson, Katie Rambur, Maria Griffith, Elizabeth Putz, and Susan Dressler Kalberer), for graciously providing feedback and case reports as they conducted their research projects using the SPM-P Quick Tips.

Sara Clancey, Kathy Barrett, Gretchen Wilce, Jamie Smith, and the Weber family in Flagstaff, AZ; Jennifer Brady-Johnson at the Wayzata School District and her team (Sarah Johnson, kindergarten teacher; Sue Winderl, paraprofessional in the classroom; and Angie Fisher, after-school-care staff member); Rose Stella Ahmed at the San Juan Unified School District; Eric Polz at Rehab Dynamics, in conjunction with Mary Immaculate School; Catherine Williams at The Chalet School in Swin-don, England; Deb Hopper in Newcastle, Australia; Jenn Capozella,

Continued

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Deanna Iris Sava, Maureen Kane-Wineland, Sue Swindeman, Katie Allgood, Renee Watling, and Janet Wright, for their friendship, strength, sample case reports, and brilliant feedback over many years.

Colleen Basaraba and her husband Bruce, for always encouraging me to “walk well.”

And finally, my husband Rick Ruess, for taking me on hikes during breaks, reviewing my draft almost a million times, and tolerating my very early 2:30 a.m. alarms (because I told him “my brain works best early mornings”).

TEACCH consultants Michael Gallo and his partner Liz, for their per-spectives and suggestions.

Mary L. Thornton-Vogel and her staff at Spurwink Services, for their ideas early on.

Victoria Nackle, Debbie Marr, and Therapro, along with Deb Wilson, Margo Heineger, Cheri Fraker, Mark Fishbein, Sibyl Cox, Laura Walbert, Kay Toomey, Maureen Kane-Wineland, Sue Swindeman, Deb Hopper, and Ann Austin, for granting permission to refer to their amazing works in the SPM Quick Tips.

Roseann Schaaf, for the following brilliant phrase I heard her repeat throughout 2012 and 2013: “Data-driven intervention process helps us articulate better what we are doing.”

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My training in Ayres SI (ASI®): I am certified in the Southern Califor-nia Sensory Integration Tests (SCSIT) and in the Sensory Integration and Praxis Tests (SIPT). I have received special training and mentoring to provide occupational therapy using an ASI or OT/SI sensory integra-tion approach, which involves individualized intervention using sensa-tion in an intentional manner to support a child’s ability to succeed in daily life activities. As I teach internationally on the use of sensory-based strategies as well as on the SPM and SPM-P, I hear the question expressed by practitioners, psychologists, administrators, educators, and parents: “What do we do now?” Many are not trained in ASI and want to know how to incorporate the results of the assessment into a program that benefits the child. Practitioners ask, “How do we get others to support the child in his or her different environments?” Parents often feel overwhelmed at the prospect of having to do more, and teachers are inundated by the many demands to meet individual students’ needs.

Why I developed the SPM Quick Tips: Although sensory processing challenges are now being identified, there is often a lack of understand-ing on the front lines of education as to how to address these challenges. The SPM and SPM-P provide a way to discover whether the child is or is not having difficulty integrating and processing sensory information. The SPM Quick Tips will help the practitioner use clinical reasoning and engage all team members in “detective” work to discover and develop what to do next to support children with sensory processing challenges across school environments and at home.

My background: I have been studying sensory integration (SI) and sensory processing since 1975 when, under the mentorship of Lorna Jean King (a pioneer occupational therapist in sensory integration, mental health, and autism), I learned to collaborate on sensory pro-cessing issues with art therapists, nurses, and psychologists at Arizona State Hospital. In 1978, I collaborated with families while working in a program with children with autism, which grew to what is now the Children’s Center, a state-certified school in Arizona. I started an SI clinic in 1984, taught nurses about sensory integration at Arizona State University, and developed various occupational therapy (OT) programs emphasizing SI and sensory processing in rural, urban, and inner-city school districts across Arizona.

My passion: My mission for the last 35 years has been to make sensory integration “user friendly,” and to empower everyone to understand, develop empathy for, and promote sensory-safe spaces for children and adolescents who have a hard time processing and integrating sensory information. Together with my husband Rick and several coauthors, I developed a set of sensory “tools” for educators, parents, and therapists: the Tool Chest, Tools for Parents, and Tools for Teens handbooks; Tools for Tots and Tools for Pets books; Tools for Students, Tools for Teachers, and Teen Sensory Tools DVDs; and Sensory Songs for Tots music CD.

My collaboration on the Sensory Processing Measure (SPM) and Sensory Processing Measure–Preschool (SPM-P): Together with David Herzberg at WPS and my colleagues Heather Miller Kuhaneck, Tara Glennon, Diane Parham, and Cheryl Ecker, we developed what are now the SPM and SPM-P. Our mission was to bring together clinic-based and school-based practitioners working with children and adolescents with sensory processing challenges. With the SPM, we sought to include on the team not only the family and main classroom teacher, but also the art, music, and physical education teachers; recess aides; and bus and cafeteria personnel. With the SPM-P, we included the parents, pre-school teacher, and day care provider.

Foreword

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What the SPM Quick Tips Is

The SPM Quick Tips is all of the following:

·A navigation tool to help answer the question “What is next?” follow-ing use of the SPM or SPM-P

·A framework based on careful standardized assessment and devel-oped from observations, across multiple environments, of the child’s sensory processing challenges

·A way to use clinical reasoning in determining which strategies should be proposed to the team

·A process for helping team members collaborate and develop the skills that will make them the “experts” in supporting the child (capacity building)

·A springboard for guiding the team in brainstorming, idea genera-tion, and problem solving

·A tool to support practitioners in using clinical reasoning and con-sultation skills in the intervention process

·A convenient navigation tool targeting a child’s sensory processing in multiple environments

·A data recording system to measure how effectively progress is monitored

·A means of measuring qualitative progress through staff responses and quantitative progress through use of the SPM or SPM-P

This document explains how to use two powerful occupational therapy tools, the SPM Quick Tips and the SPM-P Quick Tips. Each of these is a collection of strategies for integrating sensory-based activities into the fabric of a child’s everyday life. The SPM Quick Tips supplements the Sensory Processing Measure (SPM) assessment. The SPM-P Quick Tips supplements the Sensory Processing Measure–Preschool (SPM-P) assess-ment. This user guide applies to both sets of strategies.

The term “SPM Quick Tips” as used in this guide often refers to both sets of tips. Unless the text refers specifically to the “SPM-P Quick Tips,” both sets are meant.

The term “therapy practitioner,” used throughout, refers to occupational therapists, speech therapists, and physical therapists. Where this might cause confusion, the particular term (OT, SLP, or PT) is used for clarity.

The SPM and the SPM-P assessments use some lay terms, such as “body awareness” for the proprioceptive sensory system, “balance and motion” for the vestibular sensory system, and “planning and ideas” for praxis. As this guide is meant to be read by the therapy practitioner, the origi-nal terms (e.g., proprioception, vestibular, praxis) are at times used in place of the lay versions.

A note about numbering: In both the SPM and the SPM-P Quick Tips, each tip is assigned a unique four-digit ID number. Tips that are repeated (suggested for use with different forms and items) have the same ID number. The ID number is always the number of the tip’s first occurrence in the numerical sequence. For example, in the sequence 0001–0002–0003–0002–0004, 0002 is the same tip repeated.

It is essential to read the SPM and SPM-P manuals before using the assessments and the corresponding tips.

Introduction

SPM Quick Tips User Guide

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Goals of the SPM Quick Tips

Our intentions in designing the SPM Quick Tips were as follows:

·Use parent- and teacher-friendly language.

·Create a functional system that is easy and quick.

· Include on the team everyone involved in the child’s daily routine. These are family, school staff (including, when possible, the main classroom, art, music, and physical education teachers, as well as recess, bus, and cafeteria personnel), and day care provider.

·Provide access to insights and interventions in sensory processing to occupational therapy practitioners (OTs), physical therapy practi-tioners (PTs), speech and language pathologists (SLPs), psychologists, school counselors, social workers, other school staff, and parents.

·Assist in making informed decisions about intervention strategies based on clinical reasoning.

·Co-develop a plan that seeps into the fabric of everyday life, includ-ing routines and naturally occurring events.

·Use the SPM Quick Tips with Response to Intervention (RtI).

·Contribute to the development of evidence for effective intervention.

What the SPM Quick Tips Is Not

The SPM Quick Tips is none of the following:

·A watered-down version of Ayres SI (ASI), which, as noted in the foreword, is a sensory integrative approach that uses sensation to help an individual child succeed in daily life activities

·A cookbook of activities based on problematic behavior and diagnoses

·A predesigned plan to provide teachers and parents with answers as to what they should do

·A replacement for referrals for additional testing or for a compre-hensive evaluation

·A replacement for additional services

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Clinical reasoning, through imposing culturally sensitive intervention including sensory-based strategies, ensures that no harm is done to the child.

Clinical reasoning should always be used before presenting SPM or SPM-P results to the team. It should consider the child and his or her fam-ily; the home, school, and community environments; the team’s desired goals and outcomes; and knowledge of sensory processing as well as the theory and principles of intervention (Watling, Koenig, et al., 2011).

Considering the “Big Picture”

In considering the child’s challenges, clinical reasoning does not focus on a single issue and the SPM Quick Tips associated with it. Clinical rea-soning instead looks at the “big picture.” It takes into account the widest possible sampling of available data, including results from the occupa-tional profile (AOTA, 2008), standardized performance tests, and clinical observations. SPM or SPM-P scale scores, item responses, and compari-sons between environments are all considered in making informed clinical decisions. Finally, the influences of the environmental oppor-tunities within each ecocultural niche (which includes the relationship between participants in each individual setting), as well as the ability of each team member to participate in the intervention process, should be factored in when the team chooses and develops tips and strategies.

Types of Clinical Reasoning

Clinical reasoning is a multifaceted process that is central to occupa-tional therapy practice. It must also be applied when using the SPM Quick Tips. This process employs the following:

1. Scientific reasoning, to understand the sensory processing chal-lenges that may be affecting the child (Schell, 2003). These could include challenges in modulating sensory input; in sensory perception/discrimination, postural control, bilateral integration, and sequencing; and in praxis.

2. Narrative reasoning, to understand what the challenges mean to the child and family, including the occupational profile and personal life story (Schell, 2003).

3. Pragmatic reasoning, to understand the practical issues (Schell, 2003) that may affect integration of the strategies into the child’s everyday life at home and at school. Examples of such issues are the availability of time and resources.

4. Ethical reasoning, to ensure that ethically sound decisions are made regardless of pressures from other sources (Schell, 2003).

5. Knowledge and interpersonal skills (Schell, 2009) of team members including family and school personnel (therapists, teachers, and noncertified personnel such as teacher’s assistants, cafeteria work-ers, and bus drivers).

The process of clinical reasoning must be ongoing and dynamic:

·Beginning at initial referral

·Continuing through choosing appropriate assessments

·Reflecting on the results of testing

·Considering and implementing intervention strategies

·Monitoring and adjusting those strategies’ application to ensure a “just-right fit”

·Reviewing posttest results

·Examining the effectiveness of the strategies and intervention outcomes

Guided by Clinical Reasoning

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Using clinical reasoning, the practitioner identifies the underlying deficits. These could include challenges in modulation of sensory input, sensory perception/discrimination, postural/ocular control, bilateral integration, sequencing, and/or praxis.

3. Teach self-advocacy as soon as it is appropriate to do so.4. Adapt the task, materials, equipment, or environment to the needs

of the child.5. Use cognitive or behavioral strategies (or both) to teach social skills

and support social participation.

The strategy for interpreting SPM or SPM-P results emphasizes three dimensions of interpretation: scale scores, item responses, and differ-ences across environments (school, home, and day care). Reading the full discussion of interpretation in the SPM or SPM-P manual is critical.

Every SPM Quick Tips suggestion is designed to further one of the five objectives listed below. The practitioner and team choose or develop strategies that most closely align with these objectives.

1. Address the underlying deficits.2. Provide family, staff, or peer training (or any combination of these)

to increase awareness, reframe attitude and interaction skills, pro-vide support, and share resources.

Interpretation

Choosing Strategies That Meet Objectives

All members of the child’s team can participate in implementing sensory-based strategies. The team can include parents, other family members, caregivers, babysitters, and all therapists (OT, PT, and SLP). School staff on the team can include the main classroom and special education teachers; psychologist, school counselor, and social worker; art, music, and PE teachers; library staff; and paraprofessionals in the classroom, in the cafeteria, on the playground, and on the bus. Each team member receives an SPM Quick Tips Record Form for document-ing the use of strategies and accommodations.

Despite the increasing number of research studies published in the American Journal of Occupational Therapy (AJOT) that employ quantita-tive designs and answer basic research questions, a need remains for examining program effectiveness (Brown, 2010). The SPM Quick Tips Record Form (Figure 1) meets that need, providing a way to record the implementation of individualized strategies embedded in a child’s rou-tines at home, in the community, and at school. This form documents how often individualized strategies and environmental accommoda-tions have been used over a period of time and, hence, can help the therapy practitioner determine which strategies and accommodations were most effective.

Recording Data

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The team develops a plan for integrating strategies and accommoda-tions into the child’s daily routines at home, in the community, and across school environments. School environments include the main classroom; art, music, and PE classes; and other contexts such as recess, the bus, and the cafeteria.

Each team member selects at least three strategies or accommodations and documents their implementation via the SPM Quick Tips Record Form. These strategies or accommodations are unique to each environ-ment. Each team member agrees to help embed these into the fabric of the child’s life. These strategies or accommodations can be taught to the child, to other family members, and to other school staff.

The therapy practitioner most often leads the child’s SPM Quick Tips team. The practitioner first identifies what seems to be working well and what the child’s challenges appear to be. The practitioner then guides team discussion of the relationship between those challenges and the child’s difficulties in processing and integrating sensory information. In doing so, the practitioner helps team members see the child through “sensory goggles.”

Team members follow the practitioner’s lead in setting goals, develop-ing a plan, and selecting strategies. The practitioner uses the SPM Quick Tips as a springboard to help team members brainstorm and generate ideas. Team members collaborate in developing goals and targeted out-comes related to the presenting problems. Family members and school staff receive training in recognizing sensory behaviors and in adapting home and school environments to the child’s needs.

The SPM Quick Tips Team

· Increase the record form’s usefulness and accuracy by entering a number to document how many times a tip is used each day, rather than simply marking an X or check mark.

·Note that the record form, when used on a tablet or computer, auto-matically tallies the numbers you enter.

·Put the record form in the same place every time after each use.

·Complete the record form at the same times each day (for example, at breakfast, after school, at dinner, at bedtime).

· If you are having trouble recording your implementation of SPM Quick Tips strategies, let the child’s therapist know right away.

Guidelines for Using the SPM Quick Tips Record Form

Recording the data is a critical part of the intervention process. Properly recorded data will help you and your team discern which strategies are or are not contributing to the child’s progress. Recording data daily will hold each team member accountable. Consistent participation by each team member is encouraged.

·Use an alarm function or app on your phone, tablet, computer, or similar device to remind you to complete SPM Quick Tips and document their use.

·Make it easier to implement SPM Quick Tips strategies by schedul-ing similar tips for completion at the same times every day.

·Keep the SPM Quick Tips Record Form visible throughout the day (for instance, post it on the refrigerator instead of keeping it in a drawer).

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·Explain, in plain language, ASI theory as it relates to the child’s test results. The following are two examples of this:

·This theory says that challenges in processing sensory inputs (muscle, movement, touch, hearing, vision, taste, smell) can:

· Interfere with a child’s ability to learn, control his emotions, or participate in daily activities.

·Affect higher-level integrative functions like sitting and paying attention in school; coordination (motor planning); creative play (ideation); and social participation at school and home.

·Concepts important to ASI-based intervention include:

·Modulation: When a child is sensitive (overresponsive) to touch and sound, he may seek movement (vestibular) and muscle (proprioceptive) input to regulate his state of arousal.

·Perception: Adding muscle (proprioceptive) input to an activ-ity adds feedback from the body and may increase perception and be a calming influence.

·Postural control: Poor processing of movement (vestibular) input may influence the postural control needed to sit in a chair and sit cross-legged during floor time. Forward linear movement activities (belly on the ball) and adding move-ment input while sitting (using a chair ball) can help increase postural control.

·Praxis: When a child has trouble following a motor sequence (motor planning) like dressing, or has trouble creating new ideas in play (ideation), it can help to give him more sensory input and more time to come up with ideas to complete the task.

·Address the underlying sensory basis contributing to the child’s challenges.

·Develop partnerships, being careful not to give the impression that you are the practitioner “know-it-all.”

·Use open-ended questions, asking team members to visualize and explain what they would like to see happen, instead of what is happening.

Unifying Principles

·Meaningful connections are formed with each person on the team.

·Stakeholders work together as a team.

·Team members are seen as equals, not passive recipients.

·Team members share their individual expertise, their perspectives, and their concerns.

·Team members are able to notice pertinent issues within their par-ticular environments or ecocultural niches that others may not.

Preparing for the Initial Team Meeting

·Obtain consent from each team member for use of photographs or videos.

· Interview each rater after they complete the SPM/SPM-P form.

·Observe the child in each environment.

·Conduct performance assessments and clinical observations in addition to administering the SPM/SPM-P.

·At least 1 month in advance, begin sending the team reminders of meeting date, time, and place. Meetings should last no longer than 1 hour.

· If necessary, make arrangements for the use of an LCD projector and Skype.

·Provide for enough chairs and handouts for all team members.

·Be prepared to take notes during the meeting, or to record the meet-ing using video or audio.

Conducting the Meeting

·Have snacks and drinks on hand.

·Provide enough chairs and handouts for all team members.

·Take notes or record the meeting.

·Show slides or videos highlighting the child’s strengths along with the behaviors that are of concern.

·Explain the SPM/SPM-P test, its results, and the clinical reasoning.

Team Meetings

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Retest

·Collect a completed SPM Quick Tips Record Form from each team member.

·Give each team member a new SPM or SPM-P form.

· Interview each rater after they have completed the form.

·Ask raters to think about the changes they made.

· If possible, observe the child again in each environment.

· If indicated, re-do some of the performance tests (such as the Goodenough-Harris Drawing Test) and clinical observations.

·Compare the retest results and team member’s feedback with the initial test results.

·Compile information from the completed data forms.

Retest Team Meeting

·Have snacks and drinks on hand.

·Provide enough chairs and handouts for all team members.

·Compare initial test and retest results.

·Ask team members to share the changes they made in their respec-tive environments.

·Ask team members to discuss the strategies they recorded on the SPM Quick Tips Record Form.

·Show slides or videos highlighting strategies used and team mem-bers’ observations.

·Depending on initial presenting problems, discuss whether or not the child now demonstrates improvement in academics, motor coor-dination, attention, self-regulation, emotional well-being, behavior, or organization of himself and his environment.

·Discuss whether or not data shows evidence of effective intervention.

·Discuss needed next steps.

·Schedule a follow-up meeting if necessary.

·Ask “What have you tried?” and “What has worked?”

·Use the SPM Quick Tips as a springboard to facilitate brainstorming.

·Elicit ideas from team members as they are empowered to personal-ize what could be done in their own unique environments.

·Encourage team members to define three strategies that they each agree to integrate into their daily interactions with the child.

·Explain data collection and give an SPM Quick Tips Record Form to each team member.

·Have each team member write their three strategies on their copy of the SPM Quick Tips Record Form. There is space to add more at a later date. Remind team members to be specific, as in the following examples:

·At circle time: Provide intense proprioception (muscle input) through pulling on exercise band 1x a day.

·At home: Carry a heavy load 1x a day (unload 300 boxes of cook-ies from van, put wet clothes in dryer, take cushions off couch to jump across).

·Establish who will be implementing the strategies in each environ-ment. If someone else takes over, teach that person how to carry out the strategy and use the SPM Quick Tips Record Form.

·Review the section “Sensory Safeguards and Guidelines for Using Sensory-Based Strategies” and distribute the downloadable PDF to each team member.

·Encourage everyone to use e-mail to share observations, strategies used, challenges, and questions.

· If releases have been signed, ask team members to take photos or videos whenever possible.

·Schedule the next SPM or SPM-P retest and the next team meeting following the retest.

Initial Team Meeting Follow-Up

·Distribute the initial assessment report, including strategies dis-cussed at the initial team meeting, to the appropriate persons.

·Send an e-mail to all team members summarizing the initial team meeting results and reminding them to use their SPM Quick Tips Record Form. Check in regularly to ensure follow-through.

·E-mail the team weekly or bimonthly regarding observations, strat-egies used, challenges, and questions.

Section

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Case Examples Following Use of the SPM or SPM-PThe SPM Quick Tips contains many sensory-based strategies in addition to those listed below. The strategies that accompany the following case examples represent what might be provided to the child’s team prior to brainstorming. Team members would then develop their own strategies suitable for use with particular environments, ecocultural niches, curricula, or daily living activities. The SPM Quick Tips includes sensory-based strategies appropriate for chil-dren ages 5 to 12 (age range of the SPM). A separate set of strategies, the SPM-P Quick Tips, includes strategies appropriate for use with children ages 2 to 5 (age range of the SPM-P).

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Suggested approaches (from SPM Quick Tips) 1. Address the underlying deficit. Provide rich vestibular and

proprioceptive activities. Facilitate the use of the two sides of the body together and crossing the midline, along with visual information, projecting actions in future time and space to improve balance, anti-gravity control, prone exten-sion, core stability, and ocular control (Watling, Koenig, Davies, & Schaaf, 2011).

·Participate in a linear vestibular movement activity (e.g., jumping) while having to catch a large balloon or bean-bag and throw it at a stationary and then moving target.

·Provide frequent opportunities for swinging, jumping, and pushing and pulling objects.

·Play “Mother May I” featuring jumping, hopping on one foot, walking backward, toe-to-toe walking, sideways lunges, and so on.

·Encourage the caregivers to enroll the child in tumbling classes.

·Play spatial awareness games, giving the child prompts to look before moving.

2. Provide family/staff/peer training to increase aware-ness, change attitude and interaction skills, provide support, and share resources.

·Understand that the child is trying to gain proprioceptive muscle support and should therefore not be penalized. Instead, provide modeling and encouragement.

3. Teach self-advocacy as soon as it is appropriate to do so.

·Teach the child to ask, “Because it is hard for me to sit on a chair for a long time, may I use a chair ball at my desk for a while?”

Presenting problemsKindergarten child is reprimanded for not sitting cross-legged when on the rug. The child also bumps into others, does not catch himself when he falls, and is unable to ride a bike.

SPM resultsDefinite Dysfunction in Balance and Motion, Vision, and Body Awareness

Some Problems in Social Participation

Contributing SPM itemsVision

Home item 15: Have difficulty controlling eye movement when following objects like a ball with his/her eyes?

Balance and Motion

Cafeteria item 9: Tilts food tray while carrying; items may spill or fall off.

Home item 59: Fall out of a chair when shifting his/her body?

Main Classroom item 45: Wraps legs around chair legs.

Music item 13: Has difficulty moving body to rhythm (clapping hands, tapping feet, etc.).

PE item 9: Loses balance when running or playing with peers.

PE item 12: Does not notice nearby motion of others (might col-lide with others).

Hypothesis: Poor vestibular and proprioceptive processing may be contributing to difficulties with postural and ocular control, bilateral integration, and sequencing.

Case C: Charlie (postural control)

Section

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5. Use cognitive and/or behavioral strategies to teach social skills and support social participation.

·Teach the child about personal “space bubbles” by having her sit inside a hula hoop on the floor. Explain that the hula hoop is her “space bubble” and that it is important not to invade someone else’s bubble.

4. Adapt the task, materials, equipment, or environment.

·Allow the child to sit in her chair in different positions, such as with the back of the chair toward the table. (No Longer A SECRET: Unique Common Sense Strategies for Children with Sensory or Motor Challenges)

·First develop rules together for using a chair ball (e.g., “It’s okay to bounce a little; it’s not okay to bounce so much that you disturb others”), then offer the use of a chair ball so the child can get the additional movement input his body needs. (Tool Chest)

·During floor time, give the child alternatives to cross-legged sitting (e.g., long sitting or propped on his elbows while lying on his stomach).

·Break down the sequence into smaller steps so that the child moves just hands or just feet. If necessary, have the child do this one side at a time.

·If the child is extremely challenged, place the lunchroom tray on a small rolling table to help him navigate the tray to his seat.

(Tool Chest)

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·Sensation is a basic part of life. Sensory input happens all day, every day, and each of us responds in our own way.

·The word “input” is used instead of “stimulation” because some of the strategies provide “input” that is calming.

·The Sensory Processing Measure (SPM) and the Sensory Processing Measure–Preschool (SPM-P) help teams determine if sensory is a “piece of the puzzle” for the child.

·Behavior challenges are puzzles with many pieces; one piece may be sensory.

·Our mission as a team (i.e., in coordination with other school staff members, parents, and outside specialists) is to develop a “goodness of fit” between the child and what is expected of him or her. The sensory strategies and environmental modifications developed by the team contribute to that “goodness of fit.”

·This plan involves more than simply integrating activities or chang-ing the child’s environment. It is about our relationships with the child and how we each approach the child to establish a trusting partnership.

·Sensory strategies must be pleasant for the child and contribute to improved participation, performance, and self-esteem, possibly immediately. However, it may take longer to see an effect.

·These are sensory “tools,” and as such, rules governing their use may be needed. When appropriate, develop rules for using these tools and communicate those to the child, family members, or entire class.

·Use the SPM Quick Tips Record Form. Don’t rely on your memory.

Sensory Safeguards and Guidelines for Using Sensory-Based Strategies

Thank you for contributing to the well-being of this child.

A reproducible PDF form to be made available to all team members via download

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Tool Chest: For Teachers, Parents and Students™ handbook Diana A. Henry Henry Occupational Therapy Services, Inc., 2000 This illustrated handbook is easy to use in the classroom and at home. It contains the same 26 activities found in the Tools for Students™ DVD. www.ateachabout.com

Tools for Tots: Sensory Strategies for Toddlers and Preschoolers™ book Diana A. Henry, Maureen Kane-Wineland, and Sue Swindeman Henry Occupational Therapy Services, Inc., 2007 This book is designed to offer practical sensory options to improve the ability of toddlers and preschoolers to function in their environments at home, in child care centers, and in school. www.ateachabout.com

Tools for Tots: Sensory Strategies for Toddlers and Preschoolers CD™ Diana A. Henry, Maureen Kane-Wineland, and Sue Swindeman Henry Occupational Therapy Services, Inc., 2009 This companion CD contains interior pages (except References and Resources) that can be copied for use by those wishing to share the information within the Tools for Tots book. www.ateachabout.com

Sensory Songs for Tots™ music CD Diana A. Henry, Debbie Hopper, and Ann Austin Copyright © Ann Austin 2012 This music CD, which helps tots with sensory processing challenges, complements the Tools for Tots book. It includes 27 songs to support everyday life for all toddlers and preschoolers. www.ateachabout.com

Sensory Integration Tools for Teens: Strategies to Promote Sensory Processing™ handbook Diana A. Henry, Tammy Wheeler, and Deanna Iris Sava Henry Occupational Therapy Services, Inc., 2004 This handbook highlights sensory tools for teens, their parents, teachers, and therapists. It promotes collaboration using a sensory integrative framework. www.ateachabout.com

Products and Other Resources Mentioned in the SPM and SPM-P Quick Tips

The following lists products, services, and other resources referred to in the SPM Quick Tips, SPM-P Quick Tips, and this user guide, along with the respective owners or distributors of those products, services, and other resources, as far as they are known. The information offered in this section is pro-vided for the benefit of SPM Quick Tips and SPM-P Quick Tips users and their clients and should not be presumed to be exhaustive nor accurate in all ways. WPS has made an effort to verify the accuracy of all information offered in this section. Should erroneous or outdated information be noticed, please bring it to the attention of WPS by e-mailing research@wpspublish.com or calling 800-648-8857.

Henry Occupational Therapy Services, Inc.4000 Pipit Place, Flagstaff, AZ 86004

E-mail: rick@henryot.com Web: www.ateachabout.com

“Serving children and adolescents with difficulty processing and integrating sensory information.”

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Clean Up: Category Sorting app Different Roads to Learning, Inc. 37 East 18th Street, 10th Floor New York, NY 10003 Phone: 800-853-1057, 212-604-9637 E-mail: info@difflearn.com Web: www.difflearn.com/Apps “This interactive game develops language, reasoning, and sorting and classifying skills in your learners.” —Different Roads website

EASe Listening Therapy app Audioforge Labs Inc. Web: www.audioforge.ca/ease.php “Stimulate, challenge, and promote sensory processing in children on the autism spectrum and others experiencing difficulty with sensory processing and organization.” —Audioforge website

Fingerpainting Spin Canvas Art HD app © 2010 Amy Faulkner Web: itunes.apple.com

Fireworks app Computer Docs LLC Web: www.pixiotech.com © 2010 Matt Stoker “Ever wanted to coordinate your own fireworks show?” —Pixio website

Flip It! Lite app Fat Fish Apps, LLC © 2011 Fat Fish Apps Web: ryanscode.com “Have fun bringing your drawings to life, or choose an image from your photo library and animate over the top of it.” —Apple iTunes website

Look In My Eyes apps FizzBrain LLC © 2010 David Cort E-mail: fizzbrain@gmail.com Web: www.fizzbrain.com

My First Yoga: Animal Poses For Kids free iOS app Atom Group, Version 1.1, April 2010 Web: itunes.apple.com “These kids yoga flash cards use vibrant illustrations and child friendly narration to lead users through a series of easy to follow animal yoga poses. Learn to become a strong dog, quiet turtle and proud lion—stretching mind and body to improve focus, balance and concentration.” —Apple iTunes website

Under Armour® apparel Under Armour, Inc. Customer Service/Consumer Relations 1020 Hull Street, Suite 300 Baltimore, MD 21230 Phone: 888-727-6687 Web: www.underarmour.com

Zoobue™ weighted scarf Zoobue Cedar Lake, IN zoobue@gmail.com Web: www.zoobue.com “The Zoobue™ weighted scarf with the hidden fidgets inside was designed by an Occupational Therapist, as a means to provide deep pressure/sensory to students, in a way that is socially acceptable to their classroom peers.” —www.zoobue.com

Apps

3D Spin Art app Inner Four, Inc. © 2013 Inner Four, Inc. Web: www.innerfour.com “This app makes it fun and easy to create hypnotic pieces of artwork wherever and whenever.” —Apple® iTunes® website

Angry Birds app Rovio Entertainment Ltd. Web: www.angrybirds.com “Angry Birds features challenging, physics-based demolition gameplay with hours and hours of replay value.” —Angry Birds website

AutismXpress app StudioEmotion Pty Ltd Web: www.autismxpress.com “. . . designed to assist people with autism to recognise and express their emotions through its fun and easy to use interface.” —SQUISH website (www.squishgames.com)

Choiceworks™ Visual Support System app BeeVisual™ LLC P.O. Box 724 Southborough, MA 01772 Phone: 508-229-0500 E-mail: info@beevisual.com Web: beevisual.com

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ReferencesAmerican Occupational Therapy Association. (2008). Occupational therapy

practice framework: Domain and process (2nd ed.). American Journal of Occupational Therapy, 62(6), 625–683.

Aspy, R., & Grossman, B. (2008). The ziggurat model: A framework for designing comprehensive interventions for individuals with high-functioning autism and Asperger syndrome. Shawnee Mission, KS: Autism Asperger Publishing Company.

Ayres, A. J. (1989). Sensory integration and praxis tests (SIPT) [Manual]. Los Angeles: Western Psychological Services.

Bagatell, N., Mirigliani, G., Patterson, C., Reyes, Y., & Test, L. (2010). Effectiveness of therapy ball chairs on classroom participation in children with autism spectrum disorders. American Journal of Occupational Therapy, 64, 895–903.

Blanche, E. I., Bodison, S., Chang, M. C., & Reinoso, G. (2012). Development of the comprehensive observations of proprioception (COP): Validity, reliability, and factor analysis. American Journal of Occupational Therapy, 66, 691–698. http://dx.doi.org/10.5014/ajot.2012.003608

Brewer, R. D., & Mueller, T. G. (2008). Strategies at hand: Quick and handy strategies for working with students on the autism spectrum. Shawnee Mission, KS: Autism Asperger Publishing Company.

Brown, T. (2010). Centennial Vision—Child and youth practice area publications in the American Journal of Occupational Therapy in 2008 and 2009: A content analysis, methodology overview, and summary. American Journal of Occupational Therapy, 64, 814–819. doi: 10.5014/ajot.2010.09192

Bruininks, R. H., & Bruininks, B. D. (2005). Bruininks-Oseretsky test of motor proficiency (2nd ed.) (BOT-2) [Examiner’s manual]. Circle Pines, MN: AGS Publishing.

Cermak, S., Windsor, M.-M., & Blanche, E. I. (2010, May). SISIS Annual Program: Lessons learned from international sensory integration-based occupational therapy: Implications for practice at home. Workshop presented at the AOTA 90th Annual Conference and Expo, Orlando, FL.

Clark, G. F., & Polichino, J. E. (2010). Response to intervention and early intervening services: Occupational therapy roles in general education. OT Practice, (15)1, CE-1–CE-8.

Collins, A., & Crabb, C. (2010). Early childhood intervention and school based occupational therapy: Building blocks to success. Journal of Occupational Therapy, Schools, and Early Intervention, 3(2), 168–178. doi:10.1080/19411243.2010.491017

Colyvas, J. L., Sawyer, L. B., & Campbell, P. H. (2010). Identifying strategies early intervention occupational therapists use to teach caregivers. American Journal of Occupational Therapy, 64, 776–785.

Cooper, J. O., Heron, T. E., Heward, W. L. (2007). Applied behavior analysis (2nd ed.). Upper Saddle River, NJ: Pearson.

Davies, P. (1999). What is evidence-based education? British Journal of Educational Studies, 47(2), 108–121.

Dunst, C. J., Bruder, M. B., Trivette, C. M., & Hamby, D. W. (2006). Everyday activity settings, natural learning environments, and early intervention practices. Journal of Policy and Practice in Intellectual Disabilities, 3(1), 3–10.

Fidler, D. J., Hepburn, S. L., Mankin, G., & Rogers, S. J. (2005). Praxis skills in young children with Down syndrome, other developmental disabilities, and typically developing children. American Journal of Occupational Therapy, 59, 129–138.

Fraker, C., Fishbein, M., Cox, S., & Walbert, L. (2007). The proven 6-step plan to stop picky eating, solve feeding problems, and expand your child’s diet. Cambridge, MA: Da Capo Press.

Harris, D. B. (1963). Children’s drawings as measures of intellectual maturity: A revision and extension of the Goodenough Draw-A-Man Test. New York, NY: Harcourt, Brace & World.

Henry, D. (2001). Tool chest: For teachers, parents, and students. Glendale, AZ: Henry OT Services.

Henry, D., Kane-Wineland, M., & Swindeman, S. (2007). Tools for tots. Glendale, AZ: Henry OT Services.

Henry, D., & Wheeler, T. (2001). Tools for parents: A handbook to bring sensory integration into the home. Glendale, AZ: Henry OT Services.

Henry, D., Wheeler, T., & Sava, D. I. (2004). Tools for teens: Strategies to promote sensory processing. Glendale, AZ: Henry OT Services.

Lane, S. J., & Lynn, J. Z. (2011). Sensory integration research: A look at past, present, and future. Sensory Integration Special Interest Section Quarterly, 34(3), 1–4.

Lane, S. J., Lynn, J. Z., & Reynolds, S. (2010). Sensory modulation: A neuroscience and behavioral overview. OT Practice, 15(21), CE-1–CE-8.

Lane, S. J., & Schaaf, R. C. (2009). Neuroscience foundations of vestibular, proprioceptive, and tactile sensory strategies. Presentation at AOTA 89th Annual Conference and Expo (Houston, TX).

133

Lane, S. J., & Schaaf, R. C. (2010). Examining the neuroscience evidence for sensory-driven neuroplasticity: Implications for sensory-based occupational therapy for children and adolescents. American Journal of Occupational Therapy, 64, 375–390.

McCaigue, I. S. (2009). The scale of sensory strategies: Development of a sensory strategy plan through evidenced-based data collection in the classroom, clinic or home to improve behavior and learning. Suwanee, GA: Handy Occupational Therapy Rx Tools (H.O.T. Rx Tools).

Miller Kuhaneck, H., Ecker, C., Parham, L. D., Henry, D. A., & Glennon, T. J. (2010). Sensory processing measure–Preschool (SPM-P) [Manual]. Los Angeles: Western Psychological Services.

Monteiro, M. J. (2010). Autism conversations: Evaluating children on the autism spectrum through authentic conversations. Los Angeles, CA: Western Psychological Services.

Myles, B., & Southwick, J. (2005). Asperger syndrome and difficult moments: Practical solutions for tantrums, rage and meltdowns. Shawnee Mission, KS: Autism Asperger Publishing Company.

Nackley, V. L. (2001). Sensory diet applications and environmental modifications: A winning combination. Sensory Integration Special Interest Section Quarterly, 24, 1–4.

Olson, M. R. (2012). Tech support for the emotional regulation needs of children and adolescents with autism. OT Practice, 17(21), 20–21.

Orloff, S. S. (2012). Re-routing the road to anger: Strategies to address frustration in sensory-sensitive children. OT Advance, June, 6.

Parham, L. D., Ecker, C., Miller Kuhaneck, H., Henry, D. A., & Glennon, T. J. (2007). Sensory processing measure (SPM) [Manual]. Los Angeles, CA: Western Psychological Services.

Parham, L. D., Smith Roley, S., May-Benson, T. A., Koomar, J., Brett-Green, B., Burke, J. P., et al. (2011). Development of a fidelity measure for research on effectiveness of Ayres Sensory Integration. American Journal of Occupational Therapy, 65, 133–142.

Schaaf, R. C. (2012, March). An occupational therapy intervention for sensory dysfunction in autism: A randomized control study. Presented at the 14th International SPD Symposium, Boston, MA.

Schaaf, R. C., Schoen, S., Lane, S. J., Smith Roley, S., & May-Benson, T. A. (2010). A frame of reference for sensory integration. In P. Kramer & J. Hinojosa (Eds.), Frames of reference in pediatric occupational therapy (pp. 99–186). Philadelphia, PA: Lippincott Williams & Wilkins.

Schaaf, R. C., Watling, R., & Schefking, S. (2010) FAQ on autism. AOTA virtual chat (December 9).

Schell, B. A. B. (1998). Clinical reasoning: The basis of practice. In M. E. Neistadt & E. B. Crepeau (Eds.), Willard and Spackman’s occupational therapy (pp. 90–100). Philadelphia, PA: Lippincott Williams & Wilkins.

Schell, B. A. B. (2003). Clinical reasoning: The basis of practice. In E. B. Crepeau, E. S. Cohn, & B. A. B. Schell (Eds.), Willard and Spackman’s occupational therapy (10th ed.). Philadelphia, PA: Lippincott Williams & Wilkins.

Schell, B. A. B. (2009). Professional reasoning in practice. In E. B. Crepeau, E. S. Cohn, & B. A. B. Schell (Eds.), Willard and Spackman’s occupational therapy (10th ed., pp. 314–332). Philadelphia, PA: Lippincott Williams & Wilkins.

Schulken, T. M. (2009). CATT Center Integrations student intervention and measurement booklet.

Seinfeld, J. (2008). Deceptively delicious: Simple secrets to get your kids eating good food. New York, NY: William Morrow.

Smith Roley, S., Mailloux, Z., Miller Kuhaneck, H., & Glennon, T. (2007). Understanding Ayres Sensory Integration. OT Practice, 12(17), CE-1–CE-8.

Taylor, J. F. (2010). Sensory modulation and sensory integration activities for home and school. Franklin, TN: Robert McCabe and Summit Professional Education.

Test of Visual–Perceptual Skills (3rd ed.) (TVPS-3) [Manual]. Los Angeles, CA: Western Psychological Services.

Watling, R., Koenig, K., Davies, P., & Schaaf, R. (2011). Occupational therapy practice guidelines for children and adolescents with difficulty processing and integrating sensory information. Bethesda, MD: AOTA Press.

Watts, M. (2010). How to ruin a parent meeting. ADVANCE for Speech–Language Pathologists and Audiologists, 20 (October 18).

White, R. (2010, November). Treating the whole child not the parts: Supporting the rhythms of relationships. SPD Foundation 11th International Symposium, Seattle, WA.

Williams, M. S., & Shellenberger, S. (1996). How does your engine run? A leader’s guide to the Alert Program for Self-Regulation. Albuquerque, NM: TherapyWorks.

Wilson, B., Kaplan, B., Pollock, N., & Law, M. (1994). Clinical observations of motor and postural skills (2nd ed.) (COMPS) [Manual]. Framingham, MA: Therapro.

Worthen, E. (2010). Sensory-based interventions in the general education classroom: A critical appraisal of the topic. Journal of Occupational Therapy, Schools, and Early Intervention, (3)1, 76.