presented by Tracy Stackhouse
In this course, you will learn how to establish power, precision, and proper timing in the sensory diet targeted to desired outcomes. In addition, you will learn to customize the sensory diet around common issues including postural development, autonomic dysregulation, and social-emotional or affective issues. The sensory diet concept can be extended to incorporate sensory-social routines to integrate co-regulation and relation-based interventions into daily programming. The evidence-base supporting the use of a sensory diet approach will be reviewed. Case examples from children with Autism and Fragile X Syndrome will illustrate the power of matching the sensory diet to a child’s specific needs. Finally, the sensory diet concept will be contrasted with a sensory based approaches, including the "sensory lifestyle," sensory breaks, supports, accommodations, and modifications.
Tracy Stackhouse is a clinical pediatric occupational therapist who has specialized in working with children, adults, and families affected by fragile x syndrome (FXS) and Fragile X related conditions since the late 1980s. Through this work, first at Children's Hospital in Denver, continuing at the UC Davis MIND Institute, and now at the nonprofit center she co-founded (Developmental FX), she has been able to provide continuity of care with hundreds of families affected by FXS. This allows her to offer a perspective to the families she serves and the colleagues with whom she collaborates about how FXS looks neurodevelopmentally. Tracy is committed to conducting research to advance the understanding and treatment of neurodevelopmental disabilities and FXS specifically. She is the director of the Developmental & Fragile X Resource Centre in Denver, CO, which is included as a part of the Denver Fragile X Clinic of the Fragile X Clinics and Research Consortium (FXCRC). She has been involved in fragile X clinical care and research since 1989 and has been involved with the National Fragile X Foundation (NFXF) since 1989, including active contribution to clinical materials and general advice. Tracy is a member of the Clinical Research Consortium of the NFXF, as well as a member of the Scientific and Clinical Advisory Committee. In 2013, she served as a consultant to Novartis during their clinical trial for a targeted treatment in FXS. Recently, she has been involved in the efforts to identify feasible and reliable neuromotor outcome measures that can be used in clinical trials. This project resulted in development of the FX Motor Battery, which is proposed to be further piloted in this study. Tracy is committed to the success of the proposed project and has a history of collaborative work with this research team that will support this project’s success.
Introduction to the Sensory Diet approach as an option along a continuum of intervention that requires clinical reasoning to select and implement. Further situates the sensory diet as within the broad framework of Sensory Integration as developed by Ayres.
The sensory diet is ‘prescriptive’ and individualized intervention that is goal directed with the power to shift underlying processing to allow the nervous system to function optimally. When properly implemented, the sensory diet can address a range of specific needs and result in added benefits. The sensory diet is best suited to addressing needs related to arousal and attention modulation, but can be used to address other needs when developed specifically and targeted at stated functions. The sensory diet should be evidence based and data driven from formation through implementation and always requires ongoing monitoring and modification based on the data. The importance of creating precise and powerful sensory diets is the focus of this chapter’s discussion.
This chapter focuses on how to select activities for precise and powerful sensory diets. Utilizing basic neural sensory processing information about the frequency, intensity, duration and rhythmicity/variability of input allows for activities to produce targeted adaptive responses, thus making the sensory diet a powerful clinical tool that extends from the clinic into everyday life.
Sensory diets can create the structure for daily inputs that are targeted and specific. Currently, there are a number of interventions that might support or enhance the sensory-based activities to further shift identified functions. Collectively these are referred to as professionally guided treatments. This chapter provides a clinical reasoning flow chart to help guide decisions around when to select and implement professionally guided options into the sensory diet intervention plan. Further, the importance of data collection for data driven decision making to ensure the integrity of the intervention is reviews.
The sensory diet is a targeted intervention and is different in scope and focus than other education or wellness oriented sensory-based approaches. Sensory Enrichment and Sensory Lifestyles provide a contrast to the Sensory Diet concept and are reviewed in this chapter with an emphasis on why clinical reasoning is required to clarify and help select among the various treatment options. The final part of this course provides a panel discussion of clinicians considering the options of care across the continuum presented and how to gain confidence in selected and implemented appropriate plan of care. Clinical reasoning can be enhanced by considering the guiding questioned reviewed within the panel discussion. Finally, the panel considers modifications of the sensory diet to address individual strengths and needs or special diagnostic considerations.