Category Archives: Care Professional Contributions

We like to invite occupational therapists, sensory integration specialists and other care professionals that we have built a working relationship with to contribute to our blog. This offers a great insight into what they do and how we work together to improve people’s lives.

Explaining the Pool Activity Level (PAL) Instrument

Jackie PoolI am an Occupational Therapist with a specialism in dementia and in 1999, I developed the Pool Activity Level (PAL) Instrument with the encouragement and mentorship of Professor Tom Kitwood. I was convinced that a more helpful view of dementia is to identify the ability level of each individual. With that viewpoint, we are likely to enable rather than disable the person as we understand the physical and social environment required to sustain those abilities. If we only recognise the difficulties an individual is having, we will always disable them as we will only provide care and support to address their difficulties. So, the PAL Instrument uses a strengths based approach, underpinned by cognitive developmental theory.

The PAL Instrument has a Checklist of statements that identifies how the person can perform in nine every day activities. There are four statements for each of the activities and each statement describes a slightly different level of ability. By completing the PAL Checklist, it is possible to identify the overall level of cognitive and functional ability. From that knowledge, we can select the appropriate PAL Profile which describes how to support the person at that level of ability.

Pool Activity Level InstrumentI began developing the PAL Instrument by building on the work of Claudia K Allen. She had developed an Occupational Therapy model for understanding cognitive disability, based on developmental theory. Allen’s model has a robust assessment for OTs and then relies on their professional knowledge to interpret the outcomes of the assessment. I wanted a tool that would self-interpret and provide a guide to those without the clinical skills so that they could enable individuals with cognitive difficulties to be less disabled in every-day activities.

The first draft of the PAL Instrument was tested out in a local Hospital ward for people living with severe dementia and also in care homes where people were living with early to moderate dementia. Following feedback, I refined the PAL Checklist and Profiles and, with the support of Professor Tom Kitwood, published the first edition of the PAL book. This was published by Jessica Kingsley publishers as part of the Bradford Dementia Group Good Practice Guide series.

In 2008, the PAL Instrument Checklist was validated by Jennifer Wenborn and team at the Department of Mental Health Sciences, University College London.

The book is now in its 4th edition, with additions to the case studies and guidance on the use of the PAL Instrument. The PAL is now translated into several languages and is used within research programmes and also in health and social care settings to support care and activity planning. I regularly receive wonderful messages from care professionals telling me of the difference that using the PAL Instrument has made to their service. Their feedback describes the positive impact it has had on enabling people with dementia and other forms of cognitive impairment, including acquired brain injury, stroke and, learning disability to live meaningful and fulfilling lives.

Click Here to buy the Pool Activity Level (PAL) Instrument

Dr Anna van der Gaag talks to us about the CASP assessment tool

Dr Anna van der Gaag CBE talks to us about her background and the Communications Assessment Profile also known as the CASP profiling tool.

What’s your background?

Anna van der Gaag

When I finished school, I had little idea of what I wanted to do, and ended up volunteering in a school for children with learning disabilities. I met Pat Stephenson, a speech and language therapist, who encouraged me to apply, despite my lack of any science A levels. Much to everyone’s surprise, I was accepted at the National Hospital College of Speech Sciences (now UCL) in London, and qualified in 1981.

Immediately after I qualified, I went to India to work as a volunteer for 8 months, and when I returned I found myself in Glasgow, where I first encountered an “Adult Training Centre” for adults with learning disabilities. It very quickly became clear that all the communication assessments that used to assess adults had been developed for children. I returned to London a few years later, determined to use my Masters degree at the University of London as a route to developing an assessment designed for use with adults. It took many more years than my masters to complete this work, and I was fortunate to have the support of various research grants that allowed me to complete the work.

The Communication Assessment Profile was first published in 1988. It remains the only communication assessment standardized with adults – over the course of three clinical trials, its reliability and validity were tested with over 350 individuals, 66 SLTs, and 384 care workers working in 21 hospitals and 31 Adult Training Centres across the UK. We were incredibly fortunate to achieve this level of testing before we published the final version of the CASP. Since then, CASP has been updated, modernised and revised, with input from UK users and therapists, and is now in its third, colour, edition. All the data from the reliability and validity studies are included in the CASP manual. I am grateful to all those who took part and to the many people who helped me along the way.

Who can use CASP?

CASP is designed for individuals with learning disabilities, used by speech and language therapists, psychologists and OTs, working with care workers, peers and families. It has also been used with young people on the autistic spectrum and with adults with dementia (particularly the section on communication environment and vocabulary use).

What was the purpose behind CASP?

CASP Assessment ToolThe drive behind the research was simple – to develop a way of assessing communication skills of adults with learning disabilities that was respectful, relevant and robust. This meant using age appropriate photographs and materials, like money, toothpaste and shoes, rather than toys and farm animals.

There were three other important innovations – CASP was designed as a joint assessment – in which the care worker who worked most closely with the individual – was given a formal role in assessing communication. Hard to believe, but this was highly contentious at the time, as many professionals said they did not think that an ‘unqualified’ person should have a formal role in assessment. I argued that care workers (this included family members too) were frequently the people who really knew what was happening on a day-to-day basis and knew the most about the person’s experience of communication. Click here to find out more.

The second was that the CASP assessed not only the individual’s speech and language skills, their understanding and expressive skills, but also their communication environment, and the demands made upon them to use their skills. We conducted a piece of research which showed that adults with learning disabilities under-utilise their communication skills if they live in poor communication environments (click here to read this) and published this work in a paper called ‘the view from Walter’s window’ in 1989.

The third innovation was that CASP was designed to assess and build upon the person’s strengths – now called an ‘asset based’ approach – rather than their ‘deficits’ or what the person cannot do. The final part of the assessment is when the therapists, the individual and their care worker come together to talk about ‘priorities for change’ – which might mean change in their communication or it might mean change in their environment and the way that people around them communicate.

I’m delighted that all three of these innovations – seen as radical in the 1980s, have now become mainstream, part of how we approach our work, with many new advances and further innovations along the same lines occurring across the globe. CASP is now used in other parts of Europe, Canada, the US and Australia and New Zealand as well as continuing to be used in the UK. It has stood the test of time, I think, because it reflects contemporary approaches to working with people, rather than (as was the case) doing things to them.

What’s been your inspiration?
My inspiration was a man called William, who came to me for help during my years working as an SLT in Glasgow. He helped me make a short film about the CASP, and was as excited as I was that at last there was something that respected him as an adult. He had very limited expressive skills but his understanding of language far exceeded his ability to make himself understood – and he, like others, had suffered from discrimination, having been dismissed or ignored because he could not communicate like everyone else around him.

The other inspiration was a book by Joanna Ryan, called the ‘Politics of Mental Handicap’ (the title shows how long ago that was!) in which she exposed the systemic discrimination against people with learning disabilities that existed at the time. My sense from my days working in Glasgow was that people with learning disabilities and communication difficulties experienced even more discrimination – and part of my goal was to design an assessment that they were comfortable with, that showed them the respect they deserved, and was based on rigorous research.

Over the last few decades, I have been involved in teaching, research and regulation and have worn many hats. When I look at CASP, I feel that this is work I am most proud to have started, and most pleased that it continues to have practical relevance to the lived experience of people with learning disabilities.

References

The view from Walters window (1989)
van der Gaag, A (2009) eliminating professional myopia

Author Spotlight – Gali Salpeter

Introducing The World of Trains by Gali Salpeter – This unique train-themed set contains 50 illustrated cards and 50 story cards, accompanied by a professional guidebook detailing suggestions for individual and group sessions.

Gali shares with us her reasoning behind developing this exciting NEW set of therapeutic cards for healthcare professionals.

How and why these are developed?

Gali Salpeter

Gali Salpeter

I am an expressive therapist (M.A.) with specialization in drama and narrative therapy. My background is in psychology, sociology and anthropology and I am always fascinated with the ways in which these fields interact. I have been fortunate enough to live in different countries and work with inspiring children, in settings of individual therapy and group therapy.

I like to travel… Each station along the path of my life has had valuable lessons to teach me. I enjoy discovering new environments, studying them and finding my own way of being and becoming along their fixed rails and wild landscapes.

I also respect the power of narratives, both those built word by word within and – the ones told by others. Narratives are carried by the wind around us and I try to open myself to listen to them.

These are the grounds from which “The world of trains” set has grown and developed. “The world of trains” set is a psychological tool designed for facilitating, enriching and supporting therapeutic work with children. The set includes a deck of projective cards and a deck of story cards, as well as a professional encompassing guidebook.

The visual and metaphorical channels of expression, combined with the verbal and imaginary channel provided by the two decks – enrich the modes of communication offered to the client and to the therapist.

The client-child can thus choose whether to express her/himself verbally, to work through a visual mode or (as often happening naturally-) to combine the two.

The projective therapeutic space provided by the theme of an imaginary world of trains, which is shared by carriages and engines of different types, enables the client to get to know issues from his own world better and to share and process them with the therapist in a safe, metaphorical arena.

It is the flow between working therapeutically in the layer of the imaginary and working in the layer of reality that adds value to the therapeutic process.

The theme of the set – a world of personified trains – was chosen as it holds images and metaphors that can easily apply to issues children cope with daily.

Why these are different from everyone else’s card resources? What is their unique selling point?

The set is a rich and useful resource which contains a deck of 50 illustrated cards, a deck of 50 story cards and a professional guidebook for therapists. Three professional tools for therapists in one kit ! As such it is unique.

The deck of projective cards contains 50 images of carriages and engines, where each card can be worked with as a single stimuli. In addition, when the child puts one card next to the other, it creates an image of a train. The train and the cards composing it can represent a situation, a place, a feeling, an event or a group of people from the client´s life.
The deck of story cards contains the beginnings of stories told by different carriages. The client can work with the story cards, either in combination with the illustrated cards or separately.

The professional guidebook describes methods for working with the cards in settings of individual therapy and group therapy. These suggestions are organized according to relevant themes, such as: relationships and groups in different areas of the child´s life, strengths, difficulties, separation, transitions, issues within a family, coping with illness or death, aggressive behavior and violence, control, fears and more.

The set is a wonderful resource that can be used by mental health professionals from different fields according to their areas of expertise.

World of TrainsTell me why you are so proud of them and how long they took to develop.

For the world of trains to develop and come to life – as with many meaningful journeys in our life – it needed time and space, involved building relationships and demanded many hours of working alone.

A couple of years of hard work went by before I managed to create the imaginary world I envisioned, a world where therapists and clients join and are enabled to embark together safely on meaningful journeys of their own…

Each illustration was carefully designed to address relevant issues that can be processed in therapy. The colors of the cards, the material, size and shape of each illustrated carriage, the relation between each carriage and its environment, as well as other objects and features in the cards, were all carefully and professionally controlled in order to address a wide area of themes and emotions. The result of these efforts will hopefully assist the clients working with the cards to deal with the issues they are dealing with.

The story cards were created one word at a time, with the goal of offering beginnings of stories that would both enable and encourage children to relate to, articulate and work with narratives from their own lives.

The numerous options of using the cards in therapy when working with children having different needs emerged in a flow of ideas stemming from my professional knowledge and experience. These suggestions for application were edited (and re-edited☺ ) to result in the broad and useful guidebook, which can stand as a valuable therapeutic resource on its own.

As in other adventures we embark on, there were obstacles along the way, stations that kept the train from moving forward or times when an engine or two had to halt or search for the right rails to follow.

Hence, when I hold the set now, with both hands… I feel and acknowledge its visual and thematic richness and the professional therapeutic value it contains. These were born and embedded in the stations and over the tracks, in the carriages and through the changing vistas of this world of trains.

I am proud of this set. I would like to believe that the future inhabitants of this world of trains, be it passengers or drivers, by-passers, clients or therapists – will benefit from exploring its landscape and find their own trails and stations along it.

Please use it with respect, responsibility and sensitivity, for with these it was created.
From the bottom of my heart and mind, I wish you a safe and fruitful journey.

Author Spotlight – Margot Sunderland

Margot May

Margot May

Would you share a little information about your professional background with us so we have some context about the origin of the resources?

I trained to be a secondary school teacher and taught for a few years. It was the hardest years of the my life. I then went on to train as a creative arts therapist and psychotherapist and become a Senior Lecturer on a Performing Arts Degree. 

I worked for 10 years in residential care homes with troubled teenagers. I saw time and time again that without call on images and imagery, the change process is slow or doesn’t work at all. with images people engage and the change process often flows in remarkable ways.

I now run a Higher Education College entitled Institute for Arts in Therapy and Education ( academic partner of University of East London) MA in Arts Psychotherapy and MA in Integrative Child Psychotherapy and lots of Child counselling courses using the arts.

Can you give us a brief overview of the Draw On Series from your perspective?
They are to support children teenagers and adults to stand back and think about their lives and make sense of and process major life events.
It is a process designed to help them to then make good choices about what they want to do with their life now and in the future, how they want to live it who they want to be, who they want to be with and what gives their life meaning. As Socrates says, “ The unexplored life is not worth living “. Without standing back you can so easily get stuck in a rut and keep making the same mistakes d

What was the inspiration, thinking or reason that prompted their development?
Because in my work with very troubled children and teenagers, straight forward conversation about feelings just often didn’t work
Using the worksheets “ what I call the third thing in the room “ was far less shaming for them and they got really interested in the psychology of relationships with self and others which is embedded in the drawings. In this sense the drawings offer psycho-education vital facts about what it means to be human
One teenager for example had never realised he was a young carer before doing the relationship page. Another found the word “ shock” on the shock page vital to understanding his painful life as he realised he had had many shocks. He then started to make sense of them, grieve and work through so the shocks stopped derailing his life . So the work sheets can be starting points, spring boards to a really meaningful conversation that otherwise would not take place

What was your main goal when you created them?
To help ease the vital process of reviewing your life and how you want to live it, and processing painful life experiences that if left unprocessed can lead to mental and physical health problems

Were they evidence-based and tested and if so, who with and when (age group, setting etc.)
Yes with various adults ( the emotion cards especially – These adults often could not stop looking at particular cards , holding them once they had identified with them )
The worksheets lots were used with teenagers in residential care and with adults, children and teenagers in private practice over years.

Do you need to be a trained, qualified and registered clinical professional to facilitate sessions using these resources?
No. You need to be able to listen really well and to empathise and feed back that you have understand what the person is saying. .Endless questions without empathy can be dangerous and people often just shut down. And it has be totally non – judgemental listening with no lectures !! But I explain the vital dos and don’ts in the books and with the emotion cards. I would always recommend say at least a short counselling course ( e.g 30 hours) but that said, some people have natural empathy.
I really liked it that the researchers for the Government Green Paper Dec 2017 Transforming Children and Young People’s Mental Health Provision found that with children/ teenagers age 2-18, to quote.

“There is evidence that appropriately-trained and supported staff such as teachers, school nurses, counsellors, and teaching assistants can achieve results comparable to those achieved by trained therapists in delivering a number of interventions addressing mild to moderate mental health problems (such as anxiety, conduct disorder, substance use disorders and post-traumatic stress disorder)”

 Who can access and make the most use of these resources? (e.g. age of end user/their clinical needs/groups/individual 1-1 sessions etc.)
Yes anyone could use the book to do a self review of issues in their life. But they are best I think for practitioners who are helping people to look at their life, work through painful experiences, making life decisions
They can be used in groups, say in PSHE lesson on relationships that hurt and relationships that heal, leading to really good group discussion

There is a new edition of “Draw On Your Emotions” already available and a new version of the “Draw On Your Relationships” coming out soon. Can you explain what new content readers can look forward to in these updated volumes please?
I wrote the first editions a long time ago now. The new editions I think are far more moving, in depth, wider range of life experiences explored. The pictures also have been all re- drawn to be far clearer and often far more emotionally engaging

We are excited about the new add-on cards. Can you share with us how and why these were developed alongside the core resource?
The cards are very powerful. Of course being full colour they can engage you a really strong way. Participants find utter relief in seeing key life experiences relationship experiences and self – states ( which so often don’t get talked about ) there in front of them. The idea is that you lay out all the cards and then simply pick up the ones that really accurately represent you, your feelings, your life, your relationships. There are cards on the market but we haven’t found any that really provide the emotional depth of the cards we have made. Hence our motivation to do so. Humans don’t have little feelings, they epxeirence powerful, intense emotional states and they need these acknowledged. The cards do this.

What is really different about these books and cards compared to other resources available?
I think so many resources on emotions are a bit patronsing – particularly those for children. We don’t just feel sad, cross, frightened and happy. Even young children have complex feelings and self states that, if they are not worked through, not made sense of, can so easily lead to mental health problems.

Will you tell us more about the images used on the cards and the artist?
Nicky is a stunning artist. She trained at The Slade ( top art school ) and can capture the very essence of particular self – states in ways that when you see them on the cards, grabs your attention as they really do speak about some of the most profound feelings we humans are capable of.

Do you have any other projects up your sleeve that we can look out for in the future?
Yes DVDs on attachment play and ways of being in relationship with children and teenagers that bring about emotional change. Its the opposite of spending hours on screen time where no emotional development takes place.

Click Here to buy The Emotion Cards

Understanding Makaton

Makaton Badge

Makaton is a language programme using signs and symbols to help people to communicate. It is designed to support spoken language and the signs and symbols are used with speech, in spoken word order.

Using signs can help people who have no speech or whose speech is unclear. Using symbols can help people who have limited speech and those who cannot, or prefer not to sign. With Makaton, children and adults can communicate straight away using signs and symbols. Many people then drop the signs or symbols naturally at their own pace, as they develop speech.

Makaton Nursery Rhymes

Being able to communicate is one of the most important skills we need in life. Almost everything we do involves communication; everyday tasks such as learning at school, asking for food and drink, sorting out problems, making friends and having fun. These all rely on our ability to communicate with each other.

For those who have experienced the frustration of being unable to communicate meaningfully or effectively, Makaton really can help. Makaton takes away that frustration and enables individuals to connect with other people and the world around them.

Makaton is extremely flexible as it can be personalised to an individual’s needs and used at a level suitable for them.

    • It can be used to:

    • share thoughts, choices and emotions
    • label real objects, pictures, photos and places
    • take part in games and songs
    • listen to, read and tell stories
    • create recipes, menus and shopping lists
    • write letters and messages
    • help people find their way around public buildings.

Makaton Make and Do Activities

Today over a million children and adults use Makaton symbols and signs. Most people start using Makaton as children then naturally stop using the signs and symbols as they no longer need them.

However, some people will need to use Makaton for their whole lives.

The Makaton Charity exists to ensure that everyone living with learning or communication difficulties has the tools and resources they need to communicate. Our nationwide network of over 1,000 licensed Makaton Tutors and Trainers across the UK deliver training to over 30,000 parents, carers and professionals each year.

Makaton National Curriculum Symbols BookOur wide range of printed and electronic resources extends from nursery rhyme DVDs to vocabulary books covering a wide range of subjects. Our vision is a world in which all people with learning or communication difficulties are able to communicate, participate and achieve their potential.

For further information visit makaton.org

Narrative Therapy

Narrative Therapy – The River, Roads and The World of Trains

By Gali Salpeter – Creator of Narrative Therapy tools, The River, Roads and The World of Trains

Background

Gali Salpeter

Gali Salpeter

I am an Expressive Therapist with specialisation in Drama and Narrative therapy and a background in Psychology, Sociology and Anthropology.

My fields of study, work and life are closely intertwined; I have worked and volunteered as a therapist in a few countries and I feel blessed to have chosen this field of work, which enables me to connect with, support and be touched by, so many wonderful people across the world.

I live in beautiful Norway with my husband and 3 children (my most meaningful creation).

Projective cards – underlying concepts

I began to use projective cards as a psychological tool when I was working as a therapist with children having special needs. Combining the cards with art, drama and stories proved to be very useful and I realised it helped my clients raise and share the issues they were dealing with. It supplemented the verbal mode of communication in many ways.

However, with time, I felt that something was missing; putting separate cards apart from each other in order to tell stories, was in fact “losing” the idea of flow. It looked as if there was no connection or transition between the different parts of the stories that the clients were telling. I have started to search for ways to make the images illustrated on the cards “connect” so that the flow of the stories that the clients told will become visual as well.

Narrative Therapy

Joining up the cards to create a story

The metaphors of the river and roads, flow and paths, were metaphors I found enriching when speaking of processes that people are dealing with. People often speak about journeys they make, paths they choose, steps they take or a continuum of periods in their lives.

Both the metaphor of the river and the metaphor of roads enabled my clients and me as the therapist to relate to the “whole” as made of different parts. It helped clients realise that the stories they tell are built of certain chapters and to observe the processes they described as made of many stages or several sub-periods.

Thus, using the metaphors of rivers and paths matched my goals as a therapist; to help my clients tell, observe, work with, and retell their experiences in life in new ways.

The River Set

The first set I have created is “The River”. Like most journeys, it begun with a personal experience. This time it was a sad one… My grandmothers died in a short period, I was a mother of young kids and as a way to cope with my grief, I wrote “The river story”. It dealt with my interpretation of life and death, relationships, identity and memories, strengths and weaknesses. I often use writing as a tool to process the personal experiences I encounter in life so that story almost ended up “in the drawer” like many others…

Since I was working with projective cards I came to the idea of drawing the story in the form of cards. Derived from the story, the atmosphere I chose for the cards was one of – nature – as I have perceived it. I looked for subtle stimuli, and not too much fantasy in the images drawn.

One thing led to the other, “The river guidebook” kind of wrote itself, the ideas for ways to use cards kept on flowing from my experience and imagination, and then – after a long “pregnancy” – ״The River set״ was born. Like many wonderful things, it was born out of pain but it holds the strengths of sharing hope.

Roads Deck

״Roads״ was created several years later when I was living elsewhere. I like travelling to new experiences and I have lived in wonderful countries around our globe. My journey and the paths that I have chosen (and the ones which have chosen me) always led me to interesting places both within myself and in the cultures around me.

The metaphor of “Roads” for me means that I have a road that is mine, with the obstacles I encounter and the “gifts” I find along it, my own beginnings, the steps I take and the ends. However, it is also a road that goes in amazingly different surroundings, with interesting people I was lucky and maybe brave enough to get to know. So perhaps “Roads” for me is this journey as a whole – a journey that is one and unique and “mine”, but it is also many meaningful journeys, stories, paths and periods which I have experienced with others around me.

I believe that although each of us have a unique path in life, we are changing in many ways along it. I decided that the stimuli will be clear in that deck, I wanted to use fantasy and include obvious objects. The colours and atmosphere was completely different than the ones used in ״The River ״so as the method of painting used.

In a sense I think that the sets complete one another. Hopefully having these different sets enable clients to choose the most suitable tool and image they would like to work with, in each given moment.

The World of Trains set

״The world of trains” set is being edited for print in these days. I am not objective, but I think that it is a very special set. The set is designed for therapeutic work with children in settings of individual therapy and group therapy. It contains a deck of illustrated cards, a deck of story-cards and a comprehensive guidebook for therapists. The guidebook describes in detail numerous professional suggestions for application of the cards, according to the different settings and relevant issues children cope with.

Final Thoughts

It is my hope that every person working with the sets will enjoy the opportunity of telling her/his story and the wonder of discovering its rich layers and intertwining chapters.
We all have stories waiting to be told.
Thank you for reading a chapter of mine…
Gali

Occupational Therapy Students from Derby University

derby-uni-1As part of the ‘play’ module which we studied at university, we were generously invited along to Rompa to meet the people who were designing and developing sensory equipment and toys for a wide range of clients. The day began with an introduction with Tania, an Occupational Therapist who works in the role of a Product Assistant. Tania firstly spoke about her journey into this role and about how her experiences on practice placements as an OT helped her to identify barriers and enablers to the development of sensory products. We then heard some history about the company and discussed the need for sensory based equipment and toys for use within therapy. Following our discussion and a browse through the Rompa catalogue, we were guided through the set-up sensory room which incorporated products designed and built by the staff at Rompa. The products were demonstrated and explained to us and we had time to think about how each product could be utilised by an OT and graded for our clients. We initially focussed on children and how these products could be used within a paediatric setting (as this was relevant to our ‘play’ module) however soon discovered uses for these products for a wider range of clients such as stroke patients, dementia patients and those with mental health conditions.

derby-uni-2After a tour around the sensory room and introductions to the toys and equipment, we were given the opportunity to explore the equipment for ourselves and to apply the ‘sensory magic’ technology to a given case study. Our case study involved preparing a sensory room for a group of children with ASD whom had been for a day trip to the fair. This was a very fun and educational task which really got us thinking and working collaboratively to utilise the equipment we were given. This involved bubble lamps, various lights presented in creative ways around the room and ‘sensory magic’ which allowed us to select music as well as a video or still image on the interactive screen for added sensory input.

derby-uni-4We really liked that these toys and gadgets are not just for kids. They are used for adults with dementia too as well as well as clients with different abilities and needs which makes them much more widely used and applicable to areas of practice! However there may be a lack of availability of the equipment to play with from the wide catalogue range and this equipment is sadly not always affordable for all clients despite the value for money which Rompa offer.

From our experience of visiting Rompa, we learnt that the use of sensory equipment can promote wellbeing for individuals living with a multitude of conditions. These can range from individuals on the autistic spectrum to older adults living with dementia. It has been a crucial learning experience which has contributed to our development as up and coming Occupational Therapy graduates. It will be beneficial to be aware of the variety of sensory equipment that is available in our professional working with individuals with sensory difficulties. We also learnt that Occupational Therapists have unique skills that allow them to work in a variety of non – traditional positions.

derby-uni-89Overall, our visit to Rompa was extremely interesting and inspiring. It allowed us as therapists to visualise ways in which we can assist our clients with sensory impairments to become fully involved within their own environment. The demonstration of the ‘Sensory Magic’ programme allowed us to appreciate how much technology has advanced over recent years and enlightened us to the possibilities of incorporating the whole room with visual effects, sounds and smells, using one user friendly piece of equipment. As therapists, it is highly beneficial for us to be able to offer advice and educate our client groups on the available equipment for children and/or adults with Sensory Impairments, therefore this opportunity has been an invaluable step for us to gain first-hand knowledge and experience of the products and how they can be used to assist clients with sensory needs to live a more happy and fulfilled life.

We are now aware of the many types of sensory equipment available to us as OT’s and how these can be used in a variety of ways with different client groups within therapy. We would now consider using Rompa for advice and equipment in our future practice to enhance the lives of our clients with and without sensory conditions.

derby-uni-3

We would finally like to say a big thank you to Tania and the entire Rompa team for facilitating this valuable experience and would recommend this service and their products to Occupational Therapists and other allied health professionals working within any area of practice!

By Rosie Turner, Jodie Marx, Anna Marshall-Clarke, Andrea Erskine , Joanna Smith, Rosie Linder, Siobhan McPhillips and Laura Higgleton.

3rd Year OT Students, Derby University.

Caroline Molloy at the Deepti Centre

The Deepti Centre, Kerala, South India

By Occupational Therapist Caroline Molloy

Caroline Molloy at the Deepti Centre

Caroline at the Deepti Centre

Five years ago, I heard a mother speak about how hard it was to get services for her disabled child in her town in India and how she was determined to make a change by opening a special school herself. When I offered to help, it was in fact by means of a bit of fund raising or helps with accessing some resources. I never imagined that I would be taking an active role in the development of the service and that through it I would find that same light of commitment which is still burning strong after 5 years and 5 trips to India.



The Deepti Centre is situated in Kerala , South India. It is a rural, lush community popular with tourists as a holiday destination. The local language is Malayalam, although English is spoken by most people and taught at school. The word “Deepti” means light in Malayam, and from the very beginning it has been a shining example of love and care in action, that has family values at its core.

Deepti CentreDeepti was started as a centre for children with cerebral palsy, although it has broadened its remit to admit any child with special needs in the area. It was founded. By Dr Susan Mathew, who has is a mother of 4 sons whose youngest was born with cerebral palsy. Her son Jyothish is the inspiration behind Deepti, not even Susan would have imagined the growth of Deepti from 1 to 71 children in 5 years.

Our aim for our most recent trip was to set up a sensory room, in a small building next door to the physiotherapy room. We were very thankful for a significant number of items from Rompa which are now part of the sensory assessment crate, which we have left ready for use. It’s true to say that you don’t know what is missing until you realise it’s missing, but we hadn’t realised we had so few resources for our children who had visual problems. Once we had been to the shops to buy heavy suiting material for black out blinds, we were able to equip the new sensory room with battery operated lights, and soft lighting so that the Occupational Therapist could create a relaxed and calming atmosphere for our children with sensory needs. There wasn’t a dry eye in the house when one of our boys was given a flashing light ball, he rolled it around the floor, held it up to his face, and we could see he could see it! He called to his mother “I can see the light, I can see the light” it was indeed a very moving experience.

Deepti CentreOur time at Deepti is always so short, and this year we stepped up and delivered our training program from the local hotel conference suite. This enabled us to professionally film all our training, so that this can be edited and translated into other languages, which will have a significant impact in rural communities across Asia. As an accidental consequence, our training was also filmed by 2 Keralan TV stations and was on air for 8 mins on national TV. I can’t tell you what impact that had on our mothers and families, to receive that kind of media attention, and acknowledgement that both they and their children had significance and value.

If you would like more information about the Deepti Centre please visit www.carolineinkerala.wordpress.com

Guest Blog – Jigsaw OT Events

Jigsaw Occupational Therapy is a specialist provider for children and young people living in the South East of England. Our dedicated assessment and sensory integration therapy centre is the first and only one of it’s kind in Sussex.

Jigsaw OT was founded in order to offer effective and personalised assessment and therapy specifically designed around each individual child and young person’s needs. However, for a parent or a professional, upon establishing that a child may have some difficulties or challenges, trying to understand these difficulties can often generate more questions than answers. More and more information is available now on conditions such as, Sensory Processing Disorders, however, the sheer volume of documentation can become overwhelming and confusing. 

Here at Jigsaw OT we decided it would be great if we could bring together parents, teachers, SENCo’s, Teaching Assistants, INA’s, health care professionals and carers by providing the opportunity to not only learn more about their respective child’s challenges but also have the chance to meet and talk with others who may be dealing with similar circumstances.


And so it was, that last week we were able to arrange a ‘drop-in morning’ and a training day, on consecutive days! We opened our doors for all to come and visit and to learn about what our sensory integration therapy can do. All of our OT’s were on hand to talk to and lend advice, we urged our visitors to step into our sensory integration therapy room and explore the array of specialist equipment provided by Rompa. Just a few of the items on display included the Bolster Swing, the Flexion Disc Swing, the Scooter Board, Weighted Vests, Spinning Cones, Knobbly Rolls and much, much more! For many of our visitors it was the first time they had been introduced to such apparatus and provided a much clearer indication of how the equipment works in relation to a child’s needs. Invaluable information for both parents and professionals.

Our training event focused ‘supporting children with Sensory Processing Difficulties’. Some children have difficulty “behaving appropriately” as their brain does not send their senses the correct messages. These children may have Autistic Spectrum Disorder, ADHD or other learning difficulties. Those attending the event gained a better understanding of sensory processing, how to recognise children with sensory processing difficulties and how to support them in the classroom and at home.

An array of sensory toys were handed out to each of the attendees, items such as Massage Tubes, Vibration Pillows, Knot Balls, Spiky Balls, Squeezies etc. all of which were evaluated to understand how to use them as a strategy to support a child. Examples of sensory strategies were provided, involving movement, touch and deep pressure and how different items of equipment could be used together. For example, placing a weighted blanket on top of a child lying on a Walrus mattress.

All in all, both days were a fantastic success and we were delighted that we were able to reach out to so many people, both from the home and school environment. The majority of our feedback commented on how fantastic it was to be able to meet and talk to others who are experiencing similar situations. This has convinced us that it is vital that we continue to provide this platform for people and we will be arranging similar events on a regular basis in the future. For more information about what Jigsaw OT can do for your child, please contact me at dominic@jigsawot.co.uk.

Thank You!
Dominic

Oral Motor – A Sensory Perspective

Sensory processing and integration provides body control,

Chew Pendants

Chew Pendants

underpins all normative functioning and enables decision-making. It impacts on how we move, plan and co-ordinate our motor functioning, communicate, behave, develop and participate occupationally. A lack of regulated sensory control means people cannot engage effectively in everyday life activities. Dysfunctions in sensory processing therefore significantly impact on life quality.

Oral motor difficulties are a key current issue and we are regularly asked for more resources to help support this need (a new Oral Motor Kit will be launched in 2015 – watch this space!). Inappropriate behaviours exhibited that people can find confusing/distressing are:

  • Mouthing non-food items (chewing, licking, eating, biting, self-harming, tugging and shredding clothes/soft furnishings etc. with teeth. Rolling/spitting bits of chewed items)
  • Not being able or refusing to feed independently
  • Spitting out food/gagging when eating
  • Experiencing a very restricted diet with avoidance of certain foods.
  • Poor oral hygiene (cleaning teeth intolerance)

So, why does this happen?

Circular Chew Pendant

Circular Chew Pendant

Taking a sensory perspective, imagine you cannot understand or put into context the feelings and sensations that your body is experiencing or feeling (light/texture/smell/taste/sound). Maybe these are experienced as so overwhelmingly intense that you want to withdraw because the input is unpleasant. Sensory input may be so minimal/distant that you can’t hardly register it so you may seek greater/more extreme input to enable you to experience this. Sensory input can be experienced as painful or irritating. You may not understand what this input is, know what to do or be able to co-ordinate an appropriate response. Self-stimulatory behaviour such as chewing/biting can be a way of comforting, relieve anxiety, reduce fear and initiated to prevent sensory overload.

There may be other reasons why these behaviours occur and clinical assessments, profiling and observation will identify causal issue/s and establish clinical reasoning.

Taking the oral motor example, perhaps the individual;

  • doesn’t like the texture of what they are eating.
  • doesn’t like food going where they can’t see it.
  • has a poor chewing pattern.
  • can’t feel the food, perhaps there isn’t enough sensation to register the feelings of the food properly in the mouth and this feels unpleasant/painful or tickly.
  • has fine motor skill, visual or cognitive difficulties.

A sensory approach may include consideration of interventions such as:

  • Texture – Crunchy/harder textured food such as foods that you need to bite hard on such as apples. Food with inclusions (e.g. seeds/nuts etc)
  • Sucking & Licking – Thicker drinks though straws. Ice lolly.
  • Taste – sour, sweet, spicy
  • Vibration – electric toothbrush
  • Temperature – Experimentation with cold and hot. Using ice cubes, perhaps with just water, or perhaps a “taste” object inside or use flavoured water or juice. Try fizzy foods, popping candy.
  • Chewing – Offering safe chewing products. Chewing flavoured gum or chewy foods. We offer a variety here – http://www.rompa.com/catalogsearch/result/?q=chew
  • Blowing activities – blow feathers/paper around with straws? Blow through a straw in the bath to make bubbles. Blow raspberries. We sell blow lotto here – http://www.rompa.com/blow-lotto.html
  • Movement – Geurning – pulling silly faces, sticking tongue out. We have a therapy mirror here – http://www.winslowresources.com/therapy-mirror.html