Sensory Integration Therapy for disabled children is still at risk.
Our children need access to Sensory Integration therapy and the local authorities are using a flawed document produced by The College of Occupational Therapists in 2015 and an excuse to deny children vital services.
This petition is to ask the College to withdraw and publicly apologise for their document.
In April 2015 a document was published by COT which makes accessing Sensory Integration therapy for our children even more difficult than it already is. Please join me in asking them to withdraw and publicly apologise this document.
What is BAOT / COT?
The British Association of Occupational Therapists (BAOT) is the professional body and trade union for occupational therapy staff in the UK. Eight English regions and three countries are represented within its membership.
The College of Occupational Therapists (COT) is a wholly-owned subsidiary of BAOT and operates as a registered charity. It represents the profession nationally and internationally, and contributes widely to policy consultations throughout the UK. It sets the professional and educational standards for occupational therapy, providing leadership, guidance and information relating to research and development, education, practice and lifelong learning. http://cotannualconference.org.uk/about-cot
What is the purpose of a practice briefing?
Practice Briefings are written to help practitioners and managers put good practice into place in their agencies and services. For example an OT manager in your area may look to a practice briefing such as this one in order to make sure that the local service they manage is meeting current professional standards and expectations.
What does it say?
The briefing outlines and defines SI Theory and SI Therapy and also the use of Sensory Based Interventions (sensory diet). It discusses how this relates to Occupational Therapy theory and practice (the way OT’s are supposed to work) and it aims to set out some guidelines for OT’s who use SI as part of their work.
What are the main points / conclusions drawn?
The briefing appears to be trying to discredit the use of SI as an approach to helping our children; it tries to say in a few places that there is a lack of evidence to support SI. The problem is that they have left out any references to newer research which clearly supports the use of SI and shows that it does work.
The briefing says that SPD is not included in the DSM-V, this is the book which doctors use to find the criteria for diagnosing conditions such as ASD or ADHD. Because SPD’s not listed in the DSM-V book doctors can’t yet make a diagnosis of SPD and there are no NICE guidelines saying what the NHS has to provide. But the briefing leaves out other important points, it doesn’t make clear that there were some important changes put into the DSM-V about sensory processing, such as sensory difficulties now being included when doctors diagnose ASD.
The briefing advises OT’s to use their knowledge of sensory processing difficulties to advise families to make environments such as bedrooms and classrooms more sensory friendly instead of actually using sensory integration therapy.
So for example a child with oversensitivity to noise, may be advised to be in a quieter environment or use ear defenders, rather than receive SI therapy which would help their body to rewire their sensory systems to be able to cope with noisy environments better forever. As a parent I know which I intervention I would prefer for my child.
Why does this affect me?
As parents we want the best therapies for our children. In the UK it is incredibly difficult for the majority of families to access SI therapy this is because commissioners (the people who pay for the NHS services we get) are not investing time and money in training or employing the therapists who can help our children and young people through Sensory integration therapy. Our children and young people will live with the consequences of this lack of investment for the rest of their lives.
Commissioners have a tough job, the have to decide how they will spend the money that they have on services to help children and families living with conditions such as ASD / ADHD and SPD. There is lots of competition for what the funding can be spent on, and the commissioners have to be careful because they will have to answer for the decisions that they make.
Commissioners have to follow rules and get advice about where they are going to invest what little money they have. As well as taking note of demand from families they also have to look to professional bodies such as COT for advice and guidance when deciding how much if any money will be spent on SI training and therapy for children in the areas where we live.
This briefing affects all of our families because we want access to SI therapy for our children, we want there to be trained OT’s all over the country so that children can have access to SI when they are as young as possible. To bring about the changes we need to make this happen we have to have the support of the professional bodies like COT so that when commissioners look for professional advice and guidance that they see that SI is something worth investing in.
How can I respond to the practice briefing?
Please sign the petition below, or write to College of Occupational Therapists individually
- Julia Scott CEO College of Occupational Therapists
- Karin Bishop
- Karina Dancza
- Julia Scott
- Julia Skelton
- Tessa Woodfine
We want you to withdraw and apologise for the damage that has been caused by the COT Sensory Integration Practice briefing April 2015
Dear Julia Scott CEO
Based on almost a years worth of testimonies of families struggling to access sensory Integration therapy, and Many therapists who are facing barriers in providing it, we are asking you to both withdraw and publicly apologise for the practice briefing....
We the undersigned parents, carers, friends, family and teachers of children with neurodevelopmental difficulties are writing to you today to express our deep concerns about the briefing paper published by COT in April 2015 in relation to Sensory Integration therapy.
As parents living in the UK we experience many difficulties in being able to access therapies and support or intervention which will help our children. Whilst there is overwhelming scientific evidence that early intervention is the key to the best outcomes for our children it is extremely frustrating that in reality, between the delays we face in diagnosis and lack of funding for therapeutic interventions it is nearly impossible to access good quality therapy for our children. We know that there is also evidence to show that our children will live with the consequences of this lack of early intervention and support for the rest of their lives.
“There is no debate or doubt: early intervention is your child’s best hope for the future. Early attention to improving the core behavioural symptoms of autism will give your child – and the rest of the family – several important benefits that you will not gain if you take a wait-and-see” approachhttps://www.autismspeaks.org/family-services/tool-kits/100-day-kit/early-intervention
We are therefore deeply disappointed with the content of this briefing document which has been produced by the COT as we feel that it will further undermine our efforts to secure funding and the access to the therapeutic care which our children desperately need.
As you will know there are great pressures on clinical commissioners when deciding how best to spend what little money that they have. Because of this services for children with "invisible" neurological disabilities often receive lowest priority. We believe that commissioners will look to professional bodies such as COT for guidance and we are gravely concerned that upon reading this briefing document they will be far less confident when investing in services and interventions such as Sensory Integration. These services are vital to our children both for their development in the short term and also for their future well-being.
We would like to point out firstly that there is evidence and research beginning to emerge which shows both the therapeutic and neurological benefits of the use of SI therapy, such as those published by Schaaf et al in 2014. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4057638/ unfortunately this more recent research appears to have been omitted from the COT's briefing document. Secondly although SPD is not included in the DSM-V as a distinct diagnosis the sensory difficulties experienced by our children are in fact recognised in the DSM-V as diagnostic criteria for neurodevelopmental conditions such as ASD. It is also important to note that Autism was only included in the DSM as late as 1980.
“Autism was first included as a separate category in DSM-3 in 1980 when it was called 'infantile autism'. This was later changed to 'autistic disorder' in 1987. Asperger’s disorder (syndrome) was added to DSM-4 in 1994.” http://www.autism.org.uk/about-autism/all-about-diagnosis/changes-to-autism-and-as-diagnostic-criteria/qanda-dsm-5.aspx
As with ASD pre 1980 a lack of inclusion in the DSM does not mean a lack of impact on the lives of children and families.
Furthermore we find it surprising that the BAOT / COT would seek to deliberately hold back UK based professionals and create an uneven playing field internationally, both for professionals in terms of accessing funding for training and children in the UK who would most likely benefit greatly from sensory integration therapy. As parents we find it unfair that families living in other countries such as America will find that their professional body has a much more positive approach towards supporting families in accessing SI therapy.
We do not understand why the UK’s preeminent body of Occupational therapists would choose to take such a wildly different approach. However we do understand that these differences will be to the detriment of our children.
The American Occupational Therapy Association supports a full spectrum of approaches and interventions used in occupational therapy practice as part of an intervention plan that focuses on the participation of the client, including the appropriate use of sensory integration therapy (SIT). AOTA has made considerable efforts to address issues such as insurance coverage, the need for further research, and public understanding of the use of SIT as part of occupational therapy. AOTA has also advocated in various state and federal contexts for appropriate recognition of occupational therapy, including the use of SIT, as an approach for particular diagnoses, such as autism. - See more at: http://www.aota.org/Practice/Children-Youth/SI.aspx#sthash.vqXjrRdf.dpuf
In the light of the more recent research, the needs of our children and the importance of investment in their future well-being we the undersigned therefore respectfully ask you to reconsider the publication of this briefing.
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