Expert Witness Journal Issue 63 October 2025 - Flipbook - Page 87
Vestibular and bilateral integration problems
– occur as a result of problems with vestibular input.
They can cause problems with posture, balance,
bilateral coordination (coordination of both sides of
the body), reading, ball skills, or 昀椀ne motor skills,
e.g. using scissors, handwriting.
Intervention
Intervention may include:
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Praxis problems – praxis is how the brain plans and
carries out new movements, e.g. learning to jump,
hop, drive or use cutlery. There are two types of
di昀케culty. Somatodyspraxia is a problem with praxis
and the processing of touch and proprioceptive
input. Visuodyspraxia is a problem with praxis
and visual processing. Some people have both of
these problems, while others have one or the other.
They can have di昀케culty learning new skills and with
coordination, timing, complex movements, 昀椀ne
motor skills, handwriting and play.
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Occupational Therapy with Children and
Young People
Occupational therapy (OT) helps a child or
young person manage or cope with a di昀케culty or
disability. The aim is to improve function, increase
independence, and help a person learn new skills.
An occupational therapist can identify how a child
processes and responds to sensory information.
Once the areas of di昀케culty are known, strategies
are recommended to manage them.
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Assessment
Sensory processing assessments are individual. They
require assessment from an occupational therapist
who has completed training at an advanced level, i.e.
advanced practitioner in sensory integration. An
occupational therapist will help others understand
the nature of any di昀케culties and why they occur. An
assessment may include:
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Discussion and written feedback from parents
or carers, school sta昀昀 and professionals.
Discussion with the child about daily activities
and sensory issues.
Classroom observations.
Non-standardized assessments to assess gross
motor skills, 昀椀ne motor skills, handwriting,
sensory processing and behaviour.
Standardized assessments, e.g. The BeeryBuktenica Developmental Test of Visual
Motor Skills, Test of Visual Perceptual Skills,
Motor-Free Visual Perception Test, Movement
Assessment Battery for Children, The
Bruininks-Oseretsky Test of Motor Pro昀椀ciency,
Detailed Assessment of Speed of Handwriting.
Using a standardised assessment depends on
the ability of the child and whether they will
cope with it.
Sensory pro昀椀le, e.g. Sensory Pro昀椀le, Sensory
Processing Measure.
EXPERT WITNESS JOURNAL
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Helping the child, family/carers, school sta昀昀
and professionals understand their needs.
Occupational therapy programme for school
and home to develop skills, e.g. balance,
coordination, muscle tone, body awareness,
昀椀ne motor skills, handwriting skills, visual
motor skills and visual perceptual skills.
Sensory diet – an individual programme of
activities that is embedded into routine. The
aim is to provide the right amount of sensory
input to increase regulation and help a child
move into the ‘right zone’ or level of arousal,
i.e. feel calm and focused so that they are ready
to learn, take part in activities, and tolerate
change in their routine and environment.
Sensory integration therapy – a specialist
therapy, provided by an approved practitioner
in sensory integration. Sensory integration
therapy uses activities that provide
proprioceptive input (pressure), tactile
input (touch, textures) and vestibular input
(movement). Sensory integration therapy
aims to improve sensory processing so a
child or young person can adapt and respond
appropriately. Activities are challenging but set
at the right level, i.e. not too di昀케cult, not too
easy. The number of sessions varies depending
on the child’s needs.
Teaching di昀昀erent ways of approaching
activities and situations.
Changing or adapting the environment or
routine.
Reducing or changing demands.
Equipment, e.g. exercise ball, ear defenders,
昀椀dgets, pencil grips, sensory cushion, writing
slope, Theraputty.
Recommendations for tests and exams.
Regulation tools, e.g. Sensory Circuits,
The Zones of Regulation, Therapressure
Programme (reduces sensory/tactile
defensiveness, formerly known as brushing
programme).
Social stories – to help a child understand how
to respond in certain situations.
Group activities.
Supporting transitions from one area and/or
activity to another, e.g. home to school.
Managing challenging behaviours.
Evidence
Evidence on sensory processing di昀케culties and
interventions vary. It is essential that assessments
are individual to the child or young person and
are completed by an occupational therapist who
has advanced training. The following studies are
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OCTOBER/NOVEMBER 2025
