Clinicial Reasoning For Occupational Therapists

We are really looking forward to welcoming back the wonderful Occupational Therapist Tracy Stackhouse from the USA to host this fantastic Workshop in Ireland this week,


The SpIRiT© of Pediatric OT: The SpIRiT (Sensory processing/Integration Reasoning interactive Tool) is a mindful clinical reasoning tool for ensuring best practice in pediatric occupational therapy. The core of the SpIRiT model is derived from the theory and
practice of sensory integration, as originated by A. Jean Ayres (now referred to as Ayres’ Sensory Integration, or ASI©). The model is elaborated by current work connecting basic sensory integrative processes to neural plasticity through the mechanism of evincing an adaptive response. In this model, the basic sensory processing is the lowest, bottom up influence over the neural networks that support adaptive functioning. The SpIRiT© model includes a framework for looking at sensory integrative processes with the neural processes that use the sensation for organization of behavior and skill acquisition. Low route processing integrated with higher order
neural functions allows for skill in functions that depend on sensory integration, such as social emotional capacities and executive functions. Together, these processes underlie daily living and are the neurally based concepts that are utilized to devise
comprehensive treatment plans.

Clinical Reasoning for pediatric occupational therapists should be informed by many sources and levels of evidence, including the basic neuroscience, developmental theory, occupational therapy literature, and OT clinical practice. All provide rich sources
of evidence and inspiration. However, combining all of these sources of information into a format useful for in the moment clinical use can be daunting. Hence, the necessity of a comprehensive clinical reasoning process, the SpIRiT©!


The SpIRiT© introduces a clinical reasoning framework for combining sensory, affective, and motor processing into a relationship-based, sensory integrative model of intervention. The SpIRiT© is an extension of the STEPSI© model, originated by Stackhouse & Wilbarger in 1998, as the first fidelity to treatment model devised for sensory integration and pediatric occupational therapy. The SpIRiT© model draws from developmental science and current neuroscience to create an evidence-based model to guide clinicians in developing an monitoring sound intervention.


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