Spirited Conversations - Engaging and Elevating Pediatric OT

This episode takes us further along the path of social emotional development. We dance with the dilemma of knowing when the right time is in treatment to teach a specific social skill strategy. If you have ever thought about how much to challenge a child and how much to follow their lead then this discussion is definitely for you.

Hopefully we will have all the bugs in our audio sorted for our next episode but we hope you enjoy regardless!

Show notes for this episode can be found here:
www.spiritedconversationspodcast.com

For all those interested in taking the SpIRiT course you can find it here:
https://dfxlearningjourneys.thinkific.com

Show notes on our website (coming soon):
spiritedconversationspodcast.com
Want to do the SpIRiT Course? You can find it here:
https://dfxlearningjourneys.thinkific.com

Hosted on Acast. See acast.com/privacy for more information.

We are back and taking our conversations into the realms of social-emotional development. If you haven’t heard episode 7 it will be helpful to go back and listen as we reflect on the same case and how treatment moved from regulation into the social-emotional domain. 

We don’t specifically reference a number of key researchers in our discussion and deeply want to honour and respect the work these wonderful people have contributed to this field. So we have included their names for you here:

• Dr. Stanley Greenspan and Dr. Serena Wieder
• Dr. Edward Tronick 
• Dr. Dan Siegal
• Dr. Daniel Stern  

We also make reference to Mattingly and Fleming’s work in realation to clinical reasoning and occupational Therapy. 

Bon appetite! 

Show notes on our website (coming soon):
spiritedconversationspodcast.com
Want to do the SpIRiT Course? You can find it here:
https://dfxlearningjourneys.thinkific.com

Hosted on Acast. See acast.com/privacy for more information.

Hang in there! We’ll be back soon. 

Show notes on our website (coming soon):
spiritedconversationspodcast.com
Want to do the SpIRiT Course? You can find it here:
https://dfxlearningjourneys.thinkific.com

Hosted on Acast. See acast.com/privacy for more information.

This episode we work to put the concepts from the last two episodes together with a clinical case. 

As always show notes can be found here:
www.spiritedconversationspodcast.com 

SpIRiT course can be found here:
https://dfxlearningjourneys.thinkific.com

Enjoy!

Show notes on our website (coming soon):
spiritedconversationspodcast.com
Want to do the SpIRiT Course? You can find it here:
https://dfxlearningjourneys.thinkific.com

Hosted on Acast. See acast.com/privacy for more information.

These two Modulation episodes are packed full!! Definitely don't skip this one, it's packed with gold. 
So exciting that the SpIRiT course is now available for people to take online. If you're interested check it out here: https://dfxlearningjourneys.thinkific.com 
As always, our website has some links/resources to explore further from this ep in our show notes. 
https://www.spiritedconversationspodcast.com

Show notes on our website (coming soon):
spiritedconversationspodcast.com
Want to do the SpIRiT Course? You can find it here:
https://dfxlearningjourneys.thinkific.com

Hosted on Acast. See acast.com/privacy for more information.

Get ready to dive into sensory modulation, a very unique and incredibly important topic. Show notes at www.spiritedconversationspodcast.com 

Show notes on our website (coming soon):
spiritedconversationspodcast.com
Want to do the SpIRiT Course? You can find it here:
https://dfxlearningjourneys.thinkific.com

Hosted on Acast. See acast.com/privacy for more information.

Sensory discrimination has been the quiet underpinning of every episode so far. This one puts it centre stage.

Tracy, Cory, and Michelle work through what sensory discrimination actually is, how it differs from sensory modulation, and why Dr. Ayres was right to place it at the foundation of skilfulness and praxis. Along the way they get into haptic processing, the concept of affordances and action-perception coupling, and why a child who is working hard just to stay upright against gravity simply cannot prioritise sensory detail.

The key idea: sensory discrimination is not just a background process. It is the foundation on which skilfulness is built. And in treatment, the job is not drill or repetition — it is play-based, affectively rich experience that makes sensory detail meaningful enough for the brain to use.

Timestamps:

• 00:00 Welcome and framing the episode
• 01:17 Sensory discrimination as the backbeat to posture and praxis — time to address it directly
• 03:29 Michelle defines sensory discrimination — it's the detail, the fine tuning of input
• 04:36 Tracy: detail for the purpose of what? Sensory processing for skilfulness
• 05:00 The coin in the pocket example — tactile discrimination leading to representational knowledge
• 07:55 Tracy: haptic processing — when touch and vision combine to give us automatic skill
• 10:12 The guitar example — force grading, timing, and the discrimination that underpins it
• 11:25 Tracy: without deep somatosensory integration, you can't maintain core stability while executing fine motor tasks
• 12:33 Michelle: the orchestra metaphor — how the other senses support and amplify each one
• 14:20 Error detection, correction, and the formation of neural pathways through practice
• 16:25 Tracy: the role of clinical observation in discerning where in the process the breakdown occurs
• 19:19 Tracy introduces affordances and action-perception coupling
• 21:54 The bead and the string — why a child can't perceive them as combinable until they have the motor capacity
• 24:56 Tracy: schemas, affordances, and why you can't unlearn riding a bike
• 30:10 Michelle asks Tracy to unpack the difference between perception and cognition
• 30:49 Tracy: perception is the step between pure sensory reception and representational cognition
• 34:30 Tracy: when postural difficulty, modulation challenges, or anxiety make discrimination the second priority
• 35:14 Cory: the vestibular discrimination example — pumping a swing
• 37:00 Tracy: how discriminative vestibular signals organise the postural adaptive response
• 40:31 Michelle: using other sensory systems to spotlight and amplify the target system in treatment
• 42:30 Tracy: affect, mastery drive, and sensory discrimination working together in play
• 44:33 Tracy: Dr. Ayres got it right — sensory discrimination as the base of skilfulness
• 45:15 Michelle: only when a child feels safe in their body can they attend to the detail
• 45:55 Tracy: if your body can't feel detail, it's hard to feel safe — a segue into sensory modulation

Resources mentioned:

Sensory Integration Theory and Practice, 3rd edition — Bundy, A.C. & Lane, S. (2020) Principles of Neural Science, 6th edition — Kandel, E. et al. (2021) Sensory Integration and the Child — Ayres, A.J. & Robbins, J. (2005)

If this episode resonated with you, please share it with a colleague and take a moment to leave a review — it genuinely helps more people find us.

Check out DFX's Learning Journeys to build your clinical reasoning skills: https://dfxlearningjourneys.thinkific.com/

Connect with us: Instagram: https://www.instagram.com/spiritedconversations_ot/ Facebook: https://www.facebook.com/spiritedconversationsOT YouTube: https://www.youtube.com/@spiritedconversations_OT Website: https://www.spiritedconversationspodcast.com/

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What is praxis, and how do you actually see it in a child in front of you?

In this episode, Michelle brings a composite case of a vibrant, energetic 6-year-old whose postural gains have opened up a whole new set of clinical questions. He has big ideas and loads of enthusiasm, but his sequencing, motor execution, and monitoring are all lagging behind. Tracy uses this case to unpack the components of praxis from an Ayres sensory integrative perspective, linking ideation, planning, and execution back to their sensory discrimination foundations.

The episode's richest thread is a question Michelle brings from the clinic: she watched this little boy discover a ball and spend an entire session joyfully, chaotically exploring it. No mastery, no sequencing, no monitoring — but genuine delight and internal drive. Is this joyful developmental exploration, or is it time to start refining? Tracy's answer is nuanced and clinically useful, and it changes how you think about when to step in and when to trust the process.

Timestamps:

• 00:00 Welcome and introduction to Episode 3
• 00:49 Why praxis is next — picking up from the postural system
• 02:05 Michelle introduces the composite case — a vibrant 6-year-old with emerging praxis challenges
• 04:57 Tracy defines praxis and introduces the ideation, planning, execution, monitoring framework
• 08:54 Linking the Ayres model to dynamic systems theory and motor learning
• 17:04 Michelle walks through clinical observations across each component of praxis
• 32:43 The ball and the ramp — Michelle describes watching him play freely for the first time
• 33:37 Joyful, exploratory, unmonitored play — what is this telling us developmentally?
• 34:36 Clinical questions — when do we step in, and when do we let it unfold?
• 36:56 Tracy: balancing playfulness with just enough scaffolding
• 40:32 Refining the sensory discrimination systems that underpin praxis
• 44:58 Integrating theory into treatment — being present in session, heady out of session
• 49:23 Encouraging playful engagement without imposing structure
• 53:30 Final takeaways from Michelle, Cory, and Tracy

Resources mentioned:

Sensory Integration and the Child — Ayres, A.J. & Robbins, J. (2005) Developmental Dyspraxia and Adult-Onset Apraxia — Ayres, A.J. (1985) The Clumsy Child — Gubbay, S.S. (1975) Sensory Integration Theory and Practice, 3rd edition — Bundy, A.C. & Lane, S. (2020) Teresa May-Benson — Things with String ideation assessment Spiral Foundation — courses and research on praxis: www.spiralfoundation.org

If this episode resonated with you, please share it with a colleague and take a moment to leave a review — it genuinely helps more people find us.

Check out DFX's Learning Journeys to build your clinical reasoning skills: https://dfxlearningjourneys.thinkific.com/

Connect with us: Instagram: https://www.instagram.com/spiritedconversations_ot/ Facebook: https://www.facebook.com/spiritedconversationsOT YouTube: https://www.youtube.com/@spiritedconversations_OT Website: https://www.spiritedconversationspodcast.com/

Loved this episode and want an easy cost-free way to support us? Subscribe to our YouTube channel!

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What draws someone to paediatric OT and what keeps them there?

In this first episode, Cory, Michelle, and Tracy introduce themselves and share the stories that brought them to this work and to each other. Cory found her way through the Sensory Gym and Camp Jabiru. Michelle made a career pivot into paediatrics in her forties. Tracy came through neuroscience and decades of clinical leadership at Children's Hospital Denver. Three very different paths that converged into this podcast.

We talk about what mentoring actually does for a clinician, why university can only take you so far, and what it looks like when knowledge finally lands in your body and changes how you show up in a session. Tracy introduces the SPIRIT Model as the clinical reasoning framework that will run through the whole series. And Michelle names something that doesn't get said enough: this work carries a load, and without the right support around you, that load can become too much.

This episode is the on-ramp to everything that follows. If you're new to the podcast, start here. If you've been listening for a while, it's worth a revisit.

Timestamps:

• 00:00 Welcome and introductions
• 00:24 Introducing Tracy Stackhouse and Developmental FX
• 01:01 Tracy on the SPIRIT Model and the name Spirited Conversations
• 02:25 Shout out to Sarah McInnes Flemming and the Seed team
• 03:01 Cory's story — how she found paediatric OT and Camp Jabiru
• 04:26 What Camp Jabiru is and how it shaped Cory's clinical journey
• 09:51 Michelle's story — from a farming community in Trundle to paediatric OT in her forties
• 16:58 The Seed mentoring culture and learning together as a team
• 17:59 Tracy's story — Children's Hospital Denver, neuroscience, and the STEP-SI tool
• 27:22 Bill Greenough and the audacity of OT — experience changes the brain
• 28:49 Cory on what happens when mentoring shifts your clinical thinking
• 30:36 Michelle on finding your people and creating synergy
• 33:34 The value of seeking mentoring early and proactively
• 35:38 Tracy on mentoring as the space where knowledge becomes integrated practice
• 40:42 Find those mentors and collaborate
• 42:04 Tracy on integration as a cornerstone of effective practice
• 45:43 A preview of the series ahead
• 47:46 Composite cases — why we use them and how they'll work
• 49:28 The planned topic arc: posture, regulation, social relationships, sensory discrimination, executive functioning
• 52:13 Starting with the postural system and why
• 54:52 Michelle on burnout, carrying a load, and the vision behind the podcast
• 56:31 The podcast as a backup for therapists who don't have a team around them
• 56:56 Email us and come back for Episode 2
• 57:53 What's coming next: postural control

Resources mentioned:

Children Adapt — Gilfoyle, Grady & Moore (1981) Clinical Reasoning: Forms of Inquiry in a Therapeutic Practice — Mattingly & Fleming (1994) STEP-SI: A Clinical Reasoning Tool — Stackhouse, Trunnel & Wilbarger (1997) SPIRIT Model — Tracy Stackhouse, Developmental FX Dr. William T. Greenough — neuroplasticity research

If this episode resonated with you, please share it with a colleague and take a moment to leave a review — it genuinely helps more people find us.

Check out DFX's Learning Journeys to build your clinical reasoning skills: https://dfxlearningjourneys.thinkific.com/

Connect with us: Instagram: https://www.instagram.com/spiritedconversations_ot/ Facebook: https://www.facebook.com/spiritedconversationsOT YouTube: https://www.youtube.com/@spiritedconversations_OT Website: https://www.spiritedconversationspodcast.com/

Loved this episode and want an easy cost-free way to support us? Subscribe to our YouTube channel!

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What does posture have to do with handwriting? More than you might think.

In this episode, Cory brings a composite case of a 12-year-old referred for handwriting difficulties, and what unfolds is a masterclass in reasoning from output back to the underlying sensory motor inputs that support it. The assessment findings — poor prone extension, disorganised ocular tracking, a striking tonic labyrinthine reflex response — point not to a handwriting problem, but to a nervous system that hasn't integrated vestibular processing deeply enough to give this young person the automatic postural stability he needs to sit, sustain, and write. Tracy uses a postural flow chart (downloadable in the show notes) to help organise those findings into a coherent clinical picture and walks through what treatment actually looks like for a child like this. We get into why fast linear vestibular input matters, what the ramp angle on a scooter board is actually doing neurologically, and why Dr. Ayres' approach to reflex integration remains just as relevant today as it was in the 1970s. The big idea in this episode: postural adaptation is not a skill you build through practice. It is an outcome of sensory integration. When it breaks down, you have to address the underpinning.

Timestamps:

• 00:09 Assessment overview — Beery VMI, COMPS, handwriting speed test, clinical observations
• 02:03 Tracy introduces the postural flow chart and why visual models support clinical reasoning
• 05:08 Tracy on sensory integration as the organisation of sensation for use
• 07:07 Introducing the sensory postural quadrad — vestibular, proprioceptive, visual, auditory
• 10:08 Tracy: why midline instability shows up clearly and what's lurking underneath it
• 12:41 Michelle: noticing he was already problem-solving his postural challenges before the assessment began
• 13:18 Cory on the effort visible in his body even before the tasks began
• 14:19 Tracy on affect, self-compassion, and why being sweet and cooperative doesn't help his postural control
• 17:04 Cory: walking through the full COMPS findings — prone extension, supine flexion, ocular tracking, saccadic movements, TLR
• 20:57 The tonic labyrinthine reflex test — flushing, eye flutter, near-fall, and what it tells us
• 22:52 Tracy: organising the findings using the postural chart — from basic vestibular processing through to handwriting output
• 29:32 Tracy: postural adaptation, centre of gravity, and the sagittal plane — a real-time explanation
• 32:34 Cory connecting the dots — vestibular integration, centre of gravity, and why the body recruits help
• 33:45 Tracy: the definition of postural adaptation and why it's one of the primary products of sensory integration
• 37:25 Treatment planning — starting with fast linear vestibular input and why the ramp angle matters
• 38:51 Tracy: scooter board ramps, platform swings, lycra swings — how to inch toward vestibular activation safely
• 39:48 Michelle: why we sometimes need to dampen the overwhelm before we can build through it
• 43:15 The role of auditory input as a partner to vestibular and proprioceptive processing in treatment
• 49:22 Why automatic postural control is the goal, not conscious compensation
• 49:56 Tracy: it doesn't get better with practice; it gets better when you address the underpinning
• 50:24 The origins of the postural flow chart — Anne Grady, Children's Hospital Denver

If this episode resonated with you, please share it with a colleague and take a moment to leave a review — it genuinely helps more people find us.

Check out DFX's Learning Journeys to build your clinical reasoning skills: https://dfxlearningjourneys.thinkific.com/

Connect with us: Instagram: https://www.instagram.com/spiritedconversations_ot/ Facebook: https://www.facebook.com/spiritedconversationsOT YouTube: https://www.youtube.com/@spiritedconversations_OT Website: https://www.spiritedconversationspodcast.com/

Loved this episode and want an easy cost-free way to support us? Subscribe to our YouTube channel!

Hosted on Acast. See acast.com/privacy for more information.