Over the course of three days of gathering at the fifth annual Integrative Education Symposium, therapists including occupational therapists, speech therapists, and social workers thrived in the in-person learning environment. After all, that’s how these professionals need to engage with the individuals they serve – in-person with students in clinics, hospitals or school settings. The learning included exercises in movement and group observation in many of the sessions and the ability to connect with peers and bounce ideas off of each other. To provide access to those who couldn’t attend in person, Integrative Education (IE) offered virtual classes on February 23, the Thursday prior to the in-person Symposium, Feb 24-26. An easy add-on for IE based on shifts made during pandemic years to ensure their audience could continue to learn and engage.
This year’s in-person symposium was held at the Eagan Community Center with many returning exhibitors and speakers. During the breaks, attendees had the opportunity to talk with Camp Avanti, ATTACh, Sensational Spaces, Nature Superhero Network, and movemindfully. Sponsors present at the virtual event included Brightmont Academy, Legiliner, Sensory Digest and ICDL. All exhibiting organizations and businesses offer ways for therapists to enrich their practice through tools and experiences or extend offerings and solutions to their clients. There was a daily raffle each day that included prizes from sponsors and exhibitors, and other supporters including Therapro, Super Duper Publications, and Erhardt Developmental Products. Prizes varied from $20 up to a couple hundred dollars for CE courses through IE or Relationship Matters, with 5 - 7 raffle winners each day.
The speaker line-up included popular past Integrative Education instructors returning for another season to build on previous shares of their work and its continued relevance. In addition, new to the Symposium speakers, Kelly Beins, Lori Goodrich, Teresa May-Benson (for the virtual portion) and Kathy Flaminio (in-person) brought essential perspectives on Polyvagal Theory, eating and mealtime participation, executive functioning and praxis, and mind-body strategies.
Overall, there were some recurring themes in the content across courses that included the importance of meeting children where they are at, creating safety and connection through co-regulation, and developing keen observation skills. In order to truly observe, which is a critical part of the therapist/ social worker role, many instructors reminded attendees to be and remain curious about the movement patterns and behaviors to determine how to support a child. All courses had a practical application portion and science-based learning to understand how to implement new techniques; paired with the message of being curious and intentional in the strategies professionals choose in their practice.
Here are the summaries of the larger takeaways and learning from Courses A-I:
Course A: Polyvagal Theory & Sensory Processing: Bridging Theory and Practice*
Kelly Beins, OTR/L
Kelly Beins brilliantly intertwined the Polyvagal Theory and sensory integration to promote greater outcomes for the client. Attendees walked away with an EASIER (Emotions, Anchor senses, Sensation, Intuition, Expectations, Resources) way to connect with parents and learned the value of providing them with the knowledge and support they need to extend the therapeutic process into the home environment. Beins shared examples of the value of co-regulation, asserting that less is often more because we are intuitively wired to connect.
Course B: Introduction to Clinical Reasoning for Effective Eating and Mealtime Participation Using The FOCUS Program*
Lori Goodrich, OTR/L, C/NDT
Lori Goodrich’s course really spoke to how every client and every family is different. Attendees were shown why they can't plan on always starting at the same place with each client/family when it comes to implementing effective eating strategies. Many factors influence feeding difficulties so therapists need to be constantly using their clinical reasoning skills to help each client build the foundational skills needed for functional mealtime participation. In the end, functional mealtime participation will likely differ for each client. For example, rather than focus on increasing the number and variety of foods a person/family will eat right away, it may be that support to help prepare the food is most meaningful.
Course C: Praxis and Executive Functioning: Connecting Motor and Cognition*
Teresa May-Benson, ScD, OTR/L, FAOTA
Teresa May-Benson’s course opened by addressing the overlap of executive functioning and praxis and prompting attendees to be thinking about where each starts and ends. She noted that deficits in motor functions at an early age can lead to challenges in mental processing later on and that there are new ideas in how our cognition develops. Those ideas highlight the important role of praxis. Dr. May-Benson also noted that self-regulation is not the ideal term to use in relation to executive functioning. She prefers the term self-control.
Course D: A Developmental Approach to Understanding and Treating the Pelvic Floor in Babies and Young Children
Michelle Emanuel, OTR/L
Michelle Emanuel provided attendees insight on the pelvic floor field of study, acknowledging that courses on this topic are becoming more popular but there is still not much research available. Despite this, understanding the pelvic floor is a very important part of supporting functioning in babies, children, men, and women. Pelvic floor weakness and/or dysfunction can affect bowel/bladder, feeding/reflux, development of midline, neurodevelopment maturation, posture, muscle and skeletal development, and so much more. It was eye-opening to see just how important this part of the body is and how it affects so many different areas!
Course F: Developmental Roots of Trauma: A Sensorimotor Embodied Approach: Day 1
Sheila Frick, OTR/L
Sheila Frick’s sharing during day one of this course built on the past education around trauma that Integrative Education has provided. The study and understanding of it make dramatic advances each time attendees revisit it together. Frick began with the reminder that trauma manifests itself in the body and shared examples of what that looks like. In children with trauma, their window of regulation is too narrow. Their ability to feel safe in and connected to their body is limited. Therapists can recognize and work with these children to encourage sensorimotor activities and play that help them to orient to their environment and connect their body, which in turn increases their window of regulation, ability to make adaptive responses, and capacity to engage in relating with others.
Course F: Developmental Roots of Trauma: A Sensorimotor Embodied Approach: Day 2
Sheila Frick, OTR/L
Sheila Frick continued this course from day one instruction, beginning with a reminder to attendees that the work therapists do is not linear. It can be learned that way, but as professionals, it’s how we use our creativity, presence, and assessment to adapt and apply it. The course helped attendees see that everywhere vestibular processes in our brain are multi-sensory so an individual is never "only" doing vestibular interventions and the effects of vestibular input have a much broader impact. Activities that promote body awareness, paired with vestibular input that is safe and tolerable, help promote feelings of groundedness and regulation. Additionally, selecting activities that allow children to elicit their fight or flight in a playful way, and then self-regulate are important to practice. Frick also highlighted how arousal is multifaceted and appears in a cluster of behaviors, pointing to indicators practitioners can seek to uncover. She left attendees with the notion that most practitioners are very good with relationship building, so trust that a magic moment of success can be seen in the individual’s/child’s response.
Course G: Pediatric Oral Facial Taping
Michelle Emanuel, OTR/L
In Michelle Emanuel's course, a smaller class size led to a more intimate experience and whole-class discussion. Attendees enjoyed learning the taping techniques and placements by trying them out on themselves and noticing the big and small changes they elicited. There was an interesting connection from Michelle's pediatric pelvic floor class from the day before in relation to lymph congestion and drainage as signs and symptoms of both pelvic floor dysfunction and oral facial differences. Two big takeaways included how much oral facial differences affect the social nervous system and a deeper understanding of the integumentary system.
Course H: Movement Analysis in Sensory Intervention: Day 1
Kim Barthel, BMR, OTR/L
Kim Barthel took attendees back to the simplicity of the three planes of movement – sagittal, frontal, and transverse. Three audience volunteers demonstrated movements in these various planes so the complexities, subtleties, and energy could be observed. The room filled with wonder as Barthel walked through positioning, slight tweaks, and compensation patterns to identify inaccessibility, rotation, extension, and flexion scenarios. Stability and mobility – always in a delicate balance - were discussed and attendees had the opportunity to pair up and interact and learn from each other’s movements.
Course H: Movement Analysis in Sensory Intervention: Day 2
Kim Barthel, BMR, OTR/L
Day 2 focused on movement analysis related to self-regulation and alignment. Barthel taught that self-regulation is accomplished in the body. Regulation will happen quicker if the body is in alignment, while cognition is the slowest path to a more regulated state. One takeaway for attendees was to understand that vestibular information does not transfer to efficient/effective movement patterns if the body is not aligned. Barthel stressed that it is important to ask the question, “How do I support the body to get to the goal?” versus “How can I get the body to execute the goal?” Play can be a wonderful intervention but only if the child feels safe - they won’t engage when there is perceived or actual danger.
Course I: Safe to Engage: Maximize Readiness for Learning with movemindfully®
Kathy Flaminio began her session by delving into how trauma resides in the nervous system and body, not in the event itself. She touched on trauma responses, describing how they are actually protective and reflexive, not defective. Flaminio also went in-depth on the workings of and benefits of yoga-based movement. This type of movement takes the spine in six directions to unwind from the stress response (stress response= jaw tightens, eyes narrow, shoulders tighten, chest contracts, knees roll in). These moves can be used throughout the day to achieve and maintain a relaxed-alert state, where your body is calm and your mind is awake. A majority of the class was spent exploring all of the breathe, move, and rest activities so participants could experience the moves for themselves and practice how they might teach these strategies to the children they work with.