Sensory Ladders – A History

Sensory Ladders came from very early practice to reframe the unmet needs of clients with trauma who were dysregulated – our draft publication in 2009 included a suggestion we rename BPD as a sensory modulation and regulation disorder – but was a little before its time.
The diagnosis called BPD then with EUPD a preferred term nowadays is typical as a direct result of significant childhood trauma.

Here is the often forgotten history of trauma-informed care approaches linked to the direct use of Ayres’ Theory of Sensory Integration in a trauma-informed way. It was built on practice from 1999 onwards and drew on Ayres, King and Alers’ work, in combination with DBT.

We published the first adult adapted checklist in a DBT handbook in 2002. The first About Me Profiles were created in 2001/2002 and included Sensory Ladders. We published about our Be Smart Programme in 2002 in a care plan and presented this locally, in training courses at then at the first-ever conference about ASI including sensory integration in trauma-informed care in MH in 2004.

This mini-conference was delivered in Cornwall, UK. Presentations included work delivering inpatient Sensory Integration in MH (Kath Smith and Angie Turner), Eadaoin Breathnach’s work on attachment in adult LD and Tina Champagne’s work on Sensory Allen’s Levels and her use of sensory approaches to reduce restraint use in the USA.

It was recently pointed out to us our UK development work came from Tina. Tina will confirm this is not true. It appears others believe that we weren’t doing SI as the article used SPD as a term.

This was a period in ASI history after the new nosology was just published by great names in Ayres SI which we all respectfully followed given the authors. It took time to understand the history of this article and we shouldn’t jump to the new term.

Please remember history and context matter. Sensory Ladders were not created out of Zones of Regulation either. The first ones were published long before Zones and taught and presented from 2003 onwards. They were developed initially for adult clients to deliver a mental health and trauma focussed application, with consent from the Alert Program. At the time the Alert Program like SI was almost entirely child focussed practice. The levels to reflect sleep and disassociative states seen in clients with trauma were deliberate addition and the link to DBT is the Ladder – The DBT House of Fire includes a ladder to climb from behavioural dysregulation upwards – the senses can be a key part to this. Please don’t confuse our Sensory Ladders model with other Ladders and think that’s where we ‘borrowed it” from. This was a tricky post to write but one that needs writing to correct myth and legend and some hurtful assertions.

Thinking I will write up the history soon to correct any misperceptions: Borderline_personality_disorder_and_sensory_processing_impairment

2 thoughts on “Sensory Ladders – A History

  1. Thanks so much for this Kath. It really helps to understand the context and inter-relations of the approaches we use. That different researchers and clinicians build and develop from each other’s knowledge and ideas is what makes this such a rich and exciting area of practice. We are so fortunate to be supported by people like you here in the uk and across the world so, acknowledging and respecting sources is a responsibility we must take very seriously.

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