Episode 2: Tracy Stackhouse
Learn more from Tracy at Developmental Fx’s Learning Journey’s platform
Transcript:
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Amy: Hi, and welcome to OT Mentor Moments Podcast, where we explore advanced occupational therapy practice, mentorship, and the work that we can all do to become the best version of ourselves. I'm Amy Lewis, and I love the profession of occupational therapy, particularly pediatric practice. Over my career, I have had the great fortune to have some amazing mentors who have helped me to grow both as a clinician and as a person. Mentor Moments is my way of paying it forward by sharing their wisdom with all of you.
In our second episode, I am welcoming occupational therapist, Tracy Stackhouse. Tracy is a master clinician with training in neurodevelopmental treatment, sensory integration, and relationship-based interventions like DIR floor time, just to name a few. She is the author of the STEP-SI and SPIRIT Clinical Reasoning Tools, which she has taught all over the world. She is considered an international expert in the area of Fragile X, sensory defensiveness, and clinical reasoning. She has co-authored research about her experiences at Camp Jabiru, a camp for kids with sensory integrative processing challenges in Australia, and is faculty for the Polyvagal Institute. She is the director and co-founder of Developmental FX, a nonprofit company that provides services in the community, schools, and clinic, as well as providing educational outreach in Denver, Colorado. She has her own podcast, Spirited Conversations, where she shares thought-provoking mentorship sessions. I could go on and on, but I'll stop there and let you learn more about her from our conversation.
Welcome, Tracy.
Tracy: Thanks so much, Amy. It's really fun to be here with you. I always love talking with you and appreciate that you asked me to join.
Amy: Oh, well, you were on the top of my list of people to have on our podcast here when I first conceptualized the idea of this podcast. Because of the influence that you have had on my learning in probably the last three years and the clarity that you have brought to me. So I really appreciate you taking the time to be here. I know you have many, many things going on, and we will let people know about those things at the end of the podcast so that they, too, can benefit from the clarity that you have given me. But I'd like to start out with asking you a question that I ask everyone in the beginning, and that is to tell me a little bit about mentorship in your career, your mentors, people who have been important to you. And because I know you, I know that this could be a three-hour conversation in and of itself because you have had some amazing mentors.
Tracy: I have had some amazing mentors.
Amy: But if you, you know, if something occurs to you as some of the most important mentorship opportunities that you've had, we'd love to hear a little bit about that.
Tracy: Yeah. So what a lovely question, and, you know, partly just an opportunity to think about all those influences, right? So sometimes I think early on in my career when I thought about, you know, hearing about mentors and how they assist you and guide you and they're kind of a part of the fabric of your life, somehow I think early on I had this idea that, oh, you end up with one or two mentors. But when I think about the web that I kind of get to stand on, it's woven from so many different threads. And so, you know, I don't want to spend five hours explaining that heritage or that sort of lineage of beautiful layers of support, but I think that in some ways it, in terms of being able to bring clarity in clinical reasoning and for other people who I try to foster that kind of practice in, it is grounded in the mentors that I've been so fortunate to learn from. And so in a way there's a little bit of, I'd love to be able to just mention a couple threads of the mentors.
So one of them, you know, I mean, in my own personal life, I come from a big Irish family who have always, you know, supported me with lots of, you know, grandparents and aunts and uncles and cousins and my parents. So I really felt like I had this rich tapestry of like just a loving framework that sort of set the tone for how I move through the world. And then, you know, once I became an occupational therapist, there were a few different theories that caught my attention. And part of that was the journey of working with mentors who helped me find those paths. And so I don't think we all, we don't have always like a vision of like the path we're going to go down, but our mentors help us find that. And so in the OT space, you know, the threads are really first just around occupational therapy itself and the theory of spatial temporal adaptation that Anne Grady, Ellie Guilfoyle and Josephine Moore wrote. And Anne, Ellie Guilfoyle was a professor and she was the professor who taught the very first OT course that I ever took. It was an introductory course when I was trying to figure out, is this the thing that I should be doing? And how lucky for me that she was the person teaching that course. She just became a giant in my heart and mind and spirit and, you know, kind of guided me. And then Anne Grady became my boss at Children's Hospital. And then we would have Jo Moore come every year or a couple times a year to do neuro courses with us. And so that was such a fabric of kind of just the way I think and I think those three women were powerhouses or are. Ellie is still with us, obviously, and, you know, just incredible mentors.
Then in the field of sensory integration, Lois Hickman was an early, early mentor to me. She was on the faculty of the early CSSID and Sensory Integration International, and she was in Boulder, Colorado. I was working there and worked with her one day a week for a while, and she just, you know, she did this farm-based work and nature-based therapy before we ever talked about nature-based therapy. This was, you know, 35 years ago, I guess. And she led me to a course that Ginny Scardina taught, and then Ginny connected me to Jane Kumar. And Jane Kumar became one of my really dear, close friends and mentors, a real reliable person for me that I could go to Boston and spend time in her clinic and kind of observe and have direct training. But then I also would just utilize her as a friend and advisor pretty frequently. And her loss, obviously, has been a pretty significant loss in my just network around me because I did lean on her quite heavily.
And then, you know, Julie Wilbarger and I shared a job at Children's in Denver, and I worked with her mom, Pat, and learned so very much from Pat Wilbarger about mysterious things in the way that humans work and really about the importance of empowering people's voices. And really, I've always been a very good listener, but listening for themes was something that was so really powerful in the way that Pat would think and do things. And I think that also her confidence in understanding approaches to intervention, that intention, and it is where everything emanates from. So that was a powerful thing. So working with the Wilbargers has been kind of a little bit of, you know, both a professional and personal story for me. And at Children's, when I was working at Children's in Denver, Sharon Trunell and Julie Wilbarger and I put together the StepsSI tool, but I would think of them not just as colleagues, but also kind of like we were co-mentoring each other because we could stumble through things, ask each other questions, wonder about what was going on, and look forward to things. And then I had NDT training with Lois Bly, and Lois has been a really close mentor to me over the years and somebody that I've super relied on.
And then, you know, I have these other little spheres that I'd love to just mention. One is in the space of Fragile X syndrome. So Randi Hagerman was my, really kind of the leader of our Fragile X team. She's a developmental pediatrician and just an incredible mentor to me through, you know, through decades now of really showing me how science and clinical work intersect and the importance of that. And then really just working with whole families and seeing what happens when you when you really empower a whole family to understand their own journey. That's just been a really powerful source for me.
And I think within the Fragile X space, I've had a chance to meet a lot of incredible clinicians and scientists. So that's been, you know, a source of just kind of, I don't know, enriching the work that I do. And it inspired me to go to graduate school and study neuroscience and developmental psychology. I think within that, you know, more of the attunement to developmental theories and really what they bring around infant mental health in particular, when I was working at the MIND Institute, I had a chance to work with Tom Anders, who's a psychiatrist. But one of his very best friends from his medical school days and then through his life was Dan Stern. And so I had a chance to get to know him a little bit. And, you know, I think Daniel Stern changed the field of psychiatry and certainly infant mental health. And just being able to understand the underpinnings of that has been a really critical part of the way that I've been able to integrate knowledge.
So that's a lot of different threads, you know, that weave together. And I feel super grateful for all of those folks. So that's kind of a tender question, Amy. Thank you.
Amy: Yeah, that's beautiful. And. I, I want to I want to pause and appreciate all of those opportunities that you have had and all of the work you have done, and I also feel myself in this moment wanting to say that in December of last year I had a moment where I thought I can never be Tracy Stackhouse, never know everything that she knows. And yes, that's true. And that's fine. But I think that sometimes it's helpful to pause and appreciate that we all have different journeys. And what I hear you saying is you started with a really solid foundation in yourself. And a really great sense of self that allowed you to take your brilliant mind and apply it and say yes to all these opportunities to meet with these amazing mentors and really glean the information that they had to offer you. So for anyone out there who is overwhelmed with everything that you have done and comparing themselves to you, I think that, having spent time with you, I know that you also see the value in everyone's journey and know that not everyone is going to have multiple neuroscience degrees on top of their occupational therapy degree and travel the world, meeting famous scientists.
Tracy: Yeah, well, absolutely in all the ways, yes. I think, you know, every journey I mean, really, we can all mentor each other the way that Julie and Sharon and I found that we did. And I think you and I do that together sometimes, Amy. I always feel like I learned so much when I'm with you and appreciate how you see the world. And it helps me to see the world in a new way. And, you know, I think that's all part of the beauty of creating relationships with people who you want to invite in to help you to learn. And so I think the ground of being open to learning and being open to risk and vulnerability and like taking a chance on something is an interesting thing that allows you to kind of grow.
I also think that, you know, I've had a chance to to interact sometimes with some incredible, you know, scientists. So Bill Greenough is a person who I met through the world of Fragile X Syndrome, and he's one of the most preeminent kind of developmental scientists, I guess, who coined the terms, you know, and concepts that we understand around experience expectant and experience dependent development and did the science that kind of illuminated those concepts and such a brilliant and generous person. And he would he would just always say that he thought OT was awesome because we had the audacity to think that we could change the nervous system. And he thought that was, you know, spot on, that that was what set us apart as a discipline and that we should all feel super empowered by that.
Amy: And I love that. Yeah.
And what are your other degrees in?
Tracy: So I have a master's degree in developmental psychology and developmental cognitive neuroscience.
Amy: All right, that's amazing. That is so amazing. And I have heard you before talk about the significance of your work in the world of Fragile X and how that really led you to an understanding of sensory modulation. But I think that maybe rather than leading you into that, we'll come back to that after we get into the the rest of the things that I really wanted to have you here to talk about today.
So to introduce our audience to the reason that I wanted to have you as one of my first guests is like I said earlier, the way that you have helped to really provide clarity to me around the concepts of sensory integration. For background on me for people who don't know me as well, I am SIPT certified. I did that over 15 years ago and have done a lot of training in sensory integration and was familiar with a lot of different models and ways of looking at sensory integration and had some wonderful mentors who understood it. But sensory integration isn't linear and I always wanted to make it linear because that was the way that my brain worked. And so, I was looking for these linear models to make sense of the concept of sensory integration and my mentors would always say, you can't make it linear. You're oversimplifying it. You can't do that.
And I think that, you know, I had to go through those experiences of learning, um, all those pieces and wrestling with why do some things work in my mind sometimes, but not other times. And, you know, why do these models work for some kids, but not other kids? You know, it, it was all a little confusing until I met you. And then, um, you have brought so much clarity to me. And I think that what I have found to be the most elucidating is the very basic concept of theory neutral. And you were the first person that I heard present information from a theory neutral perspective. I would love for you to explain what that means to you to be theory neutral.
Tracy: Yeah. So, uh, it's, it's an interesting idea and I wrestle with it a little bit because let, let me think how to kind of even begin to say this, um. In the work that Dr. Ayers did, she really presented a platform that took from her understanding of neuroscience and suggested how this sort of plays out in a developmental. Framework, but then also what that tells us about what we might need to understand about a child. So that would maybe be a word for assessment. And then what we also can take from that theory and understanding to elaborate a treatment plan. And so sensory integration has all those layers to it. And I love the discipline that Dr. Ayers had to think across those levels and to suggest to us that we move that along, but I think in her work, she also grounded it in neuroscience. She didn't ground it in her idea, her ideas were important and unique and revolutionary and very, uh, far ahead of their time, but they also were grounded in science and science changes. So for me, theory neutral is understanding the essence of where Dr. Ayers was coming from and not reifying us any particular part of what she said as, as something that needs to be put into a glass container and not changed because she wanted it to always be accurate to the science. So for me, theory neutral is that we don't get bound to something that is theory separate from science and that the science has to inform what we're doing. Um, and in our fields of sensory integration and sensory processing, there have been some notions put forward that were more about theory that were to simplify things and make them accessible to the broader world, which I think there's value in. So, I think it's important for the everyday person to be able to understand the power of sensation and what it does in our brains and in our lives and in our overall beings, but we can't stay on a simple level if we're clinicians, because our intervention has to be powered by a deeper understanding and knowing. So for me, it's about being open to the zooming in and zooming out of zooming into the finest detail of the science and then zooming back out to the biggest application in daily life. And if you get too bound to a construct, then it doesn't allow the, the kind of tuning of that zoom, if you will, because it'll stick your lens, if you will, it'll kind of stick you in a, well, it must be this because that's the box that I understand. And so does that make sense?
Amy: It does. Let me see if I can summarize it and see if what I'm saying is accurate. What I think I hear you saying is that Jean Ayres created a theory off of theory neutral information. That was the science that existed at that time. Yeah. And several things that happened since then. The science has grown. We know a lot more than we did when she was practicing in the 1970s. And during that era, you know, there's a lot of advances in what we know about what's happening in the brain. And in the field of occupational therapy, we had a lot of people who came along and said, Hey, this complexity is too much for everyone. And so I'm going to try to make sense of it by coming up with a model that simplifies the information. And so I think what happened for me is I came along during an, during an era where the models were the primary way of learning about sensory integration. And I did do the SIPT certification and I did hear the theory neutral information, but somehow at that point in my career, it didn't land in a way that made it the foundation of everything that I knew. So I was still trying to wrestle between all of the different models and the different ways that they explain sensory integration. And just to highlight for people, you know, a super quick example of what that is, if you are an occupational therapist and you are used to using the sensory processing measure versus the sensory profile, those are giving you results based on two different models that explain certain aspects of sensory integration. And so if you gave the same person, those two evaluations or assessments and you scored them, you're going to come out with different answers that align with the different models to explain sensory integration. Right?
Tracy: Yes. Yes. And, and also I think about just practically, if you're a therapist, if you trying to reconcile, um, the categories can start to feel so overwhelming. Um, and the report would be 50 pages long because you'd have to have all these different categories that you were describing to people. And that, um, is a interesting dilemma, I think. So the thing that's tricky is that especially I think for newer clinicians is that all of these different ideas have their own level of reliability and credibility and, and the importance and value that they bring. But what is really hard is that you don't know how they fit together or don't fit together. And it starts to create tension in the field, honestly, um, because you don't really know, like, am I supposed to be doing all of this or some of it, or when do I apply what, where and when and how, and those are real questions that everyday clinicians have, uh, and I think. You end up just like, you know, the mentoring conversation we had a little while ago about you find your path often from your mentors, sometimes people find their way forward based on this is a path that makes the most sense to me, or it's the most accessible, maybe because of the proximity to another clinician who helped me learn this, but it isn't universal, uh, that we all integrate across all of these different approaches in the same way. And so you end up with so much variation from clinic to clinic in how the practice looks and actually how, what the outcomes are. So it's, it's a critical conversation and I wouldn't venture to say that I have a solution to it, other than to say that the science is going to have to be a part of it.
Amy: So yes, and I think that what the very basics of what theory neutral means to me is looking at the networks involved in the brain, um, the two major networks is what I've really gotten from you. Um, and so I would love for you to just give people a quick overview of the ways that our brain processes sensory information and how those are distinct pathways.
Tracy: Sure. Sure. So across every sensory modality, uh, you have generally two processing routes, so they all have named path tracks and pathways. And I don't think we'll get into that level of detail here, but conceptually you have sensory information from every single sensory system that ends up being more brainstem oriented. And it's engaged in the evaluation of sensation. It's telling you as like a Spidey sense is the information out there neutral? Is it more positive and something I'm inclined to and want more of? or or enjoy? or it brings me the kind of information that I need or want or feel good about, um, or is it more negative? Is it something that is potentially threatening or novel, uncertain? Um, something that maybe is, uh, something I need to protect myself from. So that basic function of evaluation is, uh, a sensory signal, but it is really quickly integrating with arousal circuitry, with affective circuitry, with autonomic nervous system and vagal circuitry from the periphery all the way into the brainstem, with circuitry that mobilizes or deactivates us. And so it's a part of our regulatory nervous system, and that's what we refer to as sensory modulation.
So we're drawing sensory modulation into the evaluative regulatory circuit. And then we have a relatively set of relatively higher set of circuits that some classic neuroscientists would say are the sensory integrative circuits. It's a polysensory integrative set of neural networks that primarily go through thalamic relays. So they don't have a huge influence over brainstem function, but through the thalamic relay, they go to cortical areas that hold the maps of detail that the sensation is bringing in, and that is referred to as sensory discrimination and it serves perception and it serves action and it serves skillfulness. So our ability to be skillfully, uh, to skillfully use sensation for the purpose of listening and looking and touching and feeling and moving and doing and interacting, all of that comes from the sensory discrimination system.
Amy: Okay. So to summarize that I would say sensory information comes in and has two main pathways that you just described, the sensory modulation pathway, and that's the one that is, um, assigning more of that positive or negative quality to what the, to the information we're taking in. And then the other pathway is that discriminative pathway that's going through the thalamus up to the cortex. And it's not as involved, although I will say what I know you would want me to say, which is that the discriminative pathways, um, are providing information down to those modulatory pathways as well. They're never separate, but they are distinct circuitry.
Tracy: Correct. Correct. Absolutely. Right on.
Amy: And I think that that just learning that for me has made a tremendous difference in understanding that when I'm looking at a child, I need to be really clear on whether the problem seems to be more in the modulation of sensory information or the discrimination or both it can be both. Um, but my, my treatment isn't going to be precise and effective if I'm not targeting it to the right circuitry in the brain, because those two sets of circuitry respond to different interventions, correct?
Tracy: That's exactly right. That's exactly right. And that distinction is a distinction that Dr. Ayers actually wrote about pretty, pretty consistently. The one time I ever heard her speak, she spoke about it when I did my early SIPT training and did the theory course, Shelly Lane taught that course. It was in the course materials that she taught. So this information isn't really new, but it's gotten lost and partly it's gotten lost because some of the theories and assessment tools that have been derived, weren't comprehensively looking at all sensory integration. They were looking more at sensory processing parts and bits. And I think it, you know, some of that information has been helpful to us and yet it sort of fragmented the overall big picture of how this all works together. So coming back to, you know, the, the reality that we're talking about brain processing here is super helpful in, in grounding us back in. Into the core information that created the theory in the first place.
Amy: Absolutely. So what I have heard from you in the past as a little summary is that modulation is for the purposes of regulation and discrimination is for the purposes of skill.
Tracy: That's right.
Amy: Is there anything you want to add to that or you want to leave it at that?
Tracy: Well, I think that that's absolutely true. I also would want to say that, you know, we know that, yes, sensory integrative processing, which is summarized beautifully, the way you just said it, it doesn't live alone. It doesn't exist in a silo and that it is a partner to lots of other processing happening in the nervous system. And, in particular we have affective and motor and sensory processing that work really intimately as partners in the service of skillfulness and in the service of regulation. So it isn't just sensation. And we have to understand that for our intervention planning and for really more comprehensively understanding what our work is all about.
Amy: Yeah. So, you know, we say sensory modulation is for the purposes of regulation, but it's not the only thing that affects regulation. And I think that, you know, when I, when you said that, I thought, I think that's kind of a sticking point that I see for a lot of therapists who get frustrated. About people assuming that sensory interventions are going to fix all regulation issues. And, I can empathize with those therapists who feel like it's not all about sensory. Because I think that's true. And you teach a lot of other networks, other, you know, regulatory capacities that interact with our sensory processing to affect regulation. And so it is true that it's not all about sensory and everything that comes into the brain is sensory. So it can ever not be about sensory, right?
Tracy: That's exactly right. That's exactly right. Yeah. And I also think, you know, Amy, like in relation to the overall regulatory networks, the Powerfully You program does a beautiful job of putting all those pieces together and it really, you know, acknowledges the sensory elements. It's so essential, but also understands that the purpose of regulation is actually the self and other system. It's about relationship of who we are and how we are in relationship with others. And so our, our self-actualization and our really evolving sense of self is based in the regulatory capacities and those are based in sensory modulation. So that thread that goes from sensory modulation through regulation and into self and other is really, you know, profound. And, and I think the Powerfully You program helps us so much to have an intervention approach that helps us to go through all those different layers.
Amy: You're very sweet. Our audience at this point, when they hear this podcast might not have heard of Powerfully You. So, Tracy is kindly mentioning a program that I have coauthored. And I'm sure that at some point I will have a guest on my business partner and we will introduce everyone to Powerfully You.
You also mentioned that the sensory affective and motor circuits. And I just want to highlight that in case people missed you saying that, because I think that that's the other piece of your work that has been so helpful for me and, and almost immediately made sense for me. Like everything that I knew kind of fit into this idea that what we do as occupational therapists isn't just sensory. It involves this, these sensory affective and motor components. And I'd love for you, I think, you know, people might have a little bit of an idea about what motor is, but maybe if you could talk a bit about what affect is, not everyone has had that background.
Tracy: Sure. Sure. So, the sensory, affective, motor functions were really first, you know, described as that little triad by Dr. Stanley Greenspan. And when I did my DIR, I was really impressed by the way that Dr. Greenspan described it as a little triad. And so, I wanted to do a little bit of a commentary on that. And so, I was really impressed by the way that Dr. Greenspan described it as a little triad. And when I did my DIR training and had a chance to kind of listen to his lectures and interact with him a little bit he would often talk about how occupational therapy was so critical because. If children are having difficulty with their sort of develop expected developmental unfolding it's highly likely that they had some disruption in sensation or motor processing or affective processing. And he put that together in this little SAM thing. And I just elaborated it based on my understanding of neuroscience. So the affective part of it, that's in the middle of the SAM, is related to the quality. The of the base of our processing is a tipping point of negativity versus positivity. And that's really how affect is the foundation of emotionality and of sociality is coded through the sensory modulation. So, the sensory modulation is the tipping point of valence. And it's a part of that evaluative system that we were talking about related to sensory modulation. So sensory modulation is duly coded for affect and it's because affect is the valence charge. And it's based on whether or not I'm being charged up by something. So I'm being charged up. And then in higher brain circuitry we have a valence that's based on our motivation. Do I want more of something or do I want less of something? Am I, am I charged up by that or am I not? Is that something that feels rewarding and wonderful and delicious to experience? Or is it something that is so overwhelmingly challenging that I can't get into a groove and a flow with it. And I kind of move away from it. And so it, it kind of is a representation of flow states. It's a representation of our motivational biasing system. And that's at the highest level of affect. So that's, that's the description I would give you of affect.
Amy: Yeah. Yeah. So I think that for anyone who is, is trying to understand what we are saying and how this applies, it's kind of a “where are we going”? We have to be intervening on all levels, right? We have to be intervening in the sensory. We have to be looking at how our physical body affects our state. And all of that processing that sensory and affective processing is closely tied to our emotional state. So, we have to be looking at how our physical body affects our state and all of that processing that sensory and affective processing is closely tied to our motor. So, I think that that it's helpful to look at all of the interventions that we have out there because we have immense amounts of things that we can learn these days. And I think that some of my mentors were at an advantage in a way back when they started learning about sensory integration, because they didn't have as many of these courses that are kind of siloed into one area or another. And now we have all these wonderful interventions. We have interventions that focus on the motor system, like NDT. And we have interventions that focus on affect like our DIR floor time and TBRI, some of these more affect/emotional relational based interventions. And then we have sensory, but even within sensory we have, you know, Ayres sensory integration, which is a particular way of using our knowledge about sensory input. And then we have things like sensory motor programs that are, you know, not the same thing as Ayres sensory integration. And obviously we can't go into all of these details here, but I just think it's helpful to put a frame around this information that you're really bringing to the field about how we always have to be looking at aspects of sensory affect and motor. When we are evaluating and working with a child.
Tracy: Yeah, absolutely. That's right.
Amy: Perfect. So I feel like I could talk to you for another five hours. And not run out of things to ask, but I also know we are getting close to the end of our time. And I do have a couple of other questions.
Tracy: Sure.
Amy: So one thing that I am asking all of my guests is to reflect on something about yourself that you might have, or that the world might have, considered not to be a positive. And I'm wondering if there's anything like that that has created sort of a superpower for you. I wonder if there's anything like that. And I did give you a heads up on this one because I threw it in on Kim and she had to say it on the spot. And she said, you need warning for that one.
Tracy: I don't know. It's a hard one for me to answer because it isn't like a, like a particularly specific thing. And, it's almost in contrast to something you said earlier. So, well, I feel like I have, you know, like I came from a well-supported and well-resourced, you know, just loving brood. Of this big Irish clan, but I think underneath all of that, I was actually a pretty vulnerable person. And I did struggle a lot with self-esteem. I had some trauma that we don't need to talk too much, you know, about at all really, but just, it is a part of the fabric of my life story. And it's in the context of a big loving family.
Amy: Right
Tracy: So there's the vulnerability of kind of. Not always feeling the most pulled together and put together person. And I think in that I sometimes would end up in a little bit of a dorsal state, a dorsal vagal state, where I was finding my power, but I was also observing. And I was a little bit of a such a good observer that I think in my work now and in my life, it's, it is certainly my superpower. I'm a very, very good observer. And I think that in that I found that, you know, finding words to put to things that were hard to understand really helped me. It was a way to find my way forward. I think it's what motivated me to study neuroscience and psychology and the things that I've studied. And to really want to understand the resilience factors because I'm a very resilient person and I've always had that strength of resilience, despite the vulnerability. And I think those two things coexist in me all the time every day. And those are parts of, of the threads of who I am and what I bring to the world. So I think there isn't any particular shame story there. That used to be more true when I was younger. I've been able to sort of integrate and weave together and so I think that's the strength you see, but it's based in challenges. And isn't that just the truth for all of us, you know?
Amy: I love it. I really love having that nuance and understanding of who you are. It's common humanity that all of us have our struggles, Right? It does have the potential to create our superpowers.
Tracy: Absolutely.
Amy: Thank you. Thank you for that vulnerability and sharing.
Tracy: Yeah, absolutely. Yeah. Thanks Amy.
Amy: And then the last thing that I'd like to do is offer an opportunity for people to hear about the things that you are doing now and where they can learn more from you. I know that I have just learned a tremendous amount, and I'm currently enrolled in one of your courses that I'm so excited is out there in the world. So tell us a little bit about those things that are available and where people can find you.
Tracy: Sure. So, I live and work in Denver Co, I was born and raised her, and Developmental Fx is a nonprofit that I mentioned and we're in our 20th year now, which is kind of mind blowing. So through DFX we've started a learning platform basically in the last couple of years that is the Learning Journeys program of Developmental Fx and on that platform we have a couple of courses that are offered now regularly. The STEPPSI course is a clinical reasoning tool that Julie Wilbarger, Sharon Trunell and I put together at Children's Hospital back in the middle 1990s. It's a course that we've taught many times over the years and then it kind of, you know, we didn't teach it for a while for a number of different reasons, none of it because the course isn't awesome but mostly just life things going on with the those of us teaching the course. So, we've kind of revamped the STEPPSI and updated it. Dave Jereb is a close colleague of mine who lives in Australia runs a few clinics and is the brother of Genevieve Jereb. Gen was a very dear friend of mine and she really was the impetus. She was like “Tracy (I wish I could say it with her Aussie accent) we've got to get this course back up and running. And so before Gen passed away we kind of put this effort together and then, you know, sadly she did pass away. So anyway the STEPPSI course is now up and running it's really a tribute to Gen, and Dave and I have a really good time teaching it together. He's hilarious and it makes it really fun to have the two of us as the instructors. So, the STEPPSI course is up and available and it will be offered once or twice a year. We're kind of still dabbling with how we offer things. None of us are businesspeople so we're really just trying to make this available to people. It's my impression that people learn best in community and in cohorts so we're trying to keep it where we gather in community and discuss the course in little moments where we come together into a discussion pod, and kind of talk through questions and insights. So the STEPPSI course is organized with us in an online forum but then with these cohort gatherings the Spirit course is also offered in that same way and is a dense, intense course, but really powerful. And both of these are clinical reasoning courses. And then I teach a lot of other kind of topics related to Fragile X syndrome, autism, trauma, sensory diets and just clinical reasoning in general. I also have a praxis course that I think is really fantastic and I haven't taught it a lot but we'll be doing a lot more of that in the next year and a half. So there's a lot of different places you can connect in. I think all of the links are really on the Learning Journeys page you can connect to the Spirited Conversations podcast we have a lot of listeners around the world, and it's really a fun collaboration with the Seed Pediatrics down in Australia with Corey Dundon and Michelle Maunder are my co-hosts on the podcast and it's a really really wonderful place to check out information and conversation. And then I think Medbridge still has four of my courses up that are pretty good introductory courses and that's pretty accessible for a lot of clinicians.
Amy: So yeah, I think that's where I started was with one of your Medbridge courses that kind of starts to introduce the concepts of sensory, affective, and motor and leads you into the Spirit. Yeah and I feel like maybe I did things a little bit backwards, because that's how they were available at the time, but now I'm doing the STEPPSI and I think that my summary for people would be that the STEPSI is a little bit more of an entry level than the Spirit. The Spirit is more of an organization of the information and you really have to already have a pretty good foundation in that information to fit it into the organization. Would you say that that is true?
Tracy: Absolutely
Amy: I think that STEPPSI is a great place to start. I will say, having listened to the 1st 4 chapters of that, that at one point I might have said that it was more beginner level and I want to encourage anyone who has been practicing for a very long time and maybe doesn't feel absolutely solid in their understanding of the evolution of sensory integration as a theory and practice, or maybe are confident in their understanding of the neuro that underlies sensory integration, to take that class before they take the SPIRIT because I have heard new things, even in as much as I have followed you and learned from you over the last three years, I still have heard new things in the STEPPSI and I think it's really valuable for setting up the SPIRIT course. And then I do just love Spirited Conversations. I've probably listened to every episode 3 or 4 times and some of them more because there's so much depth there when you have the background to understand it. So, I am so appreciative of that offering that people can access for free. That's amazing. And then these other courses I think should be the basis of practice for all of our pediatric therapists out there now. The framework that you are providing gives the most clarity and precision and is going to give us as occupational therapists in this pediatric realm the most credibility and give us the power to step forward and say we really understand this and we have the knowledge and the tools to lead this movement towards sensory processing and integration into the future.
Tracy: Yeah absolutely. You know I think it elevates our work and it really honors the legacy of occupational therapy as the beautiful profession that it is and the work of Dr. Ayers. But then it really creates the fidelity that we can create consistency. And it really allows us to be better therapists and advocates and colleagues with the multidisciplinary folks that we interact with all the time. And I just think that seeing that in action is over and over and over again super inspiring to me. And I when I see what happens when therapists you know just get a framework that allows them to have more clarity it just changes everything. So it's really powerful and I appreciate that it's been helpful for you and for so many and that you're you know giving voice to it here so thank you.
Amy: Thank you so much for your time today ,Tracy, and we'll have you back to talk about all the myriad of things that we could go into sometime later.
Tracy: Be well. Thank you.
Amy: Thank you!
Tracy is amazing it's a funny thing having these esteemed mentors of mine on to talk about the basics of their work. I know that for some people the things that they mentioned are going to be unfamiliar and overwhelming and I also know from having spent probably hundreds of hours learning from them that we have barely scratched the surface of what they know, and that makes me want to continue sharing and promoting their work. I hope you all learned something new and are inspired to connect with others to deepen your understanding we will continue on that path in the next OT mentor moments
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