Today’s blog post was written by Robyn Turnbull (ASI® certified with Fidelity Measure) and she works in Cape Town.

For a session to be considered truly Ayres’ Sensory Integration® (ASI®), one of the criteria in the fidelity measure (Parham, et al., 2011) requires that there is a variety of equipment available and they list “spandex fabric” as one of these items.  This creates the feeling that spandex and sensory integration are somehow synonymous. But is it really that necessary in the therapy room? And how can you use it with the different clients who walk into your therapy rooms? In this post, I will briefly introduce to you the therapeutic benefits of spandex, how to suspend it and how the therapeutic value changes depending on the way in which it is suspended.

What are the sensory benefits of spandex?

Spandex offers a sensory-enriched experience of especially tactile, proprioception and vestibular input. The multi-directional stretch provides a full-body proprioception experience and as it surrounds the body it provides increased tactile input at the same time. As the person climbs inside, the spandex stretches down and around the body. This creates a visual quiet space, suddenly cutting out the visual noise from the environment.

Spandex also enables the full range of vestibular stimulation, depending on how you suspend it and move it.

Active movement inside the spandex challenges praxis, postural control and bilateral integration abilities. Therefore, when using suspended spandex, encouraging active movement will help integrate the skills.

How can we use it therapeutically in Ayres Sensory Integration?

Due to its rich sensory affordances, spandex is a versatile therapeutic tool. The affordances change depending on how the spandex is suspended. So, in order to understand the different affordances we will have to look at how the spandex is suspended.

Suspending from 4 points:

To suspend spandex from 4 points you will require either overhead beams or eyebolts secured into the walls. Some therapy rooms also have steel structures from which to suspend. Suspending the spandex from 4 points allows the child to move more actively in the spandex, increasing the proprioception, postural control and motor planning challenges.

Activity ideas in 4 point spandex:

• Bounce it up and down, swing side to side or create a tornado by swinging wildly in all directions. Encourage the child to hold on to the sides of the spandex, and stop immediately if they let go. Spandex is a dangerous piece of equipment and children easily roll out, so make sure you have a lot of padding underneath them. And with padding, I mean pillows and mattresses and crash mats; gym mats won’t suffice.
• Crawling and rolling from layer to layer as if ‘climbing a mountain’.
• Build a tower or steps to climb into the spandex from the top.
• Use the spandex as part of an obstacle course. Moving from one end to the other end and then walking over a beam, jumping on blocks, swinging from one point to the next or crawling through a tunnel.
• Attach rope or bungee cord to suspension points and encourage symmetrical or asymmetrical pulling. This will enable the person to swing themselves. I often refer to this as rowing the boat.

Suspending from 2 points:

To suspend the spandex from 2 points you will need either an overhead beam or eyebolts secured into the wall. Spandex is very stretchy so you will need to have the suspension points approximately 1.5 times the length of the spandex swing (i.e. if you have a 2 meter long spandex, the suspension points need to be 3 meters apart). Suspending the spandex from 2 points enables a closed space which is visually quieter and provides more light tactile input from the spandex as it moves.

Activity ideas in 2 suspension point spandex:

• Swing side to side, bounce or create a wild tornado by swinging it in all directions. Again, encourage the child to hold on the sides of the spandex when swinging.
• If you have 3 or more layers of spandex, have the person lie in the 2^nd layer from the top. Then scrunch up the top layer so the person can hold on it like a koala bear using arms and legs wrapped around the top layer of spandex. As the spandex swings or bounces, the top layer of spandex provides even more proprioceptive feedback into the limbs.
• Climb in one end and crawl to the other end. Have mattresses underneath the spandex when doing these activities because any off balance movement will cause the spandex to throw the person out.

Suspending from 1 point:

This is the easiest way to suspend spandex as most therapy practices or homes have one point of suspension (i.e. from a tree branch or overhead beam). Suspending the spandex from 1 suspension point creates a closed, pod like swing. This forms a dark, closed visual space, and minimises the amount of moveable space inside. If you are looking to provide more passive vestibular input, then suspending spandex is a good option. However, if you are looking for more active movement and active vestibular stimulation then consider suspending the spandex from 2 or 4 points.

Activity ideas in 1 suspension point spandex:

• Person sits inside in the spandex which forms a pod or cocoon. You can then swing it linear, rotational or all over to provide Coriolis vestibular stimulation.
• The person can stand inside and jump as on a trampoline. This provides a lot of proprioceptive feedback as the spandex is completely surrounding the person’s body inside.
• Spin the spandex pod round and round until it is tight, and then let go to allow it to unspin itself. This is intense rotational input so should only be considered with people who have a high threshold for vestibular input. Also watch for signs of sensory stress such as flushing of cheeks, hiccoughs, giggling, dizziness and more. Counteract this sensory stress with proprioception such as drinking cold water through a long straw or rolling a large ball over the body with a lot of pressure.

How do I choose my spandex?

Spandex and Lycra are the same thing – Lycra is just a name which has been trademarked by a company called DuPont (Sarkar, 2013). But if you are choosing material there are some things you need to keep in mind:

1) The material needs to stretch both ways. If it only has stretch in one direction, it may be more likely to tear and changes the therapeutic input.

2) The thickness of the spandex material is key. A thickness from 195g/m² and higher is most suitable for suspending spandex.

3) The design and colour of the spandex is key too. Lines create an optical illusion of movement so when swinging in a spandex with lines on, it can be overstimulating to the visual-vestibular system.  However, this does not mean we should be nervous of boldness. Remember, as much as we have clients who need calming input, we also need to consider the clients who need alerting input. Bold colours and engaging designs can be a huge asset in your practice.

With so much to offer in terms of therapeutic value – and such fun to use – spandex is a key tool in every sensory integration therapy room.

References

Cook, R. (2017). Spandex Ideas. Cape Town.

Parham, L., Smith Roley, S., May-Benson, T., Koomar, J., Brett-Green, B., Burke, J., . . . Schaaf, R. (2011, March / April VOL 65). Development of a Fidelity Measure for Research on the Effectiveness of the Ayres Sensory Integration® Intervention. AJOT, pp. 133-142.

Sarkar, P. (2013, June 30). What is the Difference Between Lycra and Spandex?