Spirited Conversations - Engaging and Elevating Pediatric OT

Learning almost always involves some friction.

This episode started before we hit record. We were chatting about the therapists we mentor and why we love it so much, and Tracy stopped us and said we needed to be recording. So we did. It's a different kind of episode for us: unplanned, honest, and full of the things we usually only say to each other.

Each of us shares why we mentor. Tracy talks about helping clinicians find themselves in the work and bring theory into practice. Michelle talks about seeing the possibility of the clinician the same way we see it in every child. Cory talks about the privilege of sitting with someone's vulnerability and offering the just right challenge for where they're at.

From there, the conversation turns to reflective practice. What it looks like on an ordinary day, why it needs another person, and how it helps us get out of our own way so we can stay present and compassionate in session.

In this episode:
- Mentoring as knowledge translation, within and across disciplines
- Why friction and vulnerability come before growth
- A three-part reflective practice model: theory, action, and who we are in the work
- Safety as the foundation of every good mentoring relationship
- Reflective practice at the intersection of development and mental health
- Noticing your pull in session, and finding your way back

If you've ever finished a session thinking "I didn't land that", this one is for you.

[00:00] Introduction
[01:00] The conversation we almost didn't record
[02:29] Tracy's why: mentoring as the thing she loves most
[05:52] Learning from within your discipline, and across disciplines
[08:07] Michelle's why: seeing the clinician the way we see the child
[12:41] Cory's why: the friction before the aha
[17:02] The podcast as mentoring, and a three-part reflective practice model
[19:54] Michelle on the Bali CPD retreat and being on the edge of capacity
[23:01] Getting the friction out in front of you, and finding your edges
[24:44] Safety as the foundation of mentoring
[28:42] Reflective practice at the intersection of development and mental health
[32:52] What reflective practice looks like in practice
[38:11] "There that is": noticing your pull in the moment
[42:36] Loose threads: boredom, doing enough, and the pull to do
[46:02] Closing reflections
[47:18] Outro

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Listen on Apple Podcasts: https://podcasts.apple.com/au/podcast/spirited-conversations-engaging-and-elevating/id1557795901
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Sensory, affect, motor (S.A.M). Three letters that sit underneath almost everything we say on this show. In our very first Spirited Chat, Tracy explains where SAM came from and why every one of those letters has a high route and a low route of processing in the brain.
Spirited Chats are our new short episodes: one idea, short enough to fit between clients or on the drive home. We started at the very core of the SPIRIT Model, because if you've ever heard us say "the low route of M" and felt like we were speaking our own language, this one is for you.
Tracy traces SAM back to Dr Stanley Greenspan and shows the unique and amazing quality of her thinking mind as she builds on it. Using Dan Siegel's hand model of the brain, she explains why sensory processing splits into modulation and discrimination, and why affect and motor have their own high and low routes too. Michelle and Cory then bring it back to the clinic: how SAM guides assessment and intervention, and why having three clear places to look matters most when a child's presentation gets complicated.

Clinical reasoning starts with clarity. We differentiate so we can integrate.
Find the show notes and more Spirited Chats at https://www.spiritedconversationspodcast.com/

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If a child is relying heavily on their visual system to drive movement, the missing piece might not be where you think.

This one started the way our best conversations usually do, with Michelle bringing a genuine clinical wondering. A five and a half year old, a diadochokinesis task, and a quality of movement that looked robotic no matter how much practise was offered. We took that single clinical moment and mapped it through the SPIRIT model, and landed somewhere we did not expect: the vestibular system as the foundational source of bilateral coordination, rhythm and midline reference.

Tracy did what Tracy does and made the neuroscience not just accessible but genuinely exciting, and by the end of it we were all doing bicep curls at home. This is one of those episodes where we kept saying we would keep it simple, and then absolutely did not, in the best possible way.

WHAT WE COVER
Bilaterality as a distinct sensory integrative function. Dr Ayres identified bilaterality as its own cluster within sensory discrimination, not just a motor output. That changes how we reason about coordination tasks that look straightforward on the surface.

The vestibular system as the foundation for bilateral movement. Before a child can coordinate two limbs in an antiphase pattern they need a stable midline reference, and that reference is vestibularly mediated. If the foundation is shaky, children may compensate by watching you the entire time rather than generating movement from within.

In phase versus antiphase movement patterns. The difference between homologous bilateral movement and the more demanding antiphase patterns, and why grading back to the simpler pattern tells you so much about where the breakdown actually sits.

Rhythm, the saccule, and why gravity is always working. How the saccule functions as a background rhythm detector, and what the vestibular system's constant relationship with gravity means for rhythm generation and for multisensory supports in treatment.

Top down versus bottom up coordination. When a child is manufacturing movement through visual monitoring and cognitive effort rather than generating it from an embodied sense, that is clinically significant and observable.

FREE CPD WORKSHEET
Five reflective practice prompts, free to download and ready for your CPD record. Grab it with the full show notes and transcript at spiritedconversationspodcast.com

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This is a short bonus from us, and it comes with an invitation. From the 9th to the 14th of November 2026, Tracy is leading a Spirited Retreat in Ubud, Bali, through CPD Retreats, and we wanted our listeners to know.
If you have ever wanted to learn the SPIRIT model deeply, this is the way to do it. You complete the SPIRIT course online beforehand at your own pace, then land in Bali with around 25 others, mostly paediatric OTs, though other professions and educators are welcome too. Mornings are theory and lectures with Tracy. Afternoons are practical: you spend time with children in the local community, then come back together and use the SPIRIT model to clinically reason what you saw and plan for the next day. Each evening there is something restorative built in.
Michelle went last year and says it shifted the way she thinks about herself as a clinician, not just the strategies she uses. There are only a few spots left. If you can make it to Bali in November, Tracy would love to see you there.
Sign up here: https://cpdretreats.com.au/retreats/ols/products/a-spirited-retreat-with-tracy-stackhouse-bali-september-2025-a-spr-rtr-wth1
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What does it really mean for sensory integration to be a developmental theorym and how does that change the way we see the children in front of us?

In this episode, we pick up right where Episode 33 left off. Tracy opens with a powerful quote from the Sensory Integration Theory and Praxis textbook that bridges sensory discrimination and executive functioning, and the conversation takes off from there.

We explore how Praxis doesn't arrive all at once but interacts with a child's changing developmental competence, from the six-month-old reaching for a toy, all the way to the basketball player executing a perfect shot. Tracy shares a rich clinical story of a little boy with Fragile X syndrome whose play shifted dramatically, not because he was taught new skills, but because his motivational system was met exactly where it was. And we get into genuinely fascinating territory around sensory surplus, neurodivergence, and what it means when a child needs to spend far longer making sense of perceptual qualities before they can move into representational play.

Timestamps:
00:00 Introduction & recap of Episode 33
01:43 Tracy's quote from Sensory Integration Theory and Praxis (2nd ed., 2002)
03:00 Sensory integration as a developmental theory — the spiralling continuum
07:17 What does "developmental theory" really mean here?
08:14 The embodied experience of a six-month-old becoming a reacher
10:34 Praxis elaborating from affordances — the basketball example
12:33 The interrupted development of Episode 33's little cherub
14:22 "Praxis interacts with the changing developmental competence of the child"
18:00 Connecting to executive functioning — planning and inhibitory control
20:06 Sledging, dysregulation, and the autonomic nervous system
20:33 Affect is the glue — Stanley Greenspan
21:48 Clinical story: the boy with Fragile X and the red cars
26:33 Attunement, pacing, and knowing when to stretch
29:00 How you find the affect inside a child's category interest
30:03 Sensory discrimination as the foundation of executive function shifting
31:20 Executive functions are embodied before they are cognitive
33:27 Visual discrimination and cognitive flexibility
35:00 Stuck in developmental stages — integration dependency
37:26 From concrete/literal to representational thinking
38:42 The million repetitions problem — and why play partners get tired
41:00 Filling the perceptual cup
42:04 Wired to Feel — autism as a condition of sensory surplus
44:00 Motivational bias, executive function, and the "not done yet" feeling
45:26 Affect as the glue in pathway building
47:12 Meeting children exactly where they are
49:14 DIR, honeypots, and what it means to really be with a child in play
49:55 Did affect unlock self-other connection?
53:15 Pulling it together for parents — the relief of knowing this is the work
54:52 We don't teach shoe-tying to 2-year-olds — developmental readiness

Resources mentioned:
Sensory Integration Theory and Praxis, 2nd ed. (2002) — Anzaloni & Murray
Children Adapt — Gilfoyle, Grady & Moore
Wired to Feel: Autism as a Condition of Sensory Surplus — Sweezy & Bergenfeld (2025)
DIR/Floortime — Stanley Greenspan
Early Start Denver Model — Sally Rogers
SPIRIT Model — Tracy Stackhouse, Developmental FX
The Felt Sense Polyvagal Model — Jan Winhall

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