Working with clients with Functional neurologic disorders (FND) can be confusing and challenging. If you’re stuck and aren’t sure how to help your clients you’ve gotta check out this episode! Occupational therapists and industry leaders in the treatment of FND Julie MacLean and Jessica Ranford discuss their expertise in using a sensory-based approach to treatment. In their work they noticed certain patterns emerging for people experiencing FND.

By conducting detailed sensory profiles and histories, the OTs were able to identify patterns in how these patients processed sensory information. Many exhibited heightened sensory sensitivity, sensory avoidance, and low sensory registration - leading to cognitive, emotional, and motor control issues.

The OTs developed a multi-step treatment approach focused on: 1) Increasing patient self-awareness of their sensory processing and arousal levels 2) Exploring individualized sensory strategies to self-regulate 3) Creating personalized "sensory diets" of activities to maintain balance

This sensory-based framework, combined with motor retraining when needed, has been effective in helping FND patients improve their symptoms and expand their participation in daily life.

Overall, this discussion highlighted the valuable role occupational therapy can play in assessing and treating the complex sensory processing difficulties experienced by many individuals with functional neurological disorders.

FND specific resources: 

www.neurosymptoms.org 

www.FNDhope.org

Overcoming Functional Neurological Disorders Workbook, Reset and Rewire: The FND Workbook 

OT and sensory processing specific resources: 

Living Sensationally: Understanding Your Senses by Winnie Dunn 

The Spiral Foundation

Sensory Modulation & Environment: Essential Elements of Occupation by Tina Champagne

The Sensory Connection Program and Workbooks by Karen Moore 

Recent OT publications: 

Sensory Processing Difficulties and Occupational Therapy Outcomes for Functional Neurological Disorder: A Retrospective Cohort Study.

McCombs KE, MacLean J, Finkelstein SA, Goedeken S, Perez DL, Ranford J.

Neurol Clin Pract. 2024 Jun;14(3):e200286.  

Outpatient Approach to Occupational Therapy for Paroxysmal Functional Neurologic Symptoms: Sensory Modulation Training as an Emerging Treatment.

Ranford J, MacLean J.  Neurol Clin. 2023 Nov;41(4):695-709. doi: 10.1016/j.ncl.2023.02.008. Epub 2023 Apr 20

Sensory Processing Difficulties in Functional Neurological Disorder: A Possible Predisposing Vulnerability? Ranford J, MacLean J, Alluri PR, Comeau O, Godena E, LaFrance WC Jr, Hunt A, Stephen CD, Perez DL.Psychosomatics. 2020 Jul-Aug;61(4):343-352.

Occupational therapy consensus recommendations for functional neurological disorder.

Nicholson C, Edwards MJ, Carson AJ, Gardiner P, Golder D, Hayward K, Humblestone S, Jinadu H, Lumsden C, MacLean J, Main L, Macgregor L, Nielsen G, Oakley L, Price J, Ranford J, Ranu J, Sum E, Stone J. J Neurol Neurosurg Psychiatry. 2020 Oct;91(10):1037-1045.