Michelle Newby PhD

Michelle Newby PhD Occupational Therapist supporting parents in understanding their children's sensory differences. Or you can find out more about me here: www.michellenewby.com

I’m Michelle Newby PhD, occupational therapist, mentor, educator and researcher - and I help OTs build confidence, skill, and impact when supporting neurodivergent children and their families. With over 25 years of experience and a PhD exploring sensory processing and occupational performance in complex neurodevelopmental conditions, my mission is to bridge the gap between research and real-world

practice so you can feel confident that what you do every day truly makes a difference. Each week, I share The OT Learning Hub Newsletter - a free, research-packed email designed to keep you inspired and informed. You’ll receive:
✅ Bite-sized summaries of new research relevant to paediatric and neurodevelopmental OT practice
✅ Practical takeaways you can apply straight away in sessions or parent coaching
✅ Updates on upcoming webinars, eBooks, and mentoring opportunities

If you’re passionate about doing great work and want to stay connected with a community of thoughtful, neurodiversity-affirming OTs - this is for you.

👉 Join here: https://www.michellenewby.com/OTLearningHubLP

and get your first research newsletter this week.

I was speaking with a teacher last week & something came up that I hear quite often. There’s a general perception that a...
03/05/2026

I was speaking with a teacher last week & something came up that I hear quite often. There’s a general perception that accommodations are mainly for students who are struggling academically or who have behaviours that are hard to manage.

But that’s only part of the picture.

I was there advocating for a student who doesn’t fit either of those categories. He’s in high school, has no behavioural concerns, and doesn’t disrupt the classroom. Academically, he’s doing… fine. Which is where things get interesting.

Because this is a student with cognitive ability in the 90th percentile.

Without support, he performs within the average range. With the right accommodations in place, his performance shifts much closer to his actual capacity. The difference isn’t effort. It’s his ability to access the task demands and demonstrate what he knows.

He has ADHD, Developmental Coordination Disorder (DCD), and dysgraphia, and each of these shapes how he engages with schoolwork. His ADHD isn’t outwardly disruptive, but it does affect sustained attention, particularly later in the day when medication is wearing off. By the final periods, his ability to take in and work with information drops.

His DCD affects efficiency. Tasks take longer, require more effort, and fatigue builds across the day.

And his dysgraphia creates a very clear bottleneck for written output. Getting ideas onto paper is slow and effortful, which limits what he can demonstrate under typical classroom conditions.

Individually, each of these is manageable. Together, they compound.

So on the surface, he looks like a student who is coping. In reality, his performance is being constrained in very predictable ways by the way tasks and environments are set up.

When those barriers are adjusted, his performance shifts. For example:
– using a laptop or speech-to-text to bypass handwriting demands
– adjusting written output requirements so he can demonstrate knowledge without excessive motor load
– building in rest breaks to manage fatigue
– completing assessments in a smaller, low-distraction setting
– prioritising more demanding tasks earlier in the day
– allowing additional time where processing speed or output is a factor
– reducing copying demands through provision of notes
– offering alternative ways to demonstrate knowledge where appropriate

None of these change what he knows. They change his ability to show what he knows.

This is where accommodations are often misunderstood. They’re not about advantage. They’re about access.

If support is only directed towards students who are failing or highly visible, a whole group of children are easily overlooked. The students who are coping, compliant, average-achieving, and largely under the radar.

A student can be achieving within the average range and still be significantly restricted in their participation.

Every child should have the opportunity to perform at a level that reflects their capacity, not the limitations of the environment around them.

30/04/2026

Understanding where "behaviour" is coming from sits at the heart of everything we do in paediatric OT, especially when we’re working with children whose profiles don’t fit neatly into standard frameworks.

This week’s OT Learning Hub newsletter (landing Tuesday at 4pm) takes a closer look at a paper exploring parents’ experiences of supporting children with PDA - and what happens when services misunderstand that presentation.

Here’s the paper I’m unpacking for you:

🧠 Nawaz, S., & Speer, S. (2025). What are the experiences and support needs of families of autistic children with Extreme (or ‘Pathological’) Demand Avoidance (E/PDA) behaviours? Research in Autism Spectrum Disorders.

If you’d like my full breakdown, you’re very welcome to join us in the OT Learning Hub 💌 https://www.michellenewby.com/OTLearningHubLP

If you have a child with PANS/ PANDAS or if you're a therapist working with this group of children, please check out thi...
30/04/2026

If you have a child with PANS/ PANDAS or if you're a therapist working with this group of children, please check out this research study

Help Shape the Future of Psychotherapy in PANS/PANDAS

We’re inviting caregivers, clinicians, and individuals with lived experience to take part in an important research survey led by the MIND Global Council.

This brief 20-minute survey is designed to help build the evidence base for psychotherapy guidelines in PANS/PANDAS and related neuroimmune conditions. Your voice will directly contribute to developing more informed, ethical, and effective approaches to care.

There is a critical need for research that helps clinicians better understand these complex presentations—so that care is guided by thoughtful, evidence-based approaches rather than misinterpretation. When we better understand the role of biology, we can improve outcomes for individuals and families navigating these conditions.

Who can participate?
• Individuals with lived experience
• Caregivers
• Clinicians

If you are both a caregiver and a clinician, you are welcome to complete both surveys.

We would be so grateful if you could also help share this with others who may be interested. Thank you for partnering with the MIND Global Council in advancing care and creating meaningful change.

CLINICIAN SURVEY
https://chapmanu.co1.qualtrics.com/jfe/form/SV_eVUFn6VjUP38OYS

PARENT SURVEY
https://chapmanu.co1.qualtrics.com/jfe/form/SV_6W4T1lQW5qeda3Y

23/04/2026

Engagement and relationship-building sit at the heart of everything we do in paediatric OT, and especially with autistic children.

It’s important to step back and reflect on what we’re actually doing in our therapy that strengthens connection in the first place.

This week’s OT Learning Hub newsletter (landing Tuesday at 4pm) takes a closer look at a paper exploring how canine-assisted therapy may support connection, motivation, and engagement within sessions.

Here’s the paper I’m unpacking for you:

🧠 Hill, J. R., Ziviani, J., & Driscoll, C. (2020). “The connection just happens”: Therapists’ perspectives of canine-assisted occupational therapy for children on the autism spectrum. Australian Occupational Therapy Journal.

If you’d like my full breakdown, you’re very welcome to join us in the OT Learning Hub 💌 https://www.michellenewby.com/OTLearningHubLP

Occupational therapy is one of those professions that people have heard of…But quietly wonder: “What do they actually do...
23/04/2026

Occupational therapy is one of those professions that people have heard of…

But quietly wonder:

“What do they actually do?”

And often - no one asks. So assumptions fill the gap.

In paediatrics, that assumption is usually one word:

...sensory.

And yes - sensory processing is absolutely something we bring to the table. But if that’s all people think we do, they’re missing the point. Because OT has never been about sensory in isolation.

It’s about participation.

When I meet a neurodivergent child, I’m not starting with a diagnosis or a sensory profile. I’m starting with: What are this child’s strengths - and what’s actually hard in their day?

Things like:

-Getting ready in the morning

-Getting into the classroom

-Managing the day at school

-Playing, connecting, switching off at night

The everyday things.

Because that’s what childhood actually is, right?

When those things aren’t working, that’s when I start to pull things apart a bit. Sometimes sensory is sitting right there in the middle of it. But often it’s layered. It might also be:

– motor coordination or postural control

– attention or executive functioning

– social understanding or communication differences

– anxiety, interoception, emotional regulation

Most of the time, it’s not one thing. It’s a few things, all interacting.

So yes - you might see sensory strategies. But what you don’t always see is the clinical reasoning underneath. The thinking about why this activity is hard for this child, in this moment, in this environment. And what’s actually going to help.

And importantly - OTs are not here to make neurodivergent kids look more neurotypical. We’re here to support them to participate in their lives, in ways that are important to them and fit who they are.

So if you’ve ever wondered what OTs actually do…

We look at the whole child. We work out what’s getting in the way. And we help make the day-to-day things a bit more doable.

19/04/2026

We don’t talk enough in paediatric OT about where therapy happens. And when we do, it’s often framed around access or service models.

But how often do we stop and ask… Does the location of therapy change what we see?

This week’s OT Learning Hub newsletter (landing Tuesday at 4pm) takes a closer look at a paper exploring what happens when OT is embedded directly into early childhood settings.

Here’s the paper I’m unpacking for you:

🧠 Bedard, A., & Fyffe, L. (2026). Embedding Occupational Therapy Within an Early Childhood Education Centre. Child: Care, Health and Development.

If you’d like my full breakdown, you’re very welcome to join us in the OT Learning Hub 💌 https://www.michellenewby.com/OTLearningHubLP

PANS/PANDAS used to be described as “controversial.” And at the time, that was a fair reflection of the evidence we had....
14/04/2026

PANS/PANDAS used to be described as “controversial.” And at the time, that was a fair reflection of the evidence we had.

But the literature has moved on.

The research has moved beyond simply describing a cluster of behaviours and we’re now starting to see clear biological signals emerging in the literature, that can’t be ignored.

A recent paper in Molecular Psychiatry is a good example of this:
Han, V. X., et al. (2025). Epigenetic, ribosomal, and immune dysregulation in paediatric acute-onset neuropsychiatric syndrome. Molecular Psychiatry, 30, 5389–5404. https://doi.org/10.1038/s41380-025-03127-5

In this study, children with PANS had normal results on routine testing. But when they looked more closely - using RNA sequencing - a different picture emerged.

They found:
– Dysregulation across ribosomal, epigenetic, and immune pathways
– Altered immune responsiveness
– Distinct gene expression profiles separating these children from controls

And importantly, these abnormalities moved to more typical patterns following treatment with IVIG.

This paper is important because it helps us to understand that PANS is a measurable biological phenotype - even when standard investigations come back “normal.”

Then when you layer in the treatment studies, the picture becomes harder to dismiss. Here are just a handful – there are more out there:
– A double-blind, randomised placebo-controlled trial found azithromycin was associated with improvements in OCD symptoms in acute-onset presentations (PANS)
https://doi.org/10.1089/cap.2016.0190
– IVIG has been associated with reductions in pro-inflammatory immune markers alongside improvements in neuropsychiatric symptoms in PANS https://doi.org/10.3389/fimmu.2024.1383973
– At a cellular level, immune and ribosomal pathway abnormalities appear to normalise following IVIG in children with PANS. https://doi.org/10.1212/NXI.0000000000200467
–Epigenetic and immune pathway changes in PANS were observed post CBD oil treatment, moving to more typical patterns Keating, B. A., et al. (2026). Neurotherapeutics

Is there more work to be done? Of course. But are we still in a place where PANS can be dismissed as “controversial”? I don’t think so.

Because at the centre of this are children whose lives are changed overnight. Children who are full of potential, who suddenly lose the ability to do the simple everyday things they could previously manage - while we continue to debate the label.

If you’re a clinician still holding onto the idea that PANS is too controversial to investigate or treat…

It might be time to take another look at the evidence.

12/04/2026

We don’t talk enough in paediatric OT about toileting.

And when we do, it can often be framed as behavioural. Or medical.

But how often do we stop and ask…

Could this actually be sensory?

This week’s OT Learning Hub newsletter (landing Tuesday at 4pm) takes a closer look at a paper exploring sensory contributions to toileting difficulties in children and introduces a tool many of you may not have come across.

Here’s the paper I’m unpacking for you:

🧠 Beaudry-Bellefeuille, I., Lane, S. J., & Ramos-Polo, E. (2016). The Toileting Habit Profile Questionnaire: screening for sensory-based toileting difficulties in young children with constipation and retentive f***l incontinence. Journal of Occupational Therapy, Schools, & Early Intervention.

At first glance, the behaviours described feel very familiar.

– Withholding
– Refusing the toilet
– Avoiding toileting outside the home
– Strong reactions to smell, touch, or wiping

These are things we see all the time.

But this paper is interesting because it reframes them slightly and asks…

Could these behaviours be linked to sensory processing, particularly over-responsivity?

And the answer is… quite possibly.

– Experts showed strong agreement that many of these behaviours could be related to sensory over-responsivity
– Some behaviours also reflected under-responsivity, like not noticing the urge to go or soiling
– And importantly, not all behaviours were clearly sensory, which matters clinically

Which raises a really important question:

Are we sometimes treating toileting difficulties as behavioural… when for some children, they’re actually sensory?

For those of us working in this space, it’s a helpful reminder that:

– Toileting difficulties aren’t always about refusal
– They can be driven by how a child experiences sensation
– And if we miss that, we risk targeting the wrong thing

If you’d like my full breakdown, you’re very welcome to join us in the OT Learning Hub.

Over 8,000 paediatric OTs are already reading along each week 💌

👉 https://www.michellenewby.com/OTLearningHubLP

Looking forward to sharing this one.

07/04/2026

We talk a lot in paediatric OT about demand avoidance - and for many of us, PDA is showing up more and more in our clinical work.

But how often do we stop and ask…

What’s actually driving it?

This week’s OT Learning Hub newsletter (landing Tuesday at 4pm) takes a closer look at a new paper exploring demand avoidance in autistic children - and, importantly, what might sit underneath it.

Here’s the paper I’m unpacking for you:
🧠 Rai, A. J., Rishworth, B., Gutierrez, R., & Ludlow, A. K. (2026). Sensory reactivity and intolerance to uncertainty: What characterises demand avoidance behaviours in children and adolescents with pathological demand avoidance? Research in Autism.

At first glance, some of the findings feel familiar.
– Demand avoidance is linked with higher anxiety
– And higher autistic traits

But this paper is interesting because it goes a step further and asks…

What actually predicts demand avoidance - and is it the same for every child?

And the answer is… not quite.

– For autistic children with a PDA profile → sensory reactivity stood out
– For neurotypical children → intolerance of uncertainty played a role
– For autistic children without PDA → neither really held once anxiety was accounted for

Which raises a really important clinical question:

Are we treating all demand avoidance as if it comes from the same place… when it doesn’t?

For those of us working in this space, it’s a helpful reminder that:
– Demand avoidance isn’t the behaviour to “fix”
– It’s often a response to something underneath
– And for some children, sensory processing may be far more central than we realise

If you’d like my full breakdown, you’re very welcome to join us in the OT Learning Hub.

Over 8,000 paediatric OTs are already reading along each week 💌
👉 https://www.michellenewby.com/OTLearningHubLP

Looking forward to sharing this one.

26/03/2026

✨ CALLING ALL OT’S – Interoception Now available ON DEMAND ✨

Do you ever wonder what the actual evidence base is for interoception intervention?

Or feel unsure whether the interoception programs we use in occupational therapy are really creating the meaningful, functional change our clients need?

You’re not alone - and that’s exactly why I created
Interoception in Practice: A Comprehensive Guide for Occupational Therapists.

This 4-hour on-demand training is now available, so you can learn at your own pace - when it suits you.

Inside the training, we dive into:
🔹 How interoceptive awareness develops across neurotypes
🔹 What the research really says about different intervention approaches
🔹 Practical, clinically useful assessment strategies
🔹 Interoception interventions beyond body experiments

…and more.

If you’ve been wanting an evidence-informed, grounded, and truly practical approach to interoception - this is now available whenever you’re ready.

💻 On-demand access for 6 months after purchase

I’d love to have you join me.
👉 Find out more here: https://www.michellenewby.com/interoceptionlive

Let’s help children and families build regulation skills that truly make a difference. 💛

19/03/2026

We talk a lot in paediatric OT about interoception - and many of us are now using the Interoception Curriculum regularly in practice.

But how often do we stop and ask…

What does the evidence actually say about it?

This week’s OT Learning Hub newsletter (landing Tuesday at 4pm) takes a closer look at a recent study exploring the Interoception Curriculum in a school setting - and, more importantly, how we interpret findings like this.

Here’s the paper I’m unpacking for you:

🧠 Mahler, K., Hample, K., Ensor, C., Ludwig, M., Palanzo-Sholly, L., Stang, A., Trevisan, D., & Hilton, C. (2024). An interoception-based intervention for improving emotional regulation in children in a special education classroom: Feasibility study. Occupational Therapy in Health Care.

At first glance, the results sound great.

-Improvements in interoceptive awareness.
-Improvements in emotional regulation.
And this is without directly teaching regulation strategies.

But this paper is interesting because it gives us an opportunity to step back and ask a slightly different question:

-How confident can we actually be in these findings?
Because when you look more closely, there are some important considerations around study design, measurement, and bias that really shape how we interpret the results.

For those of us wokring on interoception regularly, it’s a really helpful reminder that:
-Interoception is an important and emerging area…
-But applying a structured program “off the shelf” doesn’t automatically make something evidence-based.

If you’d like my full breakdown you’re very welcome to join us in the OT Learning Hub.

Over 8,000 paediatric OTs are already reading along each week 💌

👉 https://www.michellenewby.com/OTLearningHubLP

Looking forward to sharing this one.

12/03/2026

We talk a lot in paediatric OT about self-regulation — and many of us use the Alert Program® regularly in practice.

But how often do we stop and think about how consistently it’s actually being delivered?

This week’s OT Learning Hub newsletter (landing Tuesday at 4pm) takes a closer look at something we don’t often discuss when it comes to intervention research: fidelity.

In other words…
Are we delivering the program the way it was designed?

Here’s the paper I’m unpacking for you:

🚗 Blackwell, D., Lane, A. E., Philpott-Robinson, K., & Lane, S. J. (2026). Development of a fidelity instrument for delivering the Alert Program® for self-regulation. OTJR: Occupational Therapy Journal of Research. https://doi.org/10.1177/15394492261422638

It’s an interesting paper because it doesn’t focus on whether the Alert Program works.

Instead, it steps back and asks a different question — how do we know the program is being delivered consistently across therapists, settings, and studies?

For those of us who use the Alert Program regularly, it’s a really useful reminder that the approach is more than a collection of sensory strategies.

It’s built around a particular structure, language, and therapeutic process that helps children understand and regulate their own “engine levels.”

If you’d like my full breakdown — along with how I think about this in everyday clinical practice — you’re very welcome to join us in the OT Learning Hub.

Over 8,000 paediatric OTs are already reading along each week 💌
👉 https://www.michellenewby.com/OTLearningHubLP

Looking forward to sharing this one.

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