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.

03/06/2026

ADHD medication can be very polarising, and parents are often asking OTs what their opinion is.

This week's OT Learning Hub newsletter (landing next Tuesday at 4pm) explores a study that looked beyond ADHD symptoms and examined some of the broader life outcomes associated with ADHD medication.

The paper I'm unpacking is:
Zhang, L., Zhu, N., Sjölander, A., Nourredine, M., Li, L., Garcia-Argibay, M., Kuja-Halkola, R., Brikell, I., Lichtenstein, P., D'Onofrio, B. M., Larsson, H., Cortese, S., & Chang, Z. (2025). ADHD drug treatment and risk of suicidal behaviours, substance misuse, accidental injuries, transport accidents, and criminality: Emulation of target trials. BMJ.

One finding that stood out to me was that ADHD medication was associated with lower rates of suicidal behaviours, substance misuse, transport accidents and criminality in a study involving almost 150,000 individuals with ADHD.

Families are often well aware of the potential side effects associated with medication. What may be discussed less often are the risks associated with living with untreated ADHD over many years.

This paper doesn't prove that medication is right for every child. But it does remind us that untreated ADHD is not a neutral state.

If you'd like my full breakdown on why OT's need to be aware of this study and its findings, 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

31/05/2026

Participation sits at the heart of occupational therapy. But why?

This week's OT Learning Hub newsletter (landing next Tuesday at 4pm) explores a paper that brings together evidence from 185 studies examining occupational therapy interventions for children and young people.

The paper I'm unpacking is:

Cahill, S. M., & Beisbier, S. (2020). Occupational Therapy Practice Guidelines for Children and Youth Ages 5–21 Years. American Journal of Occupational Therapy.

One finding that stood out to me was how consistently the strongest evidence supported interventions embedded within meaningful everyday occupations and real-life contexts.

As a top-down OT, I didn't find this surprising. What I found valuable was seeing such a strong evidence base supporting participation-focused practice.

And clinically, this makes a lot of sense.

Families rarely come to us because they want improved sensory processing, executive functioning, or motor skills in isolation. They come because their child is struggling to participate in everyday life.

This paper is a timely reminder that participation isn't simply the outcome of occupational therapy. It's often where development, learning, and change occur.

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

22/05/2026

Self-care goals seem to make up a huge amount of paediatric OT practice. Dressing, eating, toileting, washing, everyday independence... these are often the goals families most want support with, and areas many of us spend a lot of time trying to unpack.

Because when children are struggling with self-care, the challenge is rarely just teaching the task itself.

This week’s OT Learning Hub newsletter (landing next Tuesday at 4pm) explores a paper that asks a really interesting question: What factors actually influence self-care development in children?

The paper I’m unpacking is:
Brewer, L., Namdeo, A., Rowen, E., Oparah, C., Pearce, M., & Kolehmainen, N. (2026). Self-Care in Children and Young People With and Without Developmental Disabilities - A Systematic Review. Child: Care, Health and Development.

One finding that stood out to me immediately was that movement skills, cognitive functioning and executive functioning showed the most consistent associations with self-care outcomes.

But what I found especially interesting was something else. Sensory processing and pain were barely represented in the literature. Yet in the small number of studies where they were investigated both showed associations with self-care outcomes.

And clinically, this makes a lot of sense.

Many of us see children every day who avoid dressing because of tactile sensitivities, struggle with bathing or hair washing because of sensory demands, or find everyday participation much harder when pain or discomfort is sitting in the background.

I think this raises a really important question. Are some of the factors we regularly observe influencing self-care in practice still being underrepresented within the research literature?

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

One of the biggest misunderstandings I see around regulation in children is the expectation that they should be able to ...
12/05/2026

One of the biggest misunderstandings I see around regulation in children is the expectation that they should be able to “self-regulate” independently far earlier than many of them realistically can.

I work with many neurodivergent children who can at times need a lot of co-regulation from the adults around them in order to stay calm, engaged, flexible, and able to participate in everyday life.

This is just part of being human.

Humans are a social species. We are wired to regulate through connection with other people.

Even as adults, most of us regulate through others every day:

– talking things through with someone we trust

– seeking reassurance

– needing emotional support during stress

– feeling calmer when another person is calm and grounded

– borrowing regulation from the people around us

Yet when it comes to children, there can be an expectation that they should simply manage their emotions, behaviours, and nervous systems independently.

I see this expectation often in schools, but also within families and extended families:

– “He needs to learn to calm himself down.”

– “She’s too dependent.”

– “They need to toughen up.”

– “He's just lacking resilience.”

The problem is that expecting children to independently self-regulate before they have the nervous system capacity to do so often sets them up to fail.

Many neurodivergent children are not refusing to regulate. They are overwhelmed, dysregulated, overloaded, or lacking the internal capacity to do it alone in that moment.

Co-regulation is not “giving in.”

It is not creating dependence.

It is the process through which regulation develops.

Children learn regulation through repeated experiences of being supported by regulated adults.

This means adults tuning into the child and helping reduce overwhelm through:

– calm presence

– emotional safety

– predictable responses

– reduced demands when capacity is low

– helping the child feel understood

– adjusting the environment

– supporting the child’s sensory and nervous system needs

When adults remain regulated, connected, and responsive, children gradually build the foundations needed for more independent regulation over time.

But many children cannot skip straight to independence simply because adults want them to.

I think we need to spend less time asking:

“How do we make this child self-regulate independently?”

And more time asking:

“How do we better support the adults around this child to co-regulate effectively?”

Because often the most important regulation strategy for a child is not a program, chart, or calming tool. It is a calm, attuned adult who understands what the child’s nervous system is communicating and knows how to respond supportively.

12/05/2026

We talk a lot in paediatric OT practice about executive functioning, usually in terms of organisation, planning, attention, task completion, and forgetfulness. But this week’s OT Learning Hub newsletter (landing next Tuesday at 4pm) explores a paper that raises a really interesting question:

What if some of the biggest executive functioning challenges aren’t organisational at all, but emotional?

The paper I’m unpacking is:
🧠 Benallie, K. J., McClain, M. B., Schwartz, S. E., Davis, G., & Lopez, A. (2025). The impact of autism and ADHD symptomology and cognitive functioning on executive functioning in autistic children. Child Neuropsychology.

One finding stood out to me immediately: emotion regulation emerged as the most significantly impacted executive functioning domain.

And clinically, this makes a lot of sense.

For many of the children we support, executive functioning difficulties often show up first through emotional overwhelm, frustration intolerance, difficulty coping with transitions, rigidity under stress, and difficulty recovering once distressed.

The paper also found that greater hyperactivity/impulsivity and greater social communication difficulties were associated with more significant executive functioning challenges, while cognitive functioning/IQ was not significantly related to executive functioning difficulties in this sample.

I think this raises a really important clinical point. We often talk about executive functioning as though it’s primarily about organisation skills or productivity. But for many neurodivergent children, executive functioning is deeply tied to emotional regulation and nervous system regulation.

And if we only target planners, checklists, and task completion strategies, we may miss the emotional and regulatory load sitting underneath the difficulties in the first place.

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

08/05/2026

I’m really excited to be involved in guest editing a Special Issue of the journal Children alongside Janice Tona and Shelly Lane. This Special Issue reflects an important shift occurring across paediatric practice - moving beyond isolated impairment-based outcomes toward understanding how children participate, engage, and function in everyday life.

We’re looking for submissions exploring areas such as:
• participation and occupational engagement
• paediatric rehabilitation and neurodevelopmental practice
• functional assessment and intervention
• family-centred and strengths-based approaches
• translational and implementation science
• quality of life and wellbeing
• innovative ways of understanding and measuring participation and engagement

We welcome empirical studies, reviews, conceptual papers, and translational research from across occupational therapy, speech pathology, physiotherapy, psychology, education, developmental medicine, and related disciplines.

If your research is focused on improving meaningful participation and real-world outcomes for children and families, we’d genuinely love to see submissions in this space.

The full Special Issue details can be found here: Children | Special Issue : www.mdpi.com/journal/children/special_issues/C4GXIC1MWW

One of the important roles occupational therapy can play in PANS/ PANDAS is helping children continue to participate in ...
06/05/2026

One of the important roles occupational therapy can play in PANS/ PANDAS is helping children continue to participate in everyday life when symptoms have significantly reduced their capacity to function.

While the mental health presentation in PANS understandably becomes the primary clinical focus, many children are also experiencing substantial changes in their ability to manage everyday life.

During significant flares, children may struggle with:
– attending school
– participating in learning
– managing self-care and hygiene
– eating and mealtimes
– toileting
– sleeping
– coping with everyday routines and transitions
– social participation and family activities
– sustaining attention and completing tasks
– managing the physical and cognitive demands of daily life

These functional difficulties are often driven by a combination of underlying factors that occupational therapists assess and address, including:
– sensory overwhelm
– fatigue and reduced endurance
– cognitive fog and slowed processing
–motor planning and coordination
– pain and physical discomfort
– nervous system dysregulation and reduced stress tolerance

In these periods, children are often not just anxious or emotionally distressed. They can become profoundly functionally impaired.

This is where OT can play an important role.

Occupational therapists assess how symptoms are affecting the child’s ability to function within the context of real life:
– What is realistically manageable right now?
– Which demands are exceeding capacity?
– What environmental factors are contributing to overload?
– What accommodations and supports allow participation without further dysregulation?

OTs support families, schools, and teams to adapt expectations, environments, routines, and activities so the child can continue to participate as safely and successfully as possible during periods of instability.

Importantly, OT intervention during PANS flares does not need to rely heavily on higher-level cognitive processing or insight-based approaches (e.g.: “talk” therapy). Many children simply do not have the cognitive or nervous system capacity for this during severe exacerbations. Instead, OT focuses on reducing overload, supporting regulation, preserving participation, and helping the child maintain connection, competence, routine, and engagement in everyday life.

When participation is repeatedly lost, children can quickly lose confidence, independence, social connection, and their sense of themselves as capable.

Supporting participation through periods of instability is one of the most important things OT can offer children with PANS and their families.

06/05/2026

Selective eating is something many of us see regularly in paediatric OT, particularly in neurodivergent children. But understanding what is actually driving the eating difficulty matters, because not all food refusal comes from the same place.

This week’s OT Learning Hub newsletter (landing Tuesday at 4pm) takes a closer look at a paper exploring selective eating, ARFID-related eating difficulties, and oral sensory sensitivity in children with ADHD.

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

🧠 Çelebi, E., et al. (2025). The relationship between avoidant/restrictive food intake disorder, selective eating, and sensory processing in children with ADHD. Appetite.

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

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

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