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.

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.

05/03/2026

We talk a lot in paediatric OT about visual–motor integration - especially when we’re thinking about handwriting, drawing, and classroom participation.

But how often do we stop and think about what VMI scores are actually telling us?

This week’s OT Learning Hub newsletter (landing Tuesday at 4pm) takes a closer look at what the research says about visual–motor integration and how factors like age, diagnosis, and development influence performance.

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

✏️ Factors influencing visual-motor integration performance in children: A systematic review. Occupational Therapy International. https://doi.org/10.1155/2021/1801196

It’s an interesting paper because it doesn’t focus on intervention. Instead, it steps back and looks at what influences VMI performance across different groups of children. And that has some really practical implications for how we interpret the assessments we use every day.

If you’d like my full breakdown - along with how I think about interpreting VMI assessments in 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.

01/03/2026

We talk a lot in paediatric OT about working with parents - but we don’t always stop to think about what that actually looks like in practice.

This week’s OT Learning Hub newsletter (landing Tuesday at 4pm) takes a closer look at parent-mediated approaches and how they’re being described in the research.

Here's the paper that I'm unpacking:
Bin Zuair, H. M., Baird, J. M., & Caldwell, A. R. (2025). Parent-mediated occupational therapy interventions for children with developmental disabilities: A scoping review. Physical & Occupational Therapy in Pediatrics, 45(1), 5–21. https://doi.org/10.1080/01942638.2024.2378063

It’s an interesting paper because it doesn’t introduce something entirely new. Instead, it puts some structure around a way of working many of us are already using - supporting parents to take a more active role in intervention.

It raises some really practical questions:
👉 What do we actually mean by parent-mediated intervention?
👉 How is this different from simply giving a home program?
👉 And what does our role look like when the parent becomes the primary agent of change?

It’s a valuable read if you’re working with families and thinking about how to make intervention more meaningful, more embedded, and more sustainable beyond the session.

If you’d like my full breakdown - along with how I’m thinking about this in 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.

We talk about “self-regulation” constantly in paediatric OT… but have you ever stopped to wonder what our assessment too...
19/02/2026

We talk about “self-regulation” constantly in paediatric OT… but have you ever stopped to wonder what our assessment tools are actually measuring?

This week’s OT Learning Hub newsletter (landing in inboxes Tuesday at 4pm) takes a closer look at what current research tells us about self-regulation assessment tools and what they really capture.

Rather than focusing on intervention, this paper steps back and examines how self-regulation is conceptualised across the literature - and whether our current tools reflect the full picture.

It raises some really important questions for everyday practice:

👉 Is self-regulation a single skill, or a combination of cognitive, behavioural, and emotional processes?

👉 Do the tools we use actually measure all of these domains?

👉 And how might our assessment choices shape the way we plan intervention?

It’s a valuable read if you work with children with attention, emotional, or behavioural regulation challenges.

🧠 The construct components of self-regulation from a systematic review of self-regulation measures in children and adolescents. Janicaud et al. (2026), Current Psychology (coming to you hot off the press!!)

If you’d like the full breakdown - along with my reflections and clinical takeaways - 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

I’m really looking forward to sharing this one.

Ever wish someone would unpack paediatric research and explain what it actually means for occupational therapy practice?...
13/02/2026

Ever wish someone would unpack paediatric research and explain what it actually means for occupational therapy practice?

That’s what I do each week in the OT Learning Hub.

This week’s newsletter (landing in inboxes Tuesday at 4pm) focuses on something many of us are seeing more and more in practice -Avoidant Restrictive Food Intake Disorder (ARFID).

This paper is OT-specific and does something really helpful: it clearly outlines the role of occupational therapy across different levels of care for children and young people with ARFID.

The paper steps back and asks some important, practice-shaping questions:

👉 What is the unique role of occupational therapy in ARFID treatment?

👉 How do sensory, emotional, and participation factors influence eating?

👉 And how can OT support children and families across inpatient, day program, and outpatient settings?

It’s a really valuable read if you work with children with extreme food selectivity, sensory-based eating challenges, or anxiety around food.

🍽️ Occupational Therapy’s Role in the Treatment of Avoidant Restrictive Food Intake Disorder (ARFID) Across Levels of Care. Mack & Stanton (2025), Occupational Therapy in Mental Health

If you’d like the full breakdown -along with my own reflections - 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

I can’t wait to share this one.

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