Sensory Diet

May 29, 2013

Once a parent understands Sensory Processing (see this post for a full explanation), the next question is often “what do I do with my or my child’s sensory needs?” An OT will usually answer, “it depends on the individual.” Every person explores, feels and senses their environment differently.  For example, when I am unable to focus on my work, often times I will play calming music in the background and that helps me become more focused. For others any type of noise in the background can be very distracting.

To help figure out what is calming/alerting for you or your child, your occupational therapist will usually establish a sensory diet.  A sensory diet is something that can be embedded in your daily routine and help the individual get through tasks/transitions that can be very difficult. For example; if a child has difficulty getting dressed in the morning and complains about the feeling of the material or doesn’t like certain textures on their skin, the therapist might suggest an activity that would help the individual transition into the non-preferred activity (such as getting dressed). An example of one of the activities might include wrapping the child up in a blanket like a burrito and giving deep squishes to help desensitize the skin before putting clothes on. It could also help decrease the child’s anxiety about getting dressed as being wrapped up tightly can give a calm and safe feeling (again, every individual is different). Occupational therapists work with the family to help establish a diet that works for the child and family. Below is a list of tools, most of them are divided into calming, alerting or organizing activities. Please take note that these are suggested activities and may not be calming/alerting for your child; as I mentioned before every person processes information differently.

Activities that may be found in a Sensory Diet:

 

 Alerting Activities: Alerting activities help the undersensitive child to increase hypo-responsiveness to sensory stimulation. Stimulation activities include:

§  Applying lotion with stimulating scents (peppermint, citrus scent).

§  Jumping activities (jumping jacks, jumping on trampoline, hop scotch, jumping on bed/furniture).

§  Bouncing activities (therapy ball, beach ball, peanut ball).

§  Eating crunchy food (raw vegetables and fruits, nuts, crunchy cereal, toast).

 

 

 Calming Activities:

Calming activities should be used to help the oversensitive child decrease hyper-responsiveness to sensory stimulation. These activities are characterized by slow, linear movement or comfort. They include:

§  Deep pressure activities (being sandwiched in between 2 pillows; being rolled in a blanket pretend to become a burrito; pushing against the wall with hands, back, and head; clamping hands in each other and squeeze; pushing down on a hard surface with extended arms and flat hands…).

§  Slow rocking (in the arms of an adult, in rocking chair, placed in a blanket held by 2 adults, in a hammock).

§  Taking a warm bath/shower.

§  Applying lotion with calming scent (lavender, chamomile, vanilla).

§  Sucking on hard candy, lollipops, or pacifier.

§  Holding a cuddle toy (stuffed animal, favorite blanket).

§  Manipulating a fidget toy.

 

 

 

 Organizing Activities: These activities help regulate the child’s responses. Organizing activities use resistance and/or rotational, upside down movement. They include:

 

§  Eating chewy foods (chewing gum, eating peanut butter, chewy fruit bars, dried fruits, fresh bagels).

§  Hanging activities (hanging arms of monkey bar, or chinning bar, hanging of adult’s elevated arms).

§  Pushing activities (pushing furniture, heavy grocery and/or laundry bags).

§  Climbing (on play structures, furniture, trees).

§  Bouncing activities.

§  Digging in resistive mass (theraputty, sand, mud, rice).

§  Sitting on an air cushion, peanut ball.

§  Participating in rough play (tug of war, roughhousing).

§  Upside down movement (somersault, cartwheel, hanging off trapeze).

 

By: Laura Anderson MS, OTR/L

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Red Flags for Sensory Processing Disorder

May 21, 2013

What is sensory processing?

Sensory processing refers to how individuals process the information provided by all the sensations coming internally from the body from the environment. These senses work together to give us a sense of the world and our place in it. The brain organizes the information about the different smell, sounds, textures, sights, tastes, and movements that surround us. This organization of sensory information allows us to put meaning to the world around us and gives us a sense of how to respond and behave appropriately. When the organization of sensory information is impaired, it can affect the way in which we live our everyday lives.  Impairments with sensory processing have been found to have a great impact on activities such as play, work, learning, social interactions, and everyday activities.

You might have wondered, “Do I or Does my child/loved one have a sensory processing disorder?” There is an excellent resource for people with sensory processing difficulties at the Sensory Processing Disorder (SPD) Foundation website: http://www.spdfoundation.net/index.html.

They have a checklist (see below) describing symptoms that may fit someone you know with sensory processing difficulties. Please note that this checklist cannot diagnose someone with SPD. It can be help determine if additional testing should be done. When filling out this checklist, think about the individual’s behavior during the past six months. When more than a few symptoms are found in an individual, we recommend that you talk with your doctor/pediatrician or occupational therapist.

Sensory Processing Disorder Checklist

Many of the symptoms listed in the following categories are common to that particular age group.

Infant/ Toddler Checklist:
____ My infant/toddler has problems eating.
____ My infant/toddler refused to go to anyone but me.
____ My infant/toddler has trouble falling asleep or staying asleep
____ My infant/toddler is extremely irritable when I dress him/her; seems to be uncomfortable in clothes.
____ My infant/toddler rarely plays with toys, especially those requiring dexterity.
____ My infant/toddler has difficulty shifting focus from one object/activity to another.
____ My infant/toddler does not notice pain or is slow to respond when hurt.
____ My infant/toddler resists cuddling, arches back away from the person holding him.
____ My infant/toddler cannot calm self by sucking on a pacifier, looking at toys, or listening to my voice.
____ My infant/toddler has a “floppy” body, bumps into things and has poor balance.
____ My infant/toddler does little or no babbling, vocalizing.
____ My infant/toddler is easily startled.
____ My infant/toddler is extremely active and is constantly moving body/limbs or runs endlessly.
____ My infant/toddler seems to be delayed in crawling, standing, walking or running.

 

Pre-School Checklist:
____ My child has difficulty being toilet trained.
____ My child is overly sensitive to stimulation, overreacts to or does not like touch, noise, smells, etc.
____ My child is unaware of being touched/bumped unless done with extreme force/intensity.
____ My child has difficulty learning and/or avoids performing fine motor tasks such as using crayons and fasteners on clothing.
____ My child seems unsure how to move his/her body in space, is clumsy and awkward.
____ My child has difficulty learning new motor tasks.
____ My child is in constant motion.
____ My child gets in everyone else’s space and/or touches everything around him.
____ My child has difficulty making friends (overly aggressive or passive/ withdrawn).
____ My child is intense, demanding or hard to calm and has difficulty with transitions.
____ My child has sudden mood changes and temper tantrums that are unexpected.
____ My child seems weak, slumps when sitting/standing; prefers sedentary activities.
____ It is hard to understand my child’s speech.
____ My child does not seem to understand verbal instructions.

 

School Age:
___ My child is overly sensitive to stimulation, overreacts to or does not like touch, noise, smells, etc.
___ My child is easily distracted in the classroom, often out of his/her seat, fidgety.
___ My child is easily overwhelmed at the playground, during recess and in class.
___ My child is slow to perform tasks.
___ My child has difficulty performing or avoids fine motor tasks such as handwriting.
___ My child appears clumsy and stumbles often, slouches in chair.
___ My child craves rough housing, tackling/wrestling games.
___ My child is slow to learn new activities.
___ My child is in constant motion.
___ My child has difficulty learning new motor tasks and prefers sedentary activities.
___ My child has difficulty making friends (overly aggressive or passive/ withdrawn).
___ My child ïgets stuck’ on tasks and has difficulty changing to another task.
___ My child confuses similar sounding words, misinterprets questions or requests.
___ My child has difficulty reading, especially aloud.
___ My child stumbles over words; speech lacks fluency, and rhythm is hesitant.

 

Adolescent/Adult:
___ I am over-sensitive to environmental stimulation: I do not like being touched.
___ I avoid visually stimulating environments and/or I am sensitive to sounds.
___ I often feel lethargic and slow in starting my day.
___ I often begin new tasks simultaneously and leave many of them uncompleted.
___ I use an inappropriate amount of force when handling objects.
___ I often bump into things or develop bruises that I cannot recall.
___ I have difficulty learning new motor tasks, or sequencing steps of a task.
___ I need physical activities to help me maintain my focus throughout the day.
___ I have difficulty staying focused at work and in meetings.
___ I misinterpret questions and requests, requiring more clarification than usual.
___ I have difficulty reading, especially aloud.
___ My speech lacks fluency, I stumble over words.
___ I must read material several times to absorb the content.
___ I have trouble forming thoughts and ideas in oral presentations.

For more information the SPD Foundation website recommends checking out the SPD Foundation’s Treatment Directory (http://www.spdfoundation.net/directory/index.html) for a professional experienced with treating Sensory Processing Disorder.

 


Turning the “Terrible Twos” into the “Terrific Twos”

May 14, 2013

Many parents of two year-olds comment about the difficulty of having a two year-old.  The phrase the “Terrible Twos” is frequently used to qualify the feelings of parents about their frustration with their children’s temper tantrums and mood swings.  Whether or not a child has special needs, this period of time can be challenging.  I suggest that as we understand this unique period of growth in our children and have strategies to navigate challenging situations, we can turn this time period into the “Terrific Twos.”

Understanding: From the Perspective of a Two Year-Old

Being two years-old is hard. Children who are two are caught between having new self-help skills, leading to increased independence, and the reality that most tasks still cannot be done completely on their own.  They may have acquired a few new words and with language comes power.  Children quickly discover that the word “No!” is especially powerful.  But with this new-found power of communication, there is also realization that it is limited.  Two year-olds have limited verbal ability which leads to frustration. For children with delayed language, feelings of frustration can be even more intense.  Overall, children who are two have some ability, the taste of power, but, in the end, are relatively powerless in their situations.  That’s a very frustrating scenario.

Understanding: From the Perspective of a Professional

There is phenomenal growth and development occurring between 24 and 36 months across all areas of development.  In neuro-typical children, this is the time period of an explosion of vocabulary and language.  For children who are delayed in language, there is often significant change in language ability during this year.  With all of this growth and development, mood swing and temper tantrums are typical during this time period.

Strategies for Parents

  • Stay engaged with your child by talking with and playing with your child.  This is true in your home as well as when going out in public (to the grocery store, the doctor’s office, a restaurant).  Additionally, bring along a bag of engaging activities when going out in public.  Using a combination of engaging activities and staying engaged with your child’s interaction can go a long way to prevent a break down for your child.
  • When a child is having a temper tantrum, either offer comfort or ignore the behavior.  If you choose to ignore the behavior, ignore for a while, then offer comfort.
  • Distraction is a beautiful tool to use when a two year-old is upset.  Do something unexpected, be silly, or use humor.  Tickling sometimes works, if it is a generally desirable and engaging activity for your child.
  • When engaging in distraction, distract with interaction (tickling, being silly, etc.) rather than with another object (food or a toy). Giving a desirable food or a desirable toy can be seen as a reward and you can inadvertently reward an undesirable behavior.
  • Don’t be afraid of saying “No” to your child but reserve the firm use of “No!” for serious (i.e. dangerous) situations.  In other situations, redirect your child’s behavior to another activity instead.

By staying engaged, being prepared, and knowing ahead of time how to pull out of melt downs can turn this exciting period of development into a terrific time for you and your child!

Jennifer M. Adams, MA, CCC-SLP