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


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.

 


Sensory Integration Activities and Self-Regulation

December 13, 2012

Sensory Integration Activities promote self-regulation in children and are necessary for:

  • daily functioning
  • intellectual, social, and emotional development
  • the development of a positive self-esteem
  • a mind and body which is ready for learning
  • positive interactions in the world around him
  • the achievement of normal developmental milestones

The great news is… sensory integration activities are unbelievably fun and a necessary part of development for any child, whether they have a sensory processing disorder or not.
From the womb into adulthood, our neurological systems are developing
and processing an overwhelming amount of sensory information every day.
Our system must then interpret this information and make it ready to be
tolerated and used for specific purposes.

The best part about sensory integration activities is the creative fun
you can have coming up with ideas, playing with your child using sensory
input, or purchasing unique toys and products anyone would love!

Children think they are having fun when they are actually working strenuously at building essential skills with their bodies and better neurological systems.

It takes a lot of hard work, dedication, consistency and persistence, but in the end, you will have a thriving child who can regulate sensory input much more effectively.

The variety of sensory integration activities is endless… only limited by your creativity and imagination!

 

1)   Tactile Play:

  • Shaving cream
  • Rice, lentils, beans, pasta
  • Water and sand
  • Playdoh
  • Silly string

 

2)   Vestibular Input:

  • Swing
  • Slide
  • Spinning in an office chair
  • Rocking chair
  • Sitting or rolling on a yoga ball
  • Scooter boards

 

3)   Proprioceptive Input:

  • Trampoline
  • Tunnel
  • Heavy work chores (pulling garbage bin, stomping on cans for recycling, wiping tables and windows, carrying groceries)
  • Wrestling
  • Tug of war
  • Animal walks
  • Chewy food (bagels, licorice, gum, beef jerky)
  • Crunchy food (chips, pretzels)
  • Thick liquids through straws (milk shakes, yogurt drinks)

 

Resources: http://www.sensory-processing-disorder.com/sensory-integration-activities.html

 

– Patricia Fasang, MS, OTR/L


Sensory Strategies to Alert or to Calm Yourself or Your Child

December 3, 2012

Did you know that you can use sensory strategies to alert or to calm yourself or your child?

You may have heard of relaxation techniques to calm oneself by using soothing music or deep breathing. What about techniques to alert oneself when experiencing low energy? When addressing sensory strategies we often think of the sense of smell, sight, hearing, touch, and taste. From a sensory integration perspective, we also have the vestibular (balance) and proprioceptive (body awareness) systems. Based on personal responses and preferences, we can change or “regulate” the level of arousal through the use of these sensory systems.

There are some activities that tend to be calming in nature and some activities that tend to be alerting. You may notice that you have already used these strategies without realizing. For example, you may have used calming strategies with a young baby by dimming lights, playing soft music, swaddling and gently rocking him/her. These strategies address the vestibular, tactile, visual, and auditory input. Or you may have used alerting strategies when staying up late working or studying by removing clutter from your desk beforehand to prevent distractions, talking to yourself or reading aloud, fidgeting with your pencil, tapping your foot and eating a crunchy snack. These strategies address the visual, auditory, tactile, vestibular, and oral motor input.

Think about what you do or what your child does in a small subtle manner in order to maintain appropriate levels of arousal. This may help you select appropriate types of sensory input. Remember that each individual responds differently to different types of sensory input. Individuals need to reflect on their response to different types of input.

If you have any questions, please contact an occupational therapist who can assist you with using environmental/sensory strategies to support you or your child.

 

-Felicia M. Hashimoto, M.A.T., M.S., OTR/L

 

TYPE of INPUT ALERTING QUALITIES CALMING QUALITIES
VESTIBULAR (movement of head through space =>   contributes to balance) fast, jerky, changes directions, moving in suspended   equipment slow, rhythmic, movement in one direction,  using grounded equipment
PROPRIOCEPTIVE (on joints => contributes to body   awareness and coordination) fast paced, quick changes, jarring, jerking, starts or   stops abruptly joint compression, slow stretch, heavy resistance, (e.g.   push ups, heavy work, weighted blankets, backpacks, vests, or lap pad)
TACTILE light touch, unexpected touch, cold, rough, cool   environment pressure touch, tight wrap, firm stroking over large area,   predicted touch, warm environment
VISUAL bright colors, unexpected visual stimuli, bright lights,   red-yellow shades, changing/moving stimulus dark colors, predictable rhythmic pattern, dim lights, blue-green   shades, stimulus remaining constant
AUDITORY unexpected, loud, complex or mixed, pronounced expected, quiet, gentle rhythm, simple, melodic or   sing-song
OLFACTORY all odors tend to be alerting familiar odors associated with pleasurable & comforting   experiences, interactions or people
ORAL MOTOR Crunchy textures (e.g. pretzels, chips, raw veggies), cold   temperatures (ice chips, ice-cold drinks)) Deep breathing, resistive biting and chewing (e.g. fruit   leather, non-food items like Chewelry or Chewy tubes), sucking on hard candy,   thumb, or pacifier)

 

 

ALERT program from Therapy Works, Inc.: www.alertprogram.com

Ayres, J. (2005). Sensory Integration and the Child. Western Psychological Services.

Biel, L. & Peske, N. (2009). Raising a sensory smart child. London, England: Penguin Books.

Cohn, E., Miller, L. J., & Tickle-Degnen, L. (2000). Parental hopes for therapy outcomes: Children with sensory modulation disorders. American Journal of Occupational Therapy, 54, 36–43.

Kranowitz, C. (2006). The out of sync child: Recognizing and coping with sensory processing disorder. New York, NY: Perigree Trade.

Sensational Brain: www.sensationalbrain.com


Early Intervention

November 1, 2012

Early intervention refers to services for children with developmental delays. These services help a child develop functional life skills. In some situations, the therapy a child receives at an early age enables that child to reach developmental milestones on target or close to target. Early intervention can relate to a child’s:

  • Physical development a child’s ability to move, see and hear
  • Language and speech development a child’s ability to talk and communicate
  • Social and emotional development a child’s ability to play, interact and relate to others
  • Adaptive development a child’s ability to handle self-care functions, such as feeding and dressing
  • Cognitive development a child’s ability to think and learn

All parents and caregivers, no matter how busy, want to provide their children with the most stimulating environment for learning and using language. A trip to the supermarket, taking a car ride, playing outside, or doing everyday activities at home provide great opportunities for developing speech and language skills. There are always opportunities to maximize communication and encourage interactions, which are both language-rich and fun! Below are different daily routines with examples of ways we can maximize communication.

Bath Time

  1. Blow bubbles in the water. Talk about the size (big bubbles), speed (slow, fast), etc. as you play.
  2. Practice following simple directions like “kick”, “splash”, and “scrub.”
  3. Let your child tell you which body part to wash or give your child a choice, “Do you want me to wash your arm or leg?.”
  4. Talk about what the bath toys are doing (e.g., going up, down, hiding under, in/out of water, jump off the tub, etc.).
  5. Sing songs in the bath (e.g., “Row row row your boat”, “It’s raining it’s pouring”, etc.).
  6. Use bath toys to hide under a washrag. Allow your child to find the toys and explore hide & seek games.
  7. Talk about bathtime concepts (e.g., water temperature, washing speed, vocabulary related to the bath, etc.).

Resources:

http://www.10minutesfortalking.com

Eichten, P. (2000). Help me talk: A parents guide to speech and language stimulation techniques for children 1 to 3 years (2nd ed). Richmond, VA: PI Communication Materials, Inc.

Katey Sellers, MA, CCC-SLP


How to Provide a Functional Home Environment for your Sensory Seeking Child

May 30, 2012

Have you ever asked yourself what type of environment can help your sensory seeking child pay attention and behave more appropriately? The following strategies can help increase your child’s attention, facilitate appropriate behavior, increase organization, and prevent over-stimulation.

Proprioceptive: Make tools available for heavy work activities such as a climbing a rope or riding a bicycle.

Tactile: For tactile sensory seekers, organize your environment so that items the child uses routinely provide tactile stimulation such as textured bath mats.

Vestibular: Make equipment available that provides purposeful movement requiring an organized response such as a swing. Have your child swing and aim for a target.

Visual: Maintain organization by labeling drawers, placing toys in containers to minimize clutter, and using muted colors. .

Auditory: Provide a steady background of quiet sounds such as classical music.

Oral: Provide foods with intense tastes.

If you have any questions, please contact an occupational therapist at CSLOT who can assist you with making environmental changes in your home to support your child.

-Anna Lisa Matudio, M.S., OTR/L

References:

Miller, L.J. (2007). Sensational Kids. New York, N.Y.: Penguin Group, Inc.


You Will Not “Zone-out” With This Great Self Regulation Program

April 4, 2012

The Zones of Regulation Curriculum was designed to help children become more successful in school, at home, and in the community by independently controlling maladaptive behaviors through the process of self regulation and emotional control. Self regulation is the ability to be in the best state to successfully engage in a particular activity. When exposed to a frustrating activity, an individual with self regulation difficulties may find coping challenging and will likely demonstrate maladaptive behaviors such as physically escaping the situation or lashing out.

Through the Zones of Regulation program, students will learn how to categorize their emotions and states of alertness into four  color categorized zones.

  1. The Blue Zone: A low state of alertness. For example, when one feels sick, tired, or bored.
  2. The Green Zone: A regulated state of alertness. Characterized when one is focused, calm and content.
  3. The Yellow Zone: A heightened state of alertness. For example, when one experiences feeling of frustration, silliness, or confusion.
  4. The Red Zone: An extremely heightened state of alertness. When one feels intense emotions such as rage, panic, or terror.

The Zones of Regulation curriculum teaches children which zones are expected for given circumstances. For example, right before a championship sports event, it is okay for one’s body to be in the Yellow Zone as a heightened state of alertness may boost athletic performance. In contrast, a heightened state of alertness is not appropriate when one is sitting in math class. If a child is in a zone that does not match the demands of the environment, the Zones curriculum teaches children tools that help them move between zones; this helps a child get their body in a “just right” place to do what is expected of them. A child’s toolbox of self regulation strategies consists of a variety of calming techniques, cognitive strategies, and sensory supports.

The Zones of Regulation curriculum is appropriate for any child, even as young as preschool years, that struggles with self regulation. However, some children with the following conditions frequently have difficulty self regulating: Autism Spectrum Disorder, Attention Deficit Hyperactive Disorder, Oppositional Defiant Disorder, or Anxiety Disorders.

For more information about the Zones of Regulation program, please ask your CSLOT occupational therapist.

-Rosie Commons M.S. OTR/L

References:

Kuypers, L.M. (2011). The Zones of Regulation: A Curriculum Deisgned to Foster Self-Regulation and Emotional Control. San Jose, CA: Think Social Publishing, Inc.