Sensory motor skills! What are they and are they even important?

March 13, 2012

Sensory motor skills are the basic foundation for learning. All the activities and movement we did as infants, toddlers and children help prepare our body and our brain to learn. These skills are essential to develop the ability to participate in classroom activities and affects academic achievements. Physical activities promote dual processing of the brain which means the integrated use of both our brain’s hemispheres which research shows is imperative to learning.

Sensory and motor skills build on the foundation of our innate abilities. Sensory skills are those such as vision, hearing, touch, smell, taste, vestibular (for balance and head position in space), and proprioception (information from the muscles and joints). They are responsible for receiving information. Motor skills relate to muscles and movement and include crawling, walking, running, handwriting, and speaking. Motor skills give expression to the information our senses receive and process.

Sensory motor skills comprise of:

  1. Body in space – Knowing where our body is in space helps know where we are in relation to people and objects and leads to the development of visual motor skills. Visual motor skills are essential in the areas of learning to write, social interaction by knowing boundaries of proximity and even driving as we get older.
  1. Laterality – knowing how to cross midline of the body, knowing right from left and also eye movements comprise of laterality. The development of this skill is essential in learning how to read, write and also for our brain to work in a proficient song.
  1. Balance- Development of balance is promoted through the use of our vestibular system present in our inner ear.  A higher level of balance has been shown to stimulate the growth and enlargement of neural networks which in turn cause the communication systems to grow and develop.
  1. Centering – Centering is the ability to cross the midline top to bottom.  If centering is not developed, a student will walk completely disconnected, as though the legs are working independently of the rest of this body.  This leads to poor coordination in sports; disorganization in his room and classroom desk; messy personal appearance; this child is overwhelmed

What can you do?

1. Encourage movement in your child that uses both sides of the body.

2. Incorporate right and left movements into the routine.

3. Have silly time at home with doing animal walks, tumbling on the floor to encourage skills that involve both sides of the body.

4. Park time- encourage your child to explore all the structures in the park.

5. Tactile play – water, sand, beans, rice, and even shaving cream can provide endless hours of fun for the child while being beneficial to their growth.


-Vibha Pathak, OTD, OTR/L




You don’t have to brush your teeth – just the ones you want to keep

January 20, 2012

Tooth brushing and visiting the dentist are two of the hardest things to do for our kids with sensory issues. The sheer thought of someone going into their mouths can be enough to send our children into meltdown mode. Here are some practical tips that can help both dreaded activities.

Tooth brushing:

Make it feel better. To desensitize gums, and help your child tolerate using a toothbrush, massage gums with a rubber finger cot, Toothette or Den-Tips (available in many drugstores), use a Z-Vibe or other oral vibrator, or swipe gums with a washcloth.

Change toothpastes. If your child can’t tolerate toothpaste foam, try non-foaming toothpaste such as Orajel Toddler Training Toothpaste.

Make it predictable. Develop a predictable routine for when and how to brush. Help your child choose the brushing pattern. For example, they could always start with top teeth and to brush from left to right, front to back. A consistent brushing pattern will help your child learn to sequence this complex activity, help them to predict when and where they will feel various sensations (instead of feeling assaulted by the toothbrush) and help them feel proud about keeping their mouth and teeth nice and clean.

Visiting the Dentist:

Do a trial run: About a 2-3 weeks before your initial appointment, ask the office if you could stop by and take a tour of the office. This will allow your child to see the waiting room, and explore the office so that it is not a shock on the day of the appointment. If the setting feels familiar, your child will be less likely to meltdown on the day of the appointment.

Sensory solutions: Ask the office if your child could wear the lead apron throughout the appointment. The apron is very heavy and would serve as a weighted blanket, which is calming. Bring headphones for your child to decrease the sounds of all the equipment.

Practice, Practice, Practice: Call your local dentist and ask what they typically do for an initial visit and practice those at home (i.e. explore and play with rubber gloves, vibrating toothbrush, lying back with a bright light overhead). Going through these activities in a safe environment with help your child tolerate them in the dentist office.

For more ideas on practical solutions to everyday sensory concerns visit Raising a Sensory Smart Child.

-Larissa Ksar, MS, OTR/L

Report from the OTAC Annual Conference

January 9, 2012

CSLOT’s occupational therapists attended the Occupational Therapy Association of California (OTAC) annual conference inSacramento in October. We had a blast conversing with occupational therapists from across the state, attending informative and dynamic presentations, and hearing all about the latest research in the field. We were privileged to attend a presentation hosted by Susan L. Spitzer, PhD, OTR/L, an internationally know pediatric occupational therapist, who outlined some creative and fun strategies for playing with children on the autism spectrum that we would love to share.

    1. Spitzer challenged us to step down from our role of “authority figure” when playing and minimize directing behavior during play. Let the child take the lead and hold back on using directive language such as “try this; put that here; go over there”.
    2. Enter into the child’s sensory world during play. Many children on the autism spectrum process sensory information differently than we do. Seek to understand what has captivated the child’s attention during play and share that experience with them. For instance, if the child enjoys the visual effects of pouring dirt, enter into their sensory world and “feel” the experience along with them. For example, comment on how cool the clouds of dust look when illuminated by the sunlight. During play sharpen your conscious awareness of what you see, smell, feel, hear, and taste.
    3. Use your voice to convey excitement and fun during play. Use a playful tone by varying the pitch, volume, and rhythm. Use songs or melodies during play. Even try talking in silly voices (a robot voice for example!) to captivate their attention.
    4. Help the child work through challenges in play by modeling how to effectively work through them. For example, create contrived challenges during play and talk the child through them. For example, intentionally leave out a puzzle piece and say “Oh no! I am missing a piece. That’s ok. I still had fun even though I do not have all of the pieces”.

We had such a wonderful time at conference and are thrilled to share our experience with the entire CSLOT community! We look forward to sharing some of the highlights from next year’s conference.

Spitzer, Susan L. “Creative Strategies: Working, Playing, and Children with Autism”. Occupational Therapy Association of California. Sacramento, CA. 14 Oct. 2011.

Rosie Commons, MS, OTR/L

Occupational Therapy and Sensory Regulation

October 25, 2011

What comes to mind when one hears the term “occupational therapy”? When many people hear the word “occupational” they automatically think of work. So what do pediatric occupational therapists do?  Do they find jobs for babies?  According to the American Occupational Therapy Association (2008), occupations are anything a person does to occupy their time, including play, work, self-care, etc.  With this definition, it is clear to see how occupational therapy can contribute to the pediatric population, through addressing areas of play, school, and self-care. Children who have difficulty regulating their senses often have difficulty participating in these areas of occupation that are crucial to their development. Therefore, one major focus of pediatric occupational therapy is to support children with sensory processing disorder so that they can effectively process sensory input and participate in occupations that are functional and meaningful.

When children are unable to regulate their senses effectively, they may exhibit behaviors that interfere with their ability to participate in play, school, or self-care.  For example, a child that is hyper-sensitive to touch may resist important self-care activities such as bathing, brushing hair, and even eating. Children that are under-responsive to proprioceptive input (the sense of one’s body position in relation to the environment) may have difficulty making friends because they are constantly bumping in to or pushing other kids. A child who is under-responsive to sound may have difficulty listening to the teacher in the classroom.  These are just some examples of how problems with sensory registration can impact a child’s daily activities. Occupational therapy can help by providing children with play experiences that help the brain organize sensory information. In doing so, children can overcome their difficulties with sensory regulation so that they can engage in activities that are fulfilling and contribute to their overall growth and development.

American Occupational Therapy Association. (2008). The occupational therapy practice framework: Domain and processes (2nd ed.). American Journal of Occupational Therapy, 62, 625-683.

-Meridith Porter, OTS

How Can You Help Your Child with Sensory Integration?

October 18, 2011

Sensory integration is the way we take in and make use of information about the environment around us through our senses.  Our brains are constantly receiving and processing little bits of information about what we are touching, how we are positioned in space, how we are moving in relation to gravity, as well as what we are seeing, hearing, smelling, and tasting.  The sensory input then gets organized and integrated and is used to develop and nourish the brain. When sensory information is not processed well, children have difficulty directing behavior, learning, coping with stress, and developing a positive self-image.

If you suspect your child has difficulties with sensory integration, here are some suggestions on how you can help:

  1. Recognize the problem. Early detection and intervention by a trained specialist offer the best chances of reducing the effects of poor sensory integration on the child’s life.
  2. Encourage a positive self-image and reduce feelings of frustration or inadequacy. Recognize that your child’s difficulties are caused by physical dysfunction involving chemicals and impulses in the brain. Often the results of the problem manifest in behavior, mood, and the child’s ability to learn. However, keeping in mind that the cause of the problem is beyond the child’s control (just like a cold or broken bone) can help you cope with negative behaviors while continuing to provide the love and support your child needs. It is appropriate to tell your child when he or she behaves in a way that is not acceptable, but be sure to comment on the behavior, not the child. Use a disciplinary style that is consistent and sensitive to your child’s nervous system. Try to foresee situations that will push your child to lose control, and guide your child to participate in activities that will help soothe the nervous system when an emotional crisis appears to be on the horizon.
  3. Control the environment. Provide structure and organization of your child’s time and environment. Create an environment that provides tactile experiences (textures, pressure, etc.) that your child finds comfortable and calming. Provide plenty of opportunities to engage in the types of movement and stimulation that most help to organize his or her unique brain.  Watch and listen to your child to learn which sensory experiences he or she needs.
  4. Help your child learn to play. Children with sensory integrative dysfunction tend to have less varied play, and may have difficulties playing with peers. Show your child imaginative ways to move the body, interact with toys and the environment, and play with others. Simple, durable toys and games often allow for the most flexibility and variety of play experiences, as well as presenting greater opportunity for success. Most importantly, make sure your expectations match your child’s ability and that your efforts are rooted in encouraging your child to follow his or her inner drive for play. Bring a sense of fantasy and creativity to make play truly fun and rewarding.
  5. Seek Professional Help. If you suspect your child has difficulties with sensory integration, do not wait to speak to a trained professional, such as an qualified occupational therapist. Your child is not likely to outgrow the problem, and furthermore, it is possible that the difficulties will compound as the child gets older and has more expectations placed on his or her performance.


The following resources may be helpful:

Sensory Integration and the Child by A. Jean Ayres

The Out of Sync Child by Carol Stock Kranowitz

Sensory Smarts

The Sensory Integration Network


-Holly Restani MS, OTS & Vibha Pathak, OTD, OTR/L


September 13, 2011

Please do the following in order:


  1. Read the title of this article.
  2. Answer the question below.


Q: Are you feeling somewhat confused? Disorganized? Unsure of what your eyes visually perceived.


If you haven’t already figured it out, the title of this article reads OT’s can help with SENSORY PROCESSING DISORDER!!!


It is our sense of vision that allows us to see and make sense of the title of this article. However, our sense of vision may not always process information correctly, leaving us to feel disorganized, confused, and unsure of what we see. The feeling you felt when you read the article title is similar to that of a child who has difficulty processing sensory information.


Sensory processing disorder (SPD) is a neurological disorder. It is the way our nervous system receives sensory messages and turns them into responses. Lucy Jane Miller, Ph.D., OTR, states “Children with SPD experience touch, taste, sound, smell, movement and other sensations differently in comparison to typical children. Some feel sensations more intensely, while others feel them less intensely. A child with SPD does not process sensory information the way other children do, and may not always behave the way typical children do.”


Here are a few examples of a child with SPD:


Sensory Over-Responsivity: Responds to sensory messages more intensely, quickly, and for a longer period of time. Examples are your son or daughter is frequently bothered by certain textures such as fuzzy or furry, dislikes walking barefoot on grass, having their fingernails cut, loud unexpected sounds, and bright lights.


Sensory-Under-Responsivity: Exhibits less of a response to sensory information, taking longer to react, requiring intense sensory messages before they take action. Examples are your son or daughter doesn’t seem to notice when they are touched, seems unaware of what’s going on around them, doesn’t hear their name being called, does not notice food or liquid on their lips.


Sensory Seeking: Craves sensory experiences and actively seeks sensation, often in ways that are not socially acceptable. Examples are your son or daughter is constantly on the move, likes crashing, bashing, bumping, shows a preference for excessive spinning, swinging, or rolling, constantly touches objects or people, seems unable to stop talking, and takes risks during play such as jumping off high furniture.



Occupational therapists are trained to diagnose sensory based disorders. If you would like your child to be evaluated, please contact one of our clinics.


Click on the following link to obtain more information regarding SPD:


Anna Lisa Matudio, MS, OTR/L






August 12, 2011

In school, we all learned that we discover our environment through the use of our 5 basic senses, but did you know that we have an additional special sense known as the vestibular system?  This complex system is located in our inner ear and consists of gravity receptors that detect linear (such as running straight or swinging back and forth) and rotary (spinning) movements.  The vestibular system allows us to know where our body is in relation to space.  It causes us to keep our balance and make sure that we are safe in our environment.  This system plays a very important role in terms of organizing which sensory input is and is not important in order to have an optimal level of focus and attention.

What might a child look like if they had problems processing vestibular information?  Here are a few things to look for from Jean Ayre’s Sensory Integration and the Child:

Does the child:

  • Generally appear to be developing in a typical way but have trouble learning to read or do mathematics?
  • Seek and/or tolerate movement activities such as swinging, running, and jumping and not seem to get dizzy as readily as others? 
  • Not perform especially well at some aspects of sports?
  • Seem to have trouble sitting upright, or tend to slouch when at a table or desk?

Getting vestibular input is very important in terms of a child’s development.  But you might be asking, “What are vestibular activities that our kids can engage in?”  Good question!  Check out the list below of easy suggestions:

  • Teach your child to push/pull themselves on the swing
  • Encourage activities that require balance (i.e. gymnastics, skating, biking, riding a scooter)
  • Jumping activities (i.e. learning to jump rope,  bouncing on therapy balls, jumping on trampolines)

For more information on sensory integration, please check out Sensory Integration and the Child by Jean Ayres, Ph.D.

Deborah Bae, MS, OTR/L