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Sensational Kids Occupational Therapists work to help identify your child's sensory strengths and areas of challenge. Using several assessment tools including observation your Occupational Therapist will devise an individualised sensory "diet" to help your child become more calm, organised and ready to attend. Your Occupational Therapist may also use other therapeutic tools such as the Wilbarger Brushing Protocol as part of your child's sensory diet. Importantly, you as the parent will be taught to observe and recognise behaviours that your child may be exhibiting so you are able to help them at home and in the school environment.
Sensory Integration (SI) is the process by which the nervous system takes in and organises information through the senses for use in daily life. When faulty or inefficient sensory processing occurs, a range of functional challenges may exist; including a lack of control of emotions and behaviour, difficulties in motor skills, poor coordination, learning and attention challenges, and under or over reaction to sensation. SI Treatment strategies incorporate a range of techniques and equipment to address these challenges.
Think about if we had a chat on the side of a busy highway: We could tune in to each other's voice, notice but tune out the trucks going past (even though they have greater volume, we can tune in to the frequencies of human voice) and when the loud busy street starts to bother us we can go back in to a quiet building to feel calm and alert and not on edge. Often children with sensory modulation difficulties miss important sensory details and have trouble tuning out the irrelevant. They may have trouble tuning into the teacher's voice, particularly when the dull sound of the air conditioner is going. They may have trouble manipulating small objects or the tag on their shirt may feel like a spider all day.
Back on the highway, if we didn't have the choice to leave that over-stimulating setting, we may choose other sensory strategies to keep us calm and paying attention: we may rock on our feet (movement or vestibular and proprioceptive input), lean on a post (deep touch or proprioceptive input) or chew on a piece of gum (oral motor proprioceptive input).
Now what if this chat on the highway was happening after a 9 hour work day and one of those trucks had just splashed water on you? Would you still be feeling calm and would you be attending as well as you were in the earlier scenarios?
This is how many kids with one type of sensory modulation challenge - sensory defensiveness - feel from the very start of their day. These children may be picky eaters, may only wear particular clothing such as cotton T-shirts with the tags cut out, may avoid touch or movement activities like swings or may react negatively to sounds that others don't notice or don't find offensive like vacuums or fireworks.
What if that conversation was happening at 6am (when you normally don't get up until 7:30am and even then it's a slow process), you didn't get your morning coffee... or shower, not a car was on the road and even the birds were still asleep and not making a peep? You may, or may not, be feeling calm but would you be feeling alert? I certainly would not be alert and so you would need to attend at an even higher level to make sense of what I'm telling you.
Children with another type of sensory modulation challenge - low arousal - feel like this all day and it may take a lot to get them feeling awake and alert. These children may not get in trouble, because they don't tend to cause waves, but they may not be attending to all the information that is presented to them.
But what if you really had to listen and get the information off me? You may pace, tap your foot, fidget with your nails, push on your hands, rub your face, open your eyes wide and nod vigorously in an effort to stay awake.But what if you really had to listen and get the information off me? You may pace, tap your foot, fidget with your nails, push on your hands, rub your face, open your eyes wide and nod vigorously in an effort to stay awake.
The child with the last type of sensory modulation challenge, often referred to as a sensory seeker, most closely relates to this scenario. Sometimes these children are told to sit still, don't wriggle, don't fidget with that toy, don't rock on your chair, don't put that in your mouth, and listen!!!. As Sherri Shellengberger, co-creator of the Engine Program, says, "I'm sorry but you've just told that child to go to sleep!"
We all use sensory strategies to feel calm and alert. This child is just seeking input to help them feel calm and pay attention. Patti Oetter says that these children don't need to be 'calmed down', they need to be 'calmed up'! They always choose sensory experiences that help them to be more alert but sometimes they choose input that is also disorganising and may be inappropriate for a particular setting, like a classroom. That's where it's our job to help them get the input that their bodies need in a way that is organising to them and is not dangerous to or distracting to everyone else.
A sensory diet is a form of home program intervention plan that incorporates organising sensory input, or utilises already existing sensory input, into everyday life in order to assist your child to maintain a regulated behavioural state, such as the calm, alert state required during certain school activities (Wilbarger & Wilbarger, 2006; Williams & Shellenberger, 1994; Cool, 1990).
Sensory diet strategies may be implemented at regular intervals throughout the day. In particular, these strategies may be performed prior to times that may be considered challenging, in order to prepare or set up the body to maintain an organised state throughout the activity. Alternately they may also be used during activities in order to assist your child to maintain an organised state throughout the activity (Williams & Shellenberger, 1994).
Every human uses sensory strategies, often non-consciously, to assist them to calm down, wake up, and/or maintain attention. Such strategies, when used consciously and strategically may be considered sensory diet strategies. These sensory diet strategies are individualised and vary from person to person; where one person may take a shower to become more awake, another to calm down, another for both reasons and another dislikes showers, preferring only to have baths.
When helping children and caregivers create and implement sensory diets, the occupational therapist collaborates with them to identify what challenges exist that may be assisted by a sensory diet, what sensory strategies does the client seek, what naturally occurring possibilities exist and/ or may be included and when to implement the strategies (Williams & Shellenberger, 1994).
It is important to note that not all sensory experiences are 'organising' events. Effects vary form one person to another and sensory experiences vary in how powerful they may be in assisting the person to regulate their behaviour. For this reason, sensory diets are individualised to the specific person preferences and needs and monitored accordingly.
Sensory diets generally include activities that incorporate proprioceptive input, deep pressure and movement but may also include other sensory experiences, such as visual, auditory as well as oral motor and respiration activities (Wilbarger, 2002).
Sensory diets may also include environmental adaptations to assist functioning by promoting a more wakeful state such as opening the blinds in a room; or reducing distractions, such as decreasing visual stimuli on classroom walls.
Please speak with your Occupational Therapist for further details on development of a sensory diet for your child as part of their therapy.
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