SENSORY STRATEGIES FOR

SELF-REGULATION

Heather Harris, OTD, LOTRAshley M. Waguespack, MS, LOTR

The Center for Pediatric Therapy1713-C Ridgefield RoadThibodaux, LA 70301www.therapyforpeds.com

What is Occupational Therapy?

• Definition• Background/Training• Population of clients

SENSORY PROCESSING

At each moment a person takes in information from the environment or

his/her own body and must screen what is important to organize him or herself to

act on the environment

SENSORY PROCESSING

• Visual System (Sight)• Gustatory System (Taste)• Auditory System (Sound)• Olfactory System (Smell)• Tactile System (Touch)• Vestibular System (Movement)• Proprioceptive System (Muscle and Joint Input)

SENSORY PROCESSING DISORDERS

• The child with tactile dysfunction• The child with vestibular dysfunction• The child with proprioceptive dysfunction

WHAT WORKS FOR US?

• Which types of sensory input are comforting to our nervous systems? Which types bother us?

• Adult Sensory-Motor Preference Checklist

• How Does Your Engine Run? The Alert Program for Self-Regulation

WHAT WORKS FOR US?

• What do you put in your mouth?

• What do you prefer to touch?

• Which types of movement do you use?

• What are your visual preferences?

• What auditory input do you use?

WHAT WORKS FOR CHILDREN?

• What do they put in their mouths?

• How do they typically move themselves?

• What preferences do they show for touch?

• In what visual environment do they work best?

• How much and what type of auditory input seems to support them?

WHAT WORKS FOR CHILDREN?

• What is the child using currently for alerting and/or calming strategies?

• How do we expand his options for self-regulation?

• Which strategies have the longest effects on his levels of alertness?

• Which combination of sensory strategies support the child’s best functioning?

Replace—Don’t Extinguish Behaviors!Replace—Don’t Extinguish Behaviors!

SENSORY DIET

“Planned and scheduled activity program designed by an OT to specifically meet the needs of the child’s own nervous system”

“Purpose is to help the child become more focused, adaptable, skillful” (Kranowitz)

ALERT Program

• Put Something In Your Mouth!Put Something In Your Mouth!

• Touch!Touch!

• Move!Move!

• Look!Look!

• Listen!Listen!

PUT SOMETHING IN YOUR MOUTH!

• Food vs. Non Food Items• Consider: Sweet, Chewy, Crunchy, Sour/Tart,

Spicy, Cold, Warm, Sucking, Blowing, Tugging/Biting/Pulling

• Water Bottles/Sports Bottles• “Chewelry”/Chew Tubes• Making Music: Kazoos, whistles, party blowers,

silly noises and songs

TOUCH!

• Fidgets• Consider: Koosh balls, stress balls, small Slinkys,

drinking straws with flexible necks, paperclips, rubberbands, bendable figures, pipe cleaners, hair

scrunchies, worry stones, velcro under desk• Temperature Variables• Light and Deep Touch• “Cozy Corner”

MOVE!

• Variations of Intensity• Ways to Move: Up and Down, Front and Back,

Upside Down, Crash and Bump, Circles, Heavy Work

• Movement Breaks• RECESS!• Seating Options

– Disco Sit Cushion– Move-N-Sit Cushion– Therapy Ball– T-Stool

LOOK!

• Visual distractions

• Lighting

• Color

• Visual Toys

LISTEN!

• Music

• White Noise

• Earplugs and Headphones

SENSORY STRATEGIES

ALERTING• Crunching dry cereal, chips, crackers, popcorn,

nuts, carrots, pretzels, celery, apples• Taking a shower• Joint compression• Vibrating input (massage bug)• Bouncing on a ball • Jumping up and down on a mattress,

trampoline• Sour or spicy candy (lemonhead, hot tamale)

SENSORY STRATEGIES

ORGANIZING• Chewing granola or fruit bars, dried fruit, gums,

bagels – resistive, chew tubes, “chewelry”• Hanging from a trapeze or monkey bar• Pushing or pulling heavy loads• Inverted positions• Blow Toys, bubbles • Bubble bin (pickle jar with tubing)

SENSORY STRATEGIES

CALMING • DEEP PRESSURE = MOST EFFECTIVE• Eat, suck, chew thick liquids or soft substances • Sucking hard candy, frozen fruit bar, spoon of

peanut butter• Isometrics (pushing against wall with hands,

shoulders, back, head)• Rock, sway, swing slowly back and forth• Back rub• Taking a bath

HEAVY WORK IDEAS• Push chairs under table• Carry heavy objects• Roll up in a heavy mat• Sandwich the child between pillows• Use crunchy or chewy snacks for heavy work to the mouth• Erase or wash board, wipe tables• Catch/throw weighted objects (beanbags, thick/padded ball)• Carry a tray with books on it• Move backpacks to a corner in the room• Weighted vest or lap pad• Theraband on chair legs• Clay writing• Chair push ups

SENSORY STRATEGIES

CALMING • Slow, rhythmical, repetitive activities – rock,

sing, swing• Dimmed lighting or blocking visual input

(hideout, tent, lie under blanket)• Hideout• Neutral warmth – blankets, lycra and spandex

work well• Swing upright or on stomach in linear direction• Reduce fluorescent lighting

CHANGING THE ENVIRONMENT

Reduce Sensory Overload

Visual Distractions• Reduce clutter; secure artwork to walls; use a sheet to cover

open shelves with toys, games, etc in open view; remove things hanging from ceiling

• sit child with back to peers; may place the overaroused child by a child who is calm, still

• quiet corner, room dividers• soft or neutral colors, consider natural lighting, halogen lights• visual timer

CHANGING THE ENVIRONMENT

Auditory Distractions• Hard surfaces reflect sound (desk, floor, tables); cover with

cloth, carpet, corkboard when able; Bach, Mozart, background music, white noise machines, headphones, quiet corner, Consider how different music affects levels of alertness

Olfactory Distractions• Keep pets, paint supplies, aromatic materials away from

desks, use vanilla and lavender to diffuse smells and odorsTactile Distractions

• Consider nearness of classmates, seat near corner or teacher, respect the need for space, provide opportunities for deep touch pressure

• Consider using lycra or weighted sensory tools

CHANGING THE ENVIRONMENT

Provide a quiet space (tent or teepee) to help the child regroup and organize

Chair: dycem or corduroy in the seat if slipping; Disc-o-sit; ball chair

Take shoes off and have a carpet square, pillow, or sandpaper for their feet; wrap theraband around chair leg for quiet kicking

Routine: they may have trouble organizing themselves, so provide assistance to do this through structure; keep a list of pictures on the board (pictures)

CHANGING THE ENVIRONMENT

Movement breaksProvide acceptable ways for fidgety kids to

move, including stand and stretch, reach to the sky, stomp the floor, stand and jump 5 times

InstructionsShort and simple; try to gain eye contact first if

possible

Praise effort not performance!

CHANGING THE ENVIRONMENT

Respect sensory preferences. It may take the child’s entire cognitive and

emotional energy just to sit still, fidgeting may be necessary to maintain

focusVoice: low is best;high pitched and animated will

increase arousal levelPhysical Cues: get close, put hands on shoulders

and apply firm pressure, approach from the front where child can see you, use firm touch, not light touch; use whole hand

TRANSITIONS

Plan carefully! Allow plenty of time

• Notify in advance “After snack time, we will …”• Push or carry heavy object• Walk behind the child and provide

compressions to shoulders or hold their hand and skip, dance, hop to new activity

• Keep a list of pictures on the board of the day’s activities to help with sequencing

TRANSITIONS

• Give more notice if the change is out of the ordinary

• Signify what will happen next with CLAPPING or BEATING drum rhythms; I.e. two long claps followed by 3 short claps = nap time

• Can also sing songs or recite ABC’s, count to 10 altogether

• Can provide regular environmental cue, such as flashing light on/off, playing a song, blowing a whistle 3 times, etc.

PLAY!

• “Play is the work of children. Through play, they learn about themselves and the world around them. When all they see, hear, and feel makes sense to them, we believe their brains and bodies are ready to learn.” (Sensory Integration International 1991)

ReferencesAmy Fuselier, LOTR. (2006) Abilities, Baton Rouge, LA.Abraham, M.C. (2002). Addressing Learning Differences: Sensory Integration: Practical Strategies

and Sensory Motor Activities for Use in the Classroom. Michigan: Ayres, J. (1972). Sensory Integration and the Child. Los Angeles: Western Psychological Services.Bundy, A.(1992). Using Sensory Integration to Solve Problems at Home and School. Course

materials.Bundy, A.C., Lane, S.J. & Murray, E.A. (eds). (2002). Sensory Integration: Theory and Practice. (2nd

ed). Philadelphia: F.A. Davis.Case-Smith, J., Allen, A.S., & Pratt, P.N. (1996). Occupational therapy for children. (3rd ed.). St.

Louis: Mosby. Kranowitz, Carol Stock. (1998). The Out-of-Sync Child. New York: Berkley Publishing Group. Kranowitz, Carol Stock (2003). The Out-of-Sync Child Has Fun. New York: Penguin.Oetter, P. & Richter, E. M.O.R.E. Integrating the Mouth with Sensory and Postural FunctionsTrott, M. (1993). SenseAbilties: Understanding Sensory Integration. (1993). New York: Therapy Skill

Builders.Williams, M.S. & Shellenberger, S. (1996). How Does Your Engine Run? A Leader’s Guide to the

Alert Program for Self-Regulation. Albuquerque: TherapyWorks.Williams, M.S. & Shellenberger, S. (2001). Take Five! Staying Alert at Home and School.

Albuquerque: Therapyworks.* Ideas were also adapted from literature provided by Occupational Therapy Associates,

Watertown, MA.

1713-C Ridgefield RoadThibodaux, LA 70301

985-449-0944www.therapyforpeds.com