Expert Tips on Helping Children with Sensory Processing Disorder: A Guide for Occupational Therapists

As occupational therapists, we play a crucial role in supporting children with sensory processing difficulties. Understanding the sensory system and implementing effective strategies can make a significant difference in helping these children thrive. In this guide, we will explore key points, provide explanations, and specific examples, and offer valuable tips for therapists working with children with Sensory Processing Disorder (SPD).

◆ WHAT ARE THE SENSES?

As occupational therapists, it is essential to have a solid understanding of the sensory system. The five senses commonly heard include sight (eyes), hearing (ears), taste (gustatory), smell (olfactory), and touch (skin). However, it's crucial to note that there are two additional senses: the vestibular sense (information about movement and head position) and the proprioceptive sense (information about our body parts/body awareness).

◆ WHAT IS SENSORY PROCESSING?

Sensory processing refers to the way children notice, process, and respond to sensory information. It is a fundamental aspect of their development and daily functioning. Children learn to register information from their senses, process it, and then respond appropriately. For example, they may notice and process the sound of an alarm clock going off in the morning, prompting them to wake up and get out of bed.

However, for children with SPD, this process can become challenging. They may struggle to notice, register, or process sensory information effectively, which can impact their participation in everyday tasks. Occupational therapy often becomes necessary when these difficulties hinder a child's ability to engage in daily activities.

◆ TYPES OF SENSORY PROCESSING DIFFICULTIES: OVER-RESPONSIVE AND UNDER-RESPONSIVE

Children with SPD can present with various sensory processing difficulties. It's essential to identify whether they are over-responsive or under-responsive to specific sensory input. Over-responsive children are quick to notice and highly aware of sensory information. Even a small stimulus can feel overwhelming to them. On the other hand, under-responsive children may not notice or process sensory input as effectively, often seeking additional sensory input or requiring support from others to register it.

It's crucial to understand that children with SPD can present differently. They may be over-responsive to touch and avoid wearing tight clothes, but at the same time, they could be under-responsive to movement and seem constantly on the go. Each child's sensory processing profile may vary, and it's essential to tailor our interventions accordingly.

Sensory Processing Tips and Strategies for Occupational Therapists:

OVER-RESPONSIVE TO SENSORY INPUT

• Can be sensory sensitive. ● Can be sensory defensive/sensory avoider.

Sensory Sensitive: Children who are sensory sensitive register sensory information intensely but do not necessarily remove themselves from the situation. They may appear easily distracted by noise, light, or touch.

Sensory Avoider: Children who are sensory avoiders register sensory information intensely and actively avoid certain experiences. They may avoid touch, situations with high sensory input, loud noises, or certain textures of foods.

UNDER-RESPONSIVE TO SENSORY INPUT

• Can be sensory seekers/Always on the go. ● Can be slow to register sensory information/lethargic/fatigued easily, bump into things easily.

Sensory Seeker: Children who are sensory seekers often appear always on the go, chew or bite non-food items, enjoy crashing and jumping, and have difficulty sitting still.

Slow to Register Sensory Input: Children who are slow to register sensory input may have low arousal, fatigue easily, appear slow to react and respond to environmental stimuli, display clumsiness, or frequently bump into objects.

As occupational therapists, our primary goal is to support children with sensory processing difficulties throughout their day and help them develop appropriate responses to sensory information. To achieve this, here are some recommended strategies and tips for therapists:

GENERAL STRATEGIES

1. Activities Can Be Alerting or Calming: Incorporate both alerting and calming activities into therapy sessions. Alerting activities include running, jumping, hopping, skipping, or using a trampoline, while calming activities involve heavy work, such as pushing, pulling, carrying, and weight-bearing activities.
2. Heavy Work Activities: Integrate heavy work activities, as they can be calming for over-responsive children, help refocus under-responsive/sensory-seeking children, and increase body awareness in children who are slow to register sensory input. Examples of heavy work activities include placing chairs on the desk or unstacking/stacking them, wall presses/pushes, chair push-ups/lifts, chair dips, and various animal walks like donkey kicks, bear walks, inchworm movements, seal walks, and wheelbarrow walking.
3. Consider the Child's Surroundings/Environment: Take into account the child's environment and make appropriate modifications. For example, reduce visual distractions in the bedroom by decluttering, create a designated calm space where the child can retreat when feeling overwhelmed, consider optimal seating arrangements in the classroom to minimize distractions, and trial the use of a "move n sit" cushion on their chair to provide movement for under-responsive/sensory-seeking children who struggle to remain seated. 

INCLUDE SENSORY PLAY ACTIVITIES IN THERAPY:

Sensory play is highly beneficial for both over-responsive/sensory-sensitive children and under-responsive/sensory-seeking children. Incorporate sensory play activities into therapy sessions to help children explore new sensory situations and provide the sensory input they need.

Here are some examples of sensory play activities:

• Messy play: Finger painting, shaping objects in shaving foam, and creating with flour paper mache.
• Arts and crafts: Gluing, pasting, and working with various textures such as cards, cotton wool, and crepe paper.
• Sand bins/boxes.
• Ball pits.
• Gardening: Potting plants, digging for worms.
• Baking: Making the dough.
• Barefoot play: Encourage playing barefoot in the grass or in a sandbox.
• Blowing bubbles and using party blowers/whistles.
• Smelling games: Hide scented objects in bags and explore through smelling.
• Tea parties and tasting sessions.
• Playground equipment offers various types of movement, such as trampolines, swings, slides, and climbing walls.

STRATEGIES TO SUPPORT SPECIFIC SENSORY NEEDS

Strategies to support specific sensory needs refer to a range of interventions and approaches used by occupational therapists to address the unique sensory challenges faced by individuals with Sensory Processing Disorder (SPD). These strategies are tailored to target specific sensory difficulties, such as over-responsiveness or under-responsiveness to sensory input. They may involve implementing activities, environmental modifications, and sensory play techniques to help individuals regulate their sensory experiences, enhance participation in daily activities, and promote overall well-being.

OVER-RESPONSIVE:

Touch: For children who are over-responsive to touch, incorporate tactile bins and deep pressure techniques. Tactile bins can be created using small storage boxes filled with various sensory textures like sand, rice, cotton balls, porridge flakes, or flour. Encourage the child to explore these textures gradually, starting with dry textures and progressing to wetter textures. Additionally, applying deep pressure through activities like bear hugs or providing deep pressure while washing their hair can help them tolerate touch better.

Clothing: Support children who struggle with clothing sensitivities by removing tags, using loose-fitting clothing, and seamless socks, and considering alternatives like a school tracksuit if the uniform causes distress.

Taste & Smells: Help children overcome aversions to certain tastes and smells by gradually introducing them through sensory play activities. Tactile bins can be useful for this purpose as well. Create a food chart to track their progress with new foods and make tasting sessions enjoyable and separate from mealtime.

Sound: Prepare children for loud noises by providing advance notice and using visual cues. Offer headphones, earmuffs, or ear defenders for times of intense noise. Additionally, introduce them to various sounds through headphones to familiarize them with new auditory stimuli.

Light: Make environmental modifications to reduce visual distractions and provide a calming atmosphere. Dim lights, consider colored light bulbs and adjust seating arrangements to minimize exposure to direct sunlight or glare.

UNDER-RESPONSIVE:

Seeking Movement: Incorporate alerting and heavy work activities throughout therapy sessions to meet the movement needs of under-responsive children. Provide opportunities for activities like jumping, swinging, and pushing/pulling to increase alertness. Use a wind-down routine before bedtime that includes heavy work activities to promote relaxation.

Fidgeting/Touch: Provide sensory tools such as feely objects or keyrings with different textures to redirect fidgeting and encourage appropriate touch exploration. Incorporate tactile bins, sand play, baking, and arts and crafts to offer more opportunities for touch throughout the day.

Biting and Chewing: Include activities that involve blowing, sucking, chewing, and crunching to satisfy the sensory-seeking needs of children. This can include blowing bubbles, using a straw for drinking, incorporating crunchy foods into their diet, and providing chewy toys or bracelets as alternatives to inappropriate chewing.

Lethargic/Slow to Get Going: Implement alerting activities before tasks that require attention and concentration to help wake up the child's sensory system. Use heavy work activities to increase arousal and provide a multisensory approach to learning. Consider the use of bright lights, color coding, and increased color contrast to promote alertness and attention to detail.

Final Thoughts:

As occupational therapists, our expertise in sensory processing is invaluable in helping children with SPD navigate their daily lives. These strategies and tips provide a foundation for designing effective interventions. However, it's important to remember that each child is unique, and individualized approaches are necessary. Continual assessment, collaboration with other professionals, and ongoing support will enable us to make a significant impact on the lives of these children and their families.

Remember, this guide serves as a starting point, and further advice and ideas specific to each child's needs can be discussed and tailored upon meeting with your occupational therapist.

To enhance your knowledge and skills in serving children with Sensory Processing Disorder, we recommend enrolling in the CEU Outlet continuing education course, 'Children with Sensory Processing Disorder - Serving and Understanding Their Needs.' This comprehensive course will provide you with essential knowledge about sensory processing disorder, including its symptoms, challenges in caring for children with the disorder, and typical behavior patterns of these children. Additionally, you will learn about various modifications and tools that can help improve treatment for children with sensory processing disorders.