Why we Need to Support Directional Concepts in OT

Picture of feet with two arrows pointing left and right. Text reads "directional concepts" and has a definition of directional concepts in functional tasks.

Following directions can mean a lot of things.  Following commands, making something, or getting somewhere. Today we are going to focus on directional concepts.  Directionality is the ability to understand and use information related to direction and space. This includes understanding concepts like left/right, up/down, in front of/behind, above/below, inside/outside, etc. Thankfully, we are not going to cover things like, “turn west out of the parking lot,” because no one understands that anyway.  There is a relationship to body awareness and proprioception at stake here, too.

Picture of feet with two arrows pointing left and right. Text reads "directional concepts" and has a definition of directional concepts in functional tasks.

The reason we need to worry about this in therapy sessions is that the a spatial relations concepts are very important to functional tasks.

We will take a look at following directions, direction signs and words, body in space to find your way and activities to help enhance directional concepts.

What are DIRECTIONAL CONCEPTS

You may have recently seen our post on left right discrimination.  Directional concepts take it one step further.

Not only do you need to know left from right, but behind, in front, before, after, beside, inside, and dozens more.  Coincidentally, many of the directional words are prepositions (or many prepositions are directional words).  These are spatial relations words like:

  • over/under
  • left/right
  • above/below
  • east/west
  • in front/behind
  • near/far

These words are important to direction following.

Popular singer Jack Hartman has a catchy preposition song.  There are lots of songs about directional concepts on youtube if that is your preferred method of teaching.

Children's fingers on cars pointing in different directions. Another picture with hands moving a Rubik cube. Text reads "directional concepts in play"

In occupational therapy, we use play to support development of skills. It’s an easy tool to help kids understand spatial relations concepts.

How to Work on Directional Concepts Through Play

Occupational therapy and play go hand in hand. It is the primary role of the child, after all. Luckily, we can use play as a tool to support development of skills like directional concepts at any age.

The best way to learn is by doing. Getting kids up and moving is a great way to teach directional concepts. Kids can memorize prepositions and direction words all day long, but they will learn faster by engaging in movement activities.

  • Use a stuffed animal or toys for following directions – ask students to put their bear on the table, behind the plant, below a chair, etc.
  • Body movement – kids can work on directionality by following commands. Say things like jump on the bed, jump off the bed, go around the trash can, crawl under the table. As they move their body, your learners will make a connection with the word and action
  • Obstacle course – create a course in your clinic/class/home for learners to follow. Give verbal, picture, or demonstration instructions. They can be: go around the table, then under the chair, then over the yellow mat, through the tunnel, up the slide, etc.  
  • Simon Says – this classic game is all about giving and following directions. Simon says touch your left hand to your right ear. Travel west across the room (just kidding).  Put your left leg in front of you.  Directions can be as simple or complex as your learners can handle
  • Relay races – these can combine obstacle courses and Simon Says commands all in one
  • Hula hoop games – use a hula hoop as a prop for following directions. Put one foot in the hoop. Put the hoop over your head. Stand behind the hoop
  • Hokey Pokey – this classic song is a great practice for in/out, left/right, and body parts
  • Line dance songs – the Cha Cha Slide, Cupid Shuffle, and several other line dance songs combine several different directions in the song.  These fast paced songs not only get kids moving, but they learn to follow directions while having fun
Picture of a cone with a ball on top. Text reads " how to teach directional concepts".

Teaching directional concepts is important for kids.

MORE WAYS TO TEACH DIRECTIONAL CONCEPTS

Beyond getting up and moving, here are some tricks to teaching directional concepts:

  • Teach in opposites – we already reviewed left and right, but how about up/down, on/off, in front/behind, before/after
  • Use visual cues – pictures help learners associate an action with words. Look at books, picture cards, signs, or videos. 
  • Positional songs – singing helps language development, increase memory, and understand concepts. Help your young learners master positional/directional words with these circle time songs that your students will love! This resource is packed with simple, memorable songs (set to childhood tunes you probably already know) that will capture the attention of your students and keep them engaged and learning. You’ll find headers, posters, and printables, too, to help you teach the important early childhood topic of spatial relations!
  • Task boxes – simple task boxes are a great visual hands-on method of teaching concepts. Make laminated cards and use clothespins or clips to match the concept with the word.
  • Interactive books are another great way to teach directional concepts. 
  • Chunking – teach in small chunks instead of lots of concepts all at once. For example, maybe one week you work on up and down, incorporating many activities for these two words in isolation.
  • Barrier games – this is a great concept for learning directional concepts. Students can work in pairs, or you can have an adult work with each learner. Students sit across from each other with a barrier between them. Each player has the same items. The students take turns giving the other player very specific directions (per ability level) on how to arrange the materials in front of them. The goal of the game is to have all the players’ materials look the same at the end of the activity.
  • Mental Blox (Amazon affiliate link)- this is a great game. One of the sub games in it is giving and following directions. Instead of students copying the card, give them directions to make their design without seeing the card. Then they can try and teach the concepts to you or another student.
  • Writing on a vertical surface or slant board – I recently wrote a post on the benefits of writing on a vertical surface. One of them was understanding concepts of up and down better. If you think about it, “up” makes more sense on a wall than a flat piece of paper
  • Teaching over, under, around and through – right here on the Toolbox you can find great resources for teaching direction.
Picture of many directional worksheets. Text reads " directional concept worksheets"

Another tool to have in your therapy toolbox is a variety of movement and spatial relations worksheets like we have inside The OT Toolbox membership club.

WORKSHEETS AND PAPER PENCIL GAME FOR DIRECTIONAL CONCEPTS

A great way to round off your lessons on directional concepts and following directions, is to put pencil to paper. Writing things down can help with muscle memory and understanding.

We have many worksheets to teach directional skills inside The OT Toolbox Membership.

DIRECTIONAL CONCEPTS in Occupational Therapy

After all this research, I am inspired into adding new activities to my toolbox. I have a better understanding of what directional concepts mean, and how to facilitate learning.  I still need someone to explain what “turn west out of the parking lot means.”

It’s important to recognize that when we tell our students a direction, there might be directional challenges at play that impact functioning skills.

Victoria Wood, OTR/L is a contributor to The OT Toolbox and has been providing Occupational Therapy treatment in pediatrics for more than 25 years. She has practiced in hospital settings (inpatient, outpatient, NICU, PICU), school systems, and outpatient clinics in several states. She has treated hundreds of children with various sensory processing dysfunction in the areas of behavior, gross/fine motor skills, social skills and self-care. Ms. Wood has also been a featured speaker at seminars, webinars, and school staff development training. She is the author of Seeing your Home and Community with Sensory Eyes.

Skipping Activities for Kids

text reads "how I taught a child to skip in occupational therapy" image shows dots with arrows for skipping.

Young children often ask to learn to skip. Here, you’ll discover skipping activities for kids, as well as specific strategies to teach children how to skip. Skipping is an important gross motor target. For some children, learning to skip is a real challenge! 

I wanted to update this resource on teaching kids to skip with additional skipping activities I’ve personally used in therapy sessions. You can find that information at the bottom of this page.

These skipping activities are fun ways to teach kids to skip.

Learn to Skip with Skipping Activities

If you have ever spent time in an elementary school, you may have noticed that the youngest members of the school community, specifically kindergarteners, hardly ever walk from place to place… they skip (and hop, jump, twirl, and gallop, too)!

Skipping is a developmental milestone or marker that generally emerges around age 5, with a range of age 4-6 years.  For many kids, skipping emerges without intervention, just the way reaching, crawling, or walking develops. 

For kids who struggle with gross motor skills and bilateral coordination, direct teaching may be necessary to develop this critical skill.  Once the basics are learned, skipping activities are a great way to practice.

learning to skip requires motor planning and sensory integration

Skipping is such a perfect example of motor planning and sensory integration.  It requires ideation (having the idea about how to move), planning (sequencing the movement), and execution (carrying out the movement).  

For a person to execute the motor plan of skipping, the coordinated effort of sensory systems and the brain is required. 

Skipping also provides excellent sensory input. No wonder kindergarteners like to skip from place to place… the vestibular and proprioceptive input they receive is a natural reward for all their hard work in mastering the skill!

what about bilateral coordination?

The ability to coordinate the two sides of the body involved in learning how to skip requires balance, strength, motor planning, and bilateral coordination. Bilateral coordination refers to the ability of the brain and body to process and integrate information from both sides of the brain to respond with movements in a coordinated manner. 

Many functional tasks and daily activities, such as feeding, dressing, and writing rely on bilateral coordination. 

Being able to coordinate both sides of the body is also a foundation skill for gross motor coordination activities such as walking, running, galloping and skipping.

Wondering how to teach skipping? This blog post breaks down the steps of skipping.

How to Teach Skipping

When you have a goal for a child to learn to skip, it is important to make sure that you address all of the components of skipping.  Teaching kids to skip starts with seeing what skills the individual is able to do. There are skills that are required to skip. Can the child balance on one foot and hop? Does the child have a dominant leg? Can they gallop or perform a different version of skipping? These are all good questions to ask when teaching skipping skills.

First, evaluate and observe the following gross motor skills needed for skipping:

  • Balance – check to make sure they can balance on either foot
  • Hopping – are they able to hop in place on each foot?  Are they able to hop forward on one foot?  Have them try to take 5 hops forward on either foot
  • Leg dominance – it may be helpful to know if they have a preferred leg for activities like hopping or kicking
  • Galloping – are they able to gallop? Can they gallop on either side?  This is more of a unilateral skill, which is often easier for kids who demonstrate difficulty with bilateral coordination skills.

If any of the above skills are weak, start with developing balance and hopping.  Then progress to galloping, followed by skipping. 

Then, use these strategies to teach skipping:

  1. To teach skipping, start by breaking down the steps for the child.  Provide a demonstration and simple verbal cues like “Step, hop, switch”.  You may need to provide a visual cue as well, using colored dots or markers on the floor, such as these (Amazon affiliate link) Little Polly Markers.

2. Once the child is able to complete the “step, hop, switch” sequence. This can be a very slow process at first. Some kids will need to think through the motor plan of each step. That’s ok! Use visual and verbal cues to work on the step with one foot, the hop, and the switch to the other foot.

3. Work to improve their fluency and speed of the step, hop switch sequence. Use these steps in an obstacle course or a relay activity to work on speed and gross motor coordination to improve fluent motor skills.

3. As they master the skill of skipping, you can encourage them to incorporate their upper body into the movement as well. Show them how to swing their arms in coordination with the legs. This will become more fluent and integrated with practice.  

Working on the coordination and motor planning to master learning to skip involves more than just a hop and a skip. Skipping is a complex task, but once you break it down and address underlying skill areas, it becomes easier. 

Skipping Activities

Here are some gross motor coordination games and skipping activities that address bilateral coordination and motor skills:

  • Obstacle courses – set up a simple hopping and jumping obstacle course inside or outside.  Use pool noodles to jump over with two feet, hop in and out of hula hoops, jump over cardboard bricks, etc.  Here is a post about Outdoor Lawn Games with lots of ideas for using backyard toys and equipment to address gross motor coordination skills.
  • This Ultra Dash Game (affiliate link) is fun for kids of all ages!  You can set up an obstacle course in various ways and then the kids have to race to match the colors from the wand to the colored base.  You could incorporate skipping, jumping, and hopping into this game to work on those skills in a new way.
  • Use gross motor toys to work on balance, coordination, motor planning, and core strength.
  • Use a long jump rope to hop over on one foot. 
  • Stand like a flamingo. Try freeze dance games with a flamingo theme. When the music stops, players have to hold one leg up like a flamingo!
  • Simon says- Incorporate the hop and jump tasks needed in the task of skipping. Use these Simon Says commands in therapy sessions.
  • Yoga is a great activity to build body awareness, gross motor skills, and bilateral coordination.  Here are several different kids yoga resources:
  • Skip ball (affiliate link)- this toy is a fun tool to practice skipping skills
  • Chinese Jump Rope (affiliate link) – who remembers this classic toy? Relive your childhood while passing on this great game
  • Mini Trampoline (affiliate link)- these are great to work on jumping, hopping, coordination, following directions, all great skills to teach skipping
  • Musical Hippity Hop Stick – this rotating stick encourages children to jump over the stick as it rotates by. If the stick touches them, the game is over. Practice this with two feet first, then try hopping over the stick
  • Hopscotch!  Don’t forget about this one!  All you need is some chalk and a sunny day to get outside and practice hopping and jumping.  This would be a great activity to set up on the playground for kids to work on skipping skills during recess. Not ready for outside play? Use painter’s tape down the hallway.

Teach Skipping in Occupational Therapy

One thing I love about occupational therapy is that we can help kids with the skills they want to do. I’ve had a few kids that request things like learning to pump a swing so they can play on the swings at recess, or how to do a cartwheel even when body awareness and crossing midline is a problem.

I’ve had a child or two that wanted to learn how to skip. They wanted to skip because their peers do this at recess and they found themselves missing out. The fact is that skipping is a childhood classic! One student in particular wanted to learn to skip so they could skip down their road after getting off the school bus at the end of the school day.

Isn’t occupational therapy cool?! We get to help our clients do the things that matter the most to them, and if that’s skipping, hey, that’s what we are going to work on in OT sessions!


text reads "how I taught a child to skip in occupational therapy" image shows dots with arrows for skipping.

Here’s how I taught one child to skip in our occupational therapy sessions…

Skipping Goals in OT

Some physical therapists might argue that skipping is PT’s domain. But when we are talking about the function and the actual skill that is involved and the child’s motivation to do this task as part of play or functional tasks, we’ve got a great OT goal.

For my kiddo that wanted to skip at recess, this is exactly what I’m talking about. This particular student wanted to participate in her school day with her peers, and the function was play.

The skills we need to assess are:

Another area that’s not often considered when it comes to breaking down the task of skipping is Related, are the concepts of dominance and mixed dominance vs. ambidexterity. This is where occupational therapy can help because we do think of all of these components!

I helped this student to work on skipping by segmenting the movements into steps. We came up with a routine of sorts. This really helped this particular child because they were really interested in dance and movement. So putting the steps of skipping into a routine with step by step movements really helped her.

I had her step on a colored dot on the floor with one foot. Then I had her pick up her opposite knee by pulling it up to her trunk section. This step took a little practice because of balance and coordination of the movements. We added some animal poses into the therapy sessions to work on the core strength, balance, and coordination. It also was a great regulation activity for her.

Then, once she had that step down pat, I had her hop on one foot to another colored dot. We used different colors to add a visual cue to the steps.

Then, once she was able to do the hop we repeated the process with the other foot.

Then we put it all together into repeated movements.

She was able to move really slowly through the steps of skipping by using a pattern of colored dots on the floor. I started with big therapy dots and then we moved onto small round stickers.

It worked really well! She was very motivated to complete this task so that helped, but by using this process over and over again, she really got the steps and motor planning down to learn the steps of skipping. It became an automatic motion.

Then, we added in the component of peers and a busy environment by doing the activity outside in the actual space, the playground. Success!

Colleen Beck, OTR/L has been an occupational therapist since 2000, working in school-based, hand therapy, outpatient peds, EI, and SNF. Colleen created The OT Toolbox to inspire therapists, teachers, and parents with easy and fun tools to help children thrive. Read her story about going from an OT making $3/hour (after paying for kids’ childcare) to a full-time OT resource creator for millions of readers. Want to collaborate? Send an email to contact@theottoolbox.com.

Sitting Positions on the Floor

Image has pictures of different sitting pictures and labels of names of sitting positions.

In this post we will explore the classic crisscross style of sitting, as well as acceptable alternative sitting positions on the floor. We will explore floor sitting for circle time, gym class, and other classroom learning situations. Not only are we learning about alternative sitting positions on the floor, I am hopeful you will become an advocate for the students you serve. Another resource to check out is our post on flexible seating options for the classroom.

children sitting on the floor in different positions, text reads "sitting positions"

There are many versions of sitting positions on the floor and depending on the sensory motor considerations of each child, these floor sitting positions facilitate learning.

Image has pictures of different sitting pictures and labels of names of sitting positions.

We made this image of types of sitting positions but this visual is just the beginning. There are many other sitting positions that can be used for comfort, function, and sustained positioning on the floor.

Sitting positions on the floor

At least ten times a day I hear a teacher say, “come on in and sit crisscross applesauce.”  This type of cross-legged sitting used to be called “Indian style” or “Tailor sit” before that was deemed insensitive. I cringe when I hear this, not only because of the silly name “crisscross applesauce, but because this sitting position on the floor should not be a universal request, or the only choice students have for seating.

In the preschool setting, we usually have a circle time or floor activities where sitting on the floor is part of the school day. For kids that struggle with sensory motor skills, this can be a real challenge.

Read our blog post about Crossing Midline Activities for Preschoolers for a developmental explanation of this age range and how we can support young kids in functional midline tasks like sitting on the floor for story time or for preschool circle time.

One way to support these sitting positions is by using a ball pit as a therapy tool.

Types of SITTING POSTIONS ON THE FLOOR

There are several different types of sitting positions on the floor that are seen in classrooms. There are pros and cons to all of them.

Teachers may tell you that sitting on the floor in one specific way (criss cross applesauce) creates uniformity and structure. If everyone is sitting quietly in the same position, there is less distraction in the group.  Children benefit from rules and regulations. 

This is a great answer, however, not all children can comfortably sit in this position, thus causing more distraction as they struggle to find a comfortable seating posture or retain crisscross applesauce.

You might see a version of these various sitting postures during circle time activities, during play, or during various centers. Let’s go over each type of sitting position.

Cross-legged position

Since “crisscross applesauce” or cross-legged position is the most often used, let us start there.

This cross-legged position involves both knees bent, crossing feet at the ankle, with both ankles on the floor.

There is a rhyme that accompanies the crisscross applesauce phrase:

“Crisscross, applesauce

Hands on lap, gingersnap

Sit up straight, chocolate cake

On your rear, root beer

Zip your lip, cool whip.

Shhh, now you are ready to listen!”

Pros of Criss Cross Applesauce Sitting Position: the body is in a compact form with legs and arms “inside the vehicle.” It is a universal sitting position, known or taught to most children. If everyone is in the same sitting positions on the floor, there tends to be uniformity and less distracting chaos.

Cons of Criss Cross Applesauce Sitting Position: it is uncomfortable for many people. It can be difficult to stay in the same position for long periods of time, due to fatigue, discomfort, sensory challenges, and inattentiveness. There is not a wide base of support with the knees off the ground and arms tucked inside the lap.  Some students need more support.

W-Sit

Did you ever try to W sit? Do you know what a W sitting position looks like?

I know many of you are cringing just thinking about the dreaded “w-sit.”  It is a popular sitting position on the floor among young children, especially those with low strength and/or muscle tone.

In this position the legs literally form the letter W on the floor. When a child sits in a W sit position, their hips are internally rotated, while the knees are bent facing the midline, and the feet are positioned away from each side of the body.

Pros of the W Sit Position: offers great stability while playing, due to the wide base of support.  It is very comfortable for long periods of time, for those flexible enough to effectively achieve this position.

Cons of the W Sit Position: w-sitting is terrible for the knees and hips.  They are not meant to be in this position long periods of time. This wide based sitting position on the floor takes up a lot of space, especially when there are several children seated close to each other.  The hands do not naturally have a “bunny hole” to go into to keep them busy while sitting.

Prolonged w sitting can be a sign of developmental difficulties. For others, w sitting offers a wider base of support which offers more proximal stability so the individual can use the arms and hands with refined dexterity. For the individual who struggles with core strength and stability, and sitting balance, a W sitting position can help with attention and focus.

Children’s Hospital of Los Angeles has a different opinion. Their research claims that w-sitting does not cause hip problems, and most often children, by the age of eight, grow out of this habit on their own. 

Dr. Goldstein explains, some children have more inward twist in their thigh bones than other children, so they can easily bring their knees in and feet out. In fact, for some children, sitting with their legs crossed in front of them may be uncomfortable because their thigh bones have less twist in the forward position than the inward position.

Note: some children need this wide base in order to sit for several minutes. Without this wide base, they are unable to use the rest of their body to play with toys and engage. As they build core strength, students may be able to transition to a cross-legged pose.

Long Legged Sitting position on the floor

In this sitting posture, the hips are generally at 90 degrees with the legs extended out in front. The width of the legs, or how far apart the feet are, may vary depending on the type of support needed, and tightness in the back and hip structures.

There are times when this is the only position a person can achieve on the floor due to tightness in the hips or legs. 

Long legged sitting is a typical stage of development in children as they gain core strength, but is integrated into higher level sitting positions.

Pros of the Long Legged Sitting Position: it can offer a larger base of support than cross-legged sitting.  Long sitting may be comfortable. This position may provide enough support to free the upper body to move and engage.

Cons of of the Long Legged Sitting Position: this sitting pose takes up a lot of room.  If 30 children in the class sit like this, they will run out of carpet space. Long sitting can lead to posterior pelvic tilt, or slouching due to the stretch of the muscles, although some people have remarkable posture in this position.  It can lead to increased tightness as the student bends their knees or abducts their legs to get comfortable, thus making it difficult to straighten their legs later.  It is hard to reach forward to play with items while in this position. Sometimes this position is less stable as the child can easily tip over to the side or lean back too far. 

As with w-sit, some children can only sit in this position due to disability, tightness/weakness of muscles, or instability. In my opinion it is better to allow a person to sit this way, if sitting in other positions impairs their function.  The end goal is function.

An alternate seating option related to the long leg sitting posture is:

  • Bent Long Sit- The legs are both forward and the knees are bent. In yoga, this might be called a mountain sitting posture
  • Bent Legs Holding Knees- This position has the individual sitting with their legs in front of them with the knees bent. They may lean forward and hug the knees.

Mermaid Sitting Position

An alternative to the long leg sitting position is the mermaid sitting style, where the knees are both positioned to the side and back, in the same direction. This positioning offers greater base of support.

Short kneel Sitting Position

In the short kneel sitting position on the floor, the learner is sitting on their feet with their legs tucked under them.  This position can offer not only comfort, but needed sensory input.

Short kneel is a developmental milestone that leads to pulling up to stand.

Pros of a short kneel sitting position on the floor: this is a compact position with the legs tucked underneath.  It can be comfortable for long periods of time. Short kneel provides proprioceptive or deep pressure input while sitting, and often helps with self-regulation needed to attend to a lesson.

Cons of a short kneel sitting position on the floor: children are sitting up higher in this position, making it difficult for those behind them to see. It can cause pain in the knees.

An alternative sitting position to the kneel sit is:

  • Open knees kneel sit– the individual sits on their legs with their feet tucked under their bottom, but the knees are spread apart. This option offers greater base of support and stability through the core.
Drawings of deferent sitting positions showing posture and deferent positioning of legs and arms in sitting postures.

Image of different sitting positions on the floor from the World Distribution of Postural Habits, published in American Anthropologist in 1955.

These are the most common alternate sitting positions on the floor we see in schools. There is also side sit, lotus, squat, tall kneel, and more. This drawing illustrates over 35 different sitting positions on the floor!

How to offer alternative seating positioning on the floor

  • Teach children to stay in their personal space without touching others. You can do this by using a carpet with colored squares, taping squares to the floor, using rug samples, or mini swimming pools for each student.
  • Teach children that they cannot block another student’s vision of the circle time activity.
  • Unobtrusively put out the new possible seating options (cushions, fidget toys, lap pads, etc.) during free play so they are not so new and exciting that they take children’s attention away from the circle time activity.
  • Teachers can offer chairs in the back of the circle time area. Cube chairs, stadium seats, carboard boxes, wiggle cushions, or other alternatives. Consider DIY seating options.
  • How about weighted lap pads for children who cannot stay in one spot? They can be as simple as a sock weighted with rice, or sitting with a heavy backpack.
  • What about those children who seem to be in constant motion? Maybe they can have a squishy ball or fidget toy.  This opens another can of worms. Fidgets need to be tools, not toys, and taught to be used in a non-distracting manner. Here are some quiet fidgets you can try.  This article, The Ultimate Guide to Fidgets on the OT Toolbox provides some great ideas.
  • Maybe children who do not want to come to circle time can do a quiet activity in another area of the room.  While this does not seem like the right idea, it can allow the other 24 children to have a successful lesson.  Then work on problem solving getting this student involved in circle time.
  • Respect children’s attention span and keep circle time to 10 minutes.
  • Plan your circle time to include a welcoming time, an activity focus, and a closing tradition.
  • Tell children daily what is going to happen at circle time, first, second, third, so they know what to expect.

Neurodiversity and sitting positions on the floor

Above we illustrated some good reasons for children to all sit cross-legged on the floor. If all the students in today’s classrooms were neurotypical, with average tone, muscle strength, attention, and self-regulation, teachers might be able to expect all their students to sit in a uniform fashion.

However, classes are full of neurodivergent students who do not fit into the same box as typical peers.

Focus in classrooms needs to be on learning, not sitting positions on the floor.  In my opinion, as an occupational therapist, we need to offer students more options in classrooms to enhance their learning potential.

Some teachers are getting on board with this, while others are resistant to change. If you are a therapist in the schools, a big part of your role is education. Use your knowledge to explain why you are requesting changes to the classroom.

Victoria Wood, OTR/L is a contributor to The OT Toolbox and has been providing Occupational Therapy treatment in pediatrics for more than 25 years. She has practiced in hospital settings (inpatient, outpatient, NICU, PICU), school systems, and outpatient clinics in several states. She has treated hundreds of children with various sensory processing dysfunction in the areas of behavior, gross/fine motor skills, social skills and self-care. Ms. Wood has also been a featured speaker at seminars, webinars, and school staff development training. She is the author of Seeing your Home and Community with Sensory Eyes.

references on Sitting Positions on the Floor

Hewes, Gordon W. “World Distribution of Certain Postural Habits.” American Anthropologist, vol. 57, no. 2, 1955, pp. 231–44. JSTOR, http://www.jstor.org/stable/666393. Accessed 26 Sept. 2023.

How to Create a Sensory Diet

steps to create a sensory diet

Here you’ll discover how to create a sensory diet through information on sensory diets as well as a powerful resource to set up and establish an effective sensory diet lifestyle that works for kids. We’ve shared a lot of information about creating a sensory diet. There is a valid reason. Besides the growing need for sensory support for kids with sensory processing disorder or sensory challenges, there is a real need for parents and teachers to understand exactly what a sensory diet is and how it can help address sensory needs.  

steps to create a sensory diet

We’ll get into the steps to create a sensory diet below. Let’s first talk about how and why we need to make sensory diets.

The tips below are strategies for creating a sensory diet that can be effective and helpful in enabling a successful sensory lifestyle. Understanding how does a sensory diet help is many times, the first step in addressing sensory related needs!

Sensory diets can change the self regulation level that one is at, whether that be overstimulated and overwhelmed by the environment and internal state, or needing to become more alert. Sensory diet strategies can support these needs in any environment.

How to Create a Sensory Diet

Whether you are wondering exactly what a sensory diet entails or why a sensory diet can be effective in addressing underlying sensory needs, knowing how to create a sensory diet using the tools a child needs is essential. 

Below, you’ll find answers to questions about how to create a sensory diet and what exactly a sensory diet is. If you are wondering how does a sensory diet work, then read on! 

You can make a sensory diet in any space. Read our blog posts about creating a sensory diet on a budget and calm down corners for more information on creating a sensory diet in a specific space in the school environment.

 

Wondering how to create a sensory diet? Use these steps to create a sensory diet for children with sensory needs that result in meltdowns, attention challenges, struggles with regulation, and other sensory processing related difficulties. Perfect for the occupational therapist who works with kids with sensory needs.

The Sensory Lifestyle Handbook is a resource for creating sensory diets and turning them into a lifestyle of sensory success through meaningful and motivating sensory enrichment.

What is a sensory diet? 

First, it can be helpful to explain exactly what a sensory diet is. A sensory diet is a specific set of sensory activities designed to meet specific needs of the individual. Creation of a sensory diet requires assessment and trial followed by analysis and continued monitoring of strategies and their effectiveness. 

An occupational therapist named Patricia Wilbarger came up with the term sensory diet to describe the brain’s need for more sensory-motor input from the various sensory systems. Just like our body requires a nutritional diet of healthy foods, the sensory diet is designed to support a person’s sensory needs.

One thing that is important to remember is that without adequate and appropriate sensory input, or sensory input that isn’t registered correctly, we can have sensory deprivation or we can feel out of sorts. It’s hard to be alert and attentive when this happens! That means that learning, participating in social situations, and functioning in everyday tasks can be difficult.

Studies support the use of active participation in multi-sensory activities for at least 90 minutes per week to improve occupational performance and autism symptoms and behaviors (Fazlioglu & Baran, 2008; Thompson, 2011; Woo & Leon, 2013; Wuang, Wang, Huang, & Su 2010).

Children who have a toolbox of sensory activities available to them for daily use may benefit from prescribed sensory activities. A sensory-based strategy guide can help.

Sensory diets are a commonly known strategy for addressing sensory needs. The term “sensory diet” was coined by Patricia Wilbarger in 1984 to explain how certain sensory experiences can improve occupational performance and help to remediate disruption of the sensory processing systems. A sensory diet is a means to adjust sensory input in relation to an individual’s needs.

Remember that each and every person has their own specific needs. Some of us like a heavy blanket laying on us when we sleep. Others prefer a light and airy sheet as a bed covering. This sensory preference is just one example in one part of the day, and one specific daily occupation that describes different sensory preferences. Another way to put it is to call these preferences a sensory need. We each have different needs when it comes to the tactile, motor, tastes, smells, etc. that allow us to function.

Similarly, a sensory diet designed to support regulation and sensory processing will be different for every individual. It can be considered a formula that allows each individual to process input and function during their day.

Sensory diets can include various sensory strategies and supports that help the individual to regulate. Some additional movements, or activities can include:

A sensory diet is a meaningful set of strategies for developing sensory programs that are practical, carefully scheduled, and controlled in order to affect functioning. Sensory diet activities provide appropriate sensory input based on the needs of an individual.

Just as a healthy diet consists of a variety of foods, a sensory diet is a balanced set of sensory information that allows an individual to function. A person cannot survive on broccoli alone. Similarly, a child cannot function with only one type of sensory activities.

Wondering how to create a sensory diet? Use these steps to create a sensory diet for children with sensory needs that result in meltdowns, attention challenges, struggles with regulation, and other sensory processing related difficulties. Perfect for the occupational therapist who works with kids with sensory needs.

Why Create a sensory diet?


There are many reasons why a sensory diet should be used to support specific needs. This resource covers the goals of a sensory diet.

Sensory diets are effective for addressing many sensory-related behaviors. Just a few reasons for using a sensory diet may include:

  • Emotional overreaction
  • Meltdowns
  • Aggression
  • Hyper-attention
  • Difficulty with transitions
  • Inattention
  • Sleep issues
  • Impulsivity
  • Sensory-seeking behaviors
  • Sensory-resisting behaviors
  • Resistance to textures/food/clothing
  • Poor social Interactions

This blog post on sensory processing includes a sensory processing disorder checklist that covers many reasons and reactions that can be impacted by sensory needs.

Wondering how to create a sensory diet? Use these steps to create a sensory diet for children with sensory needs that result in meltdowns, attention challenges, struggles with regulation, and other sensory processing related difficulties. Perfect for the occupational therapist who works with kids with sensory needs.

Make a Sensory Diet Template

This next section of this article covers a sensory diet template, which is a helpful tool for creating sensory diets. However, remember that we discussed above how everyone’s needs are different and that each sensory diet will be unique to the individual.

A sensory diet template is helpful in strategizing and getting started with sensory diet creation. But it should be used as just that, a tool!

Every one of us will have a unique sensory diet formula depending on preferences, processing, needs, and environment.
One important piece of the sensory diet puzzle is the successful implementation of strategies. This is the part of actually using sensory activities, brain break, movement activities, calm down corners, sensory tools, etc.

We’ll go into how this looks in more detail below, but it’s important to remember that the sensory diet template plays a big role. Actually scheduling strategies and implementing them into day to day tasks is part of the sensory lifestyle.

There is more to a sensory diet than applying sensory input or encouraging a child to participate in sensory play activities. Knowing how and why a sensory diet should be created is essential to success, safety, and carryover of sensory strategies.

As individuals, we tend to choose activities and experiences that are pleasurable. We enjoy snuggling up under a thick blanket at the end of the day. We tend to shy away from unpleasant sensations such as a static shock that happens every time we use that certain blanket.

Likewise, some of us are thrill seekers and enjoy experiences like jumping from airplanes or bungee jumping. Others like to stay firmly on the ground and play it safe when it comes to leisure activities.

Similarly, our clients or children who struggle with sensory processing can present with different preferences, as discussed in The Sensory Lifestyle Handbook.

Steps to Create a Sensory Diet

The biggest thing I can say when making a sensory diet for a client or individual is to observe, observe, observe! Occupational therapy practitioners are very skilled at this observation piece. And the observation will make all the difference in whether a sensory diet actually serves its purpose or not.

When we make a sensory diet, especially for the pediatric population, we need to observe what works for that individual, what doesn’t work, and what kind of supports support or compromise functioning. Then there is the environment, the others involved in a functional task, and many other considerations. All of this requires observation.


The key to successful integration of a sensory diet is ensuring the clinical strategizing and application are fit into the specific needs of the individual. However, combining the needs of an individual with interests and preference along with application of specific steps ensures successful creation of a sensory diet.

There are specific steps to creating a sensory diet. Let’s go through the process:

  1. Analyze/Identify
  2. Strategize
  3. Sensory Diet Template/ Apply Sensory Strategies
  4. Monitor

Step 1: Analyze/Identify- The first level in creation of a sensory diet requires identification of sensory related behaviors, attention issues related to impaired sensory input, challenges with focus or emotional regulation as a result of sensory needs, or meltdowns that impair functioning.

This level of sensory diet creation requires assessment and identification of each challenging issue. Sensory behaviors should be identified and charted. This includes jotting down when specific behaviors occur, the setting where meltdowns occur, and antecedent to the behavior.

Make detailed notes that describe the action, the environment, the disabilities, and the impact on function, safety, learning, social participation, etc. When taking the time to analyze sensory impact on function, it’s important to look for issues that may be impacting the individual’s functional performance.

Make notes on things such as:

  • Actions/behaviors- how is the individual responding in situations?
  • Environment- where is the situation occurring
  • Timing- when does the behavior occurring? What happens just before the behavior or actions?
  • Co-existing considerations- what else is occurring during the behavior or action?

Sensory related issues can be charted in a methodological manner or they can simply be written down on a scrap paper. The point is to identify the issues through analyzation and to record them.

Identifying sensory needs when beginning the sensory diet process is much like keeping track of a food diary or sleep diary. In these situations, you’ll also want to mark down every detail including how one is feeling emotionally, physically, and other considerations. Just like these types of diaries help to identify what is really going on in a food diet, a sensory diary can help to support and identify needs for creating a sensory diet.

The Sensory Lifestyle Handbook contains printable data collection forms that can be used to analyze and identify sensory-related actions, behaviors, and resulting issues.

After dysfunctional behaviors are identified, the reason behind the behaviors should be described.

Step 2: Strategize/Reasoning- The next level in creating a sensory diet involves identifying the “why” behind the behaviors. Think about why the individual may be responding, or reacting to sensory input or environmental input in the way that they are. Can you come up with rationale that describes actions?

Ask yourself questions to strategize on the “why” behind sensory-related behaviors:

  • Is it an unmet sensory need that causes a child to bolt down the hallway?
  • Is the reason the child chews on all of their clothes because they need more proprioceptive input?
  • Did the child not get enough sleep?
  • Is the routine off?
  • Was a transition done without warning or preparation?
  • Was the individual at a level of stress?

Use this information to come up with predictions and opportunities to support the individual with specific accommodations or modifications to the environment.

In The Sensory Lifestyle Handbook, you will find printable sensory-based behavior screening tools that can be used to identify the underlying sensory needs leading to a behavior or action.

Additionally, resources in the book allow for strategizing to address existing sensory challenges for an individual. The best part is that the pages can be printed off and used over and over again for a single individual or for many individuals. 

Step 3: Create a Sensory Diet Template and Apply/Trial Various Sensory Strategies- In this stage of sensory diet development, strategies need to be trialed for effectiveness within the lifestyle of the child and family. Sensory strategies need to be incorporated as indicated across a variety of settings, based on various sensory needs as they change throughout the day.

Scheduling sensory diet strategies is an important step. If a box of sensory supplies is offered, but no schedule put into place, the sensory diet immediately is set up for failure.

Each strategy should be assessed for effectiveness. A simple checklist can be completed in the classroom or at home. When a sensory strategy is determined to work, that activity can be added to the child’s sensory diet.

If a particular sensory activity is determined to be ineffective, return to level one.

Remember that this part of the sensory diet creation process is very fluid! There will be trials, adjustments, periods of re-trialing, and monitoring. It can seem like this stage goes on and on! The thing to remember is to persist and don’t give up!

As adults who work with or raise children, we know the fluidity of childhood. Needs, strengths, interests, environment, and other areas can change as a child develops and grows. In the same manner, a sensory diet needs fluidity. Applying various strategies at different levels of growth in a child is a must. It must be said that a sensory diet for adults is just as powerful for the teen or adult with sensory needs.

Readers of The Sensory Lifestyle Handbook will find the Sensory Diet Schedule in the Addendum of the book to be a useful tool in creating a checklist for sensory diet activities. This is another series of printable pages that can be utilized over and over again as needed.

Step 4: Monitor- At this stage in development of a sensory diet, strategies should be monitored for effectiveness. Strategies should be monitored on a frequent basis with regard to effectiveness. As part of the monitoring process, a subjective assessment can be completed by adults who oversee the child’s sensory diet strategies.

Additionally, carryover of sensory strategies must be monitored. A list of prescribed activities that are not completed because they require exhaustive effort are not an effective strategy within the life of a family.

Carryover of sensory strategies is extremely important in both the home and in the classroom. If activities are not able to be carried out, then a different sensory strategy should be incorporated into the child’s sensory diet.

When using The Sensory Lifestyle Handbook to create and monitor sensory diets, users will find the Daily Sensory Diet Sheet and the Sensory Diet Schedule to be effective tools for carryover and monitoring strategies.

Use the Sensory Diet Effectiveness Tool, found in the Addendum of this book, to monitor sensory diet results and strategies. This form should be completed after a sensory diet has been in effect for two weeks. 


If creating a sensory diet and turning it into a sensory lifestyle sounds like a strategy that is needed in your home, classroom, or clinic, then The Sensory Lifestyle Handbook is a tool that you may need to get there! Check out more on The Sensory Lifestyle Handbook HERE. 

Wondering how to create a sensory diet? Use these steps to create a sensory diet for children with sensory needs that result in meltdowns, attention challenges, struggles with regulation, and other sensory processing related difficulties. Perfect for the occupational therapist who works with kids with sensory needs.


The Sensory Lifestyle Handbook is a strategy guide for sensory processing needs. With valuable insight into the sensory system and the whole child, the book details how sensory diets can be incorporated into a lifestyle of sensory success. 

The tools in this book provide intervention strategies to support and challenge the sensory systems through meaningful and authentic sensory diet tactics based on the environment, interests, and sensory needs of each individual child.   

Wondering how to create a sensory diet? Use these steps to create a sensory diet for children with sensory needs that result in meltdowns, attention challenges, struggles with regulation, and other sensory processing related difficulties. Perfect for the occupational therapist who works with kids with sensory needs.


So often, we hear that sensory recommendations are not carried over into the home or classroom. The tips and tools in The Sensory Lifestyle Handbook uses child-led interests and daily life interactions so kids WANT to participate in sensory diet activities their bodies need…because it’s part of play!

Get The Sensory Lifestyle Handbook here.

Using a sensory diet in various environments

A sensory diet is an important strategy and tool to support learning needs in the classroom environment. Here is a resource on creating sensory diets for the classroom.

Occupational therapists can be a great resource for sensory diets that flow from the home to the school environment.

In fact, using a set of sensory diet cards as a resource where the student pulls various sensory supports to use at specific times or during transitions in the classroom can be very helpful.

The best type of sensory diet utilizes sensory aspects of everyday functional tasks within the activity as it occurs. This is covered specifically in the Sensory Lifestyle Handbook. But consider this: if one is outside or in the home and needs to address regulation needs, using activities and everyday objects is ideal. These backyard sensory diet strategies is one way to incorporate the outdoors into sensory needs.

Related, a sensory diet can include recess activities as a tool to support emotional or sensory regulation needs. This resource on recess sensory diets covers this concept in more detail. Running on a blacktop surface at recess, playing with hula hoops, balls, or building blocks at a key part of the day is scheduled into the students’ schedules every day they are at school. When you think about it, each student has a sensory diet of their own in the way of recess!

At home, recess isn’t an option, but heading outside is! The outdoor sensory diet strategies can really impact self-regulation, emotional needs, attention, and sensory processing needs.

Another environmental consideration is the playground. A park or playground area offers sensory diet equipment and tools that can be used on a scheduled basis. Consider adding a trip to the playground to the schedule on specific days of the week. Maybe a visit to the playground is in order for Friday afternoons after the student’s spelling test and the end of the school week. Or, a playground visit can occur every Sunday afternoon as a way to wrap up the weekend. Perhaps a walk to a local park can occur each evening after dinner. It’s all about what the individual needs and what works for the family’s lifestyle.

Another location for sensory diets can be the woods or a wooded outdoor area. This is a great way to incorporate nature into sensory needs, and should be scheduled according to availability, time available, and family lifestyle.

Another related resource on this site is the concept of sensory diets at the beach. When we travel, there can be a lot of different or novel sensory experiences. When hot weather, wind, and scratchy sand impact sensory needs at the beach, these are all important considerations.

Another support for travel is the sensory diet on the go! This easy to create sensory support is individualized and includes the materials and strategies that support the individual’s needs. Read how to create a travel sensory diet toolbox.