Victoria Wood OTR/L, Author at The OT Toolbox

Summer OT Programs

June 24, 2024May 20, 2024 by Victoria Wood OTR/L

Is it summer break yet? This is what all the school based occupational therapy providers and teachers are asking. Whether you are working in a school system or with children who go to school, you are going to want some great summer programs to offer. Summer activities can range from seated table worksheets, chores, arts and crafts, self-help skills to outings, camps, and classes.

All the above are great to work on retaining and learning new skills. The only bad activity is no activity. I know teenagers want to sleep all summer, but this is not going to help build critical skills, especially for those students who need a leg up. In this post we will explore some great summer program and activity ideas. We also have occupational therapy at home ideas that you could do this Summer.

SUMMER SLIDE

David Quinn and Morgan Polikoff researched Summer regression and concluded on average, students’ achievement scores declined over summer vacation by one month’s worth of school-year learning, (2) declines were sharper for math than for reading, and (3) the extent of loss was larger at higher grade levels.

According to Scholastic, students lose about a month’s worth of learning on average over the summer. Some studies show that children lose up to 40% of their learning over summer break. For example, children in grades 3 to 5 lose about 20% of their school year gains in reading and 27% of their gains in math. In the summer between 5th and 6th grades, 84% of students experience summer slide in math.

This is especially important for students who are struggling to keep up with their peers in school. When I am doing end of year meetings, I make sure to stress carryover of goals with parents. I want their students to have an advantage of practicing OT interventions all summer, not sliding backward. While everyone can benefit from a summer program, students with special needs are on the top of my priority list.

Summer Program Schedules and Routines

One of the key components of summer vacation that differs from the school year, is schedules (or lack of them). Kids thrive on predictability, consistency, and expectations. Parents mistakenly feel that students have been on a strict schedule all year and need a summer free for all.

Just like adults, children feel more confident and secure when their daily activities are predictable and familiar. A consistent daily schedule and step-by-step routines give children a predictable day.

Schedules and routines in the group care setting and at home help children: feel in control, feel safe and secure, know what is happening next, and engage in learning. Engaging, predictable environments and ongoing positive adult-child interactions are necessary for promoting children’s social and emotional development and preventing challenging behaviors. You can help by following clear and simple schedules and routines. (Hemmeter, Ostrosky, and Fox 2006).

Using a visual schedule at home is a great idea to keep this routine!

KEY FACTORS IN ESTABLISHING A SCHEDULE and summer program

There are several key factors in establishing a summer program (or any other time) schedule and routine:

Keep it simple. A routine does not have to include outings, pricey trips, or a packed schedule.
Help family members break down one of their scheduled tasks into steps to create the routine. For example, the morning routine might be: go to the toilet, get dressed, eat breakfast, brush your teeth.
Encourage families to let their children be as independent as possible. You might have to break a task down into chunks to have children help.
Let parents know that reviewing the schedule every morning and throughout the day with their child helps them know what is going to happen next. They can use visual schedules, pictures, lists, timers, or whatever works for them.
Remind families to keep the routine and schedule as similar as possible each day but offer some choices when possible (do you want the red or blue shirt?)
Let parents know they should also be flexible. You can say something like, “Plans change, things happen, but give your child a warning ahead of time if things are going to be different. Let them know what is going to happen.”
Refer to the schedule before and after activities throughout the day.

Here is a fun June Summer Activity Calendar to get your summer program started!

SENSORY DIET

Some learners need a sensory diet or program built into their summer to keep their systems regulated. This article on Sensory Diets is informative in building and using this tool.

You can of course incorporate your sensory diet into your daily schedule. For example, after the morning routine, add animal walks.

SUMMER break WORKSHEETS AND PAPER ACTIVITIES

Personally, I love a good workbook or paper activity. Arts and crafts are my jam. The possibilities for workbooks are endless and often overwhelming. My standard advice is to pick a couple of websites and resources you trust, and go from there. For example, the OT Toolbox (and The OT Toolbox Membership gets you everything done for you!) has multiple programs and printables to choose from that follow the same type of theme or pattern to add to your summer program.

Summer Activity Bundle Included in this bundle of printable resources are tools to address fine motor skills, visual perception, visual motor skills, sensory processing, self-regulation, pencil control, handwriting, and more.
Occupational Therapy Activities – great OT activities to get you moving this summer.
Summer Fine Motor Kit Printable no-prep Summer fine motor activities and fine motor worksheets designed to build strong hands.
Handwriting Practice for Summer
Summer Bridge Workbooks – These workbooks are my go-to suggestion for parents. I used these with my own girls 20 years ago and they are still very popular. Must be a good sign. I like that there are specific pages for each day on different subject matter to touch all the academic areas without being overwhelming Prevent summer learning loss! Summer Bridge Activities is an AWARD-WINNING summer learning series that is an easy and proven way to help children retain their classroom skills. Research shows that on average, children can lose 2.8 months of grade-level equivalency skills over their summer vacation. By using Summer Bridge Activities books students enter their new grades prepared and confident. These are available at other retailers, but I like all the information presented on their website. Check out the contents of each book before deciding on a level. Some learners are going to be too advanced for their grade group. Whereas struggling students may need to drop down a level or two.
Teachers Pay Teachers is another one of my favorite websites for resources. This search for Summer Packets brought up multiple different suggestions.
Check out this June Morning Work activity packet aimed at kindergarten level students. Carry over the important daily routine with a daily work page.

SUMMER ACTIVITIES TO GET YOU MOVING

A good mix of summer occupational therapy activities including indoor AND outdoor activities is great to add to your schedule. These activities use things you have around the house or can easily find at the Dollar Store.

Summer Sensory Stations This set of printable sensory path activities are nice because they can be printed off, laminated (or placed in a page protector sleeve), and hung in a hallway.
Summer Bucket List – 101 things to do this summer. This is a great activity that can be added to your daily schedule. Either plan ahead for the week, or let your kids take turns picking from the list. Plan a fun outing for the end of summer if you do all 101 activities on the list!
Pool Noodle Activities – who does not have a few of these in their garage right now? If not, the Dollar Store stocks them.
These monthly movement activities use a lot of items found around the home.
Here are fine motor and coordination activities using a simple deck of playing cards.
Here are movement, dexterity, and strengthening activities using craft pom poms (or cotton balls work really well, too.)
Here are activities with paper clips to encourage coordination, visual motor skills, perception, and dexterity.
Here are sensory diet activities for the backyard.
Here are 31 ways to learn through movement and play. These strategies are perfect for learning at home or homeschooling.
Playdough is a powerful tool that can be added to home therapy programs! Here is a giant list of activities using play dough.
To encourage gross motor movement, core strengthening, and heavy work for sensory needs, try these indoor recess activities. They work at home on a rainy day, too!
Consider setting up a summer sensory camp in the backyard. It doesn’t need to be extravagant.
Consider joining The OT Toolbox Membership for access to printable resources for the whole year.

Summer CHOICE BOARD

An increasingly popular option for home and summer programs is the Choice Board. A choice board is a visual tool that teachers can use in their classrooms to allow students to… make choices! Choice boards consist of two or more options of activities for students to complete.

The teacher specifies what choices are available, and the student selects what activity (or activities) they’ll do. Choice boards give students a chance to make decisions about what they are going to do. Eventually they will get all the activities done, so it does not really matter which order they get them done.

Some choice boards are made to give students choices without having to do all the activities. For instance, pick 3 from the board for homework.

Summer Outings that build skills

Summer programs would not be the same without outings! Not everything has to cost a ton of money. There are lots of summer programs for kids out there. Here are a few ideas that are free or low cost:

Summer bowling program
Movie series – older movies during the summer that only cost a few dollars
Library – the library usually has a book challenge or other activities like Lego club, book club, arts and crafts, and more
Recreation Center – check out your local recreation center for activities. They usually offer lower cost summer camps as well as great activities.
Staycation – have you seen all there is to do in your home town? How about being a tourist for a few days and check out the local sights.
Membership – a summer membership can help create a summer schedule. If you go enough times, the cost is minimal. We loved the aquarium, zoo, water park, amusement park, children’s museum, and more
Classes – several places offer fun classes during the summer. The craft painting and pottery places offer classes. Usually the dance studios have something going on, as well as the gymnastic centers.
Bible Camp – if this is your preference, Bible camps are usually free and you can check out more than one church.

MY SUMMER PLANS

This is only the third year in my 30 years as an OT to have summers off. You can bet I am super excited! We have travel plans galore. I am thinking of adding the Summer bucket challenge for adults to my summer plans.

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.

Visual Noise and Learning

October 14, 2024May 9, 2024 by Victoria Wood OTR/L

In this post you will be discovering how to create a calm classroom, specifically tips to avoid the visual noise that distracts learning in the school environment. Classroom décor and organization can directly effect the engagement level of children in any classroom or learning space. When the environment is too visually stimulating, a student’s ability to focus becomes difficult. Keeping children’s attention can become frustrating. When a classroom environment that is soothing and organized is created, children are better able to stay engaged. In this blog, you will learn about the three different ways to make your classroom visually calm.

What is Visual Noise?

When working with children, teachers think about all of the colors of the rainbow, and want to make classrooms bright and cheery. So many classroom theme sets have fun colors, bright designs, and patterns, contrasting bulletin board boarders, etc. Many believe that having a colorful classroom will keep children interested and engaged.

Visual Noise is just that: a visually distracting, or “noisy” visual scene in the classroom. A lot of teachers set up bulletin boards throughout the room with cut-outs in various themes: animal/monster/any theme , alphabet stickers, and painted murals on the walls. Maybe your classroom has a circle time rug that includes the ten different color squares. Perhaps you want to make sure all the children have something they like to do, so you have 20 fine motor choices in the manipulative area.

There is just one problem with using these types of visuals in the classroom, they are distracting!

The bulletin boards all around the room are adorable, and fun to look at. So during circle time, you might find a child gazing at the wall, figuring out what new item is there.
When there are rugs filled with colors, you may notice children looking down at the rug, maybe at the bright colors, while singing the color song in their head.
If teachers provide too many choices in one area of the classroom, children work with one toy for three minutes, then they are onto the next, without honing in, or practicing the skills that were intended.
For young children, and lots of adults, less is more!

visual processing

Humans use vision from birth, to engage with the world around them. The way your brain process what you see, impacts how you interpret your interactions with the environment, and the people around you. To learn more about vision, this amazing PDF discusses visual hypersensitivity and under-sensitivity (or sensory seeking).

There are some visual processing red flags that may indicate difficulties with visual processing or ocular motor control:

Increased sensitivity to light
Easily distracted by visual stimuli, or difficulty sustaining visual attention to an activity
Frequently squints, rubs eyes, or gets a headache after visually demanding tasks such as reading, using a phone/tablet/computer, or watching television
Loses place in reading or writing
Trouble finding things they are looking for, even when they seem to be “right in front of them”
Distractions with reading
Difficulty tracking visual information
Difficulty initiating or holding eye contact
Difficulty focusing on one piece of visual information
Increased fear of, or desire for, being in the dark
Difficulty discriminating between similar shapes, letters, or pictures
Letter reversals or number reversals
Difficulties with handwriting such as letter reversals, sizing, spacing, or alignment of letters
Frequently loses their place while reading or copying
Often bumps into things
May be slow or hesitant with stairs
Difficulty with visually stimulating activities, i.e., puzzles, locating objects in pictures, completing mazes, word searches or dot-to-dots
Trouble knowing left from right or writing with both hands

How to reduce visual noise when planning your classroom

When planning out your classroom, visual stimulation is important, however there are many ways to make sure there is reduced visual noise, so the environment is not overwhelming.

Think about how you feel when you go to the spa. Those deep earthy wall colors calm your bodies and nerves instantly! The Montessori and Reggio Emilia educational philosophies advise visual components as a way to keep their classroom calm and focused.

The Reggio Emilia philosophy recognizes the environment as the child’s third teacher. What is in a child’s environment, how it’s organized, and what it looks like, directly impacts what a child will learn that day.

two ways to make sure your environment is visually calming

Colors – When picking out colors for your classroom, whether it be for the furniture, rugs, or wall decor, the best way to support a calm visual classroom, is to choose more natural colors. These include blues, greens and browns.

Choose toy baskets, or white bins, as opposed to brightly colored ones.
Consider turning toy shelves around or covering with neutral fabric to further reduce visual noise.
Choose predictable carpet rugs (Amazon affiliate link) like this one, instead of random colorful squares. Carpet samples of neutral colors are an excellent idea to create boundaries while limiting visual distraction.
When decorating your walls, allow for empty blank space, and use more of children’s artwork. Consider the use of cloth and fabric.

Classroom Organization – When choosing how many activities and materials to place in each are of your classroom, keep in mind that less is more! When children have too many options to choose from, this can create a short attention span, and overwhelm from choice overload.

Organization in the classroom can mean stacks of papers, tons of sticky notes, messy desks, and disorganized files, too.

In a typical preschool classroom, there are 8 areas of learning: art, fine motor, science, reading, dramatic play, block, large motor and snack! When you use furniture to visually create specific spaces for each center, the classroom is organized, and children know what is expected of them in each area.

Older classrooms may not have the toys, block areas, and motor components, but there are designated areas: group areas, centers, desks, cubbies, or lockers, teacher areas, information centers, etc. All of these areas can be considered when it comes to visual input.

This blog from Lovely Connection, on preschool classroom set up, includes important aspects to think about as you plan your classroom layout. She includes information about including noise, popularity, supervision, boundaries, space, and the race track (when kids run around the room in a circular pattern!)

What happens when children are still overwhelmed, even when the environments are visually calming?

When a child feels overwhelmed for any reason, having a calm down corner, that is easily accessible and they can stay in as long as they need, is a must have. My “Soothing Sammy Emotions Program.” is an effective calm down area because students are excited to spend time with the adorable golden retriever Sammy. Not only does “The Sammy Program” teach children how to calm down, it guides them through communication and problem solving situations in a visual way that isn’t overwhelming.

Check out this great blog about visual processing and visual efficiency from the OT Toolbox archives. When a child has visual processing difficulties, they have a harder time taking in visual information, and processing it in order to make sense of it.

This visual processing bundle, also available in the Toolbox, can support children who are demonstrating visual processing challenges.

The Sensory Lifestyle Handbook (also available on Amazon) written by Colleen Beck of the OT Toolbox, is a great resource to start understanding sensory processing disorders.

A final note about visual noise

Visual noise doesn’t only occur indoors, it can happen outdoors, especially if there is a lot of activity and sunlight. Being mindful of the visual stimuli outdoors, is just as important as setting up an indoor classroom.

If you have a child who is having a hard time visually processing their environment outside, these visual sensory activities can be completed outdoors to support their sensory system.

While considering visual sensory overload in the classroom, also be sure to check out our resource on auditory sensitivities in the classroom. Both are very useful in setting up an inclusive classroom environment for success.

Classroom themes are adorable and cute! When planning your classroom, keep in mind how “busy” and overstimulating different colors and amount of objects can be. This will help keep your students calm and engaged. Although everyone processes their environment differently, anyone can all benefit from a more calming environment, especially when learning new skills!

Jeana Kinne is a veteran preschool teacher and director. She has over 20 years of experience in the Early Childhood Education field. Her Bachelors Degree is in Child Development and her Masters Degree is in Early Childhood Education. She has spent over 10 years as a coach, working with Parents and Preschool Teachers, and another 10 years working with infants and toddlers with special needs. She is also the author of the “Sammy the Golden Dog” series, teaching children important skills through play.

How to Support Sensory Needs in the Cafeteria

May 6, 2024 by Victoria Wood OTR/L

how to support sensory needs in the school lunchroom

The cafeteria is a terrible place for people with sensory sensitivities. If you have ever joined your child for lunch at school, you will agree. Two hundred or more children, 1000 different smells, and the chaotic noise level do not create a great eating environment for anyone. In this post we will explore how to support sensory needs in the cafeteria. For the school based OT, the cafeteria can be an alternate environment for addressing daily functional needs. Because this setting is so commonly targeted in school occupational therapy, we wanted to create a blog post centered around the sensory considerations in the school cafeteria.

There are three great steps I use to try and untangle the web of sensory processing difficulties. I try and understand, communicate, and accommodate. When the behavior is noticed first, we tend to focus on that, without taking the time to understand and learn what is really going on. If a behavior is based on a sensory reaction, often it will diminish once the sensory needs are addressed.

Much like the sensory stimulation of a fire drill, the sights, sounds, scents, and overwhelming amount of people in the cafeteria can result in sensory overload. We might see sensory dysregulation pop up and if this happens on a regular basis, we might even see overstimulation anxiety because the student knows this highly stimulating experience is coming up at a specific time each school day. It’s very stressful!

This post is just one of several, highlighting strategies and tips to understand, communicate, and accommodate sensory needs. “How to support sensory needs in the cafeteria” is an excerpt from my book, Seeing your Home and Community with Sensory Eyes. I wrote this book to provide a road map to assist caregivers in navigating environments and settings that trigger sensory outbursts daily. It is a great resource for therapists, educators, and caregivers.

How to support sensory needs in the cafeteria

The first of many strategies on how to support sensory needs in the cafeteria includes understanding what senses may be triggered in this environment. This sensory input may be great for seekers, or too much for avoiders:

Understand

Almost all your senses can be considered in the cafeteria lunch room:

Visual: 200 children, 100 different food items, sitting close to peers, people eating with their fingers, people chewing with their mouths open, messy eating, lunch boxes, trays, drinks, food, and containers all create a visual distraction. This makes it difficult to focus on eating when there is this much visual stimuli present. Sometimes it takes a combination of input to send a person into overload, while for others one event such as watching someone lick their fingers can be a trigger.
Olfactory: 200 children and 100 different food items combine to form thousands of combinations of smells. One food might smell fine, but when added to twenty others, it is an unbearable combination. The brain and olfactory system have difficulty making sense of the number of the smells coming in at once. For me, smelling food at a time or place it “does not belong” is a big trigger. I cannot tolerate the smell of lunch foods cooking early in the morning, or someone bringing their smelly lunch into our office.
Auditory: 200 children all whispering at the same time creates a loud noise, especially when combined with eating noises, chewing, burping, gulping, licking fingers, and smacking lips. Misophonia is a newer term used to describe the hatred people feel toward certain sounds, especially the sound of chewing food. Plus, then you have trays dropping, teachers yelling announcements, kids that get louder and louder it seems…the sudden sounds, students moving quickly through the lunch lines…all of this combines to impact the sensory sensitive person, especially when it comes to auditory sensitivities.
Gustatory: students buy cooked lunch food, or bring food from home. Unexpected or disliked food options can present an issue for a picky eater. While the cafeteria is an opportunity to try new foods by sharing with peers, this is not advised, as allergens and germs can be spread this way.
Tactile: many children sitting in proximity, sitting on benches, touching feet underneath the table, touching food, and struggling to open different containers can quickly feel overwhelming. The sensory avoider has difficulty processing this much tactile input, while the sensory seeker becomes energized and craves more.
Proprioception: sitting close to other people can set off alarm bells to someone who is sensitive. A person without body boundaries struggles to stay seated and keep an appropriate distance from their peers.
Vestibular: while attempting to sit still for a length of time the students will be in and out of their chairs, leaning on the table, standing at the table, or moving around the room. Some students have such difficulty sitting still, they are unable to do anything else.
Emotional/behavioral: anxiety, lack of control of the situation, lack of self-control, frustration, anger, interrogation, inability to express oneself, and excitement all contribute to acting out behaviors. Often the behavior is noticed first when there is a sensory trigger.

When the senses overload, we might see a fight or fright reaction, impacting the limbic system. Overwhelming sensory input can trigger an automatic safety response called a ‘fight, flight or freeze’ response. We might see all kinds of sensory responses as a result.

There is visual noise where there is overwhelming background noise constantly. There are a lot of moving pieces happening all at once. Sometimes a simple conversation can ease the anxiety and set the stage for new or difficult situations.

Lunchroom Sensory story

The second strategy for how to support sensory needs in the cafeteriais learning to communicate about sensory preferences; how things look and feel, and what can be done to make life easier to navigate.

This is a sample conversation about the cafeteria:

“The cafeteria is where you eat lunch. There are many other students eating at the same time. This can be a fun break for some, while overwhelming to others. It is important to eat good food while you are at school to help you learn, focus, stay healthy, and grow. We can decide together if we are going to pack you a lunch from home or have you buy food at school. We can decide each day by looking at the menu. There are rules to follow in the cafeteria to keep everyone safe, and I need you to make good choices while you are eating.”

You’ll want to make the lunch room sensory story very specific to the individual. This means that you want to include specifics about the time the student goes to lunch, where they sit, and the routine that they need to follow for getting their lunch and putting their tray back, or where they get their packed lunch from and where they throw away trash. These specifics mean that it’s difficult to use a social story found online or on websites as a download, because the overwhelming nature of the school lunch room is different for each individual because of the specifics of the setting, which is completely unique for each school.

But, you can use the cafeteria sensory story in different ways, which can be very beneficial:

Laminate the lunchroom sensory story and use it each day as a handout on the lunch table. The student can use a dry erase marker to check off tasks as they happen.
Put a small version of the cafeteria sensory story into the student’s lunchbox. This can be laminated as well.
Read through a lunchroom sensory story before going into the cafeteria. This can be incorporated as part of the student’s routine.

Sensory Questionnaire for the Cafeteria

One thing that is helpful is to do a sensory questionnaire with the student to really identify where the sensory challenges are popping up. A sensory processing checklist is helpful for this.

These are some questions to ask someone about their perception of the cafeteria:

Do you like the cafeteria? Do you like sitting with your class all together?
What can you smell in the cafeteria? What smells great or terrible?
Do you like the food in front of you? What is your favorite? Do you eat all your food each day? If not, what makes it hard to eat in the cafeteria?
Is it loud in the cafeteria? Do you even notice the noise? What can you hear? Does it make it harder to concentrate on your food, or are you able to tune out the chaos? Can you hear people eating, talking, chewing, and moving around?
Are you having trouble staying in your seat for a long time? Do you like sitting this close to people or do you feel like people are in your space?
Is it hard to have conversation while trying to filter out all the noises and eat at the same time? Would you rather sit quietly; maybe with a book, or at the end of the table?
Are you able to open all the containers, cut/scoop your food, use a napkin, and drink from your cup?
Do you like touching the food, or would you rather have a fork? Do you need more napkins or wipes so you do not feel so messy? Are you spilling food on your face, hands, or table?

Accommodate by learning how to support sensory needs in the cafeteria

Step three involves making accommodations to assist a person with sensory processing disorder navigate the environment easier, and with less distress.

For example, autism and the loud noises or sudden noises can impact the rest of the day. Keeping this in mind, caregivers can help the transition go smoothly before, during, and after lunch time. Some things that specifically might help include visual schedules, a visual timer (Amazon affiliate link), noise cancelling headphones (Amazon affiliate link), quiet sitting spaces, and transition strategies for entering and leaving the cafeteria.

Some people frown on making accommodations as they feel it is giving people a crutch or making excuses. Always keep your end goal in perspective. Is the goal of the cafeteria to sit quietly and enjoy the meal like everyone else, or to refuel and get nourishment for the rest of the day?

Provide accommodations such as ear plugs, headphones, compression vest, weighted vest, or lap pad.
Consider possible flexible seating options.
Provide preferential seating at the end of the row to minimize distractions.
Create a sensory friendly table away from the crowd for the children who are overwhelmed. This can be called the sensory table or the overflow table. Children can choose to sit at one of these smaller tables if they are feeling over-stimulated. This separate table is to foster improved self-regulation, not to make the student feel punished or isolated.
Create smaller areas for dining such as an empty classroom. Smaller areas help children focus on their food.
Essential oils help mask noxious odors. A child can wear an essential oil necklace or have a drop of oil under his nose which may be more pleasing than the combination of smells in the cafeteria.
Talk to the child about what foods are preferential, as well as the ones that are going to be difficult to eat. Cafeteria staff and the teacher can work with families to decide if hot lunch is preferential, versus a packed lunch from home.
Allow the child to stand at the table and eat if sitting is proving to be too much to handle. As long as the child stays in his designated spot while eating, this can be an acceptable choice. It is not acceptable for children to walk around the room with bites of food in their mouth.
Provide conversation starters to aid in social skills.
Be specific about the cafeteria rules. These might include: no throwing food, stay seated, do not share food, use a napkin, use utensils, chew with your mouth closed, and clean up after yourself.
Be sure the child can open all their containers. Provide safety scissors for opening baggies if the child does not have the strength or coordination to pull them open.
Allow middle school or older students to read quietly instead of talking; if socializing is too overwhelming. While social skills are important, lunch can be a nice break time during the day. Students can use this time as a sensory break, by engaging in a book. Ask your students why they might prefer to read instead of talking to friends. Is it because they need help socializing, are being teased, or they would prefer a break during the day.

Real Life Examples of situations observed in the cafeteria

We often see or hear about situations in daily life that do not make sense. By being able to understand and untangle these situations, it is easier to provide support.

The child or person:

sits in the cafeteria for the 20-minute allotted time but does not eat. The cafeteria is overwhelming to the child with sensory sensitivity. Children with sensory processing disorder often have difficulty maintaining focus; they are unable to do much more than remain in their chair. Providing accommodations or preferential seating can help the child maintain his arousal level and focus enough to eat.
is disruptive. The cafeteria is overwhelming and less structured than the regular classroom. Adding accommodations or preferential seating can help the child focus and make better choices.
is awkward with peers. Social skills are difficult to learn and use correctly. Socializing is even more difficult when trying to eat while filtering out all the distractions in the cafeteria. Provide opportunities for good socialization, such as conversation starters or topics.
gets out of his seat to move around the room. The cafeteria is overwhelming and unstructured time, therefore self-control tends to deteriorate in this space. Adding accommodations such as a wiggle cushion, ankle weights, head phones, ear plugs, preferential seating, or standing on one spot instead of sitting can help the student maintain self-control.
gags or covers their face. There are many different smells and sights in the cafeteria, including cooked lunches and food brought from home. A sensitive child may have difficulty filtering these different odors and visual input. The combination of smells may prove to be too much. Preferential seating at the end of the table away from the center of the smells, sitting further away from the kitchen, or adding essential oils to mask the odors can help.

Fun activities about how to support sensory needs in the cafeteria

Sometimes children are not able to sit quietly when they are waiting or finished with what they are supposed to be doing. Adding a few quiet ideas to pass the time can be great. Of course some of the items are not going to be appropriate for the cafeteria, but can be used in other settings:

Waiting Games for Kids – these games are great for times when waiting is necessary. In an effort to get away from screen time, these are great suggestions.
Practice walking in line activities to work on spatial awareness.
Use a toolbox of coping strategies.
Focus on body awareness.
Focus on turn taking in getting food from the cafeteria line, waiting for dismissal, etc.
Would you rather questions– Ask each other questions which begin “would you rather”? The Measured Mom has 100 questions you can print out if you prefer to keep a supply in your bag.
20 Questions – this is a classic game that never gets old. Use this for students who are finished eating, waiting, or having difficulty getting their body organized
Riddles and brain puzzles are a great way to quietly get kids thinking about something other than the cafeteria
Social stories are another great idea for how to support sensory needs in the cafeteria. This set of fun and engaging social skills activities are a great starting point to help students navigate acceptable cafeteria behavior and tackle social and emotion problem-solving situations.
Cafeteria Expectations activity- Often, students forget proper cafeteria behavior. You can easily review and help your students be ready with this movement game and craft.
The OT Toolbox is full of great resources. Seeing your Home and Community with Sensory Eyes – This guide can assist caregivers, individuals, families, therapists, and teachers untangle the web of senses to give correct guidance and assistance. The Sensory Lifestyle Handbook – The Sensory Lifestyle Handbook is your strategy guide for turning sensory diets and sensory activities into a sensory lifestyle. The Sensory Processing Disorder Handbook – This 26 page guide explains SPD in easy-to-understand terms.
Social stories for the lunch room.
Take some time after eating lunch in the lunchroom and calm down or regulate in the calm down corner or a school sensory room.

Sensory Lunchroom Considerations

Because of my sensory “issues,” I avoid the cafeteria like the plague. Luckily for me, not much OT treatment has to be done in the cafeteria. I can work on feeding, opening containers, and social skills in the classroom.

However, when the cafeteria is the best option, I take a deep breath and forge ahead. Teachers and other staff can easily be triggered by environments as well as children. Structure sensory breaks after overwhelming situations for both staff and students, and encourage accommodations as needed.

What is Overstimulation Anxiety?

May 2, 2024 by Victoria Wood OTR/L

Do everyday environments like the grocery store, the mall, or your office leave you feeling anxious and stressed? Does the thought of going to these places that are highly overstimulating with sights, sounds, smell…and people… fill you with dread or a sense of anxiety? If you answered yes to both these questions, you might be suffering from overstimulation anxiety, or some aspect of social emotional skills worries. Our kiddos that we work with with sensory processing needs probably have some aspect of stress associated with overstimulation, and maybe even a sense of doom that they feel when thinking about or heading into stimulating environments.

In this post we will explore what is overstimulation anxiety, what causes it, and therapeutic interventions to help minimize symptoms. Overstimulation anxiety can play a huge role in sensory dysregulation, especially when it comes to self regulation and the ability to use coping tools to support the worries!

Our resource on sensory processing red flags can be a helpful tool as well because it highlights how sensory processing issues, like overstimulation worries, might show up as our OT kids being overwhelmed and overstimulated.

What is overstimulation anxiety?

Sensory overload (another term for overstimulation) is when your five senses — sight, hearing, smell, touch, and taste — take in more information than your brain can process. When your brain is overwhelmed and overstimulated by this input, it enters fight, flight, or freeze mode in response to what feels like a crisis, making you feel unsafe or even panicky. Read more about this in our blog post on the limbic system.

All of this recognizes the ability to check in with emotions and feelings. This is can be a real challenge point for some of our kids! It requires:

When suffering from overstimulation anxiety, also known as sensory overload anxiety, you may experience sensory overload in unfamiliar environments, when you are surrounded by new people, or when expectations are unknown to you. Your senses become heightened and perhaps you are over-responsive to sensory information that would not affect a person without anxiety.

To learn more about situations that can trigger overstimulation anxiety, check out my book, Seeing your Home and Community with Sensory Eyes. It is a comprehensive guide to helping yourself or others navigate different environments. It is broken down into chapters for ease of scanning to find the relevant information. Ultimately, the book answers the question, “why do they do that?”

If you are a child or adult with sensory processing dysfunction, it is probable that being in certain situations will cause you anxiety. The fear of not knowing what sensory experiences may arise is enough to cause you to have a heightened arousal level and be anxious about the “what-if’s” or “maybe’s,” with new experiences. It can even lead to a sensory meltdown.

What is Sensory Overload?

So what is sensory overload? According to WebMd, sensory overload and anxiety are mental health conditions that are deeply related to one another. In some studies, up to 80% of people with sensory processing difficulties experience anxiety. When a person feels anxious or already overwhelmed, they may be more prone to experiencing sensory overload in certain situations. Likewise, experiencing sensory overload can make you feel a sense of anxiety.

Sensory overload and anxiety are mental health conditions! It’s when overwhelming sensory input interferes with our ability to filter out unnecessary and conflicting sensory input. This impacts participation in daily tasks.

So, whether your anxiety causes sensory processing difficulties or your sensory issues cause your anxiety, it is important to address both manifestations.

The way I like to explain it is by describing a busy mall at Christmas time. The lights, crowds, sounds, hustle and bustle are VERY overwhelming. We even wrote a blog post about Christmas mindfulness that goes into this a little more. It’s very overwhelming and that sensory overload is just too much for many of us!

Another way to explain it is by describing therapy burnout that most of us are familiar with. The feeling of overwhelming stress because of productivity, caseloads, extra tasks, emails, phone calls, and everything else that puts us on the verge of burning out. Adding extra sensory input like a jackhammer outside your window will likely cause an overload and you might want to just toss your desk…but you likely won’t. Our kids with sensory needs, however, just might toss that desk.

What causes sensory overload?

According to the folks over at Psych Central, there are many causes of sensory overload, and some underlying conditions that can make you more sensitive to sensory overload.

Sensory processing sensitivity (SPS)– People with higher levels of SPS, or heightened awareness and reactions to their environment, are also known as highly sensitive people. Being highly sensitive is a personality trait, with about 1 in 5 people fitting into this category. Take the sensitive person quiz to find out if you are an HSP.
Sensory processing disorder (SPD)– SPD is usually diagnosed in childhood, although adults can also get a diagnosis. It involves either much higher or much lower responses to sensory input than most people experience.
Autism spectrum disorder. Autistic people are more likely to experience both SPD and anxiety.
Attention deficit hyperactivity disorder (ADHD)– People with all types of ADHD may also experience higher rates of sensory overload than people without neurodevelopmental conditions.
Post-traumatic stress disorder (PTSD)– Experiences of trauma that cause PTSD can create more hypervigilance, or awareness of your surroundings. People with PTSD may experience more sensory overload and anxiety in response to sensations that remind them of past trauma.
Anxiety disorders– Many anxiety disorders, but particularly generalized anxiety disorder, have been linked to sensory processing issues.

What are the symptoms of overstimulation anxiety?

Overstimulation can be triggered by too much input in the environment. You might feel overwhelmed and sensitive to

bright lights, chaotic movement, or a cluttered environment
rough, tight, or itchy clothes
loud noises, voices, or music
scents including chemicals and perfumes
foods with strong flavors
hot or cold temperatures
too many people in one place (body awareness and proprioceptive sense when there are people in your space)

As a reaction to overstimulation, you might feel:

overwhelm that makes you want to either shut down or have a meltdown
irritation or rage
tension in your face, neck, shoulders, or back
having either too many thoughts in your mind, or none at all
exhaustion
dissociation, or being separated from yourself and your surroundings

Because children have limited problem solving, language, and emotional regulation, their responses are often more exaggerated. They exhibit tantrums, meltdowns, shutdown, or other maladaptive behavioral reactions. We notice the behavior first, however, meltdowns caused by overstimulation usually can be traced back to a trigger.

What can you do to help combat sensory overload anxiety?

Speak to your doctor. Your doctor can help you navigate mental health resources by suggesting specific therapy sessions or medications that could be helpful. Depending on your age, particular triggers, and any associated conditions that you may have, your doctor may recommend some kind of anti-anxiety medication or antidepressant.

Self Care. Keeping yourself well-rested, well-fed, and hydrated are easy ways to empower yourself should you encounter an unexpectedly difficult or overwhelming situation. You can also explore techniques like meditation, mindfulness, and breathing exercises to help yourself de-escalate if you find your sense of anxiety on the rise.

Different types of therapy. Many people find that therapy can be very helpful in navigating anxiety and developing tactics for managing difficult situations.

Identify and avoid triggers. Once you are aware of the particular sensations, situations, or stimuli that make you feel overwhelmed, you can make efforts to stay clear of them. Being upfront with your friends and family can allow them to help you avoid these triggers, too. For example, instead of enjoying a birthday celebration in a busy restaurant, opt for someone’s quiet backyard. Instead of visiting a crowded, loud theater, host a video viewing party at home.

Create a support network – Reaching out to friends and family and sharing with them the struggles you are facing can allow them to offer support. Helping them to understand what you are going through can also make you feel less alone.

Some situations that cannot be avoided can be helped with therapy, medication, and a supportive social network.

Tips for dealing with overstimulation anxiety

There are certain steps you can take on your own to help address your struggle with overstimulation. These are not replacements for therapy but can help you cope with sensory overload in the moment. Here are some tips to address overstimulation:

Control your environment – Making sure to avoid environments that are full of triggers is a way to help alleviate the frequency of your symptoms. You may find you need to avoid loud concerts, or big parties, or make accommodations to better tolerate them.
Create a safe space – The world is full of unknowns, and creating a space where you can feel at ease is one way to help give you peace of mind. We call this a personal bubble when helping kids with this safe space. We can also help them to understand personal space. Try to create a space that you can go to feel safe. Somewhere that is free of any triggers that may cause you to feel overstimulated. This is what sparked the Man Cave and She Shed!
Develop a plan – There are only so many ways to control our environment. Preparing for situations in which you may be exposed to a trigger can help you feel more at ease when going out into the world. Practicing deep breathing exercises, engaging in positive self-talk, keeping noise-canceling headphones (affiliate link) nearby, and developing an exit strategy for situations that might trigger you can make you feel more prepared. I travel with earplugs (affiliate link) and a sweater wherever I go. As a side note, I have tried all types of earplugs and find Mighty Plugs to be superior.
Stay healthy – Getting regular and high-quality sleep, exercising, and eating a healthy diet are all ways to stay one step ahead of overwhelming situations. If you do these things, the likelihood of feeling prepared for whatever challenges you might face is much higher. You may find you are extra sensitive when you are tired or hungry. A little beach therapy goes a long way!
Communicate your needs – Whether it is at work or school, communicating your needs is an important part of living with sensory overload episodes. It is possible that accommodations can be made to help you feel more comfortable in the spaces that you need to attend. Open and honest communication can make you feel vulnerable. It is worth the trade off for some peace of mind.

Additional resources

Adult sensory processing disorder – sensory processing disorder in adults, sensory overload in adults, and how to support sensory sensitive adults.
Sensory Diet for Adults – adults need to be able to self-regulate, organize their sensory systems, and support their sensory and emotional needs.
Sensory Meltdown or Tantrum?
Sensory processing disorder information packet
Seeing your Home and Community with Sensory Eyes – This manual is a valuable tool for understanding and effectively communicating with those affected by sensory processing disorder. This guide can assist caregivers, individuals, families, therapists, and teachers untangle the web of senses to give correct guidance and assistance. This guide can be read cover to cover for optimal learning, or by selected chapters as needed.
The Sensory Lifestyle Handbook – The Sensory Lifestyle Handbook is your strategy guide for turning sensory diets and sensory activities into a sensory lifestyle.
The Sensory Processing Disorder Handbook – This 26 page guide explains SPD in easy-to-understand terms

Taking a look at the input from the environment with “sensory eyes” means that we look at how the sensory information can be a form of overwhelm!

overwhelmed and overstimulated

If you or someone you care for struggles with overstimulation anxiety to the point that the overwhelm becomes too much for functioning in day to day tasks, you/they are not alone. This is not a behavioral disorder, or a personality trait. It is caused by something in the wiring of the brain. Try and think of it that way, as if it was a vision or hearing loss. Keep returning back to the feelings and advice you would give to someone who needed glasses.

Sensory Needs and Navigating the School Fire Drill

April 25, 2024 by Victoria Wood OTR/L

Who remembers a childhood fire drill? Did you know that memories are driven by emotions? People remember times or events that trigger emotional responses because of the overwhelming input leads to sensory dysregulation. Luckily having a few strategies in place can help the child with sensory needs navigate a fire drill.

Sensory Processing and Fire Drills

A fire alarm is one of them. If you work in a school system (school based OT or otherwise), you are probably faced with regularly scheduled fire drills. In the southern United States, there are also tornado and earthquake drills. Due to the increasing number of school shootings, a lock down drill has also been implemented.

The sudden sound, moving quickly out of the building, excitement/fear during the event, and an unexpected change in routine during the day, can create a lasting memory for a sensitive person, especially when it comes to auditory sensitivities.

The fire drill does not have to be a traumatic event. In this post we will learn about Navigating the School Fire Drill; including understanding, communicating, and accommodating for sensory processing difficulties.

Navigating the School Fire Drill

Fire alarms are not isolated to school buildings. While teaching a seminar last year in a large hotel, the fire alarm went off. This brought up old feelings and memories as people rushed out of the building to gather near the tree outside of the building. There was no protocol to gather by the tree, however, old habits die hard! The adults were able to fairly quickly resume class after the fire alarm was resolved, however, some people were shaken. A person with sensory processing disorder can be out of sync for several minutes, or the rest of the day. For example, autism and loud noises can impact the rest of the day. Keeping this in mind, caregivers can help the transition go smoothly during and after the alarm.

While this post focuses on navigating the school fire drill or alarm, the information can easily transfer to anywhere there might be an alarm.

Today’s post comes from an excerpt from my book, Seeing your Home and Community with Sensory Eyes. It is a comprehensive guide to helping yourself or others navigate different environments. I broke it down into chapters for ease of scanning to find the relevant information. Ultimately, the book answers the question, “why do they do that?”

There are three steps you can implement when working on helping someone with sensory difficulties (or typical people who need to learn to prepare for something new). Understanding, communicating, and accommodating are great strategies.

Fire Drills and Sensory Processing

The first step to repair and remediate the sensory reaction and response is to understand what is going on when trying to navigate the school fire drill.

Almost all your senses can be triggered during a fire alarm:

Visual: flashing lights, disorganized movements, lots of people rushing down the hall or stairs, many children and adults moving at the same time, fire truck, and fire fighters. It is especially difficult to process all of this concurrent visual information, as there is an expectation to move quickly.
Auditory: alarm buzzing or beeping, children and adults talking, children crying, fire trucks, opening and closing doors, shuffling feet, and moving furniture. Sudden unexpected sounds and disorganized sounds happening at the same time creates auditory chaos.
Tactile: several people close together, who might bump into each other, the difference in air temperature from indoors to outside, quickly donning coat or hat, or bumping into parts of the building. In a tornado drill students sit in the hallway with their head tucked down, or under a mat or desk. Sitting under a desk can be especially confining to a sensitive person.
Proprioception: sudden disorganization can cause a decrease in body awareness. A person may trip over his feet, fall on the stairs, bump into people, get too close, push people out of the way, or stumble. In a tornado drill students sit close together, under a desk or mat, tucked into a ball, or against the wall. This feels overwhelming to a sensory avoider. The amount of activity can be stimulating and exciting to a seeker.
Vestibular: child may become disoriented by the sudden movement, walking down the stairs, and quickly navigating the building. Sounds and other incoming information can increase vestibular disorganization.
Olfactory: the close proximity of many people, or fire/smoke odors if there is an actual fire. Not being able to get away from smells can feel overwhelming to a person who is sensitive.
Emotions: Maladaptive behavioral reactions can be caused by: fear, anxiety, excitement, clumsiness, impulsivity, lack of control, difficulty following directions, difficulty processing what is being said, shut down, or defiance can cause maladaptive behavioral reactions. The emotions are often the first outward signal of distress.

All of the sensory input happening during this time is especially a challenge because for the child with sensory processing needs, or regulation needs, this is very sudden input. Sometimes teachers know that the drill is going to happen and other times they don’t. We need to keep our kiddos safe during this time but the onslaught of input can be very distressing for some of our students.

We see a hit to the limbic system, the sensory system receives sensory messages, like the shrill fire drill sound, and directs them to the part of the brain that needs to process it to keep us safe. The sudden sensory input can trigger an automatic safety response called a ‘fight, flight or freeze’ response. We might see all kinds of sensory responses as a result.

COMMUNICATION

The second step to seeing the community through “sensory eyes” and navigating the school fire drills, is learning to communicate about sensory preferences, how things look and feel, and what can be done to make life easier to navigate. When you think about all of the visual input happening during a fire drill, it can be a lot for those with sensory needs.

There is visual noise in the way of students and classrooms rushing to their designated safe space. There are a lot of moving pieces happening all at once. Sometimes a simple conversation can ease the anxiety and set the stage for new or difficult situations.

conversations about the fire alarm

The loud fire alarm sound can be very distressing. Having a conversation about the fire alarm can help.

This is what a conversation about the fire alarm might sound like

“There are times when the fire alarm will go off. Sometimes it will be a drill. Let me explain what this is. In the event of a real emergency, we need to know what to do, so we will practice first. The fire alarm is very loud. It lets us know there is an emergency, and we will need to move quickly. When you hear the alarm, get out of your seat, and make a line at the door. We will go down the hallway, down the stairs, out the back door, and stand by the tree at the far end of the parking lot. I will count and make sure we are all here.

we can go back inside after the drill or emergency is finished. There will be a fire truck and fire fighters. They are here to help us. If it is a drill, there is no emergency, just a practice. The fire fighters will talk to the principal and we can go back inside. If it is an emergency, they will do their job to make sure the building is safe before we go back in.

It is important to follow directions and stay together. Let everyone do their job and remember each person has a different job to do. Focus on your own job. What is your job during a fire alarm?

If everyone follows directions, it will go quickly and smoothly.”

Ask Students Questions about Fire Drills

These are some questions you can ask to understand the fire drill better:

(You can modify or eliminate some questions depending on the audience)

How do you feel about the upcoming fire drill after hearing about it?
Do you remember other fire drills, or is this the first?
How did you feel after going to the fire drill?
Were you scared the noise the alarm made?
Were you able to follow directions and listen?
Was it exciting doing something new and different?
Do you have questions about why there is a fire drill?
How did you know it was a drill and not an emergency?
What do you do differently in a real emergency? Answer: nothing. Treat a drill the same as a real emergency.
Did anyone cry during the drill? What can you do to be a good friend?
If the sound of the alarm bothers you, what can you do?

How to Accommodate for Fire Drills

The third step in navigating the school fire drill involves making accommodations to assist people with or without sensory processing disorder participate in the event easier, and with less distress. As with most sensory adaptations, it is a lot of trial and error to determine what the right combination is for each of your students.

Provide ear protectors for sensitive children. This will lessen the sound, allowing them to focus on the instructions. In the middle of a fire alarm (rather than a planned drill), this may not be the best option due to timing. In this case, allow child to hold hands over his ears.
Use the buddy system; children who are not bothered by the fire alarm can assist the more sensitive children. Children like being in charge, and a struggling student can have a good example to model.
Stand near children, or hold their hand, to insure they are not stumbling or falling.
Place sensitive children near the back of the line so they do not feel overwhelmed by being so close to other children.
Use a guide rope to help guide small children. Each child holds onto a portion of the rope. This keeps them in a line and gives a specific place to be.
Have strollers or a wagon ready for children who cannot safely navigate out of the building. Sometimes slow moving children are even slower when faced with a stressor.
Reassure children throughout the alarm, while continuing to provide information about what is happening. Sometimes not knowing what is happening is worse than knowing.
Provide a calm and quiet environment after the event is over. Dimmed lighting, quiet reading, small group, or independent play can help restore equilibrium after an event such as a fire drill.
Use a toolbox of coping strategies.
Use noise cancelling headphones for sensory intolerance
Use earplugs for sensory overload

Real Life Examples on Fire Drills and Autism

Sometimes you can see the behavior but not untangle why they are behaving a certain way. Here are some examples you might see when navigating the school fire drill

The child or person:

shuts down and will not move. The sudden noise has set up a flight, flight, or freeze reaction. The child is unable to make decisions, follow instructions, or move. Solution: physically help the child move out of the building.
is out of control. The alarm has triggered a fight or flight response. Solution: help the child physically to move through the building while reassuring him.
is loud or making strange noises. The child is trying to drown out the sound of the alarm with his own sounds. This is a normal reaction for a person with auditory sensitivity. Solution: allow humming during this loud experience or provide alternatives such as ear plugs, covering the ears, or headphones.
covers his ears. The sound is loud and feels deafening to a sensitive person. While it makes sense for a child to use their hands to steady themselves or grab a teacher, covering the ears is a natural reaction and should be allowed, unless an alternative is provided.
stumbles and falls. The child has diminished body awareness because they are focused on the sound of the alarm. Solution: physically help guide the child down the hall and out the door to avoid an accident. Focus on body awareness.
bumps and pushes others. Fight or flight reaction triggers the child to need to get people out of the way. The child may have lost awareness of his body position in relation to others due to the sound and chaos. Sometimes people do not realize they are pushing others. When someone may have accidentally brushed up against them, a sensitive person may respond as if they have been attacked. Solution: physically help guide the child out of the building. You can also focus on turn taking in hallways.
cries for a prolonged period after the alarm. The after effects of an event such as a fire drill can last the rest of the day, or longer. Solution: provide calming techniques after the alarm, structured time during the rest of the day, dimmed lighting, and a quiet classroom environment to allow the child’s sensory system to re-acclimate.

What are some other strategies for navigating the school fire drill?

Social stories for a fire drill- A social story about a fire drill can help. Include information related to the student and the school.
Fire Safety activities are easy to use as traditional classroom lesson plans, centers, homework, independent work, or they’re great for fast finishers in first and second grades.
Fire safety activities- Try activities on Firefighters, Fire Safety, and Classroom Fire Drill Procedures to help your students know the importance of practicing fire drills, what to do in case of a fire, and not be afraid of fire fighters!
Fire prevention week – this website has a lot of resources for learning about fire safety
Seeing your Home and Community with Sensory Eyes – This manual is a valuable tool for understanding and effectively communicating with those affected by sensory processing disorder. This guide can assist caregivers, individuals, families, therapists, and teachers untangle the web of senses to give correct guidance and assistance. You can read this guide cover to cover for optimal learning, or by selecting chapters as needed.
The Sensory Lifestyle Handbook – The Sensory Lifestyle Handbook is your strategy guide for turning sensory diets and sensory activities into a sensory lifestyle.
The Sensory Processing Disorder Handbook – This 26 page guide explains SPD in easy-to-understand terms
A fire drill song might be helpful for some kids:

This video on fire drills is helpful:

Fire Alarm and Sensory

Adults can be triggered by sensory input the same as children. Do not discount the feelings of others in the building, or making your own needs known. It is amazing the things we remember from our childhood. Who remembers Stop Drop and Roll? I remember practicing this and feeling terrified that I might actually catch on fire one day. As a young parent, thinking about my own children being trapped in our house during a fire elicited some strong emotions. We prepared at home for any emergency and practiced as well.

Do you think it is right to let teachers and staff know when the fire drill is planned? While this helps them prepare for the drill ahead of time and make accommodations, it ruins the element of surprise that would happen in the event of a real fire. Planning and practicing are great ideas, however maybe there needs to be a couple of surprise drills thrown in the mix to simulate a real life emergency. Something to think about.

How to Request an OT Evaluation at School

April 1, 2024 by Victoria Wood OTR/L

One question that comes up over and over again is how to get started with OT as a related service in the school environment. Parents of young children might see issues that their child struggles in and feel that an OT evaluation might be in order. But how do you get started with this process? Many parents ask the question “how do I request an OT eval?!” This is a great question and one we want to cover here.

School based occupational therapy can be tricky to navigate. There are a million and one steps to follow, and protocols to implement. Outpatient therapy is an entirely different ballgame. Once you have a doctor referral and insurance approval you are ready to start. But when it comes to OT in the schools, we fall under the educational guidelines. That means there are certain protocols directed by law.

How to request an OT evaluation in schools

In this post we will explore how to request an OT evaluation at school. The occupational therapy evaluation process depends on where the eval request comes from and whether or not there is already an IEP in place.

This request may come from a teacher, school psychologist, or parent. At times the occupational therapist may notice a student struggling, and get the ball rolling for an OT evaluation. We’ll cover each of these processes separately, because there can be differences. (See the challenge that we have with simply wanting your child to receive OT at school? It’s definitely not a one step process!)

How to request an OT evaluation at school

The first type of OT eval we’ll cover is the Teacher/parent driven referral. This means that the teacher or parent see a need for an occupational therapy evaluation.

The referral may come from the classroom teacher, resource teacher, school speech-language pathologist (SLP), a member of the special education department, or a parent, to name a few. Essentially, anyone can refer or request an OT evaluation at school. Typically this type of request for an OT referral comes from an individual in the school system that works with the child, teaches the child, or sees the student struggling in some aspect.

It is up to the IEP team to determine if occupational therapy support would be educationally relevant and required for the child to access their education.

Protocols and procedures vary from state to state (and different countries), however, there should be some common steps for how to request and OT evaluation at school. The process is going to be much easier if the student already has an IEP (individualized education plan) and you want to add on OT services.

When the student does have an IEP in place, the “next steps” for adding an OT evaluation would be:

The teacher can speak with the school psychologist or directly to the school based therapist about their concerns.
Then they loop in the parents and request an evaluation planning meeting to get permission to perform an OT evaluation. Our resource, the OT Screening Request Letter is a great tool to have for this step of the process.
If the parents grant permission, the evaluation process can begin.
The team will hold another meeting to review the results, and possibly a third meeting to add services to the IEP.
All requests from parents need to be taken seriously and investigated. Once a parent makes a request, if the student already has an IEP, the steps would be the same as above.

The occupational therapy referral process includes several steps. First, is a screening.

Pre-referral screening

Before jumping right in to request an OT evaluation at school, it is important for the teacher/parent to know what they are looking for. There are generally three steps in this phase (pre-referral screening, OT observation, and RTI/MTSS supports).

A pre-referral screening is exactly as it sounds. It is a basic questionnaire that helps to screen the student before evaluation. This can cut down on unnecessary referrals or too many evaluations. This might look like a form on a piece of paper or a digital form that the teacher or other professional (speech, admin, etc.) can fill out with their concerns. We do have a pre-referral checklist available as a resource for this step of the process. When filling out this checklist, the teacher needs to consider whether the form item involves a skill that is expected or performed in the student’s classroom or school environment, and whether the student is performing this skill at a level that is comparable to his/her peers. If the pre-referral screening is done digitally via a Google Form, it cuts down on time because it will allow you to easily send the form via email and receive responses electronically. The responses can also be printed.
OT Observation- The therapy referral form might be followed by an observation by the school occupational therapist (after getting permission from the parents). Followed by suggestions for best next steps. These suggestions could include strategies for teachers to incorporate, or task/ environmental modifications.
Tiered Response- Some districts use an RTI (response to intervention), or MTSS (multi-tiered system of supports), or a similar tiered approach. The school therapist supports the student’s needs within the general education setting, by providing in-services/ trainings to the educators or small group support for teachers/students, before moving on to 1:1 support incorporated by the Student Success Team (SST). This approach provides services early to struggling learners and enables them to succeed in school. RTI requires collaboration between all school personnel and involves evidence-based instructional methods as well as decision-making based on data and monitoring of the student’s progress. The RTI model can increase student performance and decrease the number of referrals to special education.

Communication is key throughout this process. After the screening process is completed, it’s helpful and appreciated to complete an OT screening results letter that describes the status of the occupational therapy screening.

When the pre-referral strategies have been exhausted, it is time to put the formal evaluation process in motion.

How to request an OT evaluation at school if the student does not have an IEP

If the student does not already have an IEP, the process to request an OT evaluation at school becomes more complicated.

Occupational Therapy is a related service. This means we support the educational goals and are not a stand-alone service. The Individuals with Disabilities Education Act (IDEA) of 2004 requires schools provide related services to a student with a disability who needs them to benefit from the special education being offered. If your child has a disability, as defined by IDEA, and needs special education and related services to meet unique learning needs, then he/she might be eligible for OT services. Your child must be eligible for special education before being considered for OT services in the schools under IDEA.

Because OT is a related service, the student must qualify for an IEP under certain diagnostic criteria. Criteria states that to qualify for special education services, a child must have one of the 13 disabilities as defined by IDEA AND the impact of the disability must create a need for services.

Those disabilities identified by IDEA include:

Specific Learning Disability
Speech and Language
Other Health Impairment
Mental Retardation
Emotional Disturbance
Autism
Multiple Disabilities
Developmental Delay
Hearing Impaired
Orthopedic Impaired
Visually Impaired
Traumatic Brain Injury
Deaf and Blindness

In order to qualify for special education, the school psychologist will initiate a comprehensive evaluation. You can include related services in a comprehensive evaluation. If the evaluation reveals one of the 13 disabilities and there is an educational impact requiring special education, the team can proceed to offer an individualized education program outlining services.

A student Qualifies for OT Evaluation but the Evaluation doesn’t indicate a Need

Here is the tricky part. A student can qualify and be in need of occupational therapy services, but not receive them. Your OT evaluation might reveal below average fine motor skills, however if their IQ is in the average range, they will not qualify for special education. Similarly, a student might qualify based on the descriptions we listed above, and show a potential need for OT, but the OT evaluation shows that the fine motor or visual motor skill development is on age level for average range of development.

This means you can not offer related services. It is a parent/teacher’s right to request an OT evaluation at school, but this does not guarantee they will get services.

To have an IEP, the IEP team needs to agree that the child requires placement in special education classrooms and/or needs services that are only provided through special education.

A second difficulty is that students who have borderline skills do not qualify for special education. If students are below average (but not too low), and are working to their IQ level, they are considered slow learners and do not receive services. This happens all the time.

While we cannot suggest outside therapy, the hope is that you are able to make suggestions to the teacher that would benefit everyone in the class. If you have an MTSS model for OT (we do not in our district in South Carolina), you may be able to provide accommodations and strategies to the student directly. Each state will have different guidelines, so it’s important to look at the guidelines by state.

Keep in mind about OT Evals in Schools

The system has it’s flaws…

No entity is perfect. The idea is to give students the education they need in their “least restrictive environment.” Special education, therapy services (whether push in or pull-out), resource, or special modifications are considered restrictions. If a teacher can educate the students without the expertise of specialized education, this is the recommendation. Education is meant to be “appropriate”. The law of a free and public education does not require a school to Provide the best services possible for kids, or “maximize” their potential. Instead, the law requires that schools provide services that are “reasonably calculated” to help a child make progress.

For more information on specifics of OT evaluations, be sure to check out our resources on:

Sensory Room Rules, Protocols, and Guidelines

March 15, 2024March 14, 2024 by Victoria Wood OTR/L

Today’s post on sensory rooms in schools is part of a series focusing on sensory rooms. We are going to explore the rules, protocols, and guidelines to using your sensory room. Other posts in the sensory room series highlight benefits, why have one, things to consider, cleaning materials, supervision, use by teachers and aides, building a sensory room on a budget, and sensory room equipment.

Why do we need sensory room rules, protocols, and guidelines?

Did you know that a sensory room is considered a controlled and intentionally created space that provides multi-sensory resources to support a student’s sensory needs? This space is used in the school environment to help students with regulation and sensory needs to help them engage in learning.

Because of this, it’s important to have some sensory room rules and guidelines in place. The therapy providers reading this might be thinking, “Oh yes. We need to definitely regulate and maintain the integrity of the sensory room as a therapeutic tool”. It’s an option for supporting self-regulation.

Unfortunately, chaotic and unpredictable environments are sometimes created when a room is poorly designed, or personnel are not trained how to properly use the room. It is essential that the support personnel like teachers, teacher aides, and other staff understand how to use the room itself, not just the equipment inside it.

In the sensory rooms that I’ve seen in place, some of the issues that come up include:

Something that we often see is that the paraprofessional takes their student to the sensory room for scheduled sensory breaks throughout the school day.
Items in the room might be used incorrectly, or the student wandering around and trying a few things.
Items are broken
Materials are not put back into place, leaving the space a mess
Students might be taken into the sensory room as a reward
Students are taken into the room after they are in a state of dysregulation.
Students use equipment like sensory swings very aggressively or unsafely
Students might be in the room unsupervised
There might be too many students in the room at once.
Staff haven’t been trained on the “why” behind the sensory input.

This list is just the beginning of the iceberg! So many therapy providers have experienced different things when it comes to a calming space.

People who do not understand sensory processing difficulties, may see the sensory room as a playground or free-for-all space. While it is designed for some freedom of movement, your sensory room is best used with some direction and instruction.

The last thing you want to have happen in your sensory space, is for your student to feel/act worse than when they came in. Instructors who are given some rules, protocols, and guidelines, are better equipped to use the space to benefit each student’s unique needs.

It is more important how you use the space not what you have in it. One of the most common mistakes is to go into a sensory room and turn on every piece of sensory equipment. This can be very over stimulating for some. If used incorrectly students can exhibit self-injurious or aggressive behavior.

Remember the equipment is only as good as the person using it.

What your sensory room should not be

There are many positives of having and using a sensory room in a school setting. It is important to use the space well, so it does not get a bad name. People might complain they sent their kids to the sensory room and they came back more out of control than before. You may have heard that Johnny acts out so he can get sent to the sensory room. Maybe teachers say their kids never “earn” their chance to use the sensory room.

These are common misconceptions and results of a poorly controlled space.

What to avoid when Setting up Sensory Room Guidelines

There are some things we’ve seen in the school settings that are actually counterproductive when it comes to setting up a sensory room. Some things that might be ineffective for students and staff include:

Don’t let the sensory room become a free for all space to send students to. The time needs to be planned and structured to work well.
Don’t make the sensory space a punishment for students. Getting the explosive student out of your classroom is important at times for the safety of the other students, going to the sensory room is not considered a punishment. It is a space to work on self-regulation and feel better so they can learn. Students who feel this is a punishment may avoid the sensory room when they can benefit from it, or may act out to get a change to go to the sensory room.
Don’t let the space be used incorrectly. When not used correctly, some students are demanding a sensory break every 20 minutes because it is fun to get out of class.
Don’t make the sensory room a reward or something that must be earned. While the sensory room space is usually a positive experience and a reward, students who are out of control are not going to be able to earn this sensory break. It needs to be recognized by the staff that your student needs a break, and explained that they need to work on their Zones of Regulation, or slow their engine down (Alert Program).
Don’t let the sensory room be a babysitter. We’ve all seen it; Teachers and staff need a break too. However, this space is not for students to be dropped off and left. It is a supervised space with direct coaching.
Sensory rooms must not be used for the purpose of separating students from their peers, either during class or break times.
This space is not an alternative curriculum or alternative to formal education.
Sensory rooms are not alternative play spaces for students who prefer not to play outside.
A school sensory rooms must only be used for students who have been assessed by an occupational therapist as having sensory needs, and in accordance with the occupational therapist’s recommendations.

Knowing what NOT to make from a sensory room can help to define the guidelines that allow us to use the space effectively…

Sensory Room Rules

Each space is going to be unique and have a different set of rules, however, there are some basic rules staff can follow:

If your kid makes a mess, clean it up
During cold and flu season it is best practice to wipe down equipment after using it, or use a sanitizing spray
When you must leave a mess behind, due to time constraints, or some other circumstance, leave a note and your plans to return. Example: this swing is soiled, please do not use it. I will take it home and wash it.
Keep fingers out of drawers, cabinets, closets, desks, or other “off limits” spaces. Restrict access to the sensory bin if your student is likely to throw birdseed all over the room.
Keep all sensory room materials in the sensory room.
Children should stay a safe distance from other kids on swings, being careful not to run or walk in front of or behind moving swings.
Limit visits to 20 minutes. Be prepared to leave the room if an emergency student needs to come in.
Limit the number of students in the sensory room to a certain number. This will depend on the size and space available in the room.
Be considerate of the equipment and space. Some items are expensive and budgets are small. Schools with limited budgets do not replace equipment quickly.
Supervision -Students using the room should be supervised at all times. Without one-on-one direct input, equipment can be damaged very easily. When you are on a tight budget, it is painful to see something broken.

Guidelines for your sensory space

If you are a therapy provider that was consulted to set up a sensory room in a school or if you are helping to create the sensory space, it’s a good idea to come up with some guidelines to help define how the room will be used.

These are things to consider to help keep the space effective for the students that truly need it.

Decide if the room is going to be exclusively used by therapists and their students, or accessible by teachers (who may not have the skilled training, or supervision) to bring their class.
Decide how items will be labeled or classified. It can be really helpful to itemize the items
Who has priority over this space? Is it an equal space for anyone, or does a treating therapist working with a student have the right to refuse more students coming in.
Scope out the room before bringing your class in there. If a child is out of control, or having a meltdown, it is best to wait before bringing your ten students into the sensory room. Our teachers often call down to the sensory room (also inhabited by therapists) to see who is in there, and if the time is appropriate.
Adult supervision should be a given when working with children with special needs. They may have poor impulse control, muscle movement, and reaction times.
Use the room as proactively as possible by incorporating sensory escape/space time into their daily routine
Determine the desired outcome for the student. Is it to give them an escape from the busy sensory filled classroom or a sensory break? Would the student benefit from a calming or alerting activity? What equipment are you going to use to meet the student’s needs?
Guide the student towards either calming or alerting activities, depending on what he/she needs. If the student needs alerting activities, ensure to do some calming, organizing activities afterwards before they return to class, so they are ready to focus and concentrate. Please see our movement break booklet and video here for more information
Explain how the prescribed item will be used, including the goals that the item will help to achieve, how long the item can be applied for and when it must be removed based on that assessment.
Consider the data. How will you keep track of who has used the space? How will you determine who needs what equipment? How will you know if something helped a student?
Equipment tracking- One guideline to consider is the status of the items in the sensory room. One thing we know for sure is that items that are used by kids tend to be used to their very end. So who will be responsible for making sure the sensory swings are working properly and that the ceiling attachment is still safe and secure? Who will monitor the items to make sure nothing has broken and to fix or replace them when they are?
How will you move kids through their time in the space? Will you use a visual schedule? A choice board? Timers?

Sensory Room Guidelines: Understanding Who Benefits Most and Who Doesn’t

It’s important to remember that the sensory room is not for everyone.

Sensory rooms look like great play spaces. It’s the engaging items that look like toys. There are fun play things, lights, and items that might not be seen all that often. However, these are sensory tools. They are not for everyone to use, and for good reason.

There are expensive pieces of therapy materials and equipment in there that can easily cause harm. It is also a dedicated space for sensory processing and regulation.

Just like everyone does not get to hang out in the Nurse’s office every day, they do not get to go to the sensory room either.

One of the most important guidelines is to regulate who goes in there, so there is not a constant flow of students going in and out. Teachers will need to count on this space being free and available when they need it.

Sensory Room Protocols

These sensory room protocols are not steadfast laws or rules. They are good guidelines to follow to be compliant with least restrictive environment.

There needs to be a system in place to monitor and ensure regular cleaning and disinfection of equipment and surfaces to prevent the spread of infections.
Check your equipment. Make sure your hanging device is secure and rated for the weight and size of your participant. This is important on a regular basis.
Accidents will happen, even if you are standing right there, but these will be easier forgiven if you were supervising your student when this happened. Have paperwork in the room for documenting any incidents.
The sensory room should have a phone or overhead system in order to call either the main teacher, the front office, or for staff to call into the room.
Provide some sort of floor padding or crash pad. Concrete floors are not forgiving.
Supervision- This is both a rule and a protocol because it’s so important. There needs to be constant supervision of clients, particularly those at risk of falls or those using heavy or complex equipment.
Equipment must stay in the sensory room. This is a rule you can use, or decide to have a borrowing system for certain items. Loaning equipment is nice; however, it comes with risks, and takes away from the use of everyone. If you have a large budget, you may be able to have multiples of certain items to loan.
Setting up a staff in-service is important. Providing proper training on the correct use of the equipment is a must for any school staff that will be in the room.

Supervision in a Sensory Room

One factor that we’ve mentioned over and over again in this blog post is the supervision aspect. It’s SO important for the safety of the students using the room that the time is supervised.

But, for busy therapy providers and busy teachers, there’s just not a moment to spare in the school day.

So, the question remains: Who is “in charge” of this space? And then, how do you keep the room from becoming a free-for-all where the items in the room are misused and broken or misplaced and kids are using equipment without supervision?

We came up with a few ways to go about this. Some of these are strategies that we’ve seen in place in various schools. Others are things you can try. Not every school building will see success with these strategies. There are different student needs, different levels of support from administration and educators, and there is different levels of buy-in. The main thing to do is consider the options and think about what might work in the specific school ecosystem that you are servicing as a provider.

How to structure a sensory room for success (supervision and usage)

Hang rules for usage in the sensory room.
Have a sign in sheet on the door.
Make a rule that anyone using the room MUST clean up before they leave the room. When they check out, put a box to mark that they cleaned up the room.
Limit the number of occupants at any one time. Depending on the size of the building and number of students that benefit from the room, that might be as little as 2 students to up to 6-7. Remember that co-regulation occurs even from a distance and that if a student is in a state of dysregulation, that can throw off others in the room. Consider having a station outside the room, like sensory paths or posters hanging on the wall that can be a transition space or an area where students can go if the room becomes inefficient because one individual is having a meltdown. This might lead to using the room with only one individual at a time. It all depends and should be a fluid status.
Students might benefit from using the sensory room at a specific time in their day. A paraprofessional might be the one to take them to the room.
Ensure staff is trained on the items in the sensory room.
Color code the items in the room for type of sensory input. Students will have colors associated with their needs/regulation states and can select from one of those options.
Use a check in/check out system where students can rate their levels of regulation (either with Zones of Regulation or Alert program for example). Then they can check out. Keep track of the data.
Consider having students take off their shoes when entering the room.
Consider limiting usage of the room to 10-15 minutes.
Consider setting up a sensory diet for students who use the room often. They can have a checklist of items that meet their needs and use a rating system for marking off how they feel before using sensory room items and then after.
Post a stop and breath sign at the door so that there is a period of deep breathing before entering the room and before leaving the room.
Educate the staff that the sensory rooms should not be used with students who are in an agitated state. They should not be used as a punishment (i.e. in replacement of recess or as a time out.)
Educate the staff that students should be used appropriately when the student asks for a sensory break or as part of a planned sensory diet. Here is information on how to create a sensory diet.

A final thought on using a sensory room

A sensory environment is a working/changing type of space. It will change depending on the needs of the current students, as well as staff. Rules and protocols may change over time, depending on the space, and who is using it. We have added several different protocols this year at our school based on experiences that have gone well, and not so great.

Ideally, a school would have several different sensory rooms. One that is quite safe with padded walls, floors, and soft everything, and another with more equipment for active regulation and heavy work. Until then, make sure you are supervising your students in this space, and training those you work with to do the same.

For additional information, check out this article for additional information on sensory needs. Here is a great resource on sensory rooms.

Sensory Room Equipment (OT Recommendations)

May 6, 2024March 13, 2024 by Victoria Wood OTR/L

Today’s post on sensory room equipment is part of a series focusing on sensory rooms. We are going to explore things to include when designing a sensory room in schools, especially for when grant money limits equipment selection. Other posts highlight the benefits of a sensory room, things to consider, sensory room rules, and building a sensory room on a budget.

These sensory room items could also be used when setting up a sensory gym.

Sensory room equipment includes therapy tools that support sensory input.

Sensory room equipment

When building a sensory room, the easiest thing to do is open an internet browser window and start shopping. Unfortunately, we are often constrained by a budget, size limitations, or rules.

I recently won a local grant for $1500 to add sensory room equipment to our existing space. That sounded like a lot of money. You may be surprised how quickly equipment cost adds up.

Occupational therapy practitioners are sensory experts. We know all things “sensory” because all aspects of daily functional skills involve some aspect of sensory!

So, when OT is consulted to help come up with a list of sensory environment tools to add to a sensory space, we like to include a wide range of items that are designed to offer stimulating or calming and therapeutic input.

Ideally, we offer ideas and sensory tool recommendations that can be used by many individuals. This might include items such as sensory lighting, textured surfaces, auditory stimulation devices, and tactile materials.

Sensory equipment and supplies: Sensory equipment and supplies encompass a diverse array of products aimed at addressing sensory needs and promoting sensory integration.

This category includes items such as sensory swings, weighted blankets, therapy balls, fidget toys, and tactile mats. These tools are essential for therapists working with individuals with sensory processing disorders to provide targeted sensory input and support sensory regulation.

Sensory room accessories: Sensory room accessories are the supplementary items that enhance the effectiveness and appeal of a sensory room environment.

These accessories may include items such as cushions, bean bags, wall decals, mirrors, and soft play structures. By incorporating these accessories into the space, therapists can create a welcoming and comfortable environment that encourages individuals to engage in sensory activities and exploration.

Stimulating sensory room gear: Stimulating sensory room gear comprises the dynamic and interactive equipment designed to provide intense sensory input and promote sensory engagement.

This gear may include items such as vibrating cushions, interactive panels, tactile walls, and auditory stimulation devices. By offering a range of stimulating experiences, therapists can help individuals regulate their sensory systems and develop sensory processing skills.

Multi-sensory space apparatus: Multi-sensory space apparatus refers to the specialized equipment used to outfit multi-sensory environments and facilitate sensory experiences.

These items may include items such as sensory pods, immersive projection systems, interactive floors, and adjustable sensory stations.

Sensory room essentials: Sensory room essentials encompass the fundamental items necessary for creating a therapeutic and functional sensory space.

These essentials may include items such as crash mats, therapy swings, balance boards, sensory bins, and noise-canceling headphones.

Equipment for sensory integration rooms: Equipment for sensory integration rooms includes the specialized tools and apparatuses used to facilitate sensory integration therapy within dedicated sensory spaces.

These equipment items may include therapy balls, trampolines, balance beams, sensory tunnels, and climbing structures. These types of tools can provide sensory experiences that for self-regulation and functional skills.

Sensory stimulation devices: Sensory stimulation devices are the tools and gadgets designed to deliver specific sensory inputs to individuals for therapeutic purposes.

These devices may include vibrating massagers, textured brushes, light-up toys, and auditory feedback devices.

Designing a sensory room

Sometimes schools have the space and a need to add a sensory room to the building. The school’s OT provider might be consulted for putting the space together. This is great!

There are several things to consider when buying sensory room equipment:

Your clientele/students/population – you need to get the most bang for your buck; therefore, it is important to select sensory room equipment that meets the needs of most of your learners. While you may love the idea of a specialized piece of equipment for one student, it is not cost effective when you are on a limited budget. I fell right into this trap, ordering a swing that works awesome for half a dozen kids, but is too small for the rest. If I had a bigger budget this would not matter. Big clinics with a large budget can afford to get one of everything, to specialize treatment.
What do you want to accomplish? First decide the goal of your sensory room. Is it a quiet relaxing space, a place for students to do some heavy work, a spot for independent play, or teacher led activity? It can be a hybrid, if you have the space to divide your areas.
Try and buy equipment that serves multiple purposes. Read on to see the awesome ball pit/trampoline/swing I put together!
Choose durable equipment. Kids are rough on equipment. I cringe every time my preschoolers come in for some sensory time. Without one-on-one direct input, equipment can be damaged very easily. When you are on a tight budget, it is painful to see something broken.

Multi-sensory room resources

Sometimes, the school based OT provider has to come up with sensory room equipment that can be used in a multi-use space.

I’ve seen many occupational therapy and physical therapy sessions run in the random closet, library, backstage space, or hallway. It’s part of practicing in a school environment.

Just like those shared spaces that are used by therapy, sometimes a sensory room is a multi-sensory space. You might see therapy resources like self-regulation tools along side breathing exercises and a calming bean bag chair. This space might be used by the school counselor, administrators, or other members of the child’s team.

When we say “Multi-sensory room”, we are simply referring to the various sensory materials and equipment used in the space to enhance sensory experiences. These resources can include items like bubble tubes, fiber optic lights, aroma diffusers, sound machines, and interactive projection systems.

What are some more considerations?

There is more to consider when choosing sensory room equipment than what fits your budget:

Check the rules to see if you can have home made equipment. This is easier on the budget, but against the rules in many places due to safety regulations. This is a tough rule to follow, as much of the home-made equipment is made better than the mass-produced sensory room equipment.
Ask if there are constraints about where you can order items from. I found the coolest things online, only to find out we can not order from large vendors such as Amazon, Target, Walmart, OR tiny mom and pop shops. This is very limiting and time consuming to have to possibly spend more money shopping for sensory room equipment at a preferred vendor, or sacrifice buying what you really want.
How is this equipment going to be used? Our other posts on sensory rooms explore things to consider, rules, protocols, and guidelines for your room. Decide if the room is going to be exclusively used by therapists and their students, or accessible by teachers (who may not have the skilled training, or supervision) to bring their class. Some of these answers may be the jurisdiction of administration to determine how their space is used. If this is the case, make sure you plan your sensory room equipment accordingly.

What to include when considering sensory room equipment

I mentioned earlier “getting the most bang for your buck.” Use this idea when looking for equipment that meets the needs of the most students, as well as pieces that meet multiple sensory needs. The first (and probably the most important), is suspended equipment. Try and pick at least one piece of equipment that satisfies each of the senses:

Swings

Some sort of swing or suspended equipment is a must in a sensory room. Vestibular input is the building block of sensory processing. If the vestibular system is off, the other systems are likely to fall apart also. Check out our posts on platform, hammock, and Lycra swings.

Check out this article on What to Know about Sensory Swings for a general overview. There many different types of swinging equipment that could be added to a sensory space. A platform swing or Lycra swing will be your most versatile.

One way that we set up a sensory space in my classroom using sensory swings:

My new pick was this awesome swing that is a larger version of the Johnny Jumper. It has been limiting because the of the weight restrictions (about up to a 5 year old), so I have since ordered the bigger version, as it will fit the needs of more students. Swinging can provide great proprioceptive input also.

One thing to consider with using sensory swings in a school sensory room is how to attach the swing to the ceiling. If you can not get a hook for a swing into the ceiling, there are different options: (affiliate links)

Stand Frame This swing stand can bear up to 440.9 lbs. Convenient and easy to move.
A Frame stand: this free-standing frame fits several types of swings.
For those wanting to add multiple swings, you can order this A-frame deluxe stand for hanging all kinds of suspended equipment.
Lastly, this doorway swing bar: Fits 26″-36″ door frames.

Trampoline

Trampolines are great for adding vestibular and proprioception, as well as coordination, muscle control, and strengthening. Trampolines can be purchased that fit each budget.

Trampolines in a sensory space are a nice piece of equipment because you can use them for vestibular input while sitting, standing, on knees, or while laying down. This can serve many purposes, and can be depending on the needs of each individual.

There are different types of trampolines that can be used in a sensory room (affiliate links):

Mini trampoline
Trampoline with support bar
Trampoline with netting (nice for adding ball pit balls or those with balance and vestibular considerations)
Mini trampoline with sensory swing attachments
Multipurpose trampoline– This one has an encloser netting, a sensory swing attachment, a slide, and a climbing apparatus.

A ball pit

If you can fit a small ball pit into your sensory room, it is a great asset. Imagine being submerged in the balls, which provide a deep-pressure sensation and a sense of calm. Gross motor and fine motor skills, sensory-motor skills, social interactions, speech and language development, and symbolic play are just some of the domains you can work on while in the ball pit.

The calming effect of swimming in a ball pit can be a self-regulation strategy, too. Check out this recent post on Ball Pit Activities for more ideas how to incorporate this into your sensory room.

Some ideas include (affiliate links):

Baby pool filled with plastic ball pit balls
Foam ball pit for a deeper ball pit
Wooden ball pit built from 2x4s to create a corner pit area. This could be filled with foam cubes

Climbing structure

if you know you are going to have supervision in your space, a climbing structure is a great addition. It meets several of the sensory categories, including the heavy work component many students crave.

These Montessori climbers are budget friendly and made well. Another option is this set, which has larger climbing pieces. They are designed for your preschool to first/second grade students who need to build basic coordination skills.

This climbing structure is for older kids. The climbing and overhead hang position offers input through the back and scapula as well as shoulder girdle.

Other climbing ideas to add to a sensory room include:

Gym equipment
Climbing dome– This one has a hammock net as well
Plastic climbing playgrounds
Balance beam
Steps
Rock wall
Climbing cargo net
Balance rocks
Soft ramps
Gymnastic wedge

We include more information on the benefits of climbing in our blog post on outdoor sensory activities. You might find other items that double as playground equipment that can be used in a sensory room.

Crash pad

Here is where your home-made ideas can come in handy. You can buy large foam pieces and stuff them into a duvet cover for a fun (washable) crash pad. This is a great soft-landing spot for kids who either need a calm down corner, some heavy work, or a safe place to get some frustration out. I have heard there are local mattress factories that have mattresses and foam pieces they can donate.

Sensory bin

We all know the tactile benefits of the sensory bin. The OT Toolbox has multiple posts on sensory bin ideas. In a small classroom, you are often limited to very small sensory bins. In a large sensory room you may have room for a sensory pool made of a child’s plastic pool, or a sand and water table.

Vibration plate

Recently we accessed a vibration plate. This was one of our newest (and coolest) sensory room equipment purchases. I thought it was going to be limiting at first, but there are so many sensory seekers in our program, it fits the needs of many. We often add vibration as part of a treatment plan as it adds great input.

A vibration plate is different than the small sensory toys and massagers which provide limited benefit. This vibration plate has multiple settings and can provide massive (and quick) sensory input.

Quiet Space

Some students benefit from a calm down space away from the noise and activity of a classroom, hallway, or loud cafeteria. The sensory needs of the cafeteria can be a real challenge for some of the kids we work with. Using a sensory room before or after going to lunch is a great addition to a sensory diet.

We’ve included many strategies in our blog post on calm down corners, which can actually be it’s own space in a sensory room.

Some items to include in a calm down space in the sensory room include: (Affiliate links)

crash pads
mattresses
weighted blankets
bean bags
rocking equipment
a tent
dimmed lighting
star projectors
soft music
hammock swing or a pod swing

As an occupational therapist working in outpatient centers, I have seen the impact that calming sensory equipment can have on a child’s ability to self-regulate. In one case, I worked with a student who would become extremely aroused and dysregulated after intense proprioceptive and vestibular activities. This child had heightened agitation and it was difficult for the child to participate in the rest of the therapy session.

To address this, we introduced a variety of calming sensory equipment, including a crawling tunnel, a cozy hammock swing, and dimming the lights. We invited the child to hum along to a favorite song.

The transition was remarkable. The crawling was a transition task that led to the swing which provided deep pressure input. We swung it in slow lateral swings, which is known to have a calming effect on the nervous system. The sensory swing allowed for gentle, rhythmic movement, which helped modulate his vestibular system, promoting relaxation. The dimmed lights and the humming added to the more regulated state.

So you can see how many different tools can be used together to support needs.

Sensory modulation tools

Sensory modulation tools are another term associated with a calming space. This basically refers to the instruments and resources used to regulate and adjust an individual’s sensory experience so that they can achieve optimal arousal levels. In the school environment, especially, these items can help the student to be alert and focused so they can learn and participate in the tasks of the school day.

Sensory modulation tools might include:

weighted vests
pressure garments
calming scents
visual schedules

100 Sensory Room Items

I wanted to add a giant list of sensory room items because it can be helpful to think outside of the box. For some schools, it might not be feasible to have a whole room dedicated to a sensory space. For situations like that, it’s very possible to create a smaller sensory area of an office or closet in the school.

In one school that I worked in as a school based OT, I created sensory kits to be included in some classrooms. These were small boxes that held sensory tools and items and could be switched out. These were very helpful and the teachers in these rooms appreciated having that toolkit put together for them.

Another scenario to consider is the mobile therapist. Many times, we as OT providers work from our vehicles either in early intervention where we travel from home to home, or as a mobile school based OT practitioner. These professionals might serve many different school buildings or even school districts within a week’s time. At one point in my career, I was a contract therapist serving 4 different school districts each week.

Having a bin or laundry basket in the trunk of my car was ideal for carting around the sensory equipment that could be used at any given location. You could also create a sensory backpack with some of these smaller items.

Here is a giant list of sensory room equipment, including larger items as well as smaller items that can be included in sensory room kits (affiliate links below):

Weighted blankets
Bean bag chairs
Soft inflatable pod
Therap y balls
Sensory swings
Masking tape- Use it to make a balance beam on the floor or a hopscotch board on the floor
Tactile mats
Foam play blocks
Crash pads
Resistance crawling tube or tunnels
Balance beams
Vibrating pillows
Cuddle Hugging ball
Sound machines
Soft lighting options (e.g., lava lamps, fiber optic lights)
Aromatherapy diffusers
Visual timers
Trampolines
Sensory bins
Fidget tools
Chewable jewelry
Mirror balls
Wall-mounted exploration panels
Tactile wall art
Sensory bottles
Squeeze balls
Bubble wall
Sand and water tables
Play dough or therapy putty
Noise-canceling headphones
Body socks
Visual projection equipment
Floor cushions
Hammock
Balance stepping stones
Kinetic sand
Bubble tubes
White noise machines
Soft play equipment
Scoop rocking seat
Rocking chairs or gliders
Swivel spinning seat
Sit and Spin toy
Therapeutic listening equipment
Weighted lap pads
Compression vests
Fine motor skill development toys
Gross motor skill development toys
Calming corner with tent or canopy
Adjustable lighting (dimmer switches)
Interactive floor games like a jumbo Connect 4 game
Scented markers or crayons
Flippy sequence wall panels
Scented lotions
Fidget toy kits
Color-changing LED strips
Interactive light table
Weighted stuffed animals
Deep pressure rollers
Soft tunnels
Floor mirrors
Rain sticks
Wobble chairs
Sensory floor tiles
Acoustic panels
Adjustable room dividers
Therapy brushes
Balance cushions
Mini trampoline with handle
Sound-proof headphones
Therapeutic storytelling kits
Bouncing balls with handles
Emotion regulation charts
Oral motor chew tools
Sensory lap pads
Cozy reading nooks
Interactive wall games
Adjustable light tables
Handheld massagers
Gel maze boards
Sensory stepping stones
Hula hoops
Puppet theater
Relaxation CDs or digital playlists
Magnetic sand tables
Soft sculptures for tactile exploration
Light prism sets
Interactive music instruments
Sensory wall wraps
Pool noodles
Anger management calming kits
Soft corner playhouses
Jump ropes
Animal walk cards for gross motor skills
Therapeutic mazes and labyrinths
Fine motor tool sets
Deep breathing exercise posters
Climbing cargo ropes
Vibrating floor cushions
Koosh balls
Breathing ball

Cost of Sensory Room Equipment

Are you doing the math on the cost of all of these pieces of sensory tools?

Adding all the cool things I just listed probably has you over budget already. I was in the same position with my winnings and had to think quick about how to get the most bang for my buck. I came up with a trampoline/ball pit/swing combination! It has served the needs of just about all my students. It is an enclosed safe space that provides vestibular, tactile, proprioceptive, auditory, and visual input all at once, and is made more exciting or calming by changing different variables.

I ordered a (Amazon affiliate links) cool enclosed mini trampoline, and a few hundred ball pit balls to go inside. I fondly (inside my head) call it the pediatric containment unit.

Sensory seekers often bounce from one activity to the next without really experiencing the effect of that piece of sensory room equipment. This is the reason I was looking for a couple of enclosed pieces like the trampoline and the jumper swing. It keeps my students on the equipment long enough for their bodies to reap the benefits. Of course, when a student wants to get out, I take them out, but often they stay longer than if they were left in a wide open space.

Many therapists/schools are looking to provide a getaway space so students temporarily escape the sensory input in their classroom. This is great, but often does not meet the needs of the sensory seekers who need to fill their buckets before they are able to work on self-regulation and calming.

Ideally, I am looking to add TWO rooms in our school. A quiet space, and a sensory room with swings and large pieces of equipment as described above. Right now, our need for a heavy work/vestibular rich environment was more of a priority than the other. I am hoping to win the grant again this year so I can fill up my next space!

Watch for our other posts describing the benefits of a sensory room, things to consider, sensory room rules, protocols, and guidelines.

Sensory Rooms in Schools

March 14, 2024March 6, 2024 by Victoria Wood OTR/L

Today’s post on sensory rooms in schools is part of a series focusing on sensory rooms. We are going to explore the benefits of sensory rooms, including why having a sensory space in schools supports student needs. We’re also covering things to consider, cleaning materials, supervision, and recommended use by teachers and aides. The thing is that sensory needs are much-needed in schools and classrooms, so we wanted to offer a resource on creating this support.

Other posts in the sensory room series highlight sensory room rules, building a sensory room on a budget, and things to include when designing a sensory room.

sensory rooms in schools with therapy equipment like trampoline, climbing toys, balance toys and more.

What is a Sensory Room?

Sensory rooms are a space in the school that offers a sensory break for those who enter. Sensory rooms might be an empty classroom that has been transformed into a space with sensory tools and is used as a movement break for students.

Sensory rooms typically offer therapy tools or sensory materials that offer sensory input, including proprioceptive input, vestibular input, auditory input, visual input, and tactile input.

Some schools have a whole room dedicated to this calming and regulating space. Others have just a nook in a hallway with a few sensory materials. Still others have a closet or cupboard with a few sensory items.

As a school based OT, I’ve seen sensory rooms used for:

self regulation
sensory diets
movement breaks
brain breaks
organizing dysregulated sensory systems

School sensory rooms have specific equipment designed to support various needs. We’re covering an extensive sensory room equipment list in another blog post.

We actually created a virtual sensory room for online therapy sessions, which is a huge help for therapy providers working in teletherapy.

Why have sensory rooms in schools?

There are several factors that contribute to the need for sensory rooms in schools:

We as occupational therapy providers tend to be involve in creating and implementing sensory diets. The sensory room is a great place to incorporate sensory strategies within the space, while meeting the goals of a sensory diet.
Sensory needs during the school day- The incidence of Autism is now 1 in 34. That is just Autism alone. Along with sensory processing disorder, attention deficit disorder (ADD) and other attention needs. There are many other special needs in students in the classroom and many of these students may struggle with self-regulation.
Districts are allowing larger class sizes to balance their budget. This means more bodies per classroom. Sensory rooms can support body awareness.
Movement opportunities may be less than they were in years past. Recess time is often reduced and outside of school, kids may not be playing outside.
Because of least restrictive environment regulations, more children with special needs are mainstreamed into typical classrooms.
Teachers without specific training in sensory processing and working with students with special needs, are finding it increasingly difficult to effectively teach their lesson plans.
COVID – there was two years when young children did not get much sensory stimulation. We have now thrown them back into mainstream education, and it is proving to be too much for many students to handle.
Other contributing factors leading to poor sensory regulation might include: too much technology and screen time, lack of exercise, poor diet, and increased sensitivity to environmental stimulants.
Students need a safe space to work on self-regulation and get back into their “just right zone” so they can perform in their classroom (Read about the Alert program for more information non this.)

What are the benefits of a sensory space?

There are many benefits to students and staff of having sensory rooms in schools. This is more than just a free for all play space.

Sensory Integration Therapy: Teachers and therapists can use this space to provide sensory integration therapy, a form of treatment designed to help children with sensory processing issues. This therapy involves specific activities that challenge the child’s ability to respond appropriately to sensory input
Sensory Diet implementation: I love to use a sensory room in the schools for a specific sensory diet location. You can set up a schedule for students to follow each day or as part of their schedule.
Emotional regulation needs: You can use sensory rooms for emotional therapy, especially for children with autism. The calming and engaging environment can help manage emotional outbursts, sensory dysregulation, and reduce anxiety
Visual Stimulation: One of the nice things about a sensory room is that you can alter the visual input with wall decorations, lighting, and reduced glare from overhead lights.
Motor Skills Development: OTs, PTs, and ST staff in the schools can use a sensory room in therapy interventions to support their student’s goal areas. It might be used for movement goals for their gross and fine motor skills, or the space can be a general treatment area for therapy.
Relaxation and Calming: If you walk into a sensory room, you might notice the calming and regulating environment. The calming environment of a sensory room can provide a safe space for overstimulated students to relax and regain control so students using the space can return to learning.
Social Skills Development: I love using group self regulation activities with a small group of OT students. Group activities in a sensory room can encourage interaction and cooperation.
Individualized Learning: You can adapt the space to meet the specific needs and preferences of individual students, while exploring what works for each student.

Considerations for creating a sensory room

There are things to consider when creating a sensory room in schools…

You’ll need a space, a budget for purchasing the sensory room equipment and therapy items, and then a few other considerations.

The available space, budget, clientele, and purpose are just a other things to consider when building and using a sensory room in schools.

Many times, OT is consulted when a sensory room is being set up. If an occupational therapy provider is setting up a sensory room, or being used as a resource in creating a sensory space in the school building, then these are things that should be considered.

By the way, we always recommend reaching out to OT staff for appropriate suggestions for the sensory space.

When creating a sensory room, you should ask these questions:

What is your clientele/students/population that will be using the school sensory room?

You need to get the most bang for your buck; therefore, it is important to select sensory room equipment that meets the needs of most of your learners. While you may love the idea of a specialized piece of equipment for one student, it is not cost effective when you have a limited budget

What do you want to accomplish with your sensory room?

First decide the goal of your school sensory room. Is it a quiet relaxing space, a place for students to do some heavy work, a spot for independent play, or teacher led activity? It can be a hybrid, if you have the space to divide your areas.

What type of equipment will be used in the sensory space?

We know that school students are rough on materials. Because of that you’ll want to choose durable equipment. I cringe every time teachers bring in preschoolers for some sensory time. Without one-on-one direct input, equipment can be damaged very easily. When you are on a tight budget, it is painful to see something broken.

Check the rules to see if you can have home made equipment. This is easier on the budget, but against the rules in many places due to safety regulations. This is a tough rule to follow, as much of the home-made equipment is made better than the mass-produced sensory room equipment.

How will the sensory room in the school environment be used?

You’ll definitely want to think about how are you going to use this space. Is the room going to be exclusively used by therapists and their students, or accessible by teachers (who may not have the skilled training, or supervision) to bring their class. School administration often has jurisdiction to determine how their space is used. If this is the case, make sure you plan your sensory room equipment accordingly.

Who has priority over the sensory space?

Finally, it’s important to consider who will be “in charge” of the school sensory room. Is it an equal space for anyone, or does a treating therapist working with a student have the right to refuse more students coming in. Is this space going to be used by other members of the IEP/504 team like school counselors, mental health professionals, teacher assistants and aides, speech therapy, etc.

Staff Training for School Sensory Rooms

Staff Training is a Must when it comes to a sensory room in the school environment.

Unfortunately, chaotic and unpredictable environments are sometimes created when a room is poorly designed, or personnel are not trained how to properly use the room. It is essential that the support personnel understand how to use the room itself, not just the equipment inside it.

It is more important how you use the space not what you have in it. One of the most common mistakes is to go into a sensory room and turn on every piece of equipment. This can be very over stimulating for some. If used incorrectly students can exhibit self-injurious or aggressive behavior. Remember the equipment is only as good as the person using it.

One thing we see all the time is that a student is taken into the sensory space AFTER they’ve had a meltdown or tantrum or are dysregulated. The additional sensory input might get them more “wound up” or out of sorts. A school based OT can help with teacher aides and personnel using the space more appropriately and when a student might need the tools.

Another thing we see all the time is the student that is allowed to spin or swing and this ends up getting them to a worse state or regulation. These are aspects of sensory input that can be dangerous for some students!

Visual schedules should be used and this is an area that will need staff training. A student shouldn’t be set free in the sensory space to run about and move from one item to the next. A planned out set of strategies should be used with intention.

People who do not understand sensory processing difficulties, may see the sensory room as a playground or free-for-all space. While your sensory room is designed for some freedom of movement, use it with some direction and instruction.

Children who are dysregulated are more likely to be less coordinated, have impulsive movements and behaviors, and act aggressively toward others. For this reason alone, it is wise to scope out the room before bringing your class in there. If a child is out of control, or having a sensory meltdown, it is best to wait before bringing your ten students into the sensory room.

Our teachers often call down to the sensory room (also inhabited by therapists) to see who is in there, and if the time is appropriate.

Staff need to understand the rules and protocols of this space. Check out our accompanying post for more information.

Cleaning sensory rooms in schools

Cleaning is a touchy subject that has resulted in some “courageous conversations” this year. Consider the sensory room like any other room in your house. Respect the space and leave it the way you found it (or better).

If your kid makes a mess, clean it up
Have wipes and other sanitizing equipment handy for cleaning items that have gone into student’s mouths
During cold and flu season it is best practice to wipe down equipment after using it. Alternativley, use a sanitizing spray.
When you must leave a mess behind, due to time constraints, or some other circumstance, leave a note and your plans to return. Example: this sensory swing is soiled, please do not use it. I will take it home and wash it.

School sensory room supervision

As a final reminder, supervision is a must in sensory rooms. It is very difficult to make a room that is 100% safe for all students who enter. Some sensory rooms have many different types of equipment, not all that is appropriate for each student.

Watch for flying swings. Keep fingers out of drawers, cabinets, closets, desks, or other “off limits” spaces. Restrict access to the sensory bin if your student is likely to throw birdseed all over the room.

What type of sensory spaces have you seen used in schools?

Our alerting and calming sensory strategy cards can be used in a sensory room in schools as a tool for adding intentional movement.

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