sensory diet

Exercises for Focus and Attention

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exercises for focus and attention

Studies have shown that the average attention span has declined over the past two decades. If you work with kids, you probably know that they are on short form video content more than ever. Do you notice your own attention span when watching things like TikTok, YouTube shorts, etc.?

When children engage with this type of media for extended periods, their brains become accustomed to fast-paced content, making it more difficult to sustain attention during slower-paced activities like reading, listening to a lesson, or completing written work in school. So, for those of us working in schools, this is huge.

focus and attention in kids

Impact on Learning and Academic Performance

Sustained attention is crucial for classroom learning. It’s directly linked to working memory, executive function, and the ability to retain and apply new information. Students with reduced attention spans may struggle to follow multi-step directions, complete assignments, or remain engaged during instruction. They are also more likely to miss important details, make careless errors, and require repeated instructions, all of which can impact academic achievement.

What Can Educators and Parents Do?

Understanding the neuroscience of attention helps educators and caregivers design more supportive environments. The brain’s attentional systems are trainable, children can learn to regulate their focus with intentional strategies and consistent practice. This includes embedding movement breaks, visual schedules, and multi-sensory learning into daily routines. Strategies like mindfulness, physical activity, visual scanning games, and timed task intervals can improve attention regulation.

Parents and educators can also help by limiting screen time, especially fast-paced media, and by encouraging structured downtime, free play, and activities that require sustained engagement, such as puzzles, crafts, or outdoor exploration. Supporting executive functioning and self-regulation through occupational therapy and educational interventions can also make a significant difference. attention.

Exercises for focus and attention depend on the individual’s unique needs, but there are underlying areas that can support the cognitive skills needed for learning, safety, and behaviors.

Occupational therapy providers may use toys for attention because of the primary role that play has in the occupations of a child. Therapy providers can also offer their expertise in the role sensory motor development plays in daily tasks like learning and occupational performance.

While these exercises for focus and attention are not a cure-all (in fact, the tools you’ll find here are simply a therapy support), there should be a plan in place to support unique needs. Going through a few sensory motor exercises likely won’t result in improved attention and focus on their own.

Saying that, it’s important to recognize the whole-body component that impact focus and attention. There are many factors at play here…Ask any occupational therapy provider about how occupational therapy supports the whole being, not just the physical components or the cognitive components of function. It all goes together…

What Impacts Focus and attention in kids?

Some of the factors at play include:

Certainly, let’s delve deeper into each area and discuss how they impact children’s learning and behaviors. Critical thinking skills is another resource to check out on this topic.

  1. Neurological Factors:
  • Brain Structure and Function: The prefrontal cortex, responsible for executive functions, undergoes significant development during childhood. Immature executive functions may lead to difficulties in sustaining attention.
  • Neurotransmitters: Imbalances in neurotransmitters like dopamine can affect a child’s ability to stay focused. For example, lower dopamine levels may contribute to attention deficits.
  1. Developmental Factors:
  • Child Development: Attention evolves as children grow. Younger children may have shorter attention spans, gradually improving with age.
  • Executive Functions: Developing executive functions, such as working memory and inhibitory control, directly impact a child’s ability to pay attention and control impulses.
  1. Environmental Factors:
  • Stimuli: A stimulating environment with age-appropriate learning materials can enhance attention. Conversely, an overly distracting environment may hinder focus.
  • Noise Levels: Excessive noise, common in busy classrooms, can be a significant distraction for some children.
  1. Psychological Factors:
  • Emotional State: Emotional well-being is closely tied to attention. Children experiencing stress or anxiety may struggle with concentration, while positive emotions can enhance focus. An individual’s emotional state refers to their ability to notice and adjust for emotions, or the ability to self-regulate. This is a huge component in attention. We can’t focus or attend on a task or conversation when our emotions are in control.
  • Motivation: Intrinsically motivated children are more likely to engage and sustain attention during learning activities.
  1. Individual Differences:
  • Learning Style: Recognizing and accommodating diverse learning styles can optimize attention. For instance, visual learners may benefit from visual aids.
  • Attentional Control: Children with better attentional control can transition between tasks more efficiently, positively impacting learning.
  1. Health Factors:
  • Sleep: Inadequate sleep affects cognitive performance. Children who don’t get sufficient sleep may exhibit difficulties in attention, memory, and behavior.
  • Nutrition: Proper nutrition, including omega-3 fatty acids found in fish, has been linked to better cognitive function in children.
  1. Technology Use:
  • Screen Time: Excessive use of screens, particularly in younger children, may contribute to shorter attention spans. Monitoring and regulating screen time are crucial for healthy cognitive development.

Understanding these factors is vital for educators, parents, and healthcare professionals working with children. Interventions should be tailored to address the specific needs of each child, considering their unique combination of factors.

It’s important to note that these factors often interact, and a holistic approach considering multiple aspects is crucial in interventions related to attention and focus.

One tool in our therapy toolbelt is exercises to improve attention and focus.

Why use exercises for focus and attention?

Now that we’ve explored what all goes into focus and attention in kids, let’s take a look at one support strategy.

Using physical exercises to improve focus and attention links the sensory, motor, and cognitive components. Think about it this way: after a big lunch, you might feel sluggish and unmotivated. That’s interoception at work.

We all experience this feeling, and our kids are no different. The fullness feeling after a big meal is just one example, though. There can be many things that lead to inattention or difficulty focusing.

Paying attention is hard for some kids.  There are a few different reasons for inattention during school work or homework, or when just participating in listening activities like conversations or reading.  

Learning disabilities, distractibility, poor core body strength, an overload of visual stimulation, poor working memory, ineffective executive functioning skills,  and even temperament can contribute to poor attention (among other reasons).


Numerous diagnoses like ADHD, Autism, sensory processing disorders, and more also have symptoms aligned with inattention.  

But sometimes, attention problems can be confused with diagnoses typically associated with poor attention.  Sometimes, the reason for trouble paying attention is something else.

Whatever the reason, there are easy ways to help your child pay attention. Today, I’ve got a simple way to play and work on core muscle strength and proprioceptive input through a sensory movement activity.  This super easy movement activity is so much fun that your kids will want to play again every day.  And, that’s a good thing, because the movement, proprioceptive input, and core strengthening involved will help them work toward improved attention.

Do you know a little one who can’t focus on school work?  Someone who is always distracted or forgets details of a task?  A little one who starts a project but easily gives up, never to return to the activity?  A student who is always daydreaming or wiggling in their seat and misses key information?

The DIY fidget toy is one type of “exercise” that supports attention.


Many children have trouble with paying attention and it can seem like it is only getting worse.

Attention and the Pyramid of Learning

If you take a look at the Pyramid of Learning, by Williams and Shellenberger, you will see that the base of the pyramid is the sensory systems.

Sensory Systems:

The next level of the Pyramid, which is labeled Sensory Motor Development is some of the components of attention and focus.

Sensory Motor Development:

  • Postural Security (Posture and control)
  • Bilateral Body Awareness (dominant side, coordination)
  • Motor Planning (complex and new activities)
  • Body Scheme (body structre and awareness)
  • Reflex Maturity (elimination of primitive reflexes)
  • Ability to Screen Input (selectively take in stimuli)

This last bullet point is extremely relevant when it comes to filtering out information and identifying relevant and important information. This is the essence of attention and focus. It’s neat to see that all of the motor skills in this level are at the same consideration as this screening skill, which is a cognitive ability. There is true connection between the motor and the cognitive.

The next level of the pyramid also has a huge role in attention and focus and again includes motor skill areas. This level is labelled as Perceptual Motor Development.

Perceptual Motor Development components include:

  • Eye-hand coordination
  • Ocular Motion Control
  • Postural Adjustment
  • Auditory Language Skills
  • Visual Spatial Perception
  • Attention Center Functions

Again, the last component is a huge red flag because it’s labelled as the very skill that we’re covering in this article: Attention. The motor and physical skills in this level are again related to the jobs of the attention focus center.

At the very top of the pyramid is the cognition and intellect.

Cognition and intellect includes:

  • Daily Living Activities
  • Behavior
  • Academic Learning at the very pinnacle of the pyramid

It’s interesting to note at this point that the sensory base supports the sensory motor skills (attention screening), which supports the perceptual motor skills (attention functions). The cognitive skills are supported by all of these other areas. In other words, you can’t have learning, daily functioning, and behaviors without all of the rest of the underlying skills. Powerful stuff!

Sensory and Attention in Learning

We talked about how sensory is an underlying skill of motor, perceptual skills, cognition, and function. So, we can see that sensory integration challenges negatively impact learning, including attention and focus.

Sensory integration interventions, especially in relation to the vestibular sensation, improves academic scores in children with learning disorders. Additionally, there is a relationship between academic performance and sensory seeking/low energy behaviors. (Ayres, 1972; Bar-Shalita, Vatine, & Parush, 2008; Chien et al., 2106; Polatajko, Law, Miller, Schaffer, & Macnab, 1991).

Other research has determined that physical activity and learning have improvements in attention, executive function, information processing speed, academic scores, and on-task behavior.

For individuals in a learning environment, a sensory ball, or stability ball (therapy ball) is a flexible seating option that provides physical activity (CDC, 2010; Erwin, Fedewa, Ahn, & Thorton, 2016; Mead, Scibora, Gardner, & Dunn, 2016; Kahn & Hillman, 2014; Tomporowski, Davis, Miller, & Naglieri, 2008).

One research review on the use of therapy balls as a flexible seating option found that some populations, including ADHD, found that there was increased engagement and in-seat behavior when a therapy ball was used as a seating option. And, this review found that improved attention, on-task behavior, in-seat behaviors, and improved reaction time occurred when a stability ball seating option was used. (Fedewa & Erwin, 2011; Messinger, 2014; Schilling & Schwartz, 2004; Schilling, Washington, Billingsley, & Deitz, 2003).

exercises for focus and attention

Sensory Ball Activities for Proprioception

One technique that is often recommended by Occupational Therapists for some children is the use of a large therapy ball for sitting and movement.  The therapist can guide the child in specific activities and exercises.  For our activity, we used a large and partially deflated Playground Ball similar to this one
for a simple sensory movement.


Proprioceptive input adds deep pressure to the body’s muscles and joints for a calming and organizing input.  Using a large ball like this one can help some children with inattention issues by promoting a postural reaction to a moving surface and heavy work input.

A calming corner can be a space to use these types of exercises.

Attention and Focus Exercise

Attentional Flexibility, also known as Flexible Thinking, refers to the capacity to shift focus during a task, contemplate things from a novel or diverse perspective, adapt to alterations, adjust in problem-solving scenarios, and integrate fresh information into plans or ideas. This cognitive skill involves various aspects of executive function (EF) such as working memory, attention, shift, praxis, metacognition, and more.

Here’s one example of a mental flexibility exercise:

  1. Copy or repeat a series of letters: tspjkl.
  2. Add these sets of numbers: 3 and 1, 6 and 2, 8 and 4.
  3. Subtract the paired numbers.
  4. Arrange playing cards facing up on the surface: Flip over all the cards with even numbers.
  5. Next, flip over all the cards with odd numbers.

Observe for seamless transitions between tasks. Keep a record of the number of errors. Document instances of verbal prompts (e.g., “Have you completed the task?”) and physical prompts (e.g., pointing gestures).

This task is designed to assess and enhance attentional flexibility, a crucial component in cognitive functioning.

stability ball exercises for focus and attention

Sensory Ball Exercises for Focus and Attention

We’ll go through a few different exercises to improve focus and attention below. Some of these are sensory motor exercises, designed to get the individual to a calm and regulated state.

Others are cognitive exercises that support attention and focus.

Sensory Ball Activity for Attention

You can use the proprioceptive and vestibular input of a sensory ball or therapy ball in core body strengthening.

A sensory ball is also known as a stability ball, a therapy ball, or a yoga ball. Essentially, we are talking about a large ball that you can sit on or use in movement activities.

When it comes to theory, a stability ball or a sensory ball is used as a tool in offering sensory input. Sensory input means there is nourishment for the brain, according to Ayres sensory integration theory. This occurs through the sensory systems: tactile, proprioceptive, vestibular.

A tool like a stability ball can provide input. Ayres goes on to say that sensory integration is the “organization of sensation for use”. In our case, the use we’re talking about is attention during learning or functional participation.

Inattention can be a result of core weakness of the body.  The core is the child’s trunk and midsection and is needed for support and ongoing positioning in functional tasks.  

With a weak core, a child may slump in their seat, or have trouble maintaining and changing positions.  Exercises like these with a ball can help work on the core muscle strength to help the child focus and attend while writing, cutting, and learning.

Incorporating stability ball exercises that leverage both vestibular and proprioceptive input can be beneficial for promoting balance, gross motor coordination, and overall stability.

Here are some therapy ball exercises that integrate these sensory systems of proprioception and vestibular input:

  1. Seated Bouncing:
    • Sit on the stability ball with feet flat on the ground.
    • Gently bounce up and down while maintaining a stable posture.
    • This activity provides both vestibular and proprioceptive input.
  2. Ball Rolls:
    • Lie on your stomach over the stability ball.
    • Place your hands on the floor and use them to roll the ball forward and backward.
    • The rolling motion engages both vestibular and proprioceptive systems.
  3. Balance Challenge:
    • Stand with one foot on the stability ball.
    • Try to maintain balance for a set duration.
    • This exercise combines proprioceptive and vestibular challenges.
  4. Sitting and Reaching:
    • Sit on the stability ball and reach for objects placed at different heights.
    • This engages both proprioception and vestibular input as you shift your body position.
  5. Stability Ball Squats:
    • Stand with the stability ball between your lower back and a wall.
    • Perform squats by bending your knees and lowering your body.
    • This exercise provides proprioceptive input while enhancing stability.
  6. Rolling Planks:
    • Assume a plank position with your hands on the stability ball.
    • Roll the ball in different directions while maintaining a stable plank.
    • This challenges both vestibular and proprioceptive systems.
  7. Stability Ball Circles:
    • Sit on the ball and make circular movements with your hips.
    • This activity engages the vestibular system while promoting core stability.
  8. Knee Tucks:
    • Start in a plank position with your shins resting on the stability ball.
    • Pull your knees toward your chest, engaging both core muscles and proprioceptive input.

Super Easy and Fun Movement Exercises

All you need for this activity is a large ball. You could use a Balance Ball
or just grab a bouncy playground ball like this one from your child’s outdoor play equipment.  

We partially deflated our ball and drew a heart on one side using a dry erase marker.  The heart provided a visual prompt for where to sit or push.  It made a fun activity even better as we tried to squish the heart!

Use the ball to sit, bounce, and squash for proprioceptive input and strengthening.

A few core exercises that you can try:

  • Sit on the ball and bounce.
  • Sit on the ball near a wall and have your child pick up their feet.  Use the wall to stabilize.
  • Lay belly down and roll side to side.
  • Lay belly down and roll the ball front to back.
  • Lay belly down on the ball and bounce.
  • Squash the ball against the wall with the child’s chest.
  • Squash the ball against the wall with the child’s back.
  • Stand on the ball against a wall, using the wall for support (use close adult supervision and contact for this one.)

Exercises for Self-Awareness Skills

Another type of exercise for focus and attention are those that offer self-awareness skills. This includes body awareness but also the ability to be aware of listening skills (auditory processing) and speaking skills. This includes the ability to attend to receptive language and carry that attention and focus over to expressive language.

These self-awareness skills include exercises that include crossing the midline. There are many self awareness games as well that support development of this area.

When we are involved in a conversation or other back and forth communication that uses both external and internal feedback, we have active listening. This means we don’t “drift off” during a conversation or learning experience where we need to listen and take in information, and then respond.

You probably can remember a time when you were supposed to be listening to an in-service or a lesson and you’ve felt your eyes and mind glaze over. This happens when we lose attention and drift off in focus. However for students that have this happen on a common basis, we have learning and comprehension issues.

The part of attention that allows us to listen, comprehend, and respond (either with actions or words) is a feedback-feedforward loop. It involves internal thoughts and responses as well as external motor responses. This involves self-talk as well.

Active Listening Exercises

While these exercises are more of an auditory processing activity, you can incorporate movement too. This involves whole body learning.

Auditory attention is a sub-component of attention.

These active listening exercises can be graded up or down, depending on the needs of the individual.

  1. Sound Discrimination Games:
    • Play games that involve distinguishing between different sounds. For example, you can use everyday objects that make distinct sounds and ask the child to identify them.
  2. Auditory Memory Challenges:
    • Create listening challenges that require the child to remember sequences of sounds or words. Start with short sequences and gradually increase the complexity.
  3. Musical Activities:
    • Engage in musical activities like rhythm games, clapping to a beat, or playing simple instruments. These activities can enhance auditory processing and attention.
  4. Listening to Instructions:
    • Provide verbal instructions for various tasks and ask the child to follow them. This can be done through games or daily activities, reinforcing both listening skills and attention. This can include games like Simon Says.
  5. Storytelling with a Twist:
    • Tell a story with pauses and ask the child to fill in the missing parts. This not only improves auditory processing but also encourages active listening. You can also do this with nursery rhymes or fill in the blank song lyrics.
  6. Echo Games:
    • Create echo games where the child repeats patterns of sounds or words. This helps in honing auditory discrimination skills.
  7. Listening Walks:
    • Take the child on a listening walk outdoors. Encourage them to focus on and identify different sounds in their environment. This supports auditory discrimination skills.

 
Try these sensory movement activites and exercises for helping kids learn to pay attention. Easy ball therapy exercises using proprioception and core muscle strengthening with a frugal and easy alternative to a therapy ball. Occupational Therapy tips for kids.
 



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Try these sensory movement activites and exercises for helping kids learn to pay attention. Easy ball therapy exercises using proprioception and core muscle strengthening with a frugal and easy alternative to a therapy ball. Occupational Therapy tips for kids.
 


 
 
Try these sensory movement activites and exercises for helping kids learn to pay attention. Easy ball therapy exercises using proprioception and core muscle strengthening with a frugal and easy alternative to a therapy ball. Occupational Therapy tips for kids.
 
Other exercises for focus and attention can be specifically play-based. Here are some ideas: 
 
 
Coke bottle water xylophone Teach kids to tie their shoes the fun way egg carton craft Creative Pencil Grasp Activities Organization, Attention, and Sensory Processing

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

What is a Sensory Diet?

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what is a sensory diet

Many times, parents are told that their child with sensory needs would benefit from a sensory diet. Most of the time, they respond with “what is a sensory diet?!” In this article, we’ll be talking a bit about what a sensory diet is and how it can be beneficial to kids with sensory needs. You may have seen some of our recent posts here on The OT Toolbox about Sensory diet activities for the classroom or sensory diet activities for outdoors that may give you a better understanding of some of the sensory activities that can be used within a sensory diet. 

A sensory diet is not just for kids! A sensory diet for adults is just as powerful in supporting regulation needs for individuals of all ages.

Inside The OT Toolbox Membership (Level 2), we have a page dedicated to sensory diet materials. This includes things like gross motor cards, sensory bin materials, self-regulation tools like brain breaks and emotional regulation strategy activities. You’ll also find materials like Yoga cards and handouts to help with making the home or classroom more sensory friendly.

The reason we have such a wide variety of sensory diet materials in the membership is because there really is an endless list of ways to support an individual with a “sensory diet”. I actually like to call it a sensory lifestyle as we explain in our book, The Sensory Lifestyle Handbook. This book is also inside The OT Toolbox Membership (Level 2).

what is a sensory diet

What is a sensory diet?

Often times, when you mention the term “sensory diet”, individuals respond with a comment about food or a eating healthier. A sensory diet has nothing to do with food or restricting foods, or eating healthier!  

A sensory diet can be described this way: 

A sensory diet is a set of activities that make up a sensory strategy and are appropriate for an individual’s needs.  These are specific and individualized activities that are scheduled into a child’s day and are used to assist with regulation of activity levels, attention, and adaptive responses. 

These are organizing activities or sensory input that helps to regulate the nervous system. Our resource on the limbic system and fight and flight of the nervous system explain this more.

You’ll also want to read more about emotional regulation and function.

Sensory diet activities are prescribed based on the individual’s specific sensory needs.  

Just as there are no two people that are alike, there are no two sensory diets that are alike. 

Sensory diets are a commonly known strategy for addressing sensory needs. We’ve seen sensory diets implemented in sensory spaces in the school environment. Read our blog posts about creating a sensory diet on a budget and calm down corners for more information.

The term “sensory diet” was coined by Patricia Wilbarger in 1984 to
explain how certain sensory experiences can improve occupational performance and help to remediate disruption of the sensory processing systems. 

A sensory diet is a means to adjust sensory input in relation to an individual’s needs. A sensory diet is a meaningful set of strategies for developing sensory programs that are practical, carefully scheduled, and controlled in order to affect functioning. 

Sensory diet activities provide appropriate sensory input based on the needs of an individual. 

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

Sensory diets are not just for kids with identified sensory issues.  We all
need a diet of sensory input.  Most people naturally participate in conscious or subconscious acts that meet their specific needs.  

Think about the student who taps their pen against the desk while struggling on an exam.  That’s a sensory strategy.

You might pace the floor while on the phone with your child’s pediatrician.  That’s a sensory strategy.

You might see a teenager who jiggles her leg while watching a movie.  That’s a sensory strategy. 

We all have a big yawn every once in a while. That’s a sensory strategy. 

Our bodies and minds instinctively know that varying sensory input allows us to function appropriately.  Neurotypical children naturally seek out a variety of proprioceptive, vestibular, and tactile sensory input.  As a result, they are able to accept and regulate other sensory input such as a seam in their shirt, a lawnmower running outside their classroom, or the scent of chicken cooking in the kitchen.

Some individuals lack the ability or support to perform these sensory strategies without interventions. 

We’ve talked about the goals of a sensory diet before here on The OT Toolbox. The goals of a sensory diet are very important. 

Equally important is the development of sensory diets. A sensory diet needs to be specific with thoughtful regard to timing, frequency, intensity, and duration of sensory input.

Sensory diets should be created by an occupational therapist who evaluates the child or individual and ensures carryover, and response to sensory input.

These vestibular sensory diet activities can give you an idea of the type of activities typically found in a sensory diet…remembering that each child’s sensory diet is specific to their needs. 

what is a sensory diet

Why use a sensory diet?

Sensory diets can be used to address the following challenges, using specific sensory input:

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

Poor social Interactions 

If you are interested in learning more about sensory diets and how they can be used to create a sensory-enriched life in all aspects of a child and family’s day, you will want to watch for The Sensory Lifestyle Handbook.

Sensory diets and specific sensory input or sensory challenges are a big part of addressing sensory needs of children who struggle with sensory processing issues. Incorporating a schedule of sensory input (sensory diet) into a lifestyle of naturally occurring and meaningful activities is so very valuable for the child with sensory needs. 

That’s why I’ve worked to create a book on creating an authentic and meaningful sensory lifestyle that addresses sensory needs. The book is now released as a digital e-book or softcover print book, available on Amazon. 

The Sensory Lifestyle Handbook walks you through sensory diet creation, set-up, and carry through. Not only that, but the book helps you take a sensory diet and weave it into a sensory lifestyle that supports the needs of a child with sensory processing challenges and the whole family.

Get The Sensory Lifestyle Handbook here.

Here are more sensory activities that may help with sensory needs or for a sensory play idea.

Snowball Shot Put Vestibular Activity 

Vestibular Activity Indoor Winter Frisbee 

Backyard Vestibular Activities for Sensory Play

Ice Wobble Disc Vestibular Activity

 

 
 
 
Wondering what a sensory diet is? This article explains what exactly a sensory diet looks like and how a sensory diet is used to help kids with a variety of sensory-related challenges, using sensory diet activities.

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

Understanding Sensory Dysregulation

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picture of a stress meter with arrow pointing to red. Words read "stress and dysregulation. Therapy tools, information, resources".

A term you may have heard when it comes to sensory processing is sensory dysregulation. What does this mean? Are there clues for dysregulation? We all have differing sensory needs, and dysregulation can look like different things for everyone. Have you ever wondered about specific sensory strategies for regulation to support a dysregulated sensory system? We’ll cover all of this in this post.

Sensory dysregulation

Sensory Dysregulation

Remember your last temper tantrum? Do you remember what it felt like to be suddenly so sad, mad, and completely out of control? Most of us probably had our last true temper tantrum more recently than we care to admit.

A majority of those emotional outbursts were probably exacerbated due to a number of reasons; lack of sleep, poor diet, undesirable environment, discomfort, or pain. Deciphering the difference between a tantrum and sensory meltdown is a must.

One ongoing debate in the pediatric therapy world is discussing what behaviors are due to sensory-related reactions, and what behaviors are due to something else. How many toddlers (or teenagers!) temper tantrums may actually be related to their sensory experience? If it really is sensory-based, then what are the solutions?

The OT Toolbox is here to do our best to answer your sensory-related questions. A great first step in determining whether unwanted behaviors are based on sensory experiences, is to learn about what sensory dysregulation is. To get started, here is an article about sensory processing red flags.

Playing a huge role is understanding self regulation and the ability to select and implement self regulation strategies based on sensory needs.

what is sensory dysregulation

WHAT IS SENSORY DYSREGULATION?

Sensory dysregulation refers to a mind or body state which occurs when the body is out of balance due to experiences in the sensory environment. Think about how sounds, textures, exercise, movement, smells, light, and other input can affect your mood. Sensory dysregulation is the result of either too much or too little stimulation for best functioning or self-regulation.

For example, overstimulation anxiety can be a result of too much sensory stimulation that results in overwhelming worries or anxiety. This is just one way that the overload of sensory input can impact us.

Read more about mood and affect and how these terms are connected to sensory dysregulation.

It’s more than sensory touch and the input we receive through our skin. It’s the inability to regulate sensory input from ALL the sensory systems.

A key component outcome of sensory dysregulation is self-regulation. There are many ways to define self-regulation, but generally, it is one’s ability to remain at an acceptable level of emotion, energy, behavior, and attention – given the demands of their environment.

 In order to achieve self-regulation, one must also have good sensory regulation. 

Sensory dysregulation is something that anyone can experience, and most people probably have experienced a level of sensory dysregulation to some degree.

Everyone has sensory preferences, like how loud they listen to music, or if they enjoy lots of hugs. If your preference is to have less, your systems would become out of balance with the music too loud or people getting too touchy.

Each of us has our own limits given any situation – but once you are in tune with your body’s needs, you know when it has become too much. When the system is unbalanced, maladaptive behaviors (tantrums) occur, if no coping strategies are implemented. We covered this individualized preferences and nuances of neurodiversity in greater detail in our post on Sensory Diets for Adults.

People with sensory processing disorder, which is an issue on a larger scale that affects a much smaller portion of the population, feel dysregulated more often and have far less ability to self-regulate. While sensory processing disorders can exist in isolation, they may be most prevalent in those with Autism or ADHD. 

One example of dysregulation is the individual with sensory needs dealing with a fire drill. There are a lot of sensory inputs all at once, and navigating that stressor is distressing!

Check out our resources at the end of this article for great coping tools! 

WHAT DOES DYSREGULATION LOOK LIKE?

Sensory dysregulation, much like emotional dysregulation, feels uncontrollable. Something is “wrong” and a person may not know what is causing them to feel “off”, or how to solve the problem. Sensory dysregulation may look and feel similar to emotional or behavioral dysregulation, that can cause temper tantrums.

The main difference is that sensory experiences are the root cause of the behavioral responses – not social disagreements or the like. It is complicated to tease out whether the issue is behavior or sensory. Look first at the triggers.

A simpler way to understand of sensory dysregulation, is by breaking it down into two categories: over-responsiveness or under-responsiveness to the environmental stimuli. 

  • Over-responsiveness may look like: sensory avoidant behaviors such as excessive covering of the ears, hiding, avoiding touch, or extreme picky eating. The body may be responding too much to the incoming information. One reaction is to avoided it to, remain at baseline. 
  • Under-responsiveness may look like: sensory seeking behaviors such as excessive or repetitive body movements, touching everything, making sounds, or licking/chewing on non-food items. Pushing other students while waiting in line. The body may be responding too little to typical input, to the point that the seeker looks for more of it to remain at baseline. 

It is important to begin to recognize sensory over-and-under responsiveness and the role it plays in sensory regulation. Understanding what kind of behaviors a child has, will allow you to choose the right remedy. 

  • Over-responsive → Sensory Avoider → Need for less
  • Solution – calming activities, breathing exercises, variety of activities to slowly increase comfort level 
  • Under-responsive → Sensory Seeker → Need for more 
  • Solution: heavy work, brain breaks, fidget tools, variety of sensory experiences

Resources from the OT Toolbox for Deep Breathing, Self-Regulation activities, Emotional Learning and Regulation, and the Sensory Lifestyle Handbook are a perfect starting point. 

SENSORY DYSREGULATION IS NOT: 

Sensory dysregulation is NOT the same as behavioral or emotional dysregulation, which may look like:

Not sensory dysregulation:

  • Crying at the store after they were told “no”
  • Pushing their brother after he took their toy
  • Eating all foods but never what the family is eating 
  • Dumping/throwing toys after being told it’s time to clean up 
  • Covering their ears during a fire alarm
  • Screaming after a sibling teased them

You may be thinking, wait a minute…some of those actions are sensory-based behaviors! 

You are correct! However, just because something is related to the sensory experience, does not always mean that sensory dysregulation is occurring. 

As an example; the sound of a fire alarm is loud auditory input, however, covering your ears during a loud sound is a normal response. If there is more of a reaction than that, for instance, if a child is inconsolable or unable to move on after the fire alarm, that may be considered sensory dysregulation.  

Sensory Dysregulation Symptoms

When symptoms of sensory dysregulation is in question, you should be asking:

  • What does the environment look like? Feel like? 
  • What is the child communicating with their actions? 
  • When and where does this behavior typically occur? In what similar situations does it not occur? 

Some behaviors, like pushing, can be tricky to determine if it is sensory or behavior; Look at the trigger. The proprioceptive system can be dysregulated. Is the child pushing for sensory reasons? 

  • Bumping into things during play, crashing often, seemingly unaware of their body? Then they may have some sensory dysregulation going on that is increasing their need for input.  Pushing people who get too close, hugging too hard, or bumping into people, may also be signs of sensory dysregulation.
  • If a child pushes a friend after they did something mean, that is just poor social skills. 

WHAT ARE THE SYMPTOMS OF DYSREGULATION

Usually we notice the symptoms of dysregulation first. It manifests in behavioral reactions, health consequences, stress, and cognitive difficulty. 

  • You are constantly on edge – you feel nervous, stressed out, overwhelmed, and have the sense that you can not keep up
  • Frequently irritable, snappy, and disagreeable. You might overreact, feel tense, get frustrated easily, and have mood swings like going from happy to sad quickly
  • Chronic pain and illness – aches and pains that do not go away, easily getting colds and other illnesses, see several specialists without relief
  • Highly sensitive to stimuli. You might identify as a highly sensitive person. Things that people may not even notice bother you.  Smells, the sound of people snapping gum, fabrics, clutter, or being in crowds may feel overwhelming. You might be anxious, depressed, or stressed by the amount of information coming in. 
  • Sleep problems and daytime fatigue – your nervous system has a hard time relaxing to go to sleep, or is hypervigilant during the night. You wake with your gas tank half full, so by mid morning you are fatigued. It may be difficult for you to regulate your temperature and heart rate during the night, leading to additional fatigue.
  • Chronic attention and concentration problems – because your system is on high alert, signaling danger, it might be hard to concentrate and pay attention to important information. You may find it difficult to tune out non important stimuli. 
  • Cravings and extreme appetite changes
  • Immune and hormonal symptoms
  • Gut and skin conditions like rosacea and IBS.  These can be aggravated by stress and dysregulation
  • You are highly sensitive to other people’s emotional states – you might be considered an empath. This may seem like a great trait, except it is draining. You take on the emotions of those around you and are constantly trying to help people.  No matter how much you do, it never seems enough.

You do not have to have all of these symptoms to be considered dysregulated.  Even if you have a couple of these symptoms, it can feel overwhelming and draining. 

HOW CAN YOU support Sensory Dysregulation?

If a child’s sensory system is dysregulated, there is good news: there are many ways to help! There is a catch though – there is no “one size fits all”. Trial and error is the name of the game with sensory interventions.

Once you and your child find out what works for them and their changing environments, they will have a deeper understanding of themselves, and display improved behaviors in no time! 

Check out these resources for sensory integration, calming exercises, self-regulation activities, and more! Also be sure to read our blog post on Ayres Sensory Integration for information on the theory behind this process, and how it all works together. It’s fascinating!

Tactile Sensory Input:

Heavy Work/ Propceptive Sensory Input:

Vestibular Sensory Input:

Combined Sensory Input:

Deep Breathing Activities:

Mindfulness:

If you have tried everything, and are feeling a bit lost, you are not alone! Sensory dysregulation is tricky. It should be considered alongside many other aspects of why a child reacts a certain way. In addition to behavior, emotions, and self-regulation; history, habits, trauma, and mental status can have a powerful influence on actions, too. 

Keep trying – some things may feel like a roadblocks but there are specific action strategies you can use!

The Sensory Lifestyle Handbook
The Sensory Lifestyle Handbook

The Sensory Lifestyle Handbook walks you through sensory processing information, each step of creating a meaningful and motivating sensory diet, that is guided by the individual’s personal interests and preferences.

The Sensory Lifestyle Handbook is not just about creating a sensory diet to meet sensory processing needs. This handbook is your key to creating an active and thriving lifestyle based on a deep understanding of sensory processing.

dysregulated nervous system

After reading all of the above about dysregulation, and what a dysregulated nervous system looks like, let’s take a step back.  In order to understand the symptoms and signs of dysregulation, we need to understand the basics of the nervous system. That’s a really important piece of the puzzle to help parents that we are supporting as the pediatric occupational therapy provider on a child’s team.

The dysregulated nervous system impacts practically everything that we do and what we see in the form of behaviors, sensory needs, emotions…it’s at the base of it all.

But when we hear from our clients’ families or the parent, the school counselor, the teacher of a child with issues impacting day to day life and learning, the nervous system isn’t’ the first thing to come to mind.

NERVOUS SYSTEM BASICS

The nervous system is made up of two parts; the central and peripheral systems. Together these systems regulate our consciousness, movement, response to the environment, and bodily functions such as digestion, heart rate, and breathing. 

  • The central nervous system is made up of the brain and spinal cord. It interprets incoming signals, formulates responses, and plays a big role in memory and cognition. 
  • The peripheral nervous system extends out from the central nervous system out to the limbs. It communicates with the CNS to respond to information coming from the environment and inside our bodies. 
  • Under the peripheral nervous system is the autonomic nervous system. This can be thought of as the “automatic” nervous system. This system works without conscious thought, controlling the heart rate, digestion, respiratory rate, and fight or flight response. 
picture of a stress meter with arrow pointing to red. Words read "stress and dysregulation. Therapy tools, information, resources".

The stress we feel impacts social emotional skills, behaviors, functioning, learning, and more.

Understanding the stress response

The fight or flight response is important to our survival. It alerts us to dangerous situations to protect us from harm.  This is a great system, until it over-responds.

A chronically over-reacted fight or flight response leads to dysregulation. There are times when our nervous system, including the fight or flight response, becomes dysregulated.

This can be caused by stress, genetic predisposition, or trauma. When the system is dysregulated, it can cause more stress, burnout, anxiety, and various types of chronic pain and illness.

Dysregulation and Trauma

Understanding the impact on a dysregulated nervous system trauma has is important because we as pediatric occupational therapy providers see a huge variety of trauma responses in our therapy clients. There can be so many levels to this but one thing is for certain: there will be some level of a dysregulated nervous system when trauma exists.

Read our blog post on trauma informed occupational therapy for information and resources on how to support clients with a history of trauma.

CAUSES OF DYSREGULATION

One thing that comes up from parents or educators who see the results of regulation troubles is the “why”. We need to explain, as occupational therapy providers, the causes of dysregulation so that the child’s team can better understand why they are seeing the resulting behaviors, social emotional challenges, learning struggles and functional task issues.

An over-response of the fight or flight system is often the cause of dysregulation. Where  does this come from?

  • Chronic stress – when the nervous system suffers from chronic stress, it remains in a state of high alert. Over time, this state of high alert can lead to hypervigilance and overwhelm.
  • Trauma can lead to dysregulation. This might come from witnessing traumatic events, abuse, accidents, or surgeries.
  • Adverse childhood experiences – negative childhood experiences such as emotional or physical abuse, neglect, living with caregivers who abuse substances, or have mental health issues.
  • Genetic factors – certain gene variations make people prone to anxiety and stress.
  • Lifestyle factors – poor diet, lack of exercise, and inadequate sleep can contribute to nervous system dysregulation. Stimulants like caffeine, alcohol, and certain medications can lead to dysregulation
  • Underlying health conditions – fibromyalgia, chronic fatigue, hormonal imbalance, and some autoimmune disorders can lead to dysregulation of the nervous system. Deficiencies in certain vitamins such as magnesium, B, and omega fatty acids can also lead to dysregulation.
  • Environmental factors – heavy metals, pesticides, chemicals, mold, noise pollution.

When you think about the people in your life, especially the young ones, can you see some of these factors in their life?  Children chronically have lack of exercise, poor diet, not enough sleep, exposure to chemicals, additives in their food, and often some sort of trauma.

With this type of lifestyle becoming the norm, it is no wonder so many littles are dysregulated.

EMOTIONAL/BEHAVIORAL DYSREGULATION CHANGES

We often notice behavior before other symptoms of dysregulation. This is a classic sign in regulation disorders such as ADHD, ADD, Autism, and bipolar disorder.  The behaviors are caused by dysregulation, that usually has an underlying factor. You might feel overly intense emotions, impulsive behavior, lack of emotional awareness, trouble making decisions, inability to manage behavior, and avoiding difficult decisions.

People with emotional/behavioral changes struggle to make and keep friends, difficulty with compliance, can be defiant, and have difficulty completing tasks. 

TREATMENT FOR DYSREGULATION

If your dysregulation is part of a larger disorder such as ADD, medication can help with the symptoms. 

  • Therapy – both talk, play, and occupational therapy to help with regulation and identifying triggers. Dialectical behavioral therapy helps you with mindfulness, identifying your emotions, and separating emotions from facts.
  • Be consistent and organized – kids thrive on routine. Give your child/partner a heads up if you plan on changing the plans
  • Adjust accordingly – sometimes you need to make accommodations and adaptations to be successful
  • Reward positive behavior
  • Journal – writing down feelings and thoughts can help you process them. Also looking back at journal entries can give you clarity
  • Heavy work helps organize the central nervous system. Chores, exercise, physical activity or taking a walk can help
  • Reverse or reduce some of the triggering factors such as sensory overload, overeating, environmental toxins, processed foods, toxic people, drugs, caffeine, technology, and stress
  • Add things that are missing such as critical vitamins, healthy food, exercise, communication, and fresh air
  • Take care of yourself physically. Seek medical attention for chronic or undiagnosed illnesses.  Some illnesses like IBS can go away once stressors are reduced

What to Do When a Child is Dysregulated: Support Strategies That Work

When a child is melting down, shutting down, or acting out, it can feel overwhelming for both the child and the adult supporting them. In these moments, logic, reasoning, and consequences simply don’t work. Why? Because a dysregulated brain can’t access higher-level thinking skills like problem-solving or impulse control.

But the good news? There are ways to help, and they start with understanding what dysregulation is, why it happens, and how to respond in the moment using evidence-based sensory and regulation tools.

What Does It Mean When a Child Is Dysregulated?

Dysregulation refers to a state where the child’s nervous system is overwhelmed. Their body and brain are no longer in a calm, alert state, they may be overly aroused (hyperactive, emotional, aggressive) or under-aroused (shut down, frozen, withdrawn).

In these moments, the prefrontal cortex (responsible for thinking and reasoning) essentially goes offline. They are in a fight or flight response.

Why Can’t They Just Listen or Calm Down?

This is a question many parents, educators, and therapists ask. The answer lies in brain science: when a child is dysregulated, they can’t process rewards, consequences, or reason. Asking them to “make a better choice” or “use their words” won’t be effective until they feel regulated and safe again.

So What Should I Do Instead?

Here’s how to help when a child is dysregulated:

1. Focus on Regulation First, Not Correction

Before offering consequences or even explanations, help the child feel physically and emotionally safe.

  • Stay calm and grounded yourself. Children borrow regulation from the adults around them.
  • Speak slowly, softly, and clearly.
  • Use phrases like: “You’re having a hard time. I’m here with you.”
    “Let’s help your body feel calm first.”

2. Use Sensory Strategies to Regulate the Body

Support the child’s sensory needs to calm their nervous system. Heavy work activities are especially effective because they engage the proprioceptive system, which promotes a calming, organizing effect on the body.

Try:

  • Wall push-ups
  • Carrying a weighted backpack
  • Jumping or stomping
  • Pushing/pulling a laundry basket

Read more about heavy work activities here.

Our Heavy Work Activity Cards are perfect to have on hand in the classroom, home, or therapy room for quick regulation strategies.

3. Offer a Low-Stimulation Environment

If possible, reduce sensory input:

  • Turn down lights
  • Reduce noise
  • Remove visual clutter
  • Guide them to a calm space with minimal demands

4. Don’t Over-Talk

Skip reasoning or explaining in the heat of the moment. Instead, focus on co-regulation:

  • Sit quietly nearby
  • Offer a fidget, weighted lap pad, or calming visual
  • Match their energy gently, then guide them toward calm

5. Once Regulated, Then Reflect

After the child returns to a calm state, that’s when the learning happens.

You can now:

  • Talk through what happened
  • Name the feelings involved
  • Brainstorm alternative responses
  • Reinforce coping tools that worked

Common Questions About Helping a Dysregulated Child

How long does it take to regulate?

Every child is different. Some may need just a few minutes, while others may need a longer period of sensory input and calm.

Is dysregulation a behavior problem?

No. It’s a regulation challenge. Addressing the nervous system first is key to helping the child access self-control.

How do I know what will help my child?

Start by understanding your child’s sensory profile. Our free Sensory Processing Checklist can help identify patterns.

For a more structured plan, check out our Sensory Lifestyle Handbook. This is a practical guide to creating daily routines that support sensory needs.

How to Prepare for the Next Dysregulation Moment

You can’t prevent every meltdown or moment of overwhelm, but you can prepare for them.

Tools to have ready:

  • A visual schedule or Zones of Regulation check-in
  • A set of brain breaks for movement and transition times
  • Go-to heavy work activities for sensory input
  • Emotions check-ins to build emotional literacy

Explore our popular resources:

Get Ongoing Support Inside The OT Toolbox Membership

Inside our Membership, you’ll find hundreds of downloadable tools that help support regulation every day, including:

  • Heavy work printable packs
  • Brain break visuals
  • Sensory check-ins
  • Calm down tools
  • Zones of Regulation supports
  • Social emotional learning printables
  • And so much more

Join today to get instant access to tools that help you prepare for dysregulation before it happens, and support kids in the moments they need it most.

Sometimes just thinking about all the things wrong in this world can make you feel stressed. Trying to fix everything and everyone is overwhelming.  Focus on one thing or one person at a time. Take care of one part of your lifestyle, rather than making radical changes all of a sudden.

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

Weighted Vests and Compression Garments

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What does a weighted vest do for kids? Picture of a weighted vest

Weighted vests, weighted clothing, and compression garments are used to offer proprioceptive input to elicit a calm and focused response. They tend to be used as a sensory intervention for children with diagnoses like sensory processing disorder, autism (ASD) and attention deficit hyperactivity disorder (ADHD), with the purpose of calming the body for functional activities.

Weighted vests are a hot topic in the therapy world, as they have been used in practice for decades. Sensory strategies are difficult to research, gather data, or prove their efficacy. Want to learn more about sensory processing disorder? Use this checklist to guide you! 

Weighted Vests for Kids and Deep Pressure Tools

Weighted compression vests are one type of sensory input tool used to support children with sensory issues, including those with special needs. These vests are designed to offer consistent deep pressure input, a calming and organizing force that comes from engaging the muscles, joints, and connective tissue. This proprioceptive input helps a child become more aware of their body in space, which can improve focus, emotional regulation, and overall function throughout the day.

Many vests are made from neoprene material, offering gentle stretch and comfort while providing compression. Some models even include built-in ventilation to increase breathability during extended wear. Others feature interior weight pockets, allowing for adjustable weight and easier customization for different year old age ranges or teens who may need less weight or a vest that matches their child’s clothing more discreetly.

What does a weighted vest do for kids? Picture of a weighted vest

What Does a Weighted Vest Do for Kids?

A weighted vest works by offering steady deep pressure across the torso, especially around the waist and top of the shoulder, areas that support postural stability and body awareness. This input can have powerful effects on a child’s ability to:

  • Stay focused during learning tasks
  • Reduce sensory-seeking behaviors like fidgeting, jumping, or crashing
  • Manage emotional responses during transitions or overwhelming activities
  • Experience the sensory integration therapy benefits often sought through OT sessions

When paired with adult supervision and used properly, these vests can be a perfect addition to a child’s home routine or even integrated into their child’s school supplies for classroom use.

For children with sensory processing disorder or those with autism, this type of sensory input tool can offer a quiet and supportive way to regulate. Some children even prefer it over other forms of input because it doesn’t draw as much attention from peers, especially when vests are designed to look like athletic wear.

When to Use a Weighted Vest for Kids

It’s important to work with an occupational therapist to decide when and how to use a weighted compression vest. Use should be purposeful, short-term, and part of a comprehensive sensory diet. Ideal times might include:

  • Homework time
  • Classroom focus work
  • Transitions that often trigger dysregulation
  • Emotional regulation practice or calming routines
  • Circle time or gross motor tasks that require attention to the body

Wearing the vest should be limited to around 15–20 minutes at a time, followed by breaks. Keep in mind that categories of vests differ in design and weight, so proper fit and width (especially across the chest and shoulders) matters. Many options come with adjustable closures like a hook system for a snug but flexible fit.

Other Deep Pressure Tools and Proprioceptive Strategies

In addition to vests, there are other tools and activities that can provide proprioceptive input and support sensory integration:

  • Click to see examples of compression clothing or snug-fitting neoprene wraps
  • Weighted lap pads or shoulder wraps
  • Wall pushes, towel wringing, or resistance-based exercises
  • Carrying heavy items, like books or laundry baskets
  • Animal walks, bear crawls, or wheelbarrow walks
  • Jumping, pushing, pulling: activities that engage multiple muscle groups
What do weighted blankets do and research vs. clinical experience

Weighted clothing Research review versus clinical observation

This article will dive into the research versus clinical observation, on the use of weighted vests and compression clothing. Here at The OT Toolbox team, we’re lucky to have therapists with a variety of experiences, and years in the field. This blog post on weighted clothing, weighted blankets, and other weighted sensory tools explores both clinical experience and evidence for a combined viewpoint.

We’re covering both here: what the research says about weighted clothing and what clinical experience and data says about these weighted tools.

The first author, Sydney Thorson OTR/L is a school based therapist who bases her practice on research and evidence based practice. The second author, Victoria Wood OTR/L is an occupational therapist with 30 years of clinical experience, who bases her treatment on clinical observation, data collection, and real life experience.

Research on weighted vests and compression clothing

Research on weighted vests and Compression Vests

(Research review by Sydney Thorson OTR/L)

Weighted vests have been used in clinical practice for many years, without strong research evidence they actually work. In my opinion, this is a big deal for our field, as we should not be implementing such tools without good reason. If you’ve ever had questions about best practice and research on weighted vests, compression clothing, and weighted compression vests, read on.

A note about Research on Weighted Clothing, Weighted Vests and Compression Garments

If you are looking to purchase a vest or implement it into therapy, there is not much data available online, or in popular pediatric therapy books. Some features of the vests may be noted in research articles. Important factors such as the amount of weight to be used, the length of time it should be donned, or the frequency of use is never suggested. Why? Because we simply do not have any data to support this yet.  

Most importantly, occupational therapists are often providing treatment under the Individuals With Disabilities Education Act, which mandates therapeutic and instructional strategies must be research-based whenever possible.

How Do I Know Which Research to Trust?

One of the most difficult parts of a literature review is understanding how likely it is that the study results are actually “true”, and therefore, clinically significant. In my review below, I have noted how strong the level of evidence, so that you can decide how best to use the information moving forward. 

What does it mean to be clinically significant? 

Statistical significance is what tells researchers if their chosen effect really happened or not. A researcher may determine that a weighted vest has a statistically significant effect based on their data from a research environment. In real-life practice, it may not have the same results.

The clinical significance is just another way to say, “does this treatment actually work for my patients in their normal environment?” 

All good literature reviews start a question that needs to be answered:Do weighted or compression vests improve regulation in children with disabilities? 

In my opinion, the simple answer is…probably not. 

Best Evidence for Weighted Vests

A systematic review is generally the best way to learn about a research topic. Researchers thoughtfully and methodically take into account numerous studies, compiling the results into one article, for the reader to enjoy. 

One of the more recent systematic reviews, titled, “Systematic Review on the Efficacy of Weight Vests and Blankets for People with ASD or ADHD” noted that earlier reviews found that these items did not have efficacy (Denny et al., 2018). Since then, data continues to show inconsistent effectiveness of weighted vests.

This review included 18 studies, four of which were also systematic reviews. The efficacy of each study in this review was noted and used to offer the following results;

Results (Denny et al., 2018)

  • In individuals with ASD or ADHD:
    • Moderate evidence suggests that weighted items can increase attention and occupational performance. 
    • Mild evidence supports that weighted items can reduce maladaptive behaviors, like aggression, self-injurious behaviors, or off-task behaviors.
    • No evidence supports the use of weighted items to increase adaptive behaviors, like seated, on-task behavior. 
  • More rigorous studies are needed to determine if weighted items actually produce a clinically significant effect. 
  • Use weighted items cautiously to determine if they will provide positive outcomes. 

Should Occupational Therapists Use Weighted Vests? 

In my opinion, with the inconsistent and insufficient available evidence of an intervention that is broadly used, OTs should turn to the leaders for guidance. This would include the American Occupational Therapy Association (AOTA). The American Journal of Occupation Therapy (AJOT) provided two systematic reviews on the topic of sensory interventions in 2020. 

One review reported that weighted vests are not effective in increasing educational performance in children with ASD (Grajo, Candler & Sarafian, 2020). 

The other systematic review from the AJOT went even further and stated that “weighted vests/items…received a red light designation…indicating that therapists should not use these approaches for children with sensory processing challenges” (Battin et al., 2020). 

Best Evidence for Weighted Compression Vests 

Compression vests are currently less likely to have specific data on their use, as they are often used a part of a treatment plan, either with weighted vests or other sensory items. Weighted vests are far more popularized in the research arena, but below you will find the best available evidence for compression vests. 

A meta-analysis (including a systematic review) that complied recent data for deep pressure therapy items, including weighted and compression vests, squeeze machines, and brushing therapy, found that none were supported by evidence for any reason (Losinski, Sanders & Wiseman, 2017).  Many of the studies reported on were low-quality for a number of reasons, and it is unknown how this could contribute to the results. 

Weighted Vests and Autism

Occupational therapists often support individuals on the autism spectrum in the classroom, home, community, and clinic. OTs work closely in early intervention services with individuals diagnosed with autism. 

While there are benefits for using weighted vests with individuals on the autism spectrum, in my opinion, it’s important to discern, through a research review, whether the specific needs of the individual are addressed.

A weighted vest, weighted clothing, compression clothing, compression bed sheets, or weighted blanket are just some of the tools used to support individuals with autism. 

The benefit suggested of a weighted device or compression material refers to the regulation of the central nervous system, and the physical input through the proprioceptive system. This input can impact sleep, temperature regulation, to organize and calm the nervous system. It’s easy to see the connection between the nervous system, regulation of the individual, and functional performance of tasks. 

Another great resource is the use of sensory clothing, or clothing that supports sensory needs, no matter the diagnoses or preference. In recent years, there are more options out there as well as greater availability to accessing sensory-friendly garments.

Should Occupational Therapists Use Compression Vests? 

Unsurprisingly, there is limited guidance from our OT leaders at AOTA and AJOT that is specific to compression vests. This means that therapists can wait for guidance to come out, conduct their own research to add to the mix, or follow their next best available guidance. My gut tells me to follow the guidelines from AJOT for weighted vests, noted above. 

This data trend is not exclusive to vests – some recent data does not support implementing any single-system sensory intervention in the school environment. Single-system sensory interventions, like swings, vests, and brushing, are becoming increasingly unsupported by leaders in occupational therapy (Grajo et al, 2020; Novak, 2019; Bodison, 2018; Wong et al, 2014; Watling, 2015).

This data does not make any statement towards other “sensory” experiences that are play-based, functional, or explorative in nature. 

Research on the use of sensory-based interventions presented in the AJOT in 2018 suggested that many OTs “continued to use primarily clinical experiences and knowledge from their professional education programs rather than formal evaluations or scientific literature” (Carter & Glennon, 2018). The authors (and I) recommend a shift in our practice to utilize research evidence over personal experiences. 

Clinical observation, data collection, real life experience on the benefit of weighted vests and compression tools

(Clinical experience by Victoria Wood, OTR/L)

The other side of the coin is a conflicting opinion, but one that therapists who have seen the benefits of weighted clothing and compression garments at work.

How does a weighted blanket work?

How a weighted vest works

Sensory seekers need to have their sensory “cup” filled in order to feel satiated. Have you ever wondered why a child with hyperactivity would be prescribed a stimulant? 

The simple answer is; they will continue to seek input until their cup is full. 

The stimulant, such as Ritalin, fills their cup faster than other sensory input. Once the cup is full, the person seeking input feels satiated, and can focus on work, functional tasks, or social skills. It is similar to needing to eat until you are full.

In a recent article on relaxation breathing, we covered how the autonomic nervous system responds to stimulation that is perceived as dangerous, over-simulating, or anxiety inducing via the commonly referred to signs of “fight, flight, freeze. It is through our limbic system that this occurs.

In response, heavy work activities support the calming or organization of this input. Other self-regulation activities such as proprioceptive input, visual input, and vestibular input can further support this sensory need. Just like the heavy work input of the proprioceptive system and vestibular system, this is organizing and regulating.

We shared more resources and tools to support this natural process in a blog post on using the benefits of a sensory burrito blanket as a sensory tool to offer heavy work input through compression.

A weighted vest, or compression garment, provides proprioceptive input similar to a deep hug. This deep pressure calms the central nervous system, thus calming, satiating, or organizing the body and brain.  

What about research?

  • The reason there is not sufficient research and evidence on tools such as weighted/compression garments, vibration, therapeutic listening, sensory diets, etc. is the method by which it is collected. 
  • Sensory data is collected through observation, interview, trial and error.  
  • A person being interviewed about the behavior of their student/child may not paint a clear picture.  Oftentimes, caregivers either over dramatize, or deny behaviors and outcomes. 
  • Clinical observation may point to a reduction in maladaptive behaviors, or an improvement in attention while wearing a vest or using another sensory strategy, however, it is difficult to determine if the vest is making the difference versus sleep, diet, mood, exercise, weather, or 75 other variables.
  • It is difficult to trial a sensory strategy in a vacuum.  Other variables are always present.
  • Behavior is difficult to measure.

Do sensory strategies such as a weighted vest work?

  • (In my opinion) weighted clothing works.

In my 30 years of experience I have seen countless patients show remarkable results from sensory strategies, especially compression and weight. The change in behavior is often instantaneous.

I have visibly seen a calm come over a child within minutes of donning a vest.

Some children are able to suddenly sit for 20 minutes at a table doing work while wearing a vest, where previously they were able to sit for barely three minutes.

Many patients I have worked with understand the value of their vest, and will begin to request it when needed. 

  • The placebo effect of weighted garments:

The placebo effect is a beneficial health outcome resulting from a person’s anticipation that an intervention will help. How a health care provider interacts with a patient also may bring about a positive response that’s independent of any specific treatment.

If patients a,b,c, and d have a great outcome while wearing their “superman” vest or “police bullet proof garment”, it matters not if this is a placebo, or actual physical change happening to their central nervous system.  If they feel better, have improved attention, and decreased maladaptive behaviors, the vest or strategy is working!

Dr. John Diamond, while reporting about the placebo effect, states; “What I am proposing is that rather than dismissing a cure as being “just a placebo effect,” we should try to do the very opposite. We should try to make all cures a result of the placebo effect.

If up to thirty-three percent of patients can improve with harmless distilled water, and only some sixty percent get the desired result with the pharmacologically active substance, we should be striving for all patients to be cured with a placebo. Then we would not have to administer a dangerous active substance.

  • Do no harm.

Health professionals follow an oath to do no harm.  Under the correct supervision, weighted/compression vests do not harm a person.  In my opinion, why not take a chance on trialing a simple strategy such as a compression vest, if it does no harm? 

It might be the key to success you have been looking for, and might prevent more intrusive treatment strategies.  Many times medical doctors prescribe simple medications in the hopes that symptoms will be alleviated, without actually having test results to confirm a diagnosis.

To me, this is much more harmful than trying a strategy such as a vest, or noise canceling headphones. 

  • Trial and error with weighted clothing (or compression garments, weighted vests, etc.

Because of the nature of sensory based treatment strategies, much of what is done is trial and error. 

What works for one may not work for another. 

One child may need a combination of ten strategies to find the organization they need.  The strategy used successfully for three months, may suddenly stop working. This is the exciting (and frustrating) element to treating sensory processing difficulties. 

How to use compression garments and weighted blankets

How to safely use a weighted or compression vest/garment

The body responds well to an on/off wearing schedule. This is because the nervous system becomes satiated or “used to” the input after about 15-20 minutes.  Similar to wearing a watch or a necklace. At first you are acutely aware it is on your wrist. 

After about 20 minutes you no longer notice it. 

If you take the object off for a period of time, then don it again, the stimulus becomes new and recognized.  

A few tips for weighted clothing:

  1. Wear the weighted clothing/use compression garment for 20 minutes.

Wearing a weighted/compression garment for more than the allotted 20 minutes is not necessarily harmful, it just stops working as effectively. Under the right supervision, a vest can be worn for longer periods if it is not possible to complete this type of rigorous wearing schedule. Watch for signs of shut down, overheating, or excessive fatigue.

2. Weighted vests or weighted blankets should be 5-10% of the body weight.

The weight should typically be 5-10% of the body weight, higher for a weighted blanket, as the weight is distributed differently. Adjust as needed for maximum effectiveness.  Some people are more sensitive to input than others. 

3. Collect data.

Trial and error with data collection, observations, and a checklist, are helpful when trying any new sensory strategy.  Have caregivers fill out a form targeting certain behaviors, rather than “improved compliance”. What does that look like?  Sit for 20 minutes without fleeing. Reduction in self injurious behaviors from X to Y.  Recover from meltdown in 5 minutes versus 20.  The NAPA center has a nice overview of weighted vests and their benefits.

Additionally, this resource offers a sensory checklist that can help with getting started on obtaining data and observations regarding sensory needs.

We hope that this discussion encourages you to further explore the quality of your practice, treatment methods and strategies, and recommendations for families – how will you move your practice forward? 

Compression Vest Alternatives

We’ve covered a variety of options to use as a compression garment to offer sensory support through pressure. Compression vests are a common term, but the vest garment is not always feasible as a sensory compression tool.

Compression vests may not be preferred because of the fit of vests.

Alternatives to compression vests may include:

  • Compression blankets
  • Compression clothing like Under Armour
  • Weighted toys
  • Weighted blankets

Have you used any of these compression tools?

Frequently Asked Questions About Weighted Vests for Kids

How heavy should a weighted vest be for a child?
A common guideline is to start with a vest that is approximately 5% to 10% of the child’s body weight, distributed evenly across the vest. For example, a 50-pound child might wear a vest with 2.5 to 5 pounds of total weight. However, the exact amount can vary based on the child’s needs, age, and tolerance. Always consult with an occupational therapist to determine the safest and most effective weight range.

Do weighted vests help kids with ADHD?
Yes, weighted vests can help children with ADHD by providing deep pressure sensory input that supports focus and self-regulation. The consistent proprioceptive input from the vest can help calm the nervous system, which may reduce fidgeting and improve attention during classroom tasks or homework. While not a cure or standalone treatment, many children with ADHD benefit from using a weighted compression vest as part of a broader sensory or behavioral support plan.

How much weight for a weighted vest for kids?
The ideal weight is typically 5% to 10% of the child’s body weight, but the design and material of the vest also matter. Vests with interior weight pockets allow for gradual weight increases or reductions. Some models provide less weight but more compression, which may still be effective without added bulk. Work with an occupational therapist to assess your child’s individual needs.

Do calming vests work for ADHD children?
Yes, many calming vests, which include weighted or compression options, are reported to help children with ADHD manage sensory overload and improve their ability to concentrate. These vests provide consistent pressure, helping to organize the sensory systems and reduce internal “noise” that can make focus difficult. Results vary by child, but they are often a useful tool when paired with other supports.

Are weighted vests safe for children?
Weighted vests are generally safe when used under the guidance of an occupational therapist and with proper supervision. It’s essential to monitor the child’s comfort, posture, and response during and after wear. Look for features like built-in ventilation, adjustable fit, and less weight for younger children. Avoid using the vest for extended periods without breaks.

How long should a child wear a weighted vest for?
Weighted vests should typically be worn for 15 to 20 minutes at a time, followed by a break. They are not intended for all-day use. This short-term wear helps the nervous system process input without becoming overstimulated or desensitized. Timed use during transitions, learning tasks, or calming routines is ideal.

Are there any risks with weighted vests?
When used improperly, risks may include fatigue, overheating, discomfort, or changes in posture. Always ensure proper fit and weight distribution, particularly around the top of the shoulder and waist areas. Children should never wear a vest that’s too heavy or too long without supervision. Adult supervision and guidance from a professional are key to safe use.

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.

AND

Sydney Thorson, OTR/L, is a new occupational therapist working in school-based therapy. Her
background is in Human Development and Family Studies, and she is passionate about
providing individualized and meaningful treatment for each child and their family. Sydney is also
a children’s author and illustrator and is always working on new and exciting projects.

How to Support Sensory Issues with Hair Brushing

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Sensory hair brushing

For many children, hair brushing is a challenging ADL task due to difficulties with sensory regulation. Using tools such as a sensory brush or a sensory diet can help support sensory issues that impact hair brushing. Individuals with sensory challenges related to their scalp can be further exacerbated by knots, pulling of hair, shampooing, or daily stress when it comes to this hygiene task. Fortunately there are some tips to help sensory needs and hair brushing.

Sensory hair brushing can be a daily challenge for children with tactile sensitivities or sensory processing differences. For some kids, the feel of a brush on their scalp or hair can trigger discomfort, anxiety, or even meltdowns. This guide shares sensory-friendly hair care strategies that support kids who struggle with hair brushing due to tactile defensiveness. You’ll find practical OT hair brushing tips, tools like a vibrating hair brush for sensory needs, and ideas for creating a calming routine that makes hair brushing more manageable.

If you’re looking for a sensory brushing protocol, advice on scalp brushing from an OT perspective, or simple sensory brushing strategies that work, this post is packed with helpful insights to support your child’s grooming routine.

NOTE: The information and strategies in this blog post on sensory hair brushing will not be appropriate for all types of hair and all sensory issues.

Sensory Hair Brushing

Individuals with sensory processing sensitivities may feel that getting their brushed hurts, or may find it overstimulating.

Other children may have challenges with hair brushing as it signals the morning routine is almost complete. They associate hair brushing with having to go to school or daycare, which increases their anxiety. Whatever the reason your child dislikes having their hair brushed, it can be very disruptive to your child’s routine, and anyone else in the home as well.

Sensory Hair Brushing Tips

Check out the tips below to help alleviate stress with hair brushing. 

Tip #1: Brush hair while in the tub or sink

When you brush your child’s hair in the tub or sink:

  • You can build on the relaxed mood to complete a stressful task
  • Warm water temperature offers calming sensory input.
  • Having probably just washed your child’s hair, the conditioner/oil (depending on hair type) will help to allow a comb to slip through your child’s hair with ease.
  • You will also be able to work out any larger knots they may have with your fingers much easier as the water runs in the direction of hair growth.
  • Your child will more than likely be distracted with toys that are in the tub/activity occurring around the sink area, keeping the focus off having their hair brushed.
  • Make sure to braid or put it into a top knot if your child’s hair is long, to prevent tangles in the morning. 
  • Bonus Tip! Don’t have time to wash your child’s hair every night, or don’t take a bath daily? Use a spray bottle to moisten your child’s hair, then brush it out. You can use a detangle to bring an extra element of fun to it too! 

When it comes to brushing, the most important thing is to set up a routine, using the hair brushing techniques that work for the child’s hair type. Stick to that routine. Consider using a visual schedule, written schedule, or checklist.

Tip # 2: Turn hair brushing into a Game 

Using humor and distraction in the form of a game is another great way to help your child feel less stress and sensory issues during hair brushing. You can have them “earn” points for each stroke or set of strokes, have a countdown, or sing a silly song.

Tip # 3: Use Role Play in Hair Brushing 

Children learn best through play! Practice with a doll or let them brush your hair. As you do this, talk about how they are feeling and acting when they are brushing your hair. Are they being gentle? What can they do if they hit a knot? 

It will also be helpful if you talk to them about how you’re feeling or how the doll might be feeling while having their hair brushed. Do you feel calm? Is getting your hair brushed hurting you?

Make sure that you emphasize the positives as well! You can use real terms such as sensory issues with hair brushing, and explain what is happening.

Share with your child how good it feels to have your hair brushed, that it makes you feel clean, and that it makes you look ready for the day. 

Tip # 4: Let Your Child Do it Themselves

When you give your child control of an activity, you take away fear of the unknown, or in this case, give back control over what you are asking to be done.

This works well for children who say that you’re pulling too hard, their scalp is super sensitive, or they dread having to work out knots. By letting them brush their own hair, they are in charge of the pressure, pace and how they work through knots in their hair.

Your children may also be more willing to participate if they know that they are in control of the situation. Be on standby in case they need help! 

If the whole hair brushing process can’t be done by the child, let them participate in some aspect. That might be applying conditioner/oil. It might be that they hand the brush or comb to the person brushing. The main concept here is taking ownership in the task through active participation.

Tip # 5: Use a Wide Tooth Comb 

A wide tooth comb will slide through hair much easier, and with less resistance than a traditional brush.

Another perk to a wide tooth comb is that it doesn’t have bristles, which many kids find irritating to their scalp, and often gets caught easily in long hair. 

Amazon (affiliate links) has several different types of brushes and combs for sensitive scalps. They also have detangling brushes. Just type “sensitive scalp brush” into the search box.

Or try a comb with wider teeth (affiliate link), depending on the hair type.

Tip # 6: Hold Hair Close to the Scalp 

Whether your child has long or short hair, holding hair close to the scalp or placing your other hand on their head can help to limit the amount of tugging they feel during hair brushing.

Limiting the tugging sensation by keeping their head stabilized will also prevent activation of the inner ear, which can be alerting or cause dizziness. If they are particularly sensitive to the tugging sensation, or have poor head/neck control, they may be compensating by letting their head drop back with the slightest of tugs. 

This is particularly important for children with long hair, as brushing down the back can elicit the startle reflex.

Tip # 7: Use a Timer 

Using a timer is a fail safe tip for working on tolerance of any activity. Set the a timer to see how long your child can tolerate having their hair brushed as a baseline, then add 5 seconds once a week until you are able to thoroughly brush their hair.

A countdown timer (affiliate link) is very effective. You can use the timer on your phone or you can look for a visual timer app to add an extra layer of fun. Many visual apps have surprises at the end or turn colors as the app is counting down. 

If you do not want the added input of electronics during this calming time of day, a separate timer (affiliate link) is best.

Tip # 8: Use a Social Story 

A social story is a book created about any activity that your child has challenges with. The story talks about what’s going to happen, how it will feel, and the appropriate social responses that your child should have with the activity. Read the story to them right before completing hair brushing to maximize its effect! 

Don’t have a social story? Ask your therapist to help you create one. You can also find free social story generators online, or use a premade one. 

Bonus Tip! If a social story is too long or advanced for your child, try using a visual schedule! This is a simplified version of the social story and can be adjusted based on your child’s abilities. 

Implementing Tips for sensory issues and hair brushing

These tips can help to break any negative behaviors or emotions that may surround your child’s sensory issues with hair brushing, and give you a foundation to start a fresh routine.

Start by trying one recommendation that you think will work for your child, give it a week, and if it’s still not working, try another.

Working through hair brushing challenges takes time, and is a trial-and-error process. Hopefully you will find these tips helpful!

Looking for more resources?

The OT Toolbox has a great resource called The Sensory Resource Handbook for tackling sensory issues related to hair brushing and creating a sensory diet for the many difficulties you are your child may be facing.

One of our new bloggers has a great resource on Amazon called Seeing Your Home and Community with Sensory Eyes (affiliate link). This is a new manual for parents, therapists, and caregivers to understand, accommodate, and treat tricky sensory situations and community settings with real life strategies, tips, and understanding.

Best Tools: Vibrating Brush, Scalp Massager & Soft-Bristle Options

When supporting a child with autism or sensory processing disorder (SPD) during hair care tasks, the right hairbrush can make a huge difference. Look for soft, flexible bristles that glide gently over the scalp without triggering tactile sensitivity. 

A vibrating brush or scalp massager may help reduce discomfort by providing calming deep pressure input that overrides the lighter, more irritating sensation of hair strands moving across the skin. 

For many autistic children, even small sensory details like the tastes of products, the texture of clips, or the sound of clippers can be overwhelming. 

Choosing an unscented shampoo (and other fragrance free products) and using a detangle sprays with a smooth glide can reduce frustration before the brushing even begins. For some families, shifting to a low-maintenance hairstyle can also reduce stress and make hair care more manageable. 

Sensory Hair Brushing Troubleshooting Guide

Hair brushing struggles often go beyond behavior. The issues might be rooted in how a child’s body processes sensory information. A child who avoids brushing may be responding to loud noise in the bathroom, bright light, or the feel of a strip of hair touching their face. 

Try brushing with your child seated on your lap or in a calming, seated position on the floor to help ground the vestibular system. 

Use deep pressure techniques like a firm shoulder squeeze or a short massage to prepare the body. If your child has an aversion to traditional brushes, try using fingers or a brush with soft, flexible bristles. 

Keep scissors, clippers, and other tools out of sight until your child feels calm and secure. Adding patience, routine, and calm pacing can help build tolerance over time. 

Quick Reality-Check: When Traditional Brushing Isn’t Working

For some kids, brushing just won’t be tolerated without adaptation. Children with SPD may feel pain or panic from the light touch of a hairbrush. They might respond by running away, flinching, or crying before the brush even gets close. 

These reactions are not defiance or tantrums. They’re nervous system responses to overwhelming sensory input. In these moments, step back and reduce expectations. 

Shift to simpler tasks like brushing in small sections, doing a gentle scalp massage first, or using detangle spray during or after a shower to make brushing easier. It’s also okay to skip brushing on hard days or use tools like wide-tooth combs. 

Working up to full grooming over time helps build trust and confidence, and sometimes that’s more important than a perfect hairstyle. 

Sensory Diet Routine: Prep > Brush > Calm

Creating a routine for hair brushing can support the body’s sense of predictability and reduce anxiety. 

Start with prep activities that provide calming input, such as deep pressure through bear hugs, joint compressions, or heavy work like pushing a laundry basket. This helps regulate the vestibular system and makes the body more ready to process sensory information. 

Move into brushing in a quiet, distraction-free space. Let the child hold clips or the brush first to build positive associations. 

End with a calming activity: reading, swinging, or snuggling with a favorite toy, or whatever works for the individual. This routine will reinforce success. 

For kids who struggle with haircuts or hair washing, breaking each task into smaller steps and reinforcing each one with praise or a preferred activity can create more success. With consistency, sensory brushing routines become less about struggle and more about connection.

Sensory-Friendly Hair Tool Recommendations

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

Play Tunnel Activities

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If you are an occupational therapist like me, then you know the power of using play tunnels in an occupational therapy obstacle course. The heavy work input provided by crawling through a tunnel is unmatched, especially when we use it as a warm up to fine motor tasks or functional activities.

Let me explain…

How Play Tunnels Help Kids

Play tunnels are one of the best tools for therapy as you can work on so many skills if you just put a little creativity into it. Tunnel activities simply invite kiddo fun and engagement while working on very important skill development across a spectrum of areas. You can use fabric tunnels or nylon, pop-up tunnels depending on the skills you want to address with tunnel play. With a little imagination you can build your own DIY tunnels too!

Tunnel for Occupational Therapy

There is a reason why OTs love using tunnels in occupational therapy sessions!

Keep reading to get some play tunnel ideas using different materials. For home-based therapists, DIY tunnels are a great tool for families to use in the home environment providing an opportunity for a fun and easy to implement home-based program. Some of these tunnel activities for babies and tunnel activities for toddlers can be used to address specific needs through play.

Play tunnel activities using a sensory tunnel
Tunnel activity for sensory input

Play Tunnels and Sensory

During tunnel play, not only do therapists want to work on the obvious gross motor skills such as crawling, bilateral coordination, motor planning, core strength. Then there is the neck/upper extremity strength, lower body strength, and body awareness.

They also like to use tunnels for sensory needs such as vestibular and proprioceptive input. In the simplest of terms, the vestibular sense is known as the movement sense telling us where our body is in space, while the proprioceptive sense is known as the deep pressure sense telling us the direction, speed, and extent of our body movement in space.

These senses are important to help a child develop balance, body awareness, understand the position of their body in space as well as knowing how much speed and pressure their bodies are exerting when completing an activity or moving within their environment.

Adding a play tunnel into sensory diet activities to meet a variety of needs. It’s an easy way to encourage sensory input in the school environment, home, or clinic.

Tunnel activities using pool noodles

So, you may be asking, how can children gather vestibular input from tunnel time activities? You can have children roll within the tunnel, perform various body movements such as forward and backward crawling, balancing on all fours while simply crawling through the tunnel, slither on their backs, or have them crawl in the tunnel placed on top of cushions and pillows.

These activities are great for supporting the development of crawling in babies and toddlers, especially because we end up seeing challenges down the road for kids that skip crawling. Here’s what an OT has to say about types of crawling.

Fabric tunnel for proprioceptive input.

Proprioceptive input can be obtained while the child is bearing weight on the upper and lower extremities during crawling providing input to the joints and muscles. They can push objects through the tunnel such as large therapy balls or large pillows, army crawl through the tunnel, and shaking the tunnel while child is inside can provide valuable proprioceptive input.

By using a play tunnel to address proprioception to improve body awareness, the proprioceptive sense allows us to position our bodies just so in order to enable our hands, eyes, ears, and other parts to perform actions or jobs at any given moment. Proprioception activities help with body awareness. Using a fabric tunnel that is snug against the body can provide good input which can also have a calming effect for some children.

DIY tunnel activity using cardboard boxes
Use these play tunnel activities to improve motor skills and sensory activities.

Play tunnel activities

When using a tunnel, you can work on other skills that address multiple areas for children. Try some of these fun tunnel time activities:

  1. Play Connect Four with pieces on one
    end and the game played on the other end.
  2. Assemble puzzles with pieces on one
    end and then transported through the tunnel to the other end.
  3. Clothespins attached on end to transport
    and place on the other end. You can use clothespins with letters to spell words.
  4. Push a large ball or pillow through
    the tunnel.
  5. Crawl backwards from one end to the
    other.
  6. Slither through the tunnel (rocking
    body left and right) to get from one end to the other.
  7. Scoot through the tunnel using hands
    and feet or even crab walk through the tunnel.
  8. Recall letters, shapes, or words from
    one end and highlight on paper at the other end.
  9. Recall a series of steps to complete
    a task at the other end.
  10. Blow a cotton ball or pom-pom ball through the tunnel. Kids
    love this to see how many they can blow in a timed fashion.
  11. With pennies on one end, have child transport them to the
    other end to insert into a bank. You can even give them the pennies at end of
    the session if you want.
  12. Push a car through the tunnel to drive it and park it at the
    other end.
  13. Build a Lego structure by obtaining blocks at one end of the
    tunnel and transporting to the other end to build.
  14. Intermittently crawl through the tunnel and lie within one
    end to work on a drawing or handwriting activity. This is just a different and
    motivating way to encourage handwriting practice.
  15. Crawl over pillows or cushions placed inside or outside of
    the tunnel.
  16. Use a flashlight and crawl through the tunnel gathering specific
    beads that have been placed inside to string at the other end of the tunnel. You
    could work on spelling words with letter beads or simply just string regular
    beads.
  17. Place Mat Man body pieces at one end and have child obtain
    pieces per verbal directive and then crawl through the tunnel to build at the
    other end.

tunnel activities for preschoolers

Ok, so for the preschool age range, let’s come up with tunnel activities for preschoolers that support development at this stage.

  • Crawl through a tunnel while holding a puzzle piece like a letter from an alphabet puzzle. Then they can place the puzzle piece in the puzzle when they get through the tunnel.
  • Set up an obstacle course with tunnels to crawl through
  • Play “follow the leader” through the tunnel. This is great for direction following and body awareness for preschoolers.
  • Crawl through a tunnel to match objects or sort colors. I like using blocks to sort into baskets.
  • Pretend the tunnel is a cave or secret hideout during imaginative play.

tunnel activity for toddlers

Next up are some of my favorite tunnel activities for toddlers. These also help to support development at the toddler stage.

  • Crawl through a fabric or pop-up tunnel
  • Push a toy car or ball through a tunnel
  • Play peek-a-boo at each end of the tunnel
  • Roll a ball back and forth through the tunnel
  • Crawl to retrieve objects placed inside the tunnel. I like to pair this idea with our ball in a muffin tin activity.
DIY tunnel activity

Next, I want to share some DIY play tunnel ideas because as occupational therapists, we are always coming up with fun play ideas using everyday materials!

DIY Play TUnnel Ideas

So, as mentioned previously, what if you don’t have a tunnel or you want to create one within a home for developing a home-based program? Well, make one! How can you do this? Read on for a few fun ideas.

  1. Create a tunnel by crawling under
    tables or chairs.
  2. Create a tunnel in the hallway with
    use of pool noodles. Bend them over in an arch to fit or simply cut them down
    to size to slide directly between the walls.
  3. Use large foam connecting mats and assemble
    a tunnel.
  4. Use tape or yarn and string to
    alternating walls down a hallway to crawl under.
  5. Use sturdy pieces of foam board
    positioned or connected together to make a tunnel.
  6. Use an elongated cardboard box. Sometimes
    you can get large boxes at an appliance, hardware, or retail store.
  7. Stretch a sheet or blanket over
    furniture and crawl.
  8. Simply place a sheet or blanket on
    the floor and have child crawl under it (a heavier blanket works well).
  9. Place a therapy mat inside a series
    of hula hoops.
  10. Use PVC pipe to build a tunnel. Add sensory items to the PVC
    frame to create a fun sensory element to the crawling experience. One such
    tunnel was built by my wonderful fieldwork student, Huldah Queen, COTA/L in
    2016.  See the picture below.
  11. Sew a fabric tunnel (if you have that skill).
  12. Use pop up clothes hampers connected together after cutting
    out the bottoms.
  13. Simulate tunnel crawling with simple animal walks or moves.

Tunnel activities can facilitate child engagement while providing an optimal skill development setting.  Tunnel time can address gross motor and sensory needs while also incorporating other activities making tunnel time a skill building powerhouse tool. Incorporate fun fine motor and visual motor activities to make tunnel time a “want to do” activity every time!

Regina Allen

Regina Parsons-Allen is a school-based certified occupational therapy assistant. She has a pediatrics practice area of emphasis from the NBCOT. She graduated from the OTA program at Caldwell Community College and Technical Institute in Hudson, North Carolina with an A.A.S degree in occupational therapy assistant. She has been practicing occupational therapy in the same school district for 20 years. She loves her children, husband, OT, working with children and teaching Sunday school. She is passionate about engaging, empowering, and enabling children to reach their maximum potential in ALL of their occupations as well assuring them that God loves them!

How to Create a Sensory Diet

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steps to create a sensory diet

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

steps to create a sensory diet

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

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

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

How to Create a Sensory Diet

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

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

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

 

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

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

What is a sensory diet? 

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

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

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

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

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

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

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

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

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

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

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

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

Why Create a sensory diet?


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

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

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

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

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

Make a Sensory Diet Template

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

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

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

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

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

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

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

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

Steps to Create a Sensory Diet

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

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


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

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

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

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

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

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

Make notes on things such as:

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

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

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

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

After sensory-related differences that impact function is identified, the reason behind the behaviors should be described.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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


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

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


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

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

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


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

Get The Sensory Lifestyle Handbook here.

Using a sensory diet in various environments

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

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

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

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

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

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

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

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

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

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

Pumpkin Deep Breathing Exercise for Halloween Mindfulness

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Pumpkin deep breathing exercise

This Pumpkin Deep Breathing Exercise is the very first visual breathing tool that we created here on the website. We now have many more deep breathing exercises designed to support self-regulation, mindfulness, and brain break needs. We’ve recently updated this Halloween mindfulness activity to include more information on WHY this pumpkin deep breathing strategy works. We’ve also updated the printable to include a pumpkin breathing poster and a pumpkin mindfulness coloring page! This printable deep breathing exercise is a great Halloween Mindfulness mindfulness activity.

This pumpkin deep breathing exercise would be a fun addition to the sensory benefits of our pumpkin sensory bin activity.

You can get both below or access them in our Member’s Club.

Pumpkin Deep breathing exercise

Pumpkin Deep Breathing Exercise

This Halloween activity is one that I came up with while thinking about our recent Halloween Occupational Therapy activities post. So often, we see kids who struggle with coping strategies and require tools to improve self regulation.

This can occur at school or at home. What if we could combine a child’s interest in all things Halloween with a deep breathing exercise that can be used as a coping strategy, or a calm down activity?

That’s where this pumpkin deep breathing exercise comes in.

This deep breathing exercise uses a pumpkin for a coping strategy for kids that is a calm down strategy this Halloween.

Halloween Mindfulness Activity

We’ve created many breathing exercises to calm down kids (and adults) here on the website, and this pumpkin themed mindfulness strategy is just one of the tools in the toolbox.

So often, parents and teachers ask for strategies to use as a coping mechanism. When kids have coping tools in their toolbox for addressing sensory needs, worries, and getting to that “just right” state of regulation, a self-reflective state can occur.

Addressing specific needs like sensory overload, worries or anxiety, fears, or nervousness can be as simple as having a set of sensory coping strategies on hand. One way to do this is using mindfulness and positive coping skills like this deep breathing exercises.

Using deep breathing exercises to support mindfulness and coping skills works for several reasons:

  • When kids are taught about how their body feels and reacts in certain situations, they can self-reflect on past responses.
  • They can better understand who they are and how their body reacts to stressful or sensory situations.
  • By better understanding their states of regulation, they can be mindful of things that may set them off, but better yet, know how to respond.
  • Having a coping strategy on hand can set them up for success in learning or social situations.

Practicing mindfulness activities and coping strategies can be powerful for kids!

Mindfulness is the ability and awareness of thoughts, feelings, and sensations as our body responds or reacts in thought, feeling, and sensations. Mindfulness is being present in the moment in any given situation with full awareness of inward and outward sensations. Practicing mindful awareness through deep breathing exercises is one way to notice how our body is reacting in a given moment and provides a tool to reset. Coping skills for kids may include deep breathing as just one strategy.

Here are some mindfulness videos on YouTube to help kids better understand what coping strategies and mindfulness in action looks and feels like.

Deep breathing acts as a coping tactic and a calming activity. It’s an easy coping strategy for kids because taking deep breaths with mindful breathing can be done anywhere and without any equipment.

Taking controlled breaths with deep breathing can give kids a sense of control that helps them rest and address self-regulation or emotional regulation when they are upset, worried, or feel a need to calm down.

Halloween Breathing Exercise

So now that we’ve covered deep breathing and why it’s a helpful coping strategy for kids, let’s talk about a fun Halloween themed coping strategy that kids will love to try.

The deep breathing printable activity uses a simple picture of a pumpkin, but you can use a real pumpkin, too.

Use a real pumpkin for more sensory benefits.

The small decorative gourds or pie pumpkins are perfect for this activity, because kids can hold the small pumpkin in their hands and feel the weight of the pumpkin as they complete the breathing strategy.

  1. Hold a small pumpkin in the palm of your hand.
  2. Use your pointer finger of your other hand to slowly trace up a ridge and breathe in.
  3. Then trace down another ridge and breathe out.
  4. Continue tracing the ridges of the pumpkin while deeply breathing in and out.

Take the breathing exercise a step further by trace the lines up toward the stem while taking a deep breath in. Hold the breath for a few seconds and then trace a line down another section of the pumpkin while slowly breathing out. Hold that breath for a few seconds. Repeat this process as you slowly trace up and down the sections of the pumpkin.

What’s happening with this pumpkin breathing exercise?

Several sensory systems are at work here when using a real pumpkin in this Halloween mindfulness strategy:

Heavy Work- The weight of the pumpkin on the arches of the palm of the hand= PROPRIOCEPTIVE sensory system.

Calming Tactile Cues- Engaging the tactile sensory system to trace the ridges of a smooth surface. Think about how some individuals like rubbing specific textures like a silky blanket or the calming strips of a fidget tool. Running a finger along the groove of a smooth pumpkin surface engages that calming tactile input.

Belly Breathing- Deep breaths combined with a visual focus offers proprioceptive input through the lungs and diaphragm. Engage belly breathing by taking in fully breaths to fully engage the lungs. Then hold the breath for a second or two before releasing the breath. When belly breathing is engaged, the lungs continue to expand for a moment and add further pressure throughout the ribcage and internal organs. This breath control evokes the interoceptive system.

Bilateral Coordination- When holding the pumpkin and tracing with a finger on the other hand, both sides of the body are at work in a coordinated manner, otherwise known as bilateral coordination. Holding the pumpkin with one hand and tracing with the other hand engages bilateral use of both sides of the body.

Whether you are using a pumpkin picture or real pumpkin, show kids how to use deep breathing as a coping tool by taking calming breaths while they trace the lines of the pumpkin.

Pumpkin deep breathing poster and coloring page
Pumpkin deep breathing poster and coloring page

Halloween Deep Breathing Poster

In this newest update to our calming breathing exercise, we created both a pumpkin deep breathing poster and a coloring page.

  1. The poster can be printed out and hung in a classroom, therapy clinic or home.

2. Use the deep breathing exercise as a brain break during the month of October.

3. It’s a great tool for using during Halloween parties as a therapist- approved activity that supports underlying needs, too.

4. Many times, children can become overstimulated during classroom Halloween parties, and the days leading up to Halloween. Use the pumpkin deep breathing visual as a tool for the whole classroom to organize their sensory systems and focus on the learning that still needs to happen.

5. This printable page is full color and makes a great addition to a calm down corner this time of year.

6. You can even add the pumpkin breathing poster to our Fall Sensory Stations, and include this in a hallway or therapy clinic this time of year.

7. One final way to use this pumpkin mindfulness exercise is during the actual trick or treating. Kids with sensory or self-regulation needs can become overstimulated during trick or treating on Halloween. There is a lot of sensory stimulation out there! From lights, to fog machines, children running in the streets, and lots of strangers in the neighborhood, trick-or-treating is an overloading environment for many kids and adults! Print off a copy of this pumpkin deep breathing tool and use it calm down, engage focused breathing strategies, and cope as needed!

Pumpkin Breathing Coloring Page

In the new download below, you’ll also find a page that is a pumpkin breathing coloring page. We know there are many benefits of coloring and one is the calming ability that coloring has.

Adding heavy work by coloring in pages can be a great way to calm the sensory system through heavy work in the hands.

Print off the coloring page and use it in several ways this time of year:

  • Color in at occupational therapy sessions
  • Use as a whole class activity
  • Kids can color in the breathing exercise page and use them as individual brain break tools
  • Hang the coloring page on a bulletin board for Halloween that explains sensory self-regulation strategies
  • Include in a Halloween party
Use a pumpkin as a deep breathing exercise for a coping strategy for kids.

This printable Halloween mindfulness activity supports coping needs.

Free Pumpkin Deep Breathing Exercise

Want to get this free Pumpkin breathing exercise in both a color Poster format AND a coloring page? You’ve got it! Just enter your email address into the form below to access both printable pages.

This resource is also inside our Member’s Club. Members can log into their accounts and download the file directly without the need to enter an email address. The printable pages are located on our Pumpkin Therapy Theme page and our Mindfulness Toolbox.

Not a member of the Member’s Club yet? JOIN US HERE.

Pumpkin Deep Breathing Exercise

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    Pumpkin activity kit
    Pumpkin Fine Motor Kit

    Grab the Pumpkin Fine Motor Kit for more coloring, cutting, and eye-hand coordination activities with a Pumpkin theme! It includes:

    • 7 digital products that can be used any time of year- has a “pumpkins” theme
    • 5 pumpkin scissor skills cutting strips
    • Pumpkin scissor skills shapes- use in sensory bins, math, sorting, pattern activities
    • 2 pumpkin visual perception mazes with writing activity
    • Pumpkin “I Spy” sheet – color in the outline shapes to build pencil control and fine motor strength
    • Pumpkin Lacing cards – print, color, and hole punch to build bilateral coordination skills
    • 2 Pumpkin theme handwriting pages – single and double rule bold lined paper for handwriting practice

    Work on underlying fine motor and visual motor integration skills so you can help students excel in handwriting, learning, and motor skill development.

    You can grab this Pumpkin Fine Motor kit for just $6!

    Halloween Mindfulness Activities

    Use this printable pumpkin deep breathing exercise as a Halloween mindfulness activity. Other printable Halloween mindfulness activities include:

    Halloween Hand Breathing Technique

    We also have a new deep breathing exercise for the Fall or Halloween season. If using a printable to achieve Halloween coping skills isn’t ideal (sometimes you don’t have the printable version with you…or for some kids it might be hard for them to picture a pumpkin as they are coping with some self-regulation needs…), then having another tool in your toolbox is a must.

    We’ve come up with a Halloween Hand Breathing Technique to fit the bill!

    All you need is your hands and fingers to using this hand tracing breathing strategy.

    We talk a bit about using the Hand Breathing Technique for a self-reset to address coping skills, mindset, offset worries or anxiety, and as a deep breathing strategy.

    Check out our video over on YouTube, or you can see it below. If you can’t view the video due to blockers on your computer or device, check out our Pumpkin Hand Breathing Technique over on YouTube.

    To complete the Halloween Hand breathing technique, you can use the same pumpkin deep breathing strategy, but trace a pumpkin on the palm of your hand. We also included a pumpkin tracing task to create a motor plan for the pumpkin shape that is incorporated with deep breaths in and out.

    FAQ about Using a Pumpkin Deep Breathing Exercise with Kids

    Why is deep breathing important for kids?
    Deep breathing helps children manage stress, calm their minds, and improve focus. It also teaches them a valuable tool for self-regulation and emotional control. The pumpkin deep breathing exercise provides a great visual prompt for breathing strategies.

    How do you use deep breathing exercises during the day with kids?
    The best way is to make it part of a routine! Add this to a sensory diet or just incorporate at different parts of the day, like before walking out the door in the morning.

    How often should kids do deep breathing exercises?
    Kids can practice deep breathing exercises daily or as needed when they feel anxious, stressed, or need help calming down. Short sessions of 3-5 minutes are usually sufficient.

    What’s a simple deep breathing exercise to start with?
    I like using the pumpkin breathing strategy because it’s fun! You can add something called “Belly Breathing”, too. Have your child place their hands on their belly, breathe in deeply through the nose to fill their belly like a balloon, and then exhale slowly through the mouth.

    How can I make deep breathing fun for kids?
    Use visual aids like the pumpkin in the picture to trace while breathing. Adding a coloring page like the one in our pumpkin deep breathing exercise printable is fun, too.

    What should I do if my child is resistant to deep breathing exercises?
    Keep the practice light and fun. Use props like a real pumpkin that they can trace as they breathe. It’s important to be patient and not force the practice, allowing the child to engage at their own pace.

    How can I incorporate deep breathing into our daily routine?
    A: You can incorporate deep breathing during transitions, such as before homework, after school, or as part of the bedtime routine. Making it a regular part of the day helps it become a natural and effective coping tool.

    Have fun!

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

    Christmas Mindfulness

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    Picture of Christmas tree with arrows on ribbons and text reading "Christmas mindfulness activity"

    If Christmas mindfulness is something you would like to achieve this holiday season, we’ve got a seasonal strategy for you. This deep breaths Christmas tree is a deep breathing exercise that is sure to be a go-to Christmas season mindfulness activity that supports self-regulation needs for kids and families. Use this holiday sensory tool along with our breathing star.

    Christmas mindfulness

    Christmas Mindfulness

    This time of year, most of us knee deep in holiday planning, prep work, and to-do lists! Having a few mindfulness for kids tools up your sleeve is a good idea this time of year. Today, I wanted to provide some tips on mindfulness during the holidays.

    For our kids with self-regulation needs or emotional regulation challenges that impact learning, emotions, anxiety, or worries, the holiday season can be a time of even more concern.

    Over the holidays, school and routines are off. There may be late nights at holiday parties, parents out for work events, unfamiliar family and friends visiting, new sights and sounds. All of this sensory input and environmental input can put a regulation system on overdrive.

    Then, in the school environment, there may be school parties, special events, and special themed days. The classroom Christmas party (or winter party) can be cause for sensory overload for some kids. Picture a classroom full of excited children at the end of a semester. The noises, sights, and environmental input can be just too much.

    In the community, there is holiday music, crowds, and a sense of excitement in the air. This can be a reason all its own for Christmas mindfulness tools.

    Then imagine the child with regulation needs at a family party with unfamiliar guests, a scratchy sweater, strange smells, and lots of noise. A Christmas mindfulness tool that the child can pull out and use to ease worries or stressors can be a great strategy for this time of year.

    Kids are barraged by schedule changes, anticipation of holiday events, later bedtimes, holiday travel, parent/teacher stress, increased sugar…and more. They feel these big feelings and can “lose it”, seemingly at the drop of a hat. Children can melt down in front of our eyes. This time of year perhaps especially, there is SO much going on inside those little bodies and minds. Focusing on mindfulness and coping strategies can help.

    I mean, think about it this way: We as adults are totally stressed out by deadlines, shopping lists, travel, extended family, holiday budgets, and the never-ending to-do lists.

    Our kids see that stress and anxiety.

    Think about our kiddos with sensory struggles. They are bombarded by lights and music, hustle and bustle in the grocery store, shopping mall, and even by the neighborhood lights. The later bedtimes and influx of sensory input is a challenge to process for them. It’s overwhelming and exhausting.

    Think about our students with praxis or motor issues. There are crowds to navigate, auditorium stages to maneuver and they need to do it FAST. There are schedules to maintain and growing to-do lists!

    And that’s just the beginning. All of our kids…no matter what their strengths or needs be…struggle with the change in routines, the adult stress, anticipation, holiday projects, gift giving issues, that extra sugar from holiday sweets, itchy holiday sweaters and scratchy tights, or mom’s stress from holiday traffic.

    That “iceberg” of underlying issues and concerns is a holiday version that leads to emotional breakdowns, poor coping skills, and sensory meltdowns.

    Now, think about the kiddo with executive functioning challenges. They can’t plan ahead or prioritize tasks when they have a holiday letter to write, a classroom sing-along to practice for, and Grandma’s house to visit next weekend. It’s hard for them to function when their routine is off kilter and anticipation is high.

    There are so many benefits to mindfulness, and supporting kids in this way makes a huge impact. Having a few Christmas themed mindfulness strategies on hand could make all the difference when it comes to experiencing all that this season has to offer.

    Christmas Mindfulness Activity

    Below, you will find a Christmas mindfulness activity and some coping strategies to address the holiday stress. This mindfulness tool goes along well with our Pumpkin deep breathing exercise, and Thanksgiving mindfulness activity.

    Christmas mindfulness activity for kids during the holiday season.

    When we think about the holidays from the perspective of a child. Having a set of mindfulness activities for kids is a great way to fill their toolbox with strategies they can use each day.

    Essentially, the post urges us to be mindful of the child’s thought process, emotions, and coping strategies this time of year.

    Holiday Mindfulness

    Below, you’ll find a printable Deep breathing Christmas tree printable that kids can use to support regulation needs. It offers relaxation breathing as a sensory tool.

    Print off the sheet and trace along the arrows as the user breathes deeply in and out. This calm and centering visual tracking paired with deep breathing can help the user to focus with mindful breathing.

    Mindful breathing is helpful in calming heart rate, easing anxious thoughts, and helping the user to focus on one thought rather than the many thoughts that may be running through their head.

    You can even pair the visual Christmas mindfulness breathing tool with visualizations.

    • Ask the user to visualize a calm space with a lit Christmas tree in a dimly lit room.
    • Ask the user to visualize a calm space rather than the hustle and bustle that may be happening around them.
    • Invite the user to imagine deeply breathing in the scent of a Christmas tree and breathing out the same scent as they empty their lungs.
    • Invite the user to picture the worry and anxiety slowly releasing from their body as they move down the slopes of the Christmas tree.
    • Pair the deep breathing with thoughts of things that remind you of peace and love (for example) for with each breath.
    • For each layer of the tree, kids can concentrate on one thing, person, or aspect of the holidays that they are grateful for. Thinking about whatever it is that you are grateful for is a simple way to pair the benefits of slow deep breaths with intentional thoughts.

    Focus on breath control as the user breaths in and out.

    Then, show the user how to carry over this Christmas mindfulness strategy using a real Christmas tree.

    1. After using the printable Christmas tree deep breathing exercise, they can look at a real Christmas tree and trace the lines of the tree’s sides with their eyes as they breathe in and breathe out.
    2. Ask them to trace an imaginary Christmas tree, or triangle shape on the palm of their hand using the pointer finger of their other hand.

    This becomes a Christmas mindfulness tool that they can use any where and any time even without the printable exercise.

    Christmas mindfulness activity

    Christmas COping Tools

    This holiday season, I wanted to fill your toolbox with the tools your little one (or client/student) needs to thrive.

    These are the strategies and tips we can use to slow down, take a deep breath, and recognize the underlying issues going on behind behaviors, meltdowns, and frustrations.

    Because when you have the tools in place, you have a blueprint for success in the child.

    Here are some holiday tools that can help both YOU and a CHILD struggling with all that this time of year brings…

    Christmas Mindfulness

    This is a coloring page. Use it as a handout or home program. Kids can color it in and work on fine motor skills, too!

    Use the Christmas mindfulness handout with kids as a group or individually. You can set this up in several ways. Ask them fist to list out some things they are grateful for. Then, quietly say an item with each breath break.

    As a mindfulness group activity, use the Christmas tree graphic and explain that they will be pairing deep breathing with a focus on love or peace. Come up with a list of things the group loves about the holidays. As you work through he deep breathing exercise, the children in the group can focus on things that brings them peace personally.

    Or, you could invite the child to think in their head about some things that remind them of the holidays and then with each breath in, they intentionally concentrate on that thing/person/idea.

    More Christmas Mindfulness Strategies

    Here are more coping tools for kids that focus on addressing underlying needs so that kids can function. Use these strategies as part of a sensory diet or within the day.

    The thing about mindfulness is that the tools that support needs will differ for every individual. During the holiday season, there are ways to support mindful needs with the holidays in mind:

    All of these are self-regulation strategies with a holiday theme and can be a powerful tool when it comes to supporting emotional and sensory needs during the holidays.

    Mindful Christmas

    Having a mindful Christmas can mean being aware of stressors or things that add a sense of dysregulation.

    During the holiday season, the connection between mindfulness and self-regulation becomes even more crucial, especially for children and therapy providers navigating the potential stress, anxiety, and worries associated with this time. Mindfulness practices offer a valuable toolkit for managing these challenges:

    Stress Reduction: The holiday season can bring added stress, but mindfulness provides a means to cultivate a calm and centered state, helping both children and therapy providers navigate and mitigate holiday-related stressors.

    Emotional Regulation: Mindfulness practices, tailored for children and therapy providers, become essential tools for recognizing and regulating emotions heightened by holiday-related pressures. This contributes to a more emotionally balanced experience.

    Anxiety Management: Mindfulness techniques, such as mindful breathing or guided imagery, can be powerful allies in managing anxiety. They provide a practical and accessible way for children and therapy providers to alleviate anxiety during the holiday hustle.

    Worry Coping Strategies: The mindfulness approach of observing thoughts without judgment is particularly helpful in addressing worries. Children and therapy providers can utilize mindfulness to create a mental space to acknowledge concerns and develop effective coping strategies.

    Enhanced Focus and Presence: Mindfulness helps maintain focus on the present moment, preventing holiday-related worries from overwhelming the joy of the season. This is especially beneficial for therapy providers supporting children, ensuring they are fully present during sessions.

    Cultivating Resilience: Mindfulness fosters resilience by promoting adaptability and acceptance. This quality becomes crucial during the holiday season, where unexpected changes or challenges may arise for both children and therapy providers.

    Empathy and Connection: Mindfulness practices that emphasize compassion and empathy contribute to a sense of connection. Therapy providers can incorporate these practices to create a supportive and understanding environment for children navigating holiday stressors.

    By integrating mindfulness into therapeutic approaches, therapy providers can empower children with valuable self-regulation tools, fostering a positive and mindful experience during the holiday season. The practices not only address immediate stressors but also contribute to building resilience and coping skills for the long term.

    Free printable Christmas Mindfulness Printable

    Want to grab our Christmas tree mindfulness deep breathing exercise? Enter your email address into the form below. This printable is also available inside The OT Toolbox Member’s Club. Members can log in and head over to our Mindfulness Toolbox where we have this and other Christmas mindfulness printable exercises.

    Print off this Christmas breathing activity and start supporting skills. This Christmas coping skills activity can be used on the go while out and about this holiday season, at a family get together, or during school assemblies for the holiday season.

    Get a Christmas Tree Mindfulness Coloring Page

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      Wishing you a thriving, stress-free, and functional holiday season for you and those kiddos you serve!

      You will also want to grab a copy of our breathing star, which can be paired with our Christmas mindfulness tool.

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

      Looking for done-for you therapy activities this holiday season?

      This print-and-go Christmas Therapy Kit includes no-prep, fine motor, gross motor, self-regulation, visual perceptual activities…and much more… to help kids develop functional grasp, dexterity, strength, and endurance. Use fun, Christmas-themed, motor activities so you can help children develop the skills they need.

      This 100 page no-prep packet includes everything you need to guide fine motor skills in face-to-face AND virtual learning. You’ll find Christmas-themed activities for hand strength, pinch and grip, dexterity, eye-hand coordination, bilateral coordination, endurance, finger isolation, and more. 

      Click here to grab the Christmas Therapy Kit.