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Christmas Mindfulness

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Use this Christmas mindfulness activity as a coping strategy for kids during the holidays.

If Christmas mindfulness is something you would like to achieve this holiday season, we’ve got a seasonal strategy for you. This deep breathing Christmas tree exercise 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

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.

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.

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.

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:

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.

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!

    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! 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.

    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!

      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.

      Forest Sensory Path

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      forest sensory path

      If taking a break is a must, but getting outside is tricky, then this Forest Sensory Path hits the mark! We’ve created another fun printable to our collection of free sensory paths with all of the calming benefits of nature and being in the woods. This printable forest sensory walk is perfect for bringing the calming input of nature into the indoors. Be sure to read this resource on sensory nature walks to read up on those calming and organizing self-regulation benefits of woods and nature.

      Forest sensory path printables

      Forest Sensory Path

      It seems life is getting more chaotic since the pandemic.  This may stem from isolation, lack of exposure, too much electronic use, stressors, or a sudden thrust back into “real life”.  Compounding this is the fact that learners do not know how to combat these environmental stressors, or self regulate.  It seems learners need instruction on how to take a break. That’s where these Forest Themed Sensory Path stations come in, which provide a structured sensory break, to help reorganize thoughts and body.

      Sensory paths and sensory stations became popular with the addition of expensive stickers set up around the school. These are awesome as a self-regulation activity and to address mindfulness with kids!  If you don’t have the budget or space for these custom stickers, try one of the sensory walk stations offered by the OT Toolbox.

      This month the Forest Sensory Path will fit in perfectly with your fall leaves occupational therapy theme.  Add your email below to be sent this FREE download.

      How does the FOrest sensory path work?

      Sensory activities like this Forest Sensory Walk Station offer tasks to promote body and mind regulation.  The initial response to a learner out of sync is to tell them to calm down. 

      What does “calm down” mean to you?  Adults generally have already figured out appropriate strategies to reduce anxiety, inducing a feeling of calm. 

      Children have no idea what “calm” looks like, because they rarely act this way.  They also lack the ability to calm themselves, or know what to do to slow their body/brain down. Having a strategy, movement, or action to stop, self-analyze, breathe for a moment, and take a break from the environmental or internal input, is a literal break for the brain and body. This is where we get the term brain breaks!

      Sensory stations provide the framework for self regulation.

      Printable Sensory Path: Forest Theme

      This Forest Sensory path combines deep breathing and proprioceptive input with eight different activities.  Proprioceptive exercise is a “go to” input for organizing the sensory processing system and regulating the sensory systems.

      It is alerting for those who are experiencing low arousal, and calming for those who seek additional input to get regulated.

      Connected to proprioception and interoception, deep breathing exercises slow the central nervous system, often elevated during periods of fight or flight responses. 

      The ultimate goal of sensory regulation is self-regulation.  Learners need to understand what strategies work for them, and when they are needed.  Sensory strategies are unique to each learner. 

      Just as adults have different routines they use for concentration and focus, children develop varied strategies. 

      Imagine the additional responsibility teachers take on remembering and learning  the sensory needs of each of their students. 

      When a student can advocate for themselves, this not only helps the student, but their caregivers as well.

      How to use the Forest Sensory Paths?

      • Lowest level learners need to be taken through the walk step by step
      • Middle level learners can be supervised while participating
      • Higher level learners will be able to complete this activity when instructed, or advocate for a sensory break
      • Laminate the page for reusability. This saves on resources.  Caregivers or young learners can help decorate these pages before they are laminated. 
      • Make this part of a larger lesson plan including gross motor, sensory, social, executive function, or other fine motor skills
      • Print in black and white, in color, or on colored paper for different levels of difficulty
      • Project this page onto a smart board for students to learn these activities as a group
      • More or less prompting may be needed to grade the activity to make it easier or harder.
      • Learners can explore other ways they could use this activity 
      • Explore different options for setting up this sensory station.  It could be appropriate in a classroom, hallway, gymnasium, outside the school, or walking into the cafeteria, depending on the needs of your learners

      sensory paths for elementary schools

      Some of the big budget sensory paths are thousands of dollars and require permanent installation over laminate floors. In many cases, getting approval for the purchase of a sensory path in an elementary school is just out of the question.

      The good news is that our printable sensory paths are totally free, AND you can print off the pages and switch out the themes according to the season.

      The other benefit that most therapist users see is that the printable pages can be positioned and placed according to the environment. These sensory path pages can be placed in a page protector sleeve and hung in a hallway. Or they can be laminated and placed in a calm down corner. The options are pretty limitless.

      A few other common questions about using the Forest sensory path in elementary schools or in therapy clinics can include:

      • Do sensory paths work for all learners?  No.  Sensory strategies are not one size fits all unfortunately.  Much of the treatment relies on trial and error.  If the forest sensory stations walk does not calm your learner, it is possible the treatment came too late, after the learner was already shut down.  Some learners are not able to self regulate through all parts of the sensory stations, however it is a great and simple activity for those who do.
      • How long should my learner use a sensory path?  There is no defined time frame for any self regulation strategies.  Some learners calm quickly, needing a diversion from their current state in order to regulate.  Other learners may take several minutes to calm after an upset.  Watch for signs of regulation and calming before suggesting your learner stops.  After the Forest Sensory Station Walk, take note of how long your learner is able to stay regulated.
      • How often should I use a sensory path?  Some learners need a boost of sensory regulation every twenty minutes, while others can go several hours before they need a moment to reset.  Watch for signs of disorganization and jump in with strategies before meltdown occurs.
      • Will a sensory path work consistently every time? Probably not. This worked last week, but not this week.  What happened?  Sensory strategies are not an exact science. Have a large “bag of tricks” in your toolbox to be able to offer several different strategies. 
      • How long will the effects of a sensory path last?  Every learner is different.  A very dysregulated learner may need almost constant strategies for self regulation.  A learner who is more organized and has been practicing strategies for a while, might reap the benefits of this sensory stations for two hours.  A great sensory workout can have long lasting effects.
      • Are sensory paths and sensory stations an evidenced based practice?  Because of the nature of sensory dysregulation and the strategies offered, it is very difficult to get consistent data in this area.  Use your clinical judgment and observations to determine how effective this Forest Themed Sensory Stations Walk is.

      Other Resources from the OT Toolbox

      Free Printable Forest Sensory Path

      Want to add a forest themed sensory path to your therapy toolbox? Enter your email address into the form below. This resource is also available inside The OT Toolbox Member’s Club. Members can log into their account and access this resource in the Forest Animals Therapy Theme area. Not a member of The OT Toolbox Member’s Club? Join us!

      Free Forest Printable Sensory Path

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        Victoria Wood

        Victoria Wood, OTR/L 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.

        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.

        Understanding Sensory Dysregulation

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        Sensory dysregulation

        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.

        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.

        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. 

        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. 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. 

        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! 

        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.

        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.

        Sensory Diets for Adults

        by

        Do adults need a sensory diet? Yes!  A Sensory Diet for Adults is just as beneficial as it is for children. Exactly what is a sensory diet? A sensory diet supports the sensory needs of any individual, providing them with a set of sensory strategies used to assist with the regulation of activity levels, attention, and adaptive responses. Looking at this list, adults definitely NEED the ability to self-regulate, organize their sensory systems, and support their sensory and emotional needs. So how can we go about this in the midst of work, parenting, and everything the day brings?

        sensory diets for adults

        How do you create a sensory diet for adults?

        The overall goals of a sensory diet are to meet the sensory needs of an individual by preventing sensory overload, supporting self-regulation, and helping to have an organized response to sensory stimuli. Sensory diets can also help an individual recover from sensory overload, if the preventive threshold has been crossed.

        In order to create the most effective sensory diet, it is important to consider ALL of the senses, which includes proprioception, vestibular, tactile, visual, auditory, gustatory, olfactory, and interoception (more about these later in this post).

        Creating a sensory diet for adults requires consideration of the lifestyle of an adult. The steps include; analysis and identification, strategizing, applying strategies, and monitoring effectiveness, to ensure individual needs are being met. 

        Even for adults, completing a sensory checklist, questionnaire, or survey is important. It will insure all sensory areas are identified, and all interests and preferences are considered when working on the development of a sensory diet for adults.

        Use a sensory journal to track sensory processing

        Another tool to assist in creating a sensory diet for adults, is keeping a sensory diary to help identify personal needs triggers, and dislikes.

        A sensory diary, or a sensory journal, is much like a food journal might be used to figure out food triggers that impact headaches or skin issues.

        Just like a journal to identify what food stimulated a physical change in the body, a sensory journal can be a helpful tool to identify sensory predictions of regulation, organization status, calmness, or ability to participate in every day activities.

        For example, if you are a school field trip chaperone for your kindergartener’s fieldtrip to the musical instrument factory, you might be on heavy overload on auditory input in the way of loud noises, screeching children, a bumpy bus ride. This can put you into a state of headaches, difficulty focusing, disorganized thoughts, emotional state of dysregulation, and overall inability to function for the rest of the day.

        When you look back at your sensory journal, you can see that all of the auditory, vestibular input was very chaotic, abrupt, and unexpected. When you see in your sensory journal that you had a migraine and couldn’t function for the rest of the day and the next day, then it makes sense.

        Scheduling sensory diets for adults

        Knowing these, will aid in the development of an individualized and successful sensory diet. 

        The scheduling of sensory diet activities is an important part of the sensory diet design when attempting to be proactive versus reactive. Scheduling the use of sensory strategies throughout the day will help keep the senses regulated in order to avoid sensory overload.

        At times, this threshold gets crossed, sensory overload ensues, and the reactive stage happens. As an adult, this is bound to happen. The good news is, many preventive strategies can be utilized in the reactive stage as well. 

        If you are seeking a comprehensive resource that can help guide your pursuit of sensory diet creation for success, check out the Sensory Lifestyle Handbook from The OT Toolbox. It will provide you with a strategy guide to create sensory diets for adults as well as children, and incorporate these choices into a lifestyle of sensory success!

        Adult sensory diet strategies You’re probably already doing

        Adults often use sensory strategies to support their needs without even realizing they are doing so. The difference between adults and children is, adults tend to use appropriate strategies. They are not likely to be jumping on the furniture, screaming in a meeting, or licking the furniture.

        Think about the adult who:

        • clicks a pen top frequently while working in the office
        • shakes their foot excessively while seated in the church pew
        • twirls their hair while listening or concentrating
        • snuggles under a heavy blanket when getting home
        • rocks back and forth while seated
        • has to have the TV or radio on in the background
        • chews gum all the time
        • exercises daily without fail

        The OT Toolbox provides information regarding Adults with Sensory Processing Disorder if you want to further explore information on this topic. 

        effective sensory diet strategies for adults

        Sensory diets for adults are similar to ones created for children. They have the same basic design, but some of the strategies are more adult-like in form, and the environment in which they are utilized differs. 

        Recognizing the triggers and stressors that cause sensory dysregulation, will help understand how and when to implement activities, before the point of stress. There are several different sensory products available for adults, as highlighted in this post on the OT Toolbox, that can help with regulation.

        There areas proactive strategies available that can help also.

        sensory activities for adults

        These are activities that can easily be done within an adult setting, to meet targeted sensory needs. There are strategies for each of the senses, as this is key to a well rounded sensory diet.

        Vestibular sensory activities for adults

        Vestibular strategies involve movement for regulation. As the head changes positions, and the body moves, input is regulated in the inner ear. Vestibular input is the building block of all of the other systems.

        Check out the vestibular activities we have here on the site. While these are movement-based play activities for kids, you can see how the different motions impact a state of calmness or alertness.

        These vestibular sensory activities for adults work in the same way:

        • yoga
        • slow rocking in a chair
        • spinning in an office chair
        • sitting on a therapy ball
        • standing at a desk
        • windmill arm exercises
        • stretch breaks
        • brisk walks
        • dancing 

        Proprioception Sensory Activities for Adults

        Proprioceptive strategies involve deep pressure, or heavy work for regulation, as the muscles, tendons, and joints are activated with increased intensity. Deep pressure often has a calming or organizing effect.

        Here on the site we have many proprioception activities for kids, but the main concept is the same. Offering heavy work through the joints offers calming regulatory input.

        Some proprioceptive sensory tools for adults include:

        • push-ups in any form – floor, chair, wall, or desk
        • yoga poses 
        • mindfulness apps
        • Using some of the same breathing exercises that we use with kids
        • squeezing arms and legs
        • weighted lap pad or weighted blanket
        • heavy work- for adults this might be mowing the lawn, gardening, running, etc.
        • self-hugging or massage
        • resistance band exercises
        • therapy putty exercises

        Tactile Sensory Strategies for Adults

        Tactile strategies involve sensory touch stimulation for self-regulation, but it also involves tactile defensiveness too. While some adults crave this input, others respond negatively to touch. For this reason, a personalized sensory diet for adults is important.

        Some tactile strategies for adults include:

        • brushing protocol (trained by qualified individual), bean bag tapping up and down the extremities
        • calm strips, sequin items, textured clothing, or some other form of texture
        • use of a stress ball
        • Fidget toys…go ahead and pick one up. You’ll see why the kids love them!
        • applying lotion to arms and legs
        • small massager to hands, arms, and legs
        • fidget tools or DIY fidget toys, such as squeeze balls, pop its, clickety gadgets, etc. Amazon (affiliate link:) has an entire fidget toy category for adults!
        • seeking the amount of personal space needed when near others. More or less may be needed depending on the needs of the individual

        Olfactory sensory strategies for adults

        Olfactory strategies involve using the sense of smell or input to the nose to either provide calm or alertness for self-regulation. Some adults have a scent sensitivity that is related to candles, certain oils (even cooking oils), fabric softeners, or allergens. An air freshener allergy is especially common when candles, room freshener sprays, or plug in scents are supposed to be calming and soothing, they are actually disorganizing for your sensory system.

        Again, each person has their own individual needs and preferences, so a customized diet is helpful. Read about the olfactory sense here.

        Consider essential oils and lotions with the following scents:

        • lavender, vanilla, orange, and chamomile to reduce tension or stress and/or promote relaxation
        • citrus, peppermint, cinnamon, and lemon to promote increased alertness and/or concentration
        • coffee beans for a neutral scent to balance other smells
        • try deep breathing strategies (inhale gently and deeply through the nose and exhale gently and slowly through the nose, repeat as often as needed)

        Visual Strategies for adults

        Visual strategies involve visual input for self-regulation.

        • changing lighting: a lamp light for reducing visual input vs. overhead fluorescent light for increased visual stimulation
        • dimmer switch for overhead lighting, to reduce or increase light 
        • reduce or eliminate visual clutter in the setting in all planes, for increased calm
        • paint calming colors on walls for such as blue or neutral colors, and for increased alertness, think orange or red
        • use patterned rugs or curtains for alertness, or more neutral and solid colors for calming
        • work in an open space with views of action within the space for alertness, or go for a partition or desk divider to eliminate visual distractions, for a more calm and focused setting
        • take eye rest breaks when exposed to excessive amounts of computer light
        • consider a computer glare screen, blue blocking glasses, or colored screen filters to block computer lighting, and decrease visual input

        Auditory sensory ideas for adults

        Auditory strategies can reduce or eliminate noise for improved self-egulation in adults. Alternatively, they can add or increase the noise for a sensory seeker.

        • music and the type of music, can be alerting or calming
        • white noise can help provide a constant sound, making it predictable, or be bothersome to more sensitive people
        • earbuds, or ear plugs, can help block out some noise
        • noise-canceling headphones help block out as much noise as possible
        • running water from a fountain or nature sounds can feel calming
        • running fan or another humming-type device
        • foam earplugs to muffle sound without completely blocking it out

        Gustatory Strategies for adult self-regulation

        Gustatory strategies can help to alert or calm individuals, simply by the sensory input provided either through the texture or flavor of the food, or the mouth movement needed to consume it. When considering foods, try to go for healthy options when possible.

        To increase alertness, try crunchy, salty, sweet, sour, spicy, hard to chew, or cold foods and/or drinks. To calm and organize, consider smooth, warm, and softly flavored foods, and/or drinks, as these tend to be more soothing.

        Likewise, different foods and drinks can be calming. Sucking a thick drink through a straw can serve to provide proprioceptive input, being calming or alerting. Iced fluids are more alerting. Warm or hot liquids are generally more calming.

        Consider these for increasing levels of alertness:

        • Crunchy: apple slices, carrot sticks, pretzels, nuts, tortilla chips, graham crackers, or rice cakes
        • Sour: lemon flavor, cranberries, sour candy, green apples, lemonade, and tart cherries
        • Sweet: yogurt, juices, frozen fruit juice pops, smoothies, grapes, oranges, and strawberries
        • Spicy: chips and salsa, cinnamon flavor, peppers, and pretzels with spicy mustard
        • Salty: baked potato chips, salty nuts, crackers, popcorn, and pickles
        • Chewy: bubble gum, gummy bears, dried fruit, jerky, fruit leather, bagels, or granola bars
        • Sucking: sucking a smoothie through a straw or sucking another warmer liquid through a water bottle nozzle
        • Cold: Iced water, ice cream, crushed ice, frozen berries, or frozen sherbet

        Consider these for increasing calm:

        • Soft and/or softly flavored: cottage cheese, peanut butter, avocado, pudding, oatmeal, freshly baked cookies, or applesauce
        • Warm: Hot tea, warm cocoa, or soup

        Interoception strategies for an adult sensory diet

        Interoception strategies involve understanding and feeling what is going on inside of the body.  Understanding how the body feels and how it reacts to certain sensory strategies can help to identify what is alerting and calming to the individual. Consider:

        • Deep breathing
        • Mindfulness activities
        • Yoga 
        • Temperature control
        • Heavy work and alerting activities
        • Understanding of feelings and emotions
        Note: Many of the sensory strategies listed here can be scheduled throughout the adult day, or within the moment of need. If seeking further sensory strategies that might help in the pursuit of sensory diet tools, take a look at the following sensory diet examples

        Sensory Diet Example for Adults

        When it comes to creating a sensory diet for the adult with sensory needs, there are aspects of sensory processing to be considered, in order to integrate sensory diet activities into the day to day functional activities. 

        How can you incorporate sensory input into everyday tasks?

        Essentially, it is important to add movement and sensory options during activities like tedious tasks, waiting periods, or times when self-regulation is essential to the task at hand. Adding the sensory diet strategies correctly into tasks supports needs. The Sensory Lifestyle Handbook is a great resource to get your started. Can you get up and walk around while on the phone making an appointment? Can you take a minute to stretch and breathe deeply during traffic?

        Here are examples of sensory diet for adults

        • Wake up, stretch at the side of the bed.
        • Start the day: yoga, exercise, cool drink of water with lemon
        • Next: bathroom/hot shower, vigorous towel to dry off, compression clothing
        • Breakfast: steamy coffee, warm milk, soothing foods
        • Transport to work or school: walk or ride to day’s events while listening to calming or alerting music, reading, journaling, listening to podcasts, etc.
        • Movement breaks during the day: use fidgets, get up and move throughout the day, eat a snack, chew gum, schedule standing breaks during the day, use a standing desk, consistent water drinking, listen to alerting music while working, deep breathing, mindfulness apps, silence notifications, use ear pods while working, etc.
        • Afternoon/Evening: go for a walk, read a book, drink tea, grocery shop or complete other tasks while listening to music, call a friend or loved one, listen to audiobooks, calm down yoga, or stretching at night
        • Prepare for next day: write out schedule or to-do lists, doodle, journal, mindfulness strategies, read, watch movies or television (electronics are visually alerting and should be limited close to bedtime)
        • Sleep: Use heavy blanket or weighted blanket, heavy pillows, cool room with fan, noise machine, ear plugs, deep breathing before bed, gratitude journal, camomile tea before bed

        An adult sensory diet is heavily dependent on the lifestyle of the individual, sensory preferences, day to day tasks, and personal preferences. Using these suggestions, a sensory diet can be integrated right into the tasks that need to be accomplished each day.

        The Takeaway to Creating adult sensory diets

        An adult sensory diet is all about discovering what works for an individual, as each person’s needs are unique, and may change over time. It is important the adult get to know themselves and what they need, before making a plan (the sensory diet) to feed their body’s needs, making it simple nutrition for the brain and the body.

        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!

        Sensory Paths and Sensory Stations

        by
        sensory paths and sensory stations

        A sensory walk, sensory station, and sensory path…what are these things and how do they support sensory processing needs? Here, we’re covering it all when it comes to using sensory paths or walks as a tool to support sensory needs. You’ll love the printable sensory station tools to add to your DIY sensory path!

        sensory paths and sensory stations- what is the difference

        What are Sensory Paths?

        Let’s start with covering these terms.

        A sensory path is a defined path, or walkway that directs users to complete a variety of sensory-motor tasks. The activities that make up a sensory path are typically gross motor tasks that incorporate proprioceptive input, vestibular input, and visual input. These sensory systems are powerful regulating tools to organize and this is why motor movements in a sensory path engage these systems.

        A sensory path is typically a literal pathway on the ground; it may be painted onto a sidewalk or schoolyard. It may be stickers or images stuck to a floor or hallway in a school.

        I know you’ve seen, or read about the (Amazon affiliate link) sensory pathways displayed on walls and floors of the school building. These are available commercially, or sensory paths can be made with paint and stickers.

        Sensory paths can support self-regulation needs during transitions for children or scheduled sensory diets within a day.

        What is a sensory walk?

        A sensory walk is another term for a sensory path, however, some sensory walks can be nature-based, in the outdoors. Including flowers, grass, benches, and sounds of nature, a sensory walk can be very calming and regulating.

        Other sensory walks are not nature-based. They are manufactured and can be also called sensory paths. Not only are the commercial versions of sensory paths expensive, but they are also highly colorful, and have multiple visual elements. These designs make for high visual noise (or visual clutter), making them ineffective for some children.

        Some pathways can be highly dysregulating, as children attempt to decipher the visual clutter, and act on the path elements.

        sensory stations and sensory station ideas for kids

        What are sensory stations?

        Sensory stations are an area set up with the intention of engaging children in exercises that help to stimulate and regulate their senses, and facilitate transitions within the day. When children need a brain break, or if you need some fun ideas to meet sensory strategy goals, these are the perfect tool.

        Sensory motor stations provide a visual, coupled with a written directive, that can be followed by most anyone who needs to build their sensory strategy bank. 

        Sensory stations can be part of a calm down corner or they can be posted in a hallway as a transition tool. These can be a specific area or “station” that allows users to pause and participate in self-regulation strategies: heavy work, vestibular movement, or deep breathing exercises, or mindfulness techniques.

        Below, we have free printable sensory stations that you can use in a sensory path, sensory walk, or sensory corner. Are you interested in some freebies that are effective and fun? You’re in the right place visiting this post. It‘s full of Sensory Stations that you can print and post to make a fresh approach to self-regulation, use in creating a sensory path of your own. 

        If you work with children who need less stimulation, and more simplified visual directions, these FREE sensory stations are a must. They are simple, providing both visual and written directives. Download the PDF and go.

        sensory stations in the school setting

        In the school setting, sensory station printables can be used for an entire classroom, a small group, or with individual children. A sensory path is often sought out for use in the school setting, but once that sensory walkway is set on the asphalt, hallway linoleum, or in a certain space, it’s there for good!

        Using a sensory station that can be removed and replaced with different themes is nice in the school setting because they can be used over and over again in different locations.

        The nice thing about using a sensory station over a sensory path is that they can be posted throughout the school setting:

        • Classrooms
        • Therapy room
        • Gymnasium
        • School hallways
        • Cafeteria
        • Library
        • Social worker’s office
        • Guidance counselor’s office
        • ESL classroom
        • Or in different locations, to help children rotate through the stations throughout the day or as a brain break.

        They offer the movement breaks students need, when and where they need them, to gain the sensory benefits they crave.

        Print the sensory walk stations and provide a simple training to your school staff, to make these activities available for any child who needs the support. 

        sensory stations in a clinic

        In a private clinic, sensory walk stations can be used in a pathway to different areas of the building, or posted in different locations where specific needs are being addressed.

        In our private clinic, we have them posted on the wall down the hallway that leads to the therapy gym. These visuals serve as a great transitional tool, that helps children get ready for a different therapeutic environment.

        Sensory walks can be provided as a home program, so they can be used as part of a child’s sensory diet. Some parents can’t afford sensory equipment like a swing or trampoline, so whenever possible, offer strategies they can afford.

        Parents will be grateful for structured home exercises that are fun and motivating for their child.

        Teletherapy sensory stations

        Since the pandemic, therapists are often providing services through teletherapy occupational therapy. Sensory walk stations can be used as a warm-up, or sensory input activity for kiddos who need that support while having an on-line session.

        They can easily be printed and displayed to the child over the computer, or do a screen share using the resource PDF. These printables are versatile. Changing them for different seasons or holidays, keeps them new and motivating. 

        what kind of sensory station ideas are available?

        What kind of sensory station ideas can you find on the OT Toolbox? Seasonal and holiday-themed stations are available, with being added.

        Grab these sensory path printables below, print, laminate, or slide them into a sheet protector, and hang them up today! 

        If you are a regular visitor to the OT Toolbox, you would benefit from our members club. Never miss a post, product, or freebie! Here are all the details:

        Want to add this resource to your therapy toolbox so you can help kids thrive? Enter your email into the form below to access this printable tool.

        This resource is just one of the many tools available in The OT Toolbox Member’s Club. Each month, members get instant access to downloadable activities, handouts, worksheets, and printable tools to support development. Members can log into their dashboard and access all of our free downloads in one place. Plus, you’ll find exclusive materials and premium level materials.

        Level 1 members gain instant access to all of the downloads available on the site, without enter your email each time PLUS exclusive new resources each month.

        Level 2 members get access to all of our downloads, exclusive new resources each month, PLUS additional, premium content each month: therapy kits, screening tools, games, therapy packets, and much more. AND, level 2 members get ad-free content across the entire OT Toolbox website.

        Join the Member’s Club today!

        Let’s take a look at what exactly you will find on the site today:

        Spring Sensory Walk Stations:

        • Frog hop walk
        • Spring flowers figure 8 deep breathing trace 
        • Flower wall push-ups
        • Butterfly wings windmills
        • Bumblebee trace and breathe 

        Summer Sensory Walk Stations:

        • Dolphin leap
        • Bumblebees figure 8 deep breathing trace
        • Beach ball press wall push-ups
        • Crab squat summer sand squats
        • Hermit crab shell trace and breathe

        Fall Sensory Walk Stations:  

        • Squirrel leaps
        • Fall leaves figure 8 deep breathing trace
        • Leaves wall push-ups
        • Fall jumping jacks
        • Acorn trace and breathe

        Winter Sensory Walk Stations:  

        • Penguin waddle
        • Frosty wind and snow figure 8 deep breathing trace
        • Snowball hands wall push-ups
        • Ice skater one leg standing balance
        • Snowflake trace and breathe

        Christmas Sensory Walk Stations:

        • Reindeer leap
        • Christmas lights figure 8 deep breathing trace
        • Santa sleigh push wall push-ups
        • Jingle bell jumping jacks
        • Christmas tree trace and breathe

        If you are new to sensory processing difficulties, the Sensory Lifestyle Handbook is a great place to start.

        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.

        One last thing to point out about these sensory walk stations, is that they not only provide the sensory input a child may need, but they also address core strength, motor planning, crossing midline, eye-hand coordination, and overall, fine and gross motor skills.

        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!

        Problem Preschool Behaviors

        by
        preschool behaviors

        Today, we’re covering problem behavior in preschoolers, including behaviors that impact learning and development because of participation in preschool activities. Every preschooler, family, and classroom is different. With the uniqueness embedded into an Early Childhood Classroom, it isn’t uncommon for teachers to have some run-ins with concerning behavior. This blog will teach you the five steps to creating a behavior plan for managing preschool behaviors, which encourages positive interactions with parents and children. 

        Problem behaviors in preschool and what's the behavior trigger for preschoolers

        The uniqueness of every family and child plays a role in each preschool classroom. Every teacher has expectations. All classrooms are set up differently, and the environment can change, based on the activities and people who are present. Understanding how to support children and their families, while teaching children academic, social, and emotional skills, can be daunting for preschool teachers. 

        examples of challenging preschool behaviors

        Some of examples of challenging behaviors in preschoolers include:

        • Hitting, scratching, slapping, grabbing
        • Biting, spitting, chewing on non food items, licking
        • Kicking others
        • Bolting out of the classroom or other setting
        • Refusing to work, refusal to cooperate, talking back
        • Yelling, screaming, crying
        • Tantrums – Check out this post on the OT Toolbox to better understand meltdown vs. tantrum behavior

        This is just the tip of the iceberg. Do any of these behaviors sound familiar? 

        What causes challenging behaviors in preschool?

        Before covering strategies to address behaviors that impact learning and the development of skills, it is important to understand why we may see challenging behaviors in the preschool setting.

        Based on these Kindergarten readiness standards of emotional readiness, 5-6 year old children are expected to know how to calm down, listen to teachers, follow directions, take turns with peers (this is a great resource on turn taking), and transition between activities throughout the school day. 

        When a child enters preschool, they typically haven’t had much experience with some of these tasks. Some young children adapt well to the social and emotional expectations of a large group situation, while other children need extra support. 

        Preschool behavior triggers

        Behavior Triggers

        There can be a multitude of reasons why problem behaviors occur in the preschool setting. Just some of the behavior triggers that lead to common issues in the preschool setting include these causes:

        • Having a new routine (potty training, time change, or differing work schedules of parents are some examples) throws off the child’s ability to self regulate
        • Experiencing a change in home environment (a new baby added to the family, moving to a new home, or other home changes)
        • Not getting enough sleep (check out this article on sleep hygiene)
        • Too much screen time
        • Developmental changes in the preschool age range

        Breaking these underlying areas down, it is possible to see three common factors that may trigger a behavioral response between the ages of 3-5 years.

        As a related read, check out our fine motor activities for preschoolers as a way to support development during the yearly childhood stage.

        Common causes of preschool behaviors

        There are three common causes behind preschool behaviors: basic needs need met, environmental issues, or the behaviors of others (peers). Let’s explore each of these common causes of preschool behaviors.

        Three common triggers of preschool behavior outbursts:

        • Basic needs (hunger, sleep, thirst, temperature) Is the child hungry, tired or overwhelmed? Is it close to snack time or nap time? Did the child drink enough water while they were playing outside? Basic needs affect everyone differently. Children tend to be sensitive to bodily changes. Medical issues may affect basic needs. Make sure to be in contact with parents about any sort of change in a child’s health. This includes toileting challenges (constipation), new medications they may have been given, and allergy concerns.
        • Environment (changes to routine of the environment, home situation, transportation, changes to the classroom environment: lights, sounds, smells, temperature, distractions, unexpected changes).
        • Behavior of others (behavior of peers, behaviors and actions of adults, parents, caregivers, educators, and behaviors of others in the classroom: other children making noise, someone provoking them, someone else having a tantrum). These friendship activities for preschool can help with this area of social emotional learning.

        Triggers of challenging behavior in the preschool age range can be compounded by several of these considerations occurring at one time. Additionally, preschoolers can struggle with communication to let others know what is happening in their world.

        How to support challenging preschool behaviors

        How to support challenging preschool behaviors

        Children learn best from consistency. This pertains to social and emotional expectations, both at home and in the classroom.

        Talking to families about concerns regarding their child’s behavior, is one of the hardest conversations that a teacher can have.

        By creating a 5 step behavior plan with the family, educators can support children, while also demonstrating to families that they are there to help by teaching their child how to interact and engage with their peers. 

        5 Step Behavior Plan for Preschoolers

        Here are the 5 steps to complete when creating a behavior plan for a child. Going through these steps, you’ll see that addressing emotional regulation, getting to the root of underlying causes and considerations, creating an age-appropriate plan, including play-based strategies or tools to support development in these areas.

        As always, the concept of the “iceberg” of underlying considerations is upheld.

        1. Determine the cause of the behavior

        There are many different causes of a child’s behavior. Parents and teachers can track the behavior of a child, gathering data using an ABC chart. This refers to antecedent (what happened before the behavior started), behavior (what that child did), and the consequence (how did the child and adult respond to the behavior.) 

        When observing children to understand the cause of their behavior, make sure to pay close attention to the common behavior triggers addressed and listed above. Getting clear on what’s causing the visible behavior is essential.

        *Keep track of children that are known to have sensory sensitivities (Here are some questions to ask yourself when monitoring the environment:

        • Have you changed anything in the room?
        • Has the weather been different (humid, rain, snow, extra cold or hot)?
        • Is it really bright and sunny, or gloomy and foggy?
        • Does the child have any sensory sensitivities such as clothing, sounds, being touched?
        • Have you changed the classroom routine?
        • Has the child touched or engaged in a sensory rich experience they may not have liked (finger-paint, sensory bin, slime, play dough)?
        • Is the classroom too loud or very busy?
        • Check if the child is wearing something new/uncomfortable (do their shoes fit? Is there a scratchy tag on their clothes? Is their diaper too tight?)
        • Here is a great post on working with children with sensory differences.

        2. Talk to parents and caregivers

        Once you have narrowed down the cause of the behavior, make a plan to meet with the child’s caregivers (parents, grandparents, daycare staff) to go over your findings. Include any member of their team who spends a great amount of time with this child.

        Documented evidence and observations from the ABC chart will give you concrete examples of what is happening, and why. 

        When starting the conversation with the family, begin by describing the child’s strengths. Share their child’s favorite activity to do at school, who their friends are, and one great thing they did that week.

        Next, show the family the ABC chart, explain what behaviors you want to change, and what new behaviors you would like the child to do instead.

        Encourage the family and other caregivers to share their observations of the child at home, and out in the community. 

        3. Create goals to improve preschool behaviors

        After sharing what you are going to work on with their child, include the team in goal setting, allowing caregivers to share what they would like their child to do. As you write these goal, phrase the goals in a positive way, showing what you expect from the child.

        As with all goals, make sure they are measurable and attainable. For goal setting tips, check out this post on using a goal ladder.

        Make an appointment for a follow up meeting with the family, so you can check in on how the child is doing at home, at school, and out in the community. 

        For example:

        • Jackie will use her words when she wants to use a toy 80% of the time. 
        • Mark will participate in circle time for 10 minutes with supports such as breaks, sensory fidgets, alternative seating without leaving the area.
        • Trent will transition from outside to inside time on her own without maladaptive behaviors or needing to have physical support. 

        Next, it’s time to come up with a way to support the child in meeting these goals. 

        4. Establish interventions for challenging preschool behaviors

        As you determine the interventions to be used at school, share them with the family, encouraging them to use the same interventions at home and in the community.

        Children thrive on consistency. When receiving the same messages and intervention techniques at home and school, children will learn the behavior faster. They will learn to carry over the behaviors from one setting to the next.

        Three common interventions to include in a preschool behavior plan:

        • Create a calm down corner with tools for emotional regulation- Children tend to become overwhelmed, losing control of their emotions, when they don’t have a positive way to calm down. Soothing Sammy teaches children how to calm down, using visual and tactile tools, while supporting a positive image of feelings. As children learn how to manage their feelings, they are able to communicate and problem solve in different situations.
        • Sensory diet for the classroom – When children become frustrated due to sensory difference, a sensory diet for the classroom and home works wonders, by giving children the tools to cope with their struggle. This list, created by occupational therapists, includes practical strategies easily implemented in any preschool classroom.
        • Utilize Visual and Auditory Cues for Transitions- Children who are overwhelmed or frustrated, don’t always hear what others are saying to them. These transitions for children can be a challenge. The use of visual schedules, visual prompts, and auditory cues remind children what is expected of them, when they aren’t able to process what is said. Using visual tools such as a picture schedule, first/then chart, or picture exchange cards (PEC), while keeping directions clear and simple can help. Adding an auditory prompt, such as a bell or clapping, to signify it is time to clean up, gives children multisensory ways to receive a direction. 

        Check out this visual cue resource for use in daily activities, sensory diets, PECs, and visual supports.

        5. Preschool Behavior Plan Follow through 

        When following through with a preschool behavior plan, the next steps are important. This follow through looks like many things.

        Talking with parents and caregivers, make sure that you follow up with a second meeting to discuss the child’s progress. This is important, as it gives the parents the ability to weigh in on the next steps, the teachers to provide parents with constructive feedback of how their child is doing, and an opportunity to discuss a referral to specialists if needed.

        Some of the most common specialist referrals are:

        • Audiologist for a hearing evaluation
        • Occupational therapist for sensory, behavior, motor skill concerns
        • Speech therapist for language delays
        • Early Intervention for developmental delays
        • Behavior therapist for more intensive behavior needs
        • Pediatrician for concerns about medically based delays (including autism, ADHD, nutrition, sleep, or gastrointestinal issues)
        • Note: teachers need to be cautious when suggesting referrals to other professionals, offering possible diagnoses, or alarming caregivers.

        check out these other great resources from the OT Toolbox to support behavior

        Creating a behavior plan helps parents and teachers work together regarding preschool behaviors. Providing an environment that includes consistency, open communication, and sensory supports, will give every child a supportive environment they need to thrive. This five part behavior plan blueprint includes strategy ideas, goal creation tips and resources for behavior tracking. A behavior plan is an essential component of a healthy classroom.

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

        Weighted Vests and Compression Garments

        by
        research vs clinical experience on weighted blankets and compression garments.

        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! 

        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

        (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? 

        Victoria Wood

        Victoria Wood, OTR/L 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.

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