Problem Preschool Behaviors

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, 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.

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).

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. 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

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.

School Bus Deep Breathing Exercise- A Stress Relaxation Tool

School bus deep breathing exercise for stress relaxation on the bus

Whether you are needing a bus stop activity to keep the kids calm and collected near a busy street or a sensory diet activity for the rides to school on the bus, this   school bus deep breathing exercise fits the bill. The school bus setting is unpredictable for sensory kids and this breathing activity is an easy stress relaxation tool that kids can add to their toolbox of coping strategies.

Time for school buses, school supplies, backpacks, new teachers, new friends, and new stressors.  While school can be fun and educational, it can also be a time of stress and overwhelm.  Teaching self regulation is important for school success.  Students and teachers love these Deep Breathing Exercises

School bus deep breathing exercise self regulation tool for stress relaxation on the bus.
Use this printable school bus deep breathing page as a sensory strategy for the school bus!

Just in time for back to school, the OT Toolbox has a great new School Bus Deep Breathing Exercise page to share. AND, it includes a school bus coloring page, too!

Stress Relaxation

One benefit of this sensory school bus strategy is the use in stress relaxation strategies in response to fight, flight, freeze, and other autonomic responses.

What do we mean by stress relaxation?

First, let’s cover how this works. When faced with an unfamiliar, unwanted, or overwhelming challenge, the central nervous system employs its fight, flight, or freeze response.  This is an automatic brain stem response to input.  Because everyone’s central nervous system is different, people respond differently to input.  Some people startle easily, are afraid of bugs, don’t tolerate loud noise or crowds, and are very sensitive. 

Others take life in stride, nothing tends to bother them. 

While this School Bus Deep Breathing Exercise is targeted for those who need to slow their central nervous system, everyone can benefit from taking a break once in a while to reset. When a body is in its fight, flight, or freeze mode, the central nervous system takes over.

The following may be symptoms of this autonomic response:

  • The heart rate may increase
  • Increased breathing rate 
  • Elevated heart rate/blood pressure/temperature 
  • Sweating
  • Hiccups
  • Excessive emotional outbursts
  • Decreased cognitive skills as all energy goes into protecting the body
  • Digestive issues

Because of this autonomic or automatic response to stimuli, people can make a conscious effort to combat these symptoms.  One quick and easy way to slow down heart rate, blood pressure, temperature, and emotional outbursts is by using deep breathing exercises to relax the stress response. 

Education on self regulation is an important step of sensory based treatment.  Teaching a person to understand their body, triggers, and response to input will help them choose an appropriate treatment method, and a perfect time to use it. 

The use of stress relaxation strategies is a work in progress, and takes a long time to achieve self regulation.  Adults as well as children need help and reminders along the way when they are feeling out of control.

We have other fun and motivating breathing exercises for kids in the school setting on the site, too. These include:

School Bus Deep Breathing Exercise

The OT Toolbox is full of Breathing Exercise Worksheets.  The newest one, The School Bus, comes at a great time of year. It’s the perfect tool to use in stress responses on the school bus. Add this sensory strategy in school environment to the bus environment which can be unpredictable, full of loud sounds, vibration and unpredictable movements, and an opportunity for sensory overload.

Use the school bus sensory strategy to support different needs:

  • A sensory diet for the school bus
  • Waiting for the bus activity
  • Stress response to a simulating school bus environment

Have learners place their finger on a white dot.  Instruct them to breathe in while sliding their finger across the arrow.  On the next arrow, they are instructed to breathe out.  Learners can go around the bus as many times as it takes for them to feel more in control of their body.  

We’ve also included a deep breathing coloring page, in this set, too. Use it to work on coloring skills and pull in other areas of development such as fine motor skills and visual motor skills. Kids can then use the deep breathing coloring page as a coping strategy tool they have created and have ownership over.

How does this work?

These Deep Breathing Exercises are more than just working on breathing. Think about the following sensory systems that are activated using this free printable:

  • Deep breathing slows the heart rate
  • Visualizing the bus creates a distraction, or changes the learner’s focus
  • Listening to the sound of deep breathing can help tune out other stimuli
  • Counting breaths or holding for a number of seconds also creates a shift in focus
  • Themed breathing opens a door to change the subject and talk about the picture
  • Slowing the body down during the exercise, helps with regulation
  • Following a rhythm is organizing to the central nervous system

How to use the School Bus Deep Breathing Exercise Worksheet

Strategies such as breathing exercises are not as easy as handing your learner a piece of paper.  There is a lot of teaching, education, practice, and trial/error that goes into any of these treatment methods.

  • Initiate the activity BEFORE total meltdown or shut down occurs.  Once shut down occurs, it may not be easy for your learner to tolerate, listen, or sit and focus on this task
  • Use these exercises as part of your prescribed sensory diet, proving them at regular predictable intervals during the day, such as before/after transitions
  • Learner does not have to sit in a chair to work on deep breathing. They may lay on the floor, do yoga poses, climb under a blanket, sit in a rocker, or a comfy beanbag
  • If this exercise does not work for your learner, either try again at a different time, or move onto another strategy.  The OT Toolbox is full of ideas for self regulation

Thematic lesson or treatment planning is motivating for students, and a way for educators to organize their daily teaching. Back to school is a popular theme using school buses, school tools, and apples to get to know your students.  It is a great segue into the fall theme.

Other Back to School Activities from the OT Toolbox:

Free printable stress relaxation for the school bus

Want to add this printable stress relaxation tool to your therapy toolbox? Enter your email address into the form below.

This item is also available inside the Member’s Club. Members can log into their account and access the tool by heading to Mindfulness Tools. Grab this stress relaxation exercise as well as others including unicorn deep breathing, pencil deep breathing, rainbow breathing, and more.

FREE School Bus Deep Breathing Exercise

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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.

    Co-regulation

    In this blog, you will learn how the environment, and the feelings of those around us, directly affects behavior. You will learn simple ways to support children in calming down, while in our care, through co-regulation. This important skill is part of our emotional intelligence and one that takes fostering and nurturing. Let’s go over what coregulation means, how this skill develops, and how we can support co-regulation through practical strategies.

    Co-regulation information, facts, and references for developing this emotional intelligence skill in children and peers.

    CoRegulation

    The feelings and behavior of people in close proximity to us, directly impact how we feel, and respond to our own emotions. When children become upset, if those areound them stay calm, demonstrating how to calm down, the child can calm down quicker.

    How would you feel if your neighbor was yelling at the mailman for stepping on their freshly cut grass?  Do you feel annoyed? Can you feel the fear the mail man is feeling?

    How would you feel while walking past someone doing yoga in the park? Do you feel calm?

    In the same way adults are impacted by others actions, children pick up the moods of others around them. When people around us are behaving a certain way, we can be directly affected, responding both internally and externally. 

    When witnessing an uncomfortable event such as the confrontation at the mailbox, internally you might feel your heart start to pound, or clench your teeth as nervousness sets in. You might run and hide behind the window curtain to try and separate from yourself from what is making you feel uneasy (while still peeking in horror). 

    Once separated, you are often able to calm down using strategies to regulate your sensory system. I like to sip water and take breaths of lavender. My husband likes to go for a run and lift weights to decompress. As adults, we have learned how to adapt and overcome these intense feelings through different strategies. Children need support to separate themselves from stressful situations, and regulate their emotions.  They are not able to understand the triggers and determine an acceptable calming mechanism.

    Co-regulation definition and terms

    What is co-regulation?

    The definition of co-regulation is– the ability to regulate emotions and behaviors to soothe and manage stressing internal sensory input or external situations, with the support and direction of a connecting individual. Co-regulation is nurturing connection of another individual that supports regulation needs through the use of strategies, tools, and calming techniques in order to self-soothe or respond in times of stress.

    Co-regulation and self-regulation are part of the developmental process. In order to move from a co-existing place to a place of independence, the child needs to develop emotional intelligence and social emotional learning. All of this is part of typical development.

    Development of co-regulation

    Co-regulation is a part of development. Before one can self-regulate, they need to co-regulate.

    • Co-regulation begins in infancy. Before a young child can self-soothe, they need a parent to help them. When an infant is crying a parent picks them up, holds them close, rocks, and wraps them up in a tight swaddle, and offers a pacifier. All of these strategies are tools to provide correct sensory input that calms and regulates the baby’s system. This is co-regulation; the parent is offering tools and strategies to support the infant’s needs. 

    As caregivers we play a huge role in helping children calm down. When children are upset or overwhelmed, they look to us for help with regulating their emotions. This article explains how to support co regulation in infants through three year olds. A caregiver needs to project calmness in order to soothe their infant. This is very difficult for an anxious or upset parent.

    • Co-regulation in toddlers might look similar, but with more input from the child. The toddler prefers to be active and jump, run, roll, or move, rather than be held and cuddled all the time. The caregiver offers toys and activities to get the child moving in the way they enjoy. If the toddler only does these alerting activities, they might run themselves down, and move into a meltdown state. The parent then offers a calming tool such as a cool sip of water, a slow walk, singing a song, a break from the action, or a moment to stop and look at something interesting (also known as mindfulness). All of these are co-regulation strategies for toddlers. The parent offers strategies to the young child, and hopefully, the child accepts them. 

    As children grow into toddlers, the most successful way to support their feelings is to calmly use words and gestures to redirect them when they are upset. When adults are feeling anxious or upset when trying to redirect the child, children respond with increased adrenaline, becoming more upset and dysregulated.

    They match or mirror the energy of their caregivers. When adults stay calm, children can become calm. When children become or stay calm, they are able to listen and problem solve. 

    • Co-regulation in preschoolers can be similar to that of a toddler. As they develop, preschoolers are able to offer more input as to their preferences, interests, and dislikes. For example; the young child can request a certain sippy cup they like. They may not know why they like certain activities or items like the long straw on their favorite cup, or the weight of a plush toy, but they know that it feels good. Similarly, adults often do not understand why they choose to run or listen calming music, they just know it helps. Parents can help young children co-regulate sensory and emotional needs through providing ideas for strategies and activities. 
    • Co-regulation in older children– Preschoolers, kindergarteners, elementary aged children and teens are able to self-regulate using skills taught to them while being supported through co-regulation at a younger age. As children grow, they have more autonomy. They have more ability to move from co-regulation to self-regulation. 

    The ability to self-regulate occurs through co-regulation with parents, teachers, and older peers. Typically, it’s through the first 7 years of life that children need support to regulate emotions, sensory input, and external stressors.  Even after the age of 7, most kids need help! 

    Self-regulation development continues over time, but the ability to co-regulate begins to move from a supported mechanism, to an individual and independent ability.

    Co-regulation parenting tips and strategies to support emotional development.

    Co-regulation Parenting

    The above paragraph should help explain what coregulation means in young children, but how can we help support kids with co-regulation, so they can develop these self-soothing skills?

    We can focus on co-regulation parenting as a tool and a means to support our children.

    Many adults struggle with self-regulation. This is where we see additional problems. When young children need support to co-regulate, sometimes the adults in their lives are not offering the tools and strategies as a support person.

    If a parent responds to a young child’s meltdowns or behaviors with emotional outbursts, anger, stress, and anxiety, the young child cannot soothe themselves.

    It is important for adults to take a look at stressors, internal anxiety, and emotional state so they can support the young child. 

    • How many times have you witnessed frustrated teachers/parents/caregivers yelling at children?
    • Does it calm them, or make them afraid and shut down?

    This is why it is important for caregivers to step away from a situation where the toddler is “pushing their buttons”. Take a deep breath, get a date night out, go for a run, or some other mechanism of self-regulation.  I often said, “Mommy needs a time out.”

    self regulation

    You have probably heard the term “self-regulation” which refers to the ability to control oneself in any given situation by balancing and calming internal sensory systems within the world around us. 

    Before young children can self-regulate, they need the support of adults around them to teach and help them develop the abilities to regulate on their own. They need to co-regulate, or co-exist with parents, teachers, and others, who can “show them the ropes” and learn to balance and calm their internal and external systems. Co-regulation comes before self-regulation developmentally.

    Neuroscience of Co-regulation

    What does co-regulation look like in the brain?

    Brains are amazing machines, capable of processing the environment, including the feelings of others. Dr. Caroline Leaf, neuroscientist has stated “As you co-regulate with someone, the mirror neurons in their brain are activated, and this enables the person in the deregulated state to literally ‘mirror’ your calmness,” For long-term benefits and effective results, Johnson recommends practicing co-regulation often. “It will effectively rewire the brain so that over time, things that once were triggering or set off alarms no longer have the same effect and happen less often.” 

    Wow! The brain can process the feelings of others in milliseconds, directly affecting our our own moods and behaviors. No wonder all of the children in a preschool class feel overwhelmed, as soon as one child becomes dysregulated. 

    How do you prevent the whole room from becoming overwhelmed, when only one person is stressed? Co-regulation is the first step for a person to learn self-regulation. 

    According to this research article by Howard Beth, “Neuroscience shows that humans develop their abilities for emotional self-regulation through connections with reliable caregivers who soothe and model in a process called “co-regulation.” … In time, the child internalizes the expectation of a soothing response which provides a foundation for learning self-regulation. “

    It is the responsibility of caregivers to support co-regulation, which directly impacts a child’s ability to self soothe as they grow. When children are upset, the most important thing for caregivers to do, is remain calm.

    If caregivers become upset or overwhelmed in response to another person’s behaviors or actions, everyone will continue to feel stressed, and the situation will explode.

    Co-regulation activities and strategies to help kids with emotional development of cooregulation skills.

    How to help kids with co-regulation

    My own regulation techniques were put to the test once, when I was teaching at a preschool that backed up to a farm. The children (all 2-5 year olds) were inside eating lunch and I was setting up their nap mats. We had a futon in the classroom for children to relax and read books on.

    Out of nowhere, a humongous snake slithered out from under the futon! The initial shock wore off quickly, and my nerves set in. The snake was coming towards me, and I had 24 preschoolers eating lunch only ten feet away! I calmly helped the children walk out the door to the playground with the aide, breathing and saying “It will be okay. No need to worry.” 

    The kids walked out of the room curious, but not frightened. I raced to the phone and called for help (my voice was much more panicked as I talked to the janitor about the huge snake in the room)! I knew nothing about snakes, and I wasn’t about to get in its’ way. Luckily it ended up being a garter snake, removed quickly by a specialist and relocated, far away from my classroom!

    At that moment, I knew that I had to “keep my cool”, so the children wouldn’t become scared. They co-regulated off of my calmness, and were able to safely follow directions and watch the situation unfold from outside.

    Children learn new skills through hands-on activities. Regulation skills are learned the same way.

    Regulation Strategies:

    1. Deep Breathing- Deep breathing exercises for kids teaches young children how to calm down through pausing, and taking large breaths. Relaxation breathing is a great strategy for adults and kids to do together. The ones on this site use a fun and engaging strategy that introduces breathing techniques using visuals and imitation. The printables in this resource form the OT Toolbox teach kids all about breath control using fun pictures, arrows, and places to pause, and hold their breath. Print out the free PDFs, show the child the picture and the arrows, and practice deep breaths. When your child becomes upset, immediately start to “breathe like a polar bear”, or “do rainbow breaths” and watch as your preschooler starts to calm down too!

    Some of the most commonly used deep breathing tools include on the OT Toolbox include: 

    1. Toys and stuffed animals- Using a preferred toy or stuffed animal integrates strategies from DIR Floortime therapy strategies.  Kids gain the emotional vocabulary, and strategies to use in co-regulation, through play. I developed the Soothing Sammy (affiliate link) learning system. It is a great tool for co-regulation, because of the picture books and activities included with the emotional regulation toy. 

    In my book, Soothing Sammy, a golden retriever puppy, teaches children how to calm down using a variety of sensory strategies (such as jumping in place, blowing bubbles, sipping water, singing a song and squeezing a ball or play dough). First, read the Soothing Sammy story, where children visit Sammy in his dog house. He provides them with all of the tools needed to calm down. Once calm, the children are ready to play again. Use the stickers and shipping container to have your own preschoolers create a space for their own calm down items and place Sammy, the plush dog, inside! This is your child’s very own Sammy house to visit, just like the children did in the story.  When children are overwhelmed, experiencing big feelings, they are easily redirected to these activities by saying “Sammy Time.” Help children co-regulate by creating your own Sammy House and using items to calm down when they are upset, modeling calm and soothing behaviors.

    1. Go outdoors and co-regulate!

    Sometimes all we need is a little bit of fresh air to help feel better. Use these outdoor sensory diet cards to discover calm down strategies to use outside with children. These cards contain outdoor play challenges to get kids moving, experiencing various sensory systems, and receiving calming input from the great outdoors. Included, are over 180 ideas on how to calm the bod through movement. The outdoors is a great place for a sensory diet. In the backyard there is a variety of movement opportunities. A playground is another great space for calming and regulating play. Check out this blog post on sensory input at the playground

    Children, especially toddlers and preschoolers, depend on adults to show them how to calm down or self-regulate.

    tools for adults to learn self regulation

    Being that co-regulation requires the ability to support another individual with regulation needs, it’s important to address emotional and coping needs as the adult in a parent/child (or other adult/child, peer/peer relationship). As a support person, regulating ones’ own needs can go a long way in modeling appropriate reactions, coping strategies, and following through with regulation needs.

    Below are some great tools for adults to learn, or improve self-regulation so they can be models and important roles in the co-regulation relationship include:

    If you’ve ever flown on a plane, taken a cruise ship, you’ve heard the safety information: In the event of an emergency, adults should place the breathing mask over their faces before they attend to their child.

    Parents should put on their life jacket before they put the life jacket on their children. This seems backwards and selfish, however these life-saving mechanisms are of no use if the adult is struggling.

    If they don’t put on their own face mask or life preserver first, there is no chance to support and help the child. The same is true for regulation; parents must first self-regulate in order to help co-regulate their children’s internal and external needs.

    Empathy versus Empath

    Empathy is being able to understand a person’s feelings, or realize why someone might be angry or sad. It is an important social skill, especially if you are the one causing the upset. Young children do not have the capacity to understand the complexity of empathy.

    An empath is a person highly attuned to the feelings and emotions of those around them. Their ability to discern what others are feeling goes beyond empathy (defined simply as the ability to understand the feelings of others) and extends to actually taking those feelings on; feeling what another person is feeling at a deep emotional level.

    Try this empathy activity to teach these concepts to children.

    According to this article, What we do know is that researchers have discovered what they’ve dubbed “mirror neurons” in the brain which may help us to mirror the emotions of those we come in contact with.1 And it appears some people may have more mirror neurons than others; suggesting that empaths may exist.

    The positives of being an empath are being able to offer support to others, knowing when someone is in need of assistance, and reading a person’s energy to see if they are a good fit for you.

    The cons of this “ability” are that it is draining taking on the emotions of others around you, it feels like you are too sensitive, and you feel burdened taking on so much.

    Being an empath can be described as feeling like a vacuum cleaner, sucking up the emotions of those around you, often before they realize how upset they are.

    Empaths need to be experts at co-regulation because of the amount of sensory and emotional input they are “sucking in”.

    A final note on co-regulation

    Children aren’t born knowing how to manage their feelings in a positive way. As infants, they depend on their caregivers to soothe. As they grow into toddlers and preschoolers, children continue to depend on cargivers to teach them new strategies to calm down. When they sense how calm their caregiver is, they calm down also. The best way for caregivers to help children develop their self-regulation skills, is to support them in co-regulation, by showing them calming activities they can learn to use on their own.

    To learn more about sensory processing disorder and strategies, check out The Sensory Lifestyle Handbook and this resource on sensory processing disorder chart to understand all aspects of SPD.

    *Note: The term caregiver has often been used instead of parent. This is to be inclusive. Caregivers can be parents, older siblings, grandparents, teachers, daycare workers, bus drivers, coaches, and many more.

    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.

    DIY Fidget Toys

    Diy fidget toys

    These DIY fidget toys are homemade fidgets that kids can make. Use these fidget items to help kids pay attention and focus in the classroom or home.

    Kids can use these DIY fidget toys to help with attention and sensory needs in the classroom or at home.

    DIY Fidget Toys

    Fidget toys are in the hands of many school-aged kids.  Students without sensory or attention needs are playing with fidget toys on the playground, on the school bus, and in the classroom.  You can find spinner fidgets, and so many other fidget toys in many stores and online, but what about the DIY version?

    The thing about some store-bought fidget tools is that they are noisy and call attention to the user. Fidget toys have become more popular in recent years, allowing those that truly need them for meeting sensory and motor needs to be more mainstream.

    However, that can be another issue when a student has a fidget tool in the classroom. It can draw attention to the student because other students see the itm as a toy rather than a tool to support learning.

    Coming up with quiet fidget toys that help the child meet their sensory and movement needs without creating more noise or attention in the classroom can be tricky. Here are more ideas for quiet fidget toys for the classroom.

    So what is the obsession with these fidget toys?  

    The fidgets are intended to provide kids with a means to occupy their hands so that they can focus during tasks that require attention.  There are many children who need fidget tools in order to complete work.  Most of us know the feeling: the urge to doodle when talking on the phone or the tendency to tap a foot during a lengthy work meeting.  

    Fidgeting is a tool that helps us to actually pay attention and focus on the task at hand in many situations. Fidgeting during homework or in the classroom is a common behavior. 

    Diy fidget toy for kids to use when learning
    Make a DIY fidget toy using beads and a craft stick.

    DIY Fidget Toys

    Affiliate links are included here.


    You have probably seen kids (and maybe your own kids) spinning these spinner fidget toys.  

    The fidgets that are in every school and classroom these days are beneficial to some students.  For others, they are a cool new toy.  For those that require a fidget tool to focus or attend, or have sensory needs requiring the hands and fingers to move, other fidget toys may work just as well. 

    keychain fidget toys
    Keychain fidget toys can be a great way to add movement inexpensively.


    Fidgeting during work stimulates the brain, allowing a child to complete school work or homework.

    Fidgeting is mindless play or touching fingers, pencils, hands…anything that allows a person to focus on the task at hand. Kids that are fidgeting are seeking calm, and focus so that their brain can complete a task.

    The problem is when the brain’s urge to fidget distracts a child from school tasks. They might be so wiggly and moving that they just can not sit still and focus in a functional manner. Fidgeting can be managed with less distracting techniques which can allow the child to accomplish the homework, and move on to other things.

    Calming weighted fidget toys for kids
    Use a glove to make a weighted fidget tool for kids. Here are the instructions for this DIY fidget tool.

    Homemade Fidget Toys for Kids

    Here are a variety of DIY fidgets that can work for kids in the classroom or at home:

    How to Make Fidget Toys

    Getting kids involved with making homemade fidget toys is part of the fun. There are fine motor benfits involved in this process, too.

    1. First, select the type of DIY fidget you would like to use to meet specific needs.
    2. Next, select materials. You may need pipe cleaners, beads, balloons, or nuts and bots.
    3. Prepare a work space. Set out the materails on a table or desk.
    4. Students can select the materials they would like to use.
    5. Create a fidget tool using the materials.

    The nice thing about fidgets is that with the growth of YouTube as a resource, there are many videos on how to make fidget toys out there. Use one of those available videos as your inspiration, or use the materials you have on hand.

    If one thing is for certain, it is possible to make a DIY fidget toy using anything!

    homework fidget toys
    Try these suggestions for homework and classroom fidget tools.

    What are your favorite DIY fidget toys?  Do you have any favorite tools that work for your child, student, or client?

    fidget tool or a fidget toy? 

    Here is your disclaimer on the wording of this blog post…

    The term fidget toy is very well known these days, with the popularity of spinner fidgets.  However, there is a distinction between a fidget toy and a fidget tool.  When there is a therapeutic need for a product, it is a tool.  A therapy tool is one that helps meet goals, results in independence through intervention.  Something that looks like a toy can be a tool for the child with sensory needs, fine motor challenges, attention difficulties, or any other problem areas.  

    Fidget tools are those that help kids cope, meet sensory needs, and get the input they need so they can focus, pay attention, and move. In this blog post, I am using these terms interchangeably, for best search results. In other words, people complete a Google search for fidget toy, not a fidget tool, and I want this information to be found on Google so that the kids who need a fidget tool are well-served!

    These DIY fidget toys are a perfect addition to the classroom to address sensory and attention needs in kids.

    Need to add DIY fidget toys to a sensory diet? Wondering how to integrate a sensory diet into everyday tasks? A sensory lifestyle may be more of what you are looking for! DIY fidget toys fit right into a sensory lifestyle with ease and flexibility.

    Read all about how to create a sensory lifestyle here:

    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.

    Colleen Beck, OTR/L is an occupational therapist with 20+ years experience, graduating from the University of Pittsburgh in 2000. Colleen created The OT Toolbox to inspire therapists, teachers, and parents with easy and fun tools to help children thrive. As the creator, author, and owner of the website and its social media channels, Colleen strives to empower those serving kids of all levels and needs. Want to collaborate? Send an email to contact@theottoolbox.com.

    Summer Sensory Stations

    Summer sensory activities

    Today’s sensory resource is a self-regulation tool that is very popular among therapy professionals and educators: an all-new Summer Sensory Stations set! This set of printable sensory path activities are nice because they can be printed off, laminated (or placed in a page protector sleeve), and hung in a hallway. We’ve received so much great feedback about out other seasonal sensory stations that this summer version was a must! Add this resource to your Summer occupational therapy activities.

    You’ll want to check out the other sensory station printables at the bottom of this post.

    Free summer sensory stations for a DIY sensory path or self-regulation tool with a summer theme.

    Summer Sensory Stations

    A DIY sensory path can include a few quick stops to add deep breathing, mindfulness, proprioception, vestibular input, eye-hand coordination, crossing midline, and whole-body movement.

    And that’s just what this set of summer themed sensory stations includes!

    The movement-based stops offer users to take a break at various stations and integrate movement, coordination, and visual input with deep breathing, and heavy work.

    What a great way to add a quick brain break between activities or to get ready for a therapy session!

    In this summer themed set of activities, you’ll find a printable page for each “station” or stop along the sensory path:

    Bee path infinity loop-

    The first page in the summer sensory path kit is a bee infinity loop, which is great for mindfulness, deep breathing, crossing midline, eye-hand coordination.

    Tracing the infinity loop offers an opportunity for mindfulness through the summer bees’ paths as they move along the loop. This creative way to foster visual attention, self-regulation, self-awareness, coping skills, and concentration is fun for summer! By tracing the loop, hand-eye coordination and mindfulness allow the user to be more present in the moment, and more aware of themselves.

    Some users may stand on an uneven surface while doing this activity to challenge balance and visual skills. Think about adding a gymnastics mat, slant board, balance pod, or other uneven standing surface.

    Others may want to kneel or do a lunge while completing this activity to further challenge balance and coordination skills. The nice thing about the printable sensory station is that it can be raised or lowered on the wall easily.

    Leap like a dolphin-

    The next page in the sensory paths for summer is a “leap like a dolphin” activity. It’s a powerful activity for vestibular input, motor planning, and proprioceptive heavy work

    Proprioception offers a way to “wake up” the joints and muscles in the body. This leaping activity can be done from a standing, kneeling, or from the floor. Proprioceptive input from the muscles and joints provides information about body position, weight, pressure, stretch, movement and changes in position in space, so this leaping activity adds a summer theme!

    Beach ball wall push-up-

    Next in the Summer Sensory Stations kit is a beach ball wall push up page. Add whole body proprioceptive input through the upper extremity: shoulder girdle, elbows, wrists, and arches of the hands. Plus wall push ups are a great strength and stability exercise for the core.

    You can modify this activity to place it lower on the wall for a lunge position, or even can do the wall push-ups from a seated position to challenge seated balance. This is a great motor and sensory opportunity for wheelchair users.

    Seashell trace and breathe printable-

    Users love our spiral path deep breathing exercises. There is so much heavy work benefit to filling and emptying the lungs as a self-regulation strategy.

    Follow the circular path from the crab to the seashell while breathing in. Then follow the path again to breathe out. This visual offers a deep breathing exercise for filling and emptying the entire lungs, which is a great interoception and proprioception exercise for mindfulness and self-regulation.

    Summer Sand Squats-

    Finally, the last page in the Summer Sensory Stations printable is a summer-themed squat exercise.

    Users can do a certain number of repetition of squats along with the visual for a balance activity and coordination exercise. This visual is left open-ended but you could challenge users to pick up an object from the floor for more balance opportunities, or you could ask them to move their hands or keep their vision on an object for visual attention, etc.

    How to Use these Summer Sensory Stations

    Using these Summer sensory path stations is simple:

    • Print off the pages.
    • Laminate them or slide them into a page protector sleeve. This way the sheets can easily be cleaned with a spritz of cleanser or disinfectant spray.
    • Hang the pages in a hallway to create a DIY sensory path. Or, hang them in a corner of a room to make a sensory calm down corner.

    You can use these stations as a brain break, a scheduled sensory diet activity, a calm-down activity, or a transition activity for routine sensory input. The stations are great because they can be used with all individuals, making them perfect for a groups of children at a sensory summer camp (or any type of summer camp!) or meeting individual needs during therapy sessions.

    Want these Printable sensory Stations?

    Enter your email address into the form below. You’ll receive an email containing the PDF file. This resource is also available in our Member’s Club, where members can head to the dashboard and click a download button to immediately access the printable along with hundreds of other resources…no need to enter your email address!

    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.

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    Free Summer Sensory Stations

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      Looking for more Sensory Stations?

      Check out these other themed sensory station printables:

      Colleen Beck, OTR/L is an occupational therapist with 20+ years experience, graduating from the University of Pittsburgh in 2000. Colleen created The OT Toolbox to inspire therapists, teachers, and parents with easy and fun tools to help children thrive. As the creator, author, and owner of the website and its social media channels, Colleen strives to empower those serving kids of all levels and needs. Want to collaborate? Send an email to contact@theottoolbox.com.

      Shirley Temple Popsicles Recipe

      Shirley Temple popsicle

      Today’s Shirley Temple popsicle recipe is a cool treat for summer, but also a great way to get kids busy in the kitchen cooking and developing skills. We’ve shared a ton of cooking with kids recipes, and this 7up popsicle recipe is even better because its an alerting sensory food that can be a great sensory tool for this time of year.

      Shirley temple popsicles are a sensory food. Use lemon lime popsicle treats to wake up the mouth!

      Shirley Temple Recipe

        I wanted to share a sweet treat with you  today that my kids ( and the neighborhood kids) love. Who doesn’t love Shirley Temples? These are in popsicle form and are oh so good. I hope you enjoy!   

      When I was a little girl, there was a seafood restaurant in the town we lived in called Neptune’s Galley. I have no idea if that restaurant is still in business or not, but I remember it vividly. There was a huge statue of Neptune on the roof of the building and it was dark and nautical on the inside. I have to admit, I do not remember the food that was served there.

      I remember first being introduced to Shirley Temple’s!

      At the time, my favorite movie just happened to be Shirley Temple in The Little Princess. And my daddy knew that and ordered me a Shirley Temple to drink…and the rest is history.

      I think I requested that drink at every restaurant  we ate in for the next five years after that!

      In case you didn’t know, a Shirley temple drink is a kids’ drink that has 7up, Sprite, or other cool and refreshing fizzy drink. You add a touch of cherry, and maybe another fruit juice, and you’ve got yourself a kid-friendly drink that is a huge hit.

      Therapy Benefits to Make these Popsicles

      Not only are these popsicles a fun treat, there are also benefits to getting kids involved in the actual preparation process.

      Pour and Scooping Activity- The best thing about making a Shirley temple drink with kids is that it’s an easy recipe. There are only a few ingredients, but children can pour and scoop the food items, working on so many fine motor skills. By pouring and scooping the ingredients, you address bilateral coordination, crossing midline, eye-hand coordination, strength, graded motor control, motor planning, and much more.

      Fine Motor Skills- We’ve covered the benefits of fine motor development during cooking in the past, and this is a great starter recipe to try with kids…they get a huge reward in the end- a refreshing Shirly Temple popsicle!

      Executive Functioning Skills– Another benefit to making this Shirley Temple recipe is to add executive functioning skills while following the directions to prepare the recipe.

      Shirley temple popsicle on a plate

      Shirley Temple Popsicles Recipe

      Cold, bubbly Sprite, grenadine and a cherry on top. Oh, how I loved getting that pink-tinted drink brought to me. I felt so grown up!

      Flash forward 20 years. My boys and I were at Red Robin and I introduced them to Red Robin’s Shirley Temples.

      Ummm, they were not impressed. I guess it is a girl thing. They ended up with root beer floats. But I was determined to get them to like them!

      So last week I set out to make Shirley Temple Popsicles.

      At first I tried with just Sprite and maraschino juice. Eh. Then I added cherries to the mix. Still not right. So, after a few trial and errors, I added fresh orange juice, sprite, cherries and cherry juice. Perfect. And the boys ate them all.

      So here is to nostalgia. And Shirley Temple!

      Ingredients:

      • 2 cups Sprite or 7-Up soda
      • 1/2 cup fresh orange juice ( it took about 3 medium oranges to get the juice I needed)
      • Grenadine (I find this in the aisle with the margarita mix, etc)
      • Maraschino cherries

      Directions:

      1. In a large mixing cup, combine the soda and the orange juice. Set aside.
      2. Fill popsicle molds with maraschino cherries. (Mine were smaller molds, so I used 3 cherries in each mold.)
      3. Add about a teaspoon of grenadine to each mold. (You could use the cherry juice in the bottle of cherries, if there is enough, in place of the grenadine)
      4. Add the soda and orange juice mixture to each mold, about 2/3 full. Don’t fill to the to the top of the molds. It will expand after freezing.
      5. Place tops on popsicle molds and freeze.

      Sensory Food

      This popsicle recipe is a great sensory food, because of the alerting factor the cool ice pop offers to the mouth. We talked a lot about the benefits of sucking and alerting or calming properties of cool and warmth on this website in the past.

      In fact, our post on using a sports bottle as a self-regulation tool shares information on the sensory receptors in the mouth and jaw. It is these receptors that register the cool, alerting temperature of a popsicle.

      The cold temperature alerts, or “wakes up” the mouth. This can be a great sensory strategy to use for achieving attention or focus. It can help to regulate a child’s sensory needs when they are feeling lethargic or overly run-down.

      Not to mention that during the hot summer months, a cold popsicle is the perfect treat!

      However, there’s more to it than that. Sucking on a popsicle engages proprioceptive input through the muscles and joints in the mouth and jaw. Essentially, the popsicle is a strategy to offer heavy work through the mouth. So, a popsicle can actually be calming, too. It really depends on the child as well as the situation.

      Think about a hot and humid summer day. A popsicle and a moment of chill-out time can help a child to calm down, re-group, and regulate their senses.

      As an added benefit, a popsicle can be a great tool to use in oral motor exercises.

      Lemon Lime Popsicle

      Important to note about this recipe is that you can use Sprite or other pop or soda that contains lemon lime flavoring as one of the main ingredients.

      The lemon-lime flavor is very alerting, as they are citrus foods. This flavoring in the popsicle “wakes up” and alerts the taste buds and acts as sensory input.

      One tip: If you are concerned with the sugar intake, or want to find a lower sugar version, consider using low calorie lemon lime drink or 7-UP ten as an alternative to the lemon lime popsicle treat.

      So? What do you think? Let us know if you make Shirley Temple popsicles and use them to develop skills!

      Colleen Beck, OTR/L is an occupational therapist with 20+ years experience, graduating from the University of Pittsburgh in 2000. Colleen created The OT Toolbox to inspire therapists, teachers, and parents with easy and fun tools to help children thrive. As the creator, author, and owner of the website and its social media channels, Colleen strives to empower those serving kids of all levels and needs. Want to collaborate? Send an email to contact@theottoolbox.com.

      Benefits of Nature Play

      benefits of nature play

      Research has a lot to say about nature play. When it comes to outdoor play, there is a lot that can be discussed too. Occupational therapy professionals encourage a lot of open-ended play, outdoor games, and outdoor play. There is a natural sensory aspect to outdoor play, which supports self-regulation, emotional regulation, attention, and learning, all through just playing outside! Today we are talking all about what the research has to say about outdoor sensory diet activities and outdoor play.

      Benefits of nature play in developing skills in kids and adults of all ages.

      Benefits of Nature Play

      Taking sensory diet strategies outside is nothing new. But, doing so may just be a meaningful way to create the “just right” state of alertness and calming nature that, well, nature provides! But to take it a step further, did you know there are benefits of outdoor games? Did you know that the outdoors support executive functioning skills, self-regulation, and motor skill development…all through playing outside?

      Use this information when explaining about what a sensory diet is and what a sensory diet looks like for kids with sensory needs. 

      There are quite a few benefits to sensory experiences in the outdoors:

      Children have a large opportunity for sensory input through playground play. But, in recent times, children experience playgrounds that are more safe, allowing for less risky play. Encouraging specific activities such as a playground sensory diet on playground equipment can be beneficial to sensory needs. 


      Another item to consider is the aspect of applying sensory diet strategies within the classroom or home environments as a fix for sensory processing needs. The specific and prescribed sensory diet activities for a particular child can be very helpful in addressing specific sensory-related behaviors.

      However, the use of a sensory tool such as an alternative seating system within the classroom provides only one type of vestibular and/or proprioceptive input, such as up and down vestibular input. The child who plays outdoors encounters a wide variety of sensory input across all sensory systems! 


      You might even call sensory tools used to address specific needs a sensory band-aide. What if we as therapists could encourage authentic sensory input in the outdoors (or indoors, as indicated) that addresses all of the sensory systems. Using meaningful play experiences not only provide all the benefits of play. They encourage healthy development through the senses. 


      Research says outdoor sensory play is beneficial in the development of children. Use these outdoor sensory diet activities to inspire outdoor activities that boost skills like motor development, attention, regulation, and more.

      Research on Outdoor Play



      There have been decades of research on the benefits of play in kids. The information below depicts how outdoor play impacts sensory needs in kids. This is not an exhausted review of the literature, simply a smattering of research available on the topic. 

      Research shows us that some of the developmental and primary tasks that children must achieve can be effectively improved through outdoor play.

      These include:

      • exploring
      • risk-taking
      • fine and gross motor development
      • absorption of basic knowledge
      • social skills
      • self-confidence
      • attention
      • language skills

      Wow! Playing outside has a bigger impact than we may have thought!

      Other research has shown an increase in communication, along with more observed emotions, and increased interactions in children with autism when more time was spent outdoors. 

      Studies have found that dynamic and varied outdoor play offers opportunities for decision making that stimulate problem solving and creative thinking, opportunities that aren’t as easily found in the more static indoor environment.

      Still other research supports the many health benefits:

      • reducing stress
      • decreasing symptoms of ADHD
      • protecting against myopia
      • boost the immune system

      Outdoor Nature Play and Attention

      One study found a sensory diet in outdoor play along with sensory integration therapy resulted in better functional behavior of kids with ADHD (Sahoo & Senapati). 


      Using sensory activities that are specific in time and quality such as those in a sensory diet should be done in an authentic and meaningful manner in a child’s life. In this way, sensory input is motivating to the child in that it goes along with interests and the environment in which the child lives.

      It’s a fact that kids are spending less time playing outdoors. From after-school schedules to two working parents, to unsafe conditions, to increased digital screen time, to less outdoor recess time…kids just get less natural play in the outdoors. 

      Some therapists have connected the dots between less outdoor play and increased sensory struggles and attention difficulties in learning.

      Knowing this, it can be powerful to have a list of outdoor sensory diet activities that can be recommended as therapy home programing and family activities that meet underlying needs.

      From an occupational therapy perspective, nature play offers supports for underlying skill development. Children have the opportunity to develop motor skills, visual perceptual skills, confidence, executive functioning skills, and self-regulation that enables them to feel confident in their abilities. These areas of development support functioning and independence!

      When heading outdoors, you can put on a coat, boots, or jacket and work on self-dressing skills. You can experience all of the motor rich opportunities for movement in the outdoors. Navigating the environment (whether in the woods or the city) offers visual perception, motor planning, and eye-hand coordination opportunities.

      Just going outside for a walk is an exercise in skill-building!

      Research says outdoor sensory play is beneficial in the development of children. Use these outdoor sensory diet activities to inspire outdoor activities that boost skills like motor development, attention, regulation, and more.

      Outdoor Sensory Play Ideas

      Knowing the benefits of outdoor games and free play, let’s cover some fun ways to offer the movement, regulation, and input from the outdoors.

      Need some outdoor sensory play ideas? Try these outdoor backyard sensory diet activities that inspire free play in the outdoors while encouraging sensory input of all kinds! 

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

      Sensory diets and specific sensory input or sensory challenges are a big part of addressing sensory needs of children who struggle with sensory processing issues. Incorporating a schedule of sensory input (sensory diet) into a lifestyle of naturally occurring and meaningful activities is so very valuable for the child with sensory needs.    That’s why I’ve worked to create a book on creating an authentic and meaningful sensory lifestyle that addresses sensory needs. The book is now released as a digital e-book or softcover print book, available on Amazon.    The Sensory Lifestyle Handbook walks you through sensory diet creation, set-up, and carry through. Not only that, but the book helps you take a sensory diet and weave it into a sensory lifestyle that supports the needs of a child with sensory processing challenges and the whole family.   Get The Sensory Lifestyle Handbook here.

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

      That’s where the Outdoor Sensory Diet Cards and Sensory Challenge Cards come into play.   They are printable resource that encourages sensory diet strategies in the outdoors. In the printable packet, there are 90 outdoor sensory diet activities, 60 outdoor recess sensory diet activities, 30 blank sensory diet cards, and 6 sensory challenge cards. They can be used based on preference and interest of the child, encouraging motivation and carryover, all while providing much-needed sensory input.  

      Here’s a little more information about the Outdoor Sensory Diet Cards

      • 90 outdoor sensory diet activities
      • 60 outdoor recess sensory diet activities
      • 30 blank sensory diet cards, and 6 sensory challenge cards
      • They can be used based on preference and interest of the child, encouraging motivation and carryover, all while providing much-needed sensory input. 
      • Research tells us that outdoor play improves attention and provides an ideal environment for a calm and alert state, perfect for integration of sensory input.
      • Outdoor play provides input from all the senses, allows for movement in all planes, and provides a variety of strengthening components including eccentric, concentric, and isometric muscle contractions. 
      • Great tool for parents, teachers, AND therapists!

      Be sure to grab the Outdoor Sensory Diet Cards and use them with a child (or adult) with sensory processing needs!  

      Benefits of Nature Play References:

      • Frost, J. & Sutterby, J. (2017). Our Proud Heritage: Outdoor Play Is Essential to Whole Child Development. Retrieved from: from: https://www.naeyc.org/resources/pubs/yc/jul2017/outdoor-play-child-development
      • Hanscom, A (2017, October). The decline of play outdoors and the rise in sensory issues. OccupationalTherapy.com, Article 3990. Retrieved from http://OccupationalTherapy.com.
      • Moore, R. (2014). Nature Play & Learning Places. Creating and managing places where children engage with nature. Raleigh, NC: Natural
      • Learning Initiative and Reston, VA: National Wildlife Federation
      • Version 1.2.
      • Von Kampen, M. (2011). The Effect of Outdoor Environment on Attention and Self-Regulation Behaviors on a Child with Autism.  Retrieved from: https://digitalcommons.unl.edu/cgi/viewcontent.cgi?referer=https://search.yahoo.com/&httpsredir=1&article=1118&context=cehsdiss
      • Sahoo, S. & Senapati, A. Effect of sensory diet through outdoor play on functional behavior in children with ADHD. The Indian Journal of Occupational Therapy. Vol. 46, (2 ) 49-54.