Occupational Therapy Obstacle Course

Occupational therapy obstacle courses

Occupational therapy practitioners often times use obstacle courses in therapy sessions to target specific skills through the child’s primary occupation: play. It is through an occupational therapy obstacle course that one can work on sensory input, balance, coordination skills, heavy work input, visual motor skills, bilateral coordination, visual motor skills, direction following, and so much more. Let’s break down OT obstacle courses for functional performance.

Occupational therapy obstacle course ideas

Occupational therapy obstacle courses

Life is full of obstacles. Navigating life’s obstacles builds strength, character, resilience, and focus. Occupational therapy obstacle courses can do the same!

Obstacle courses are naturally a sensory obstacle course, through the actions and activities involved, however specific themes and underlying targets can be incorporated as well.

Occupational therapists and occupational therapy assistants use obstacle courses, to address a variety of needs. 

In this blog post you will discover the benefits of obstacle courses, how they help development using obstacle course, and ideas to build amazing obstacle course activities.

Benefits of obstacle courses

What are the benefits of occupational therapy obstacle courses?

At first glance, obstacle courses build muscle strength, coordination, and motor planning.  This is just the tip of the iceberg. While occupational therapy obstacle courses are great for building strength and coordination, they do so much more. 

  • Executive function – following directions, attention, focus, sequencing, planning, initiation, and  task completion
  • Social function (if working with peers) – working together in a group, problem solving, turn taking, waiting, sharing, and negotiation
  • Behavioral skills – compliance, behavior, and work tolerance
  • Sequencing – remembering all of the tasks in the correct order
  • Motor planning – Target motor planning by working through new obstacles and movement patterns builds new skills and motor pathways
  • Kinesthetic learning – learning by doing, rather than talking about an action
  • Strength – core strength, shoulder and wrist stability, head control, balance, and hand strength are built through obstacle courses. These skills lead to improved sitting balance and fine motor skills
  • Bilateral coordinationBilateral coordination refers to coordinating both sides of the body to do the same action such as holding onto a rope, or alternating actions such as climbing a ladder
  • Proprioception – information comes into the body through the muscles and joints. This information helps with arousal level, coordination, and attention
  • Sensory information – tactile, visual, olfactory, vestibular, and auditory receptors are activated during obstacle courses

How do occupational therapy obstacle courses help development?

All of the skills above are core skills needed for further development. Fine motor skills are built from core strength. Attention and focus are built and regulated from sensory input. Following directions builds working memory. Executive function and social skills are necessary for academic and professional development. 

How to develop an obstacle course in occupational therapy

One thing that comes up often is that one will see an OT clinic full of fun toys and think, “OK, in occupational therapy, we play.” This is true! However there is purpose behind each skilled selection of the toys and therapy equipment, and this is particularly true in an OT obstacle course.

ere are the important steps in setting up an OT obstacle course:

  1. Determine the goals to be addressed.  What is the priority for your learner?  
  2. Build your course around the goals, with emphasis on the highest priority goal
  3. Add motivators – learners work harder given motivation
  4. Create a beginning and ending point – everyone needs to know how far they need to go
  5. Check out Pinterest for obstacle course ideas
  6. Select your obstacle course ideas
  7. As always, Amazon (affiliate link) is full of resources for items to incorporate in your obstacle course

Obstacle Course Ideas

Depending on the goals in which are being targeted, you can select from many different obstacle course equipment and activities:

  • Balance beams
  • Sensory swings
  • Sensory bins
  • Sensory writing trays
  • Play with weighted toys
  • Play with specific targeted toys
  • Floor ladder
  • Ball pit
  • Walk on uneven surfaces
  • Sit on unstable surfaces
  • Crawling through tunnels
  • Using ride-on equipment
  • Complete pushups or sit ups
  • Crawling under objects
  • Hopping into hoops
  • Hopscotch
  • Hula Hoop activities
  • Outdoor balance beam ideas
  • Indoor balance beam ideas
  • Animal walks
  • Jumping jacks
  • Crossing midline activities
  • Push or pull heavy items
  • Throw bean bags or balls
  • Carry heavy items
  • Throwing or catching tasks
  • Deep breathing stations
  • Relay race tasks
  • Stand or hop on one foot
  • Fine motor tasks such as manipulating objects, handwriting activities
  • Functional tasks like dressing or tool use

By using any combination of the occupational therapy goal areas above, you can create a “course of action” to move through a therapy session while accomplishing goals. Combine these target areas with a client’s interest such as super heroes, animals, sports, events, or therapy themes, and you’ve got a client-centered therapy activity that is not only meaningful but also motivating

Examples of occupational therapy obstacle courses

Build your course around your prioritized goal(s) to target specific areas:

  • Following directions – set up several obstacles in succession with different variables to follow and remember.  Over, under, times 10, backward, clap your hands, touch your toes.
  • Executive function – have your learner develop and organize the obstacle course for themself or another partner. They can write it down, draw pictures, or use verbal skills to describe the course
  • Self regulation – incorporate heavy work into the course. This could include wearing ankle weights, pushing a ten pound ball, wearing a heavy backpack, and several repetitions of the course
  • Frustration tolerance – make the course very challenging. Add several elements that will challenge your learner, then change the sequence to continue to add more of a challenge
  • Social function – have one learner teach another, pair two learners of different levels to work on waiting, taking turns, and tolerance.  Two similar peers can build competition, or dealing with emotions
  • Coordination – vary the difficulty of the course to build different levels of coordination. Time your learner to measure improvement in coordination without falling
  • Visual motor skills – each time your learner finishes a round of the obstacle course, they have to write a letter, draw a picture, cut out a design, or put pieces into a puzzle

sensory obstacle courses

Obstacle courses naturally offer sensory input. By moving through and around obstacles, a child can participate in organizing and regulating sensory processing tasks in a very real and functional manner. It’s through play that this happens.

Sensory obstacle courses are in fact, every obstacle course! In a typical obstacle activity, sensory input includes:

  • Proprioceptive inputHeavy work input occurs through movement activities but also by using obstacle course equipment such as ladders, ball pits, tumble pits, foam equipment, crawling, animal walks, etc. Each activity offers different motor planning opportunities and different types of body awareness input.
  • Vestibular input crawling, scooting, sliding, jumping, rolling, tumbling, climbing, etc.
  • Visual input Visual processing skills are part of navigating in, through, around, under, over obstacles on a course.
  • Tactile input Moving through a course offers tactile input through movement and manipulation of objects and equipment.
  • Auditory While not always a necessary aspect of sensory obstacle courses, auditory processing can be targeted in obstacle course objectives.

You’ll notice that the first three areas listed are the “big three” sensory systems that calm and regulate the body and play a major role in sensory processing. Because of this, an obstacle course is a great therapy tool and often used in sensory interventions. Sensory obstacle courses can be used as part of a sensory diet.

The Tactile Sensory System is one of the earliest developed senses of the body.  The skin is the largest and the most prevalent organ. The skin performs unique duties for the body.  Most importantly, the skin protects and alerts us to danger and discriminates sensation with regard to location and identification.

These two levels of sensation work together yet are distinctively important.  Discrimination of touch allows us to sense where a sensation is felt on the body.  With discrimination, we are able to discern a fly that lands on our arm. 

The second level of the tactile system alerts us to danger.  It allows us to jump in response to the “fight or flight” response when we perceive a spider crawling on our arm. The information received from the tactile system also includes light touch, pain, temperature, and pressure.

When either of these levels of sensation are disrupted, tactile dysfunction can result.  This presents in many ways, including hypersensitivity to tags in clothing, a dislike of messy play, difficulty with fine motor tasks, a fear of being touched by someone without seeing that touch, a high tolerance of pain, or a need to touch everything and everyone.

When the tactile system is immature or impaired, the brain can become overly stimulated with resulting poor organization and regulation of input.  Children can then experience difficulty with behavior and concentration as a result.

Treatment for the child with an impaired tactile sensory system focuses on providing a variety of deep- and light-touch experiences (Koomar & Bundy, 1991).  Additionally, resistance activities, much like those indicated for decreased discrimination of vestibular and proprioceptive information, may be used in the therapeutic sensory diet.

The Proprioception Sensory System is the recognition and response to the body’s position in space with an internal feedback system using the position in space of the joints, tendons, and muscles.  This sensory system allows the body to automatically react to changes in force and pressure given body movements and object manipulation.  The body receives more feedback from active muscles rather than passive muscle use.  Related to the proprioception system is praxis or motor planning.  Individuals are able to plan and execute motor tasks given feedback from the proprioceptive system. Praxis allows us to utilize sensory input from the senses and to coordinate hat information to move appropriately.

Treatment for the child with an impaired proprioceptive sensory system focuses on providing intense proprioceptive information and improving postural responses.

The Vestibular Sensory System is the sense of movement and balance, and uses the receptors in the inner ear and allows the body to orient to position in space.  The vestibular system is closely related to eye movements and coordination. 

Vestibular sensory input is a powerful tool in helping children with sensory needs.  Adding a few vestibular activities to the day allows for long-lasting effects.  Every individual requires vestibular sensory input in natural development.  In fact, as infants we are exposed to vestibular input that promotes a natural and healthy development and integration of all systems. 

The sensory vestibular activities listed in this book are playful ways to promote performance and tolerance to movement activities.  They are also challenges against gravity to help kids with difficulties in equilibrium, balance, self-regulation, and adjusting to typical sensory input. 

The vestibular system operates through receptors in the inner ear and in conjunction with position in space, input from the eyes, and feedback from muscle and joint receptors, is able to contribute to posture and appropriate response of the visual system to maintain a field of vision. 

This allows an individual to detect movement and changes in the position of the head and body.  Dysfunction in the vestibular system may result in hypersensitivity to movements or hyposensitivity to movements. 

Attention and focus are built and regulated from sensory input.

Printable sensory stations in obstacle courses

Sensory paths and sensory stations can support the areas listed above by simply printing off materials to use in a simple or complex sensory obstacle course.

An obstacle course can be anything.  It can start as simple as furniture, couch cushions, and a puzzle, or become as elaborate as American Ninja Warrior. First, determine your “why”, then come up with the “what and how”. 

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.

Understanding Sensory Dysregulation

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? What are 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 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 Paths and Sensory Stations

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 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 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!

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.

Sensory Processing Disorder Chart

sensory processing disorder chart

Did you know that sensory processing disorder can be broken down into several aspects of “sensory” based on considerations that you see in sensory challenges? Here, you’ll find a sensory chart covering these sensory processing attributes to better explain the vastness of SPD. You’ll also want to check out our resource containing a sensory processing disorder checklist as it covers sensory red flags that potentially indicate the terms you see below in this sensory chart.

Printable sensory processing disorder chart for educating on complexities of sensory processing challenges.

Sensory Processing Disorder Chart

Let’s cover the sensory breakdown to better understand this complex concept and various attributes of sensory preferences and behaviors. These explanations and sensory information is found in greater detail in our resource, The Sensory Lifestyle Handbook.

Sensory Processing Disorder as a global umbrella term that includes all forms of this disorder, which includes three primary areas (Sensory Modulation Disorder, Sensory Discrimination Disorder, and Sensory-Based Motor Disorder).

Let’s look at each of these areas:

Sensory discrimination disorders– 

Sensory discrimination is defined as the ability to discriminate (or identify) sensory input, sensory differences, quantities, and qualities of sensory stimuli. When we discriminate sensory input, we use our sensory systems to taste, touch, hear, feel, smell, and perceive sensory information. This discrimination allows for safety and functional participation in everyday tasks. Sensory discrimination can mean smelling smoke from the stove vs. smoke from a backyard firepit, hearing an alarm sounding, tasting spoiled food, knowing when to go to the bathroom, knowing when to stop spinning on the swing, and so many other aspects of daily life!

Children with sensory discrimination difficulty have problems recognizing or interpreting differences in stimuli. 

  • They will bump and crash into others or objects. 
  • They might eat until they are sick rather than stopping when full.
  • They may write with a heavy or overly light pencil pressure.
  • Individuals with sensory discrimination disorders frequently drop items
  • There might be poor balance
  • Others may be overly afraid of heights
  • You may see balance and coordination challenges.

It can look like so many different things! Check out this resource on sensory red flags for more descriptions.

There are so many aspects of daily life that are related to sensory discrimination!

Sensory modulation disorder

Sensory modulation disorder is defined as the challenge of interpreting sensory information, either overly responding, under-responding, or specifically seeking out sensory input.

Sensory Modulation Disorder is further broken down into subtypes, or three categories:

  1. Sensory Over-Responsiveness
  2. Sensory Under-Responsiveness
  3. Sensory Seeking

Sensory Over-Responsiveness– With one type of sensory modulation disorder, over-responsiveness, sensory input can be irritating, painful, or abrasive and the individual avoids that particular sensory input. The sensory systems are overly responsive in this way. You may see food or texture avoidance, issues with noisy environments, and distractions by light, sounds, textures, etc.

Sensory Under-Responsiveness- The other end of the spectrum is a under-responsive sensory system. In this case, the individual may not realize or recognize sensory input. They may seek sensory input, but they can also be lethargic or fatigue easily. This is where you will see running into traffic, slow to react, or clumsiness.

Sensory Seeking- Another type of sensory modulation issue is the seeking out of specific sensory input. Likewise, sensory input can be stimulating and pleasant. The individual will seek out sensory input that they prefer: rubbing a particular texture, jumping, crashing, etc. are some examples of sensory seeking.

With each of these types, you will see preferences of certain sensory inputs and a withdrawal from other responses. They may become upset by noises and sounds and are easily distracted by stimuli. Each individual will be drastically different.

These kids have problems regulating response to sensory input. 

These subcategories are explained in further detail under the sensory systems section. 

For children who struggle in this area, a sensory diet might help them to modulate sensation in the environment. Children experience a poor compatibility of sensory information and the tasks they need to accomplish.

Sensory Based Motor Disorder

Sensory Motor Disorder is another aspect of sensory processing, referring to the motor output as it relates to sensory information. Those with sensory motor disorder challenges have difficulty navigating their world.  Their bodies don’t do what their brains tell them to do. 

Sensory Based Motor Disorder has two subcategories: Dyspraxia and Postural Disorder.

  1. Dyspraxia– Children with dyspraxia have difficulty planning, timing, organizing, sequencing, or executing unfamiliar actions.  These children may appear awkward and poorly coordinated. Dyspraxia describes developmentally acquired motor planning deficits and includes poor planning of movements.  
  2. Postural-Ocular disorder–  Children with postural-ocular disorder have trouble with controlling movements and posture.  They may have difficulty with coordination of functional vision. Joint instability seen in these children results in controlled motions.  These children may slouch in their seats and exhibit muscle weakness, low tone, or poor balance.  Kids with postural disorders have difficulty keeping up with their peers and may appear as lazy or clumsy.

Sensory Processing Disorder Considerations

Each of the areas described in the sensory processing disorder chart may have some or all of the considerations listed below. We cover these areas in greater detail in our book, The Sensory Lifestyle Handbook.

Emotional regulation– Children with this difficulty have trouble maintaining an emotional state that matches the task or activity.  They may overrespond to emotional situations. Read more on emotional intelligence to determine typically developing emotional regulation skills vs. challenges in this area.

Somatodyspraxia is a type of sensory-integrative based dyspraxia where there is evidence of poor processing of somatosensory information.  Essentially, somatodyspraxia is a combination of visual and proprioceptive input. The somatosensory system interprets information from the skin and around joints and carries that information to the central nervous system. 

This includes tactile discrimination or sensory touch which includes heat or temperature awareness, vibration, pain registration, interoception, pressure, proprioception, and position of body in space.  All of this information leads to one’s ability to perceive temporal and spatial organization, develop body scheme and postural response, stabilize the head and body during movement, and interpret touch sensation and pain needed for movements and actions.

Children with somatodyspraxia often exhibit poor tactile and proprioceptive processing, clumsiness, frequent tripping, falling, and bumping into objects; difficulty with fine motor and manipulation skills, and poor organization (Cermak, 1991).

Treatment focuses on providing heavy work, deep pressure, and light-touch experiences. Verbal cuing and feedback may also be used (Koomar & Bundy, 1991). The sensory diet/sensory lifestyle and environmental modification ideas for decreased discrimination of tactile and proprioceptive information should be used in addition to the ideas specific to praxis issues.

Impaired Bilateral Motor Coordination

Children with impaired bilateral motor coordination often exhibit difficulty with bilateral activities, or tasks that require the two sides of the body to work together in a coordinated manner.

This includes clapping, hopping, skipping, and jumping jacks.

Individuals with impaired or delayed motor coordination may have some right–left confusion, avoid midline crossing, and have difficulty developing a hand preference.  Additionally, they appear to have vestibular and proprioceptive difficulties

Treatment generally focuses on providing vestibular and proprioceptive experiences and graded bilateral activities.  Treatment may start with simple crossing midline, rotation, and symmetrical activities and work toward asymmetrical activities and more complex coordination skills (Koomar & Bundy, 1991).

The sensory diet/sensory lifestyle and environmental modification ideas for decreased discrimination of vestibular and proprioceptive information that address vestibular input should be used in addition to the ideas specific to bilateral motor coordination.

Tactile Defensiveness

Children with tactile defensiveness often exhibit an aversive response to a variety of tactile experiences, such as craft materials, food, clothing, bathing, or touch. They will often avoid a variety of activities and may react aggressively at times. They can be easily distracted and have difficulty with attention.

Therapy generally focuses on providing heavy work and deep pressure input. Slow linear vestibular input may also be helpful.

Therapy also provides opportunities for participation in graded tactile experiences (Royeen & Lane, 1991). The proprioceptive sensory diet ideas for decreased discrimination of proprioceptive and vestibular information could be used in addition to the ideas specific to tactile defensiveness.

Gravitational Insecurity

Children with gravitational insecurity may exhibit limited participation in gross motor play; avoidance or fear of escalators, elevators, cars, or planes; or resistance to being off the ground. Treatment in the clinic environment generally focuses on providing proprioceptive input and graded vestibular input. In treatment, the child is always in control of the amount of vestibular input received and is never pushed beyond his or her limits (Koomar & Bundy, 1991).

Environmental modifications would focus on helping the child to feel safe in all environments and situations. Sensory diet activities would focus on providing calming proprioceptive input throughout the day. The proprioceptive sensory diet ideas for decreased discrimination of proprioceptive and vestibular information could be used in addition to the ideas specific to gravitational insecurity.

Individuals with these difficulties may have certain behaviors or characteristics in common.  There are underlying needs that result in adverse reactions to sensory processing. 

The integration of sensory input leads to poor attention, self-regulation, co-regulation, self-monitoring, self-esteem, anxiety, discrimination, motor skills, communication, or responsiveness.  Incorporating healthy sensory habits within the family lifestyle is critical to success.

The Sensory Systems

Most of us learn about the five senses early in our childhood education.  Taste, touch, sight, sound, and scent are ingrained from a very young age.  It might be surprising to find out there are actually more than just five sensory systems.  With a typical Google search, you will learn that there are two more sensory systems that are added on to those five sensory systems. 

The sensory breakdown includes aspects of each of the sensory systems (listed below):

The proprioception system and vestibular system are two additional sensory systems.  However, when we consider perception, regulation, movement, interaction, and functioning, there are actually MORE systems that are involved. 

These important systems are deeply connected to the central nervous system and are essential for perceiving and interpreting our world around us.  While they do not specifically sense input from the environment, they are and always have been an essential part of our existence. 

Interoception is the sensory system of our inner body.  It includes organs, our heart, blood vessels, etc.  While the receptors to the five commonly known senses are obvious and clear, the receptors to the interoceptive system are inside our bodies.  They may not be seen but they are definitely important for functions such as emotional awareness, hunger, nervousness, fear, and feelings.  Our ability to sense fullness, elimination needs, temperature, thirst, sweat, and all require regulation of the interception system.

You can see how this system is very much related and a part of other sensory systems in how a person functions.

Additionally, there are other important systems that we are going to discuss in this book.  The somatosensory system refers to the integration of the visual and proprioceptive systems in order to perceive and respond with temporal and spatial organization, develop body scheme and postural response, stabilize the head and body during movement, and interpret touch sensation and pain needed for movements and actions.

Finally, praxis, or kinesthesis help us understand how to move our bodies.  The praxic system, or the kinesthetic system essentially “puts it all together” when it comes to motor responses to sensory information that has been perceived by the other senses. 

Putting it all together

Let’s look at all of the sensory systems in a list:

And the systems that are deeply connected to these sensory systems:

  • Somatosensory System (Movement organization)
  • Praxic/Kinesthetic System (How to move)

Challenges with processing can mean that each of these sensory systems do not functioning adequately as an overall well-oiled machine. It’s then that you’ll see individuals with a poor reaction to the environment.

Typically, dysfunction within these sensory systems present in many different ways. 

  • You may see withdrawal or over-responsiveness to auditory and visual stimuli.
  • You may see lack of focus on tasks and may feel insecurity in the environment, with poor body perception as a result. 
  • A child with sensory difficulties may be over- or under-responsive to sensory input. 
  • They may operate on an unusually high or unusually low level of activity. 
  • They may fatigue easily during activity or may constantly be in motion. 

Children may fluctuate between responsiveness, activity levels, and energy levels.

Additionally, children with sensory processing dysfunctions typically present with other delays.  Development of motor coordination, fine motor skills, gross motor skills, social-emotional skills, behaviors, executive functioning skills, language, and learning are all at risk as a result of impaired sensory processing.

It is important to note that sensory processing is deeply connected to a combination of the sensory systems working together as well as the impact of environmental stimuli. 

Sensation from the environment is combined with family life, parent expectations, peer interactions, classroom rules, community expectations, internal states such as feelings, hunger, fatigue, and health to result in behaviors responses.  Looking at the underlying reasons for behavioral responses is absolutely key to identifying strategies to help with “behaviors” or the actions we see. 

Sensory Chart

We’ve created a visual, sensory processing diagram to show exactly how these terms break down from an umbrella term of sensory processing disorder into more detailed and nuanced areas. As you can see, there is a lot to the overarching term of “sensory processing”.

This free printable sheet guide to the breakdown or types of Sensory Processing Disorder is a great addition to your therapy toolbox.

Print off the sensory chart and hang in on a wall or bulletin board for sensory processing awareness. This occupational therapy chart is a great visual to share with parents or educators when explaining how the whole system relates to behaviors and sensory considerations.  

Types of sensory processing disorders in a printable sensory processing disorder chart.
Sensory Processing Disorder Chart- Enter your email address below to get access to a printable version that can be hung on bulletin boards or used as an educational tool.

Want a printable version of this sensory processing disorder chart? Enter your email address into the form below. You’ll receive the printable chart in your email inbox.

This sensory chart is also found in our Member’s Club. Members can log in and access the handout under our Sensory Downloads area in the membership. While you’re there, also grab other sensory resources without the hassle of entering your email address for each resource.

Free Sensory Processing Disorder CHART

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    More Sensory Processing Information

    Want to know more or to add another handy educational handout to your therapy toolbox? Grab a copy of each of the sensory processing tools below.

    1. Sensory processing information handout– It’s a great way to break these complex concepts down into easily digestible and understandable information. Print off the pamphlet and use it to share with educators, parents, caregivers so they can better understand sensory processing disorder.
    2. Sensory Red Flags– Print off this list of sensory red flags to use as a checklist to determine sensory challenges.
    3. Sensory Strategies Toolkit– The Classroom Sensory Strategy Toolkit is a free printable packet of resources and handouts that can be used by teachers, parents, and therapists. Whether you are looking for a handout to explain sensory strategies, or a tool for advocating for your child, the Classroom Sensory Strategy Toolkit has got you covered.
    4. Sensory Lifestyle Handbook– This is a resource for those living with, teaching, or working with children with sensory needs. For the child with sensory processing needs, everything about life can be distressing! Sensory processing challenges can impact a child’s every interaction and environment. Sensory challenges affect behavior, self-regulation, attention, development, learning, social skills, emotional development, and independence. The child who struggles with sensory processing may be challenged daily with rigorous interactions. For these children, sensory input or sensory-based accommodations can make all the difference.

    Sensory Summer Camp at Home

    sensory camp for summer

    Summer camp is an exciting experience for most kids, but what if you could create a custom sensory summer camp that supports sensory processing for all needs?  Summer is a time of learning, fun, and new adventures over the lazy days of summer.  Summer camp in the traditional sense is a time of themed activities that build character for a child.  

    However, it’s not always possible to sign up for a week of summer camp. Summer camp is expensive.  Parents work or have busy schedules that make a week-long summer camp just not feasible.  A backyard DIY summer camp experience is a way to save money while creating a summer learning experiences right in the backyard. 

    Be sure to check out this resource on how to run a therapy camp for tips and strategies with sensory summer camp planning.

    Sensory Summer Camp

    One great addition to a sensory summer camp is our free summer sensory path! It’s a free sensory printable you can hang on a wall to add sensory motor, mindfulness, and sensory coping tools with a summer theme. 

    I’m joining several other bloggers who write about sensory processing in a Sensory Summer Camp at Home backyard summer camp experience.  


    Scroll through the links below to find enough sensory summer camp themes and ideas to last all summer long.  You’ll find themed activities touching on all of the sensory systems to create an environment of learning through the senses.

    Looking for a sensory camp that supports specific needs? No worries! The activities below support and challenge sensory touch!

    You can find so many summer sensory activities here on the website to address various sensory motor considerations.

    Specifically, these summer occupational therapy activities support development of skills across the board while focusing on the primary job of kids: play!


    These sensory summer camp experiences are perfect for the child who craves or resists sensory input and can be modified to meet the needs of every child with sensory processing disorder.  While these sensory summer camp ideas are perfect for kids with sensory processing disorder, they can easily be used in traditional summer camps.  So, take a look at each of the camp themes below and get ready for a summer of sensory fun and memories!

    Looking for activities and ideas to use in summer programming? You’ll love our new Summer Occupational Therapy Activities Packet. It’s a collection of 14 items that guide summer programming at home, at school, and in therapy sessions. The summer activities bundle covers handwriting, visual perceptual skills and visual motor skills, fine motor skills, gross motor skills, regulation, and more.

    You’ll find ideas to use in virtual therapy sessions and to send home as home activities that build skills and power development with a fun, summer theme. Kids will love the Summer Spot It! game, the puzzles, handouts, and movement activities. Therapists will love the teletherapy slide deck and the easy, ready-to-go activities to slot into OT sessions. The packet is only $10.00 and can be used over and over again for every student/client!

    Grab the Spring Occupational Therapy Activities Packet HERE.

    summer occupational therapy activities for kids

    n the Summer OT packet, you’ll find:

    • Beach Fun Google Slide Deck/PDF set
    • Summer Spot It! Printable Game
    • Hole Punch Cards for matching upper case and lower case letters
    • 7 Roll and Write Play Dough Sheets – Apples, Bees, Bugs, Buttons, Donuts, Play Dough, and Unicorn themes
    • Summer Fun Pencil Control Strips
    • Summer Lists Writing Prompts
    • Summer Number Practice
    • Summer Visual Perception Pages

    All of the Summer OT activities include ideas to promote various developmental areas with a Summer-theme. Activities guide and challenge development of handwriting, eye-hand coordination, bilateral coordination, body scheme, oculomotor control, visual perception, fine motor skills, self-regulation, gross motor skills, and more.

    Use these activities as warm-ups to your therapy sessions, or add them to the homework page below to create a home program.

     
    Sensory Summer camp at home ideas for kids with sensory processing needs
     

     

    Occupational Therapy Summer Camp

    I love the play-based sensory and motor activities in the summer camp ideas listed below. Each would be a great summer camp theme for using in an occupational therapy summer camp.

    OT professionals know the power of play. But occupational therapy supports development, and while a traditional occupational therapy summer camp may not be an individualized process, there is still skill development happening even in a group setting. 

    An occupational therapy summer camp can focus on an area of function: sensory play experiences, handwriting, shoe tying, typing, or social emotional skills. The sky is the limit this summer when it comes to OT camps as a tool and resource for kids and parents. 

    However, because an OT camp might not be focused on individual needs and goals of the camp participant, a summer occupational therapy camp can integrate play, sensory experiences, and any summer theme you can imagine. 

    These summer sensory camp ideas below can get you started with brainstorming:


    Outer Space Summer Camp at Home Ideas


    Circus Summer Camp At Home Ideas

    Sensory Handwriting Camp

    Address handwriting skills during a summer camp with sensory input, tactile play, and sensory motor experiences!

    Sensory Space Camp | My Mundane and Miraculous Life


    Sensory Olympic Games Camp | Growing Hands on Kids


    Sensory Nature Camp | Putting Socks on Chickens

    Sensory Summer camp at home ideas for kids with sensory processing needs

     

    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.

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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.