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 vibration, touch-pressure, proprioception, 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! 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.

      What you need to know about Sensory Swings

      Sensory swings

      If you’ve ever walked into an occupational therapy gym, you may have seen a variety of sensory swings and wondered, “why does occupational therapy swing kids in their OT sessions?” There are many reasons why, and in this blog post, we’ll cover sensory swings, the best swings to use for sensory needs, and why!

      Sensory swings for sensory input and occupational therapy swings used in OT sessions

      Sensory Swing Movements

      Swings are simply a great tool for sensory input as well as sensory integration. The predictability of linear swinging can be calming and settling for the children who need that support. 

      Having the swing perform unpredictable moves such as rocking, spinning, side to side movement, and even start and stop movements while suspended in air, can be very alerting and stimulating for the children who need that support.

      In our blog post, Sensory Swings for Modulation you will read how powerful the swing can be when used as a sensory strategy for individual sensory processing needs and modulation. 

      There are many considerations when it comes to sensory swings, however. A swing can be a tool for modualtion but ican also cause dysregulation in users.

      Dysregulation refers to internal needs of the sensory systems that result in meltdown because the sensory processing system is out of balance.

      You might find that only 5 minutes of intense swinging leads to dysregulated sensory system with overstimulation. This state can require a long period of time and intervention to get the individual to reset or calm down.

      When it comes to sensory swings, different types of movements can impact modulation or dysregulation. It’s important to be aware of these considerations before using a sensory swing as a tool in therapy.

      Each individual will be different and it can be a delicate balance of movements that are stimulating verses calming. A swing for one child might spiral into dysregulation with a lengthy period of time and calming input required to regulate the sensory systems. Other individuals may crave intense movements and can benefit from that swing input for a longer period of time, allowing for functional participation.

      Alerting sensory swing movements

      In general, fast rotary vestibular input is often stimulating. Likewise, quick and sporadic movements on the swing are stimulating.

      The vestibular sense which is utilized during swing use helps to activate more body awareness, muscle tone, balance, and coordination as well as providing a level of increased alertness. If you want to learn more about vestibular activities in general, you can read the blog post Vestibular Activities.

      Calming sensory swing movements

      Calming or regulating sensory swing movements may include gentle, linear movement to calm the vestibular system. These swing pushes should be rhythmical and linear movement as these are more calming swing movements.

      The proprioceptive sense can be activated during swing use by reclining in a swing and rocking rhythmically in a swing providing deep pressure input to the body can help soothe strong emotions and decrease engine levels of high alertness. This helps with self-regulation and body control. 

      You can see that there are many different variables and each individual will require independent assessment from a qualified professional. This is why simply adding a sensory swing to a sensory room in a school can be a detriment to all of the students. School administrators and educators should always consult the occupational therapy professional before using a sensory swing in the school environment.

      Types of sensory swings in occupational therapy and activities to do with sensory swings

      Occupational therapy Swings

      Sensory processing is not the only area that can be addressed with the use of swings.

      How you utilize a swing and even the type of swing you use, can help a child to work on core and upper extremity strengthening, balance, visual processing, bilateral coordination, motor planning, righting reactions, body awareness, position in space, gross motor coordination, neck extension, eye-hand or eye-foot coordination, and visual tracking.

      When working with occupational therapy swings, each child is different in their needs and their preferences and it is up to you as the OT professional to determine what is needed and what needs to be worked on for skill development.

      It is also your role as the OT practitioner to guide and educate other professionals and parents of children to ensure the child’s needs are being met properly and that safety measures are being utilized.

      Now, two questions for you regarding those OT swings:

      1. Do you know what swing to use for the kiddos you see in therapy? 
      1. Do you often ask what activity can I do while they are on this swing so they will continue to remain motivated?

      Well, let’s take a look at six of the most common occupational therapy swings utilized in therapy clinics and therapy rooms in schools.

      Also, there are swings that parents can use indoors or outdoors to address a child’s sensory needs.  If you read our post Outdoor Sensory Swing you will learn how taking sensory play activities into the outdoors will provide children with many outdoor sensory experiences just by using the world around us.

      If purchasing a sensory swing is just simply too expensive to think about, read all about how you can use the playground equipment to address Sensory Integration at the Playground with the guidance of the therapist to meet each child’s needs.  

      Bolster Sensory Swing

      A Bolster swing challenges balance, vestibular processing, motor planning, cervical extension endurance, proximal control/stability, and core strengthening, The child can lie prone, inverted, kneel, sit or straddle the swing. 

      Bolster Swing Activities:

      1. Have a child work on hanging inverted like a koala bear and then time them to see if they can meet or beat their last best time.
      2. Have a child kneel on the bolster while hanging on and then attempt to toss bean bags into a basket.  
      3. Have a child straddle the bolster swing like a horse and use a reacher to pick up bean bags from the floor and then try to toss them into a basket using the reacher to toss.
      4. Spread balls around on the floor under the swing and have the children lie prone on the swing and attempt to reach out to pick up the balls and place them in a basket. You will move the swing around as needed.

      Ladder Sensory Swing

      A Climbing ladder swing provides the challenge of motor planning while simultaneously working on balance, strength, and body awareness. The child simply works to climb the ladder from the bottom to the top and then back down again. It adds the fun of swinging while providing a challenging workout.

      Ladder Swing Activities:

      1. Place a bucket or basket filled with puzzle pieces, letters, shapes, or other items at the top of the ladder for a child to retrieve one at a time by climbing up and down the ladder swing. Then, have them either put the pieces into the puzzle base or practice writing the letter or drawing the shape before going back up the ladder to grab the next item. 
      2. An adult can stabilize the bottom of the swing by holding it steady while the child climbs or an adult can slightly twist and turn the ladder swing while the child attempts to climb up and down. It’s called the ship on the rocky seas! 
      3. Place two or three articles of clothing at the top of the ladder and have the child retrieve one at a time and when they get to the bottom they can work on zipping, buttoning, or snapping!

      Hammock Swing

      A Cuddle hammock swing (also called a cocoon swing), provides proprioceptive input, assists with soothing strong emotions, and gives a nice deep pressure input which is calming and grounding for some children. This swing can be an easy first swing for children who need more gross motor support and are fearful of the movement other swings provide.  The Lycra-type material allows children to sit, stand, or lie in the swing making it a highly versatile swing. 

      Hammock Swing/ Cocoon Swing Activities:

      1. Have a child lie prone with their head and arms positioned outside the swing. This position creates a form of weight bearing through their arms and works on full upper body strengthening. They will work to pull and push themselves using the floor while inside the swing. 
      2. Place items around on the floor under the hammock just out of the reach of the child and then have them pull themselves along the floor to reach the items, such as bean bags, to toss into a basket. 
      3. Have the child lie prone and then grasp and hold your hands while you are seated on the floor in front of them. They will pull themselves toward you to shift the swing back and forth. 
      4. Have the child lie supine and reach up to remove clothespins that are clipped on the edge of the swing. The swing provides body support but works on building upper extremity strength and endurance as the child works against gravity to reach up. You can alternate activities and have the child place the clothespins instead.
      5. Have the child recline or lie within the swing and simply do deep breathing or mediation exercises while slowly swinging back and forth. 

      Pod Swing

      A Hanging pod swing provides vestibular input, assists with balance, and makes a nice cozy pod that gives children a sense of calm regulation and relaxation to just simply cool inside. This swing can serve as a good first swing as it allows for seated support while simply swinging slowly and provides more comfort to children who may be more fearful of the freedom of other types of swings. 

      Pod Swing Activities:

      1. Try turning off the lights, playing soft music, and have a child hold a small fidget or light-up toy while swinging slowly back and forth as they stay cuddled inside. 
      2. Place a pillow inside of the pod swing and have the child climb inside to provide a cushy, deep pressure input while swinging slowly and rhythmically in a linear fashion.
      3. Blowing bubbles for the child to watch while seated in the swing provides a calming feel as the motion of the bubbles will be slow as they descend. 
      4. Have the child sit in the swing and complete deep breathing or mediation exercises while slowly swinging back and forth. 

      Platform Swing

      A Platform swing (or this version of a platform swing with net base or material platform base) is the most common swing found in therapy settings and provides the opportunity for calming and alerting to get the child’s engine right where it needs to be for a treatment or classroom session. It is highly versatile as it can help a child build upper body strengthening, core strengthening, balance, and motor planning. 

      Platform Swing Activities: 

      1. Use this unstable surface swing to challenge a child’s body positioning to include side-lying, tummy time, tall kneeling, standing, criss-cross sitting, long sitting, and partial kneeling. 
      2. Have the child lie prone with their head and arms positioned over the edge. Then have them walk with the upper extremities around the floor picking up puzzle pieces to place in the puzzle base located in a central location. Pieces are picked up one at a time. 
      3. Place different colored bean bags in a circle on the floor around the swing. Call out different colors and have the child rotate themselves while lying prone on the swing and using their hands to walk around on the floor to stop at each color called out.  Letters and shapes can be used for this activity too.
      4. Place cones on an elevated surface and while the child is either lying prone or in a quadruped position, have them reach out to drop rings onto the cones. 
      5. Have the child sit criss-cross in the center and toss a beach ball to themselves.

      Trapeze swing provides a good opportunity to work on upper extremity strength and endurance, gross grasp skills, trunk strength, and motor planning. If you add lower extremity work also, then you address upper and lower body coordination. 

      Activities:

      1. While swinging or not, encourage a child to hold and lift their legs to kick a ball.
      2. While swinging, the child can simply jump over a therapy ball that is placed inside of a tire tube. 
      3. Simply work with a child on grasping and swinging while pumping the swing with their own feet. 
      4. While swinging or not, have a child hold on and lift their legs to kick a set of bowling pins or have them attempt to pick up each bowling pin with their feet and place them in a basket. 
      5. While swinging the child, can work on timing and release to let go and crash into a crash pad.

      Sensory Swing Tips

      What do you do with all of this information and activity ideas? Go get onto a swing and try out some of these fun activities! That’s right, we as adults need to have some fun too!

      But, after you’ve tried them, demonstrate them to the kiddos as they will most likely be more motivated to do the same activity after they see YOU do it. After all, you and I both know that the best way to teach a child is by setting a good example and you’ll get to have some fun in the process! It’s a win-win folks! 

      One tip for using a sensory swing in a therapy session can include a visual schedule with a plan that helps the individual with regulation needs. It can include swinging, then heavy work, music, blowing bubbles, dim lights, heavy rhythmic play, and deep breathing. All of these sensory tools regulate the system and can calm the system after the movement from the sensory swing. This is just one example and each individual will benefit from different strategies.

      Be sure to take a look at the maximum pounds allowed for some swings as you’ll want to be sure that it will work for all of your kiddos before purchasing.

      Always supervise children while on swings especially when rotary swinging as this can instigate seizure activity in some children.

      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.

      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!

      Fidget Kits for Travel and On-the- Go Sensory

      fidget kits

      Do you know a kiddo that LOVES all things fidget toys? This Fidget Kit is a DIY Travel Sensory Kit that is perfect for on-the-go sensory needs for kids with Sensory Processing Disorders children or those who are Autistic and prefer sensory fidget items. Let’s cover fidget kits, just one occupational therapy kit that meets specific needs.

      Read on for tips to help with sensory issues while out and about, how to use and set up a fidget kit, and why fidget kits are a great sensory tool for self-regulation, a sensory diet (based on meaningful and motivating sensory strategies (aka a sensory lifestyle), or sensory needs. 

      Sensory fidget kits

      What are Fidget Kits

      A fidget kit is essentially a collection of fidgets that can be used to meet sensory needs and can be used as a movement break to incorporate specific sensory motor actions into daily functional tasks. Fidget kits may contain squeeze toys, fidget items, pop toys, putty, slap bracelets, Rubix cubes, stress balls, and many other fidget items. These sensory items can be housed in a box, bin, tote bag, shoe box, or any small carrying case. Fidget kits can be used by occupational therapy professionals with a whole caseload of clients, or a fidget kit can be individualized based on one person’s specific sensory preferences.

      Fidget toys support self-regulation and sensory needs so that kids can pay attention, focus, learn, and interact with others. Some fidgets offer heavy work through the hands. Others offer movement for the hands or body.

      A fidget kit can be used in many different ways:

      1. A fidget kit can be used in a sensory corner of a classroom as a calm down area.
      2. Or, a collection of sensory fidgets can be used by one individual for meeting various needs.
      3. Other times, a fidget kit is used as a choice, where use of a sensory tool is selected from a bin or bag of sensory fidget items. In this case, a visual schedule may be incorporated into the fidget toolbox.

      We’ve shared various collections of fidget toy recommendations here on the website in previous years.

      These types of fidget toys are all excellent additions to a fidget kit:

      Occupational Therapy Fidget Kits

      Occupational therapy practitioners know the benefit of carrying a collection of intervention tools in their therapy bag. They create a collection of materials designed to meet various needs on their caseloads. OTs make handwriting kits, scissor skills kits, auditory kits, functional skills kits, and even themed OT kits, or seasonal kits. Each therapy kit contains materials and activities designed to make therapy sessions fun and innovative. A fidget kit is no different!

      Why use fidget kits?

      Have you ever been out shopping the day before Christmas Eve when the entire city is packing everything from pineapples to pickles in their carts?  And while you wear your itchy winter coat and drippy boots, the carts bump into aisles, people are talking everywhere, and buzzes, dings, and noise are everywhere.  

      It is utterly unorganized chaos.   Now imagine you have difficulty ignoring those beeps and buzzes.  That itchy wool coat is SO there.  The people talk and talk and you hear them all.  The utterly unorganized chaos makes you feel so out of sorts that you can’t help but breakdown, throwing yourself on the floor, and trying to make it all go away.  

      Children who live with a Sensory Processing Disorder experience situations like this every day.  It doesn’t have to be a busy holiday for the environment to be too much for their body to organize.  It is everyday life for SPD kiddos.  They over or under process environmental stimulation at the bus stop, in the library, in a restaurant, or while waiting with Mom at the Department of Motor Vehicles. The disruption of typical processing can occur at minor or severe levels, but is always a struggle.     

      Use of a specialized sensory diet can help with over or under sensory responses while out and about.  Specific sensory inputs can help to organize these inappropriate sensory responses.

      Treatment of Sensory Processing Disorder with a Sensory Diet To treat these responses to input, Occupational Therapists perform an assessment of individual abilities and needs.  Using information from evaluation, they establish a diet of sensory integration activities to organize sensory systems so that appropriate and meaningful responses occur. Function and purposeful responses to sensory input in all settings are the goals of sensory integration and sensory diets.  

      A sensory diet is highly specific to the needs of a child with sensory processing disorder.  Sensory diet activities should be specialized to the meet the child’s regulation needs.  Items that are often times found on a sensory diet include activities like wall push-ups, jumping on a trampoline, vacuuming, pillow sandwiches, and kneading play dough (among tons of other ideas!)    But how do you do these sensory diet activities while in a classroom, car, restaurant, or in a while waiting for appointments? 

      This is where a fidget kit comes into play, that can help with sensory needs and can go anywhere.

      How to set up classroom fidget kits

      How to use a fidget kit in schools

      When I started working in school-based therapy in 2000, long before the craze of fidget toys, I created a set of fidget kits for each classroom in one school that I served.

      As the occupational therapist in this school, I worked with many of the children in various classrooms on my caseload. However, I knew the benefit of using fidget items during specified times in the classroom.

      The kits were contained within a clear plastic shoebox with a lid. There would be a list of materials in the kit and a sign out sheet if students removed an item to use at their desk.

      Because I knew the students on my caseload in each classroom, and their sensory preferences, I was able to select specific sensory tools to place in each classroom’s fidget kit. Then, I added additional materials that may benefit the general population of the classroom. These items included things like stress balls, a string of paperclips, a bead on a keychain ring, a fidget desk strip, wacky tracks (clicking string of blocks), finger trap, and Koosh ball.

      I offered a quick in-service to each teacher on the fidget kit that I created for their own classroom. I introduced the fidget kit, showed them the items in the kit and how to use them, and quickly explained the benefits of using a fidget kit to support attention, focus, sensory, and regulation needs in the classroom.

      I explained preferred sensory tools for the students on my caseload and when they may use the materials to best support their education.

      I also quickly explained that we all (whether receiving OT services or not) use sensory strategies all day long throughout our day to regulation, to focus, attend, deal with anxiety, or even boredom. For most of us, this fidgeting, or sensory breaks, looks like getting a cool drink of water, standing up after sitting for a long time, taking a deep breath, sitting up strait, stretching, clicking out pen, or jiggling a leg.

      Finally, I instructed teachers to use the supports as they deemed fit within their classroom. This way, the kit was used correctly within the classroom.

      Consult time with students was spent identifying needs and making changes to the individual student’s items and supports.

      At the end of the school year, I collected all of the kits and saved them for the next school year. These sensory kits were a success with every teacher and were requested again at the start of the next school year.

      How to make a sensory kit

      Sensory fidgeting breaks support learning and paying attention for all individuals and using a kit of fidget tools can support the entire classroom. Plus, another benefit to using a kit with the whole classroom is the normalization of the fidget tools as a generalized support, and using the tools correctly, and not as a means to gain attention. Still other students may feel as if they are being watched when using the fidget tools and when the entire classroom has fidget time, the use is less ostracizing.

      The benefit of creating fidget kits for schools is that you can put the items in any container that suits the needs of the students. Some can even travel from classroom to classroom. Try these ideas:

      • Plastic shoe box
      • Mini tote bag
      • Pencil box
      • Pencil pouch

      fidget kit

      This post contains affiliate links.

      sensory fidget kit

      This travel sensory diet is perfect for on-the-go sensory needs.  We made a small tote bag with fun paint and used it to create a travel sensory diet.  A tote of this size can be slid into a big purse, carried by the child, or carted around in the minivan.  

      The best thing about this travel sensory diet is that you can switch out activities so that new regulating items are added in and old favorites remain.    

      Travel Sensory Diet Bag for on-the-go-sensory needs

      What goes in a fidget Kit?

       A fidget kit can be made up of any sensory motor item!

      Some common sensory items include movement based fine motor or activities that offer heavy work through the hands, or Proprioception Activities Related articles: Proprioception and the hands impacts pencil pressure, and can be a great way to add a quick heavy work brain break.

      • Bungee cord or Exercise band.  These can be used by arms or legs while sitting or standing. 
      • 1 pound wrist weight:  This is an important addition to a travel sensory bag.  The weight provides proprioceptive input as the child carries the bag. Sometimes, just carrying the tote bag can be enough to regulate sensory needs. 
      • Other ideas include wearing the weight on the wrist, ankle, placed on the lap, or draped over shoulders.
      • Use the weight of the bag as input: While seated, hang the loop of the handles over a knee for weight down through the calf and into the foot.  Switch legs after a while.
      • Hang the bag on one shoulder, then the other.
      • Hold the loops of the bag by the hand as if carrying a suitcase. Switch hands often.
      • Hold the loops of the bag by individual fingers.

      Oral Fidget Items

      • Sugar free hard candy
      • Sugar Free gum
      • Eat dried fruit, bagel pieces, popcorn, pretzels, or raisins
      • Kazoo
        (take the paper out for less noise!)
      • Chew Toy ” or Chew Necklace

      Scent Fidget Tools

      • Small bottle of scented lotion

      Tactile Fidgets

      • Fidget with sensory koosh balls.
      • Pipe cleaners twisted together make a great fidget toy.
      • Beaded Keychain Friends
        for fidgeting
      • Small Scrub Brush
        (The pictured brush is used in the Wilbarger Brushing Protocol.  An Occupational Therapist should train you in this treatment
      • Baby wipe to wipe the face, arms, hands to “wake up” the skin.
      • Fidget items– The nice thing that is different than in 2000 is that Amazon now has large kits of items available that can be distributed into various smaller kits and recirculated among classrooms.

      Vestibular Fidgets

      • Heavy work activity cards
      • Hang the head and arms down between the legs to touch the floor.
      • Arm windmills
      • Twisting walks: Twist at the waist as the child walks.

      Other sensory diet ideas that work while on-the-go

      These are fidget kit ideas to have on hand that don’t require any equipment. these are sensory strategies that can be “pulled out” anywhere to support attention, focus, emotional needs, or sensory needs.

      • Carry grocery bags.
      • Push shopping carts.
      • Bend over hand hang the head and arms down to the ground.
      • Find a wall for wall push-ups.
      • Hug from a loved one.
      • Chew gum.
      • Drink from a straw.
      • Carry a sports bottle with crushed ice for resistive sucking and chewing ice.
      • March down a hallway.
      • Duck walks.
      • Find stairs and climb them.
      • “Mountain Climb” up a stairwell banister.
      • Use a coat as a sensory wrapper.  Wrap the child up like a sensory burrito with an extra coat.
      • “Prayer Stretch”  Press the palms of the hands together and press hard.
      • “Spider Finger” Stretches” Place fingertips of both hands together and stretch fingers up and down.
      • Spin in a chair (if at a doctor’s office).
      • Chair Push ups.
      • Weighted vest for situations that you know will cause sensory overload.
      • Headphones to cut out background noise.  
      Travel Sensory Diet Bag for on-the-go-sensory needs

        This on-the-go travel sensory bag can go everywhere from the doctor’s office with the too-hot waiting room and buzzing fluorescent lights to the hair salon with the noisy dryers and itchy hair clippings.  

      Travel Sensory Diet Bag for on-the-go-sensory needs


      This post is part of our 31 Days of Occupational Therapy series where you can find free or almost free treatment activities and ideas.  Stop by every day!  You’ll find more fun ideas each day in October.

      Looking for more sensory integration ideas?  These are some of my favorite:

      Dinosaur-Sized Sensory Feelings and Proprioception Activities

        Oobleck in the Marble Run

      Oobleck in the Marble Run

       Alphabet Discovery Bottle

      Alphabet Discovery Bottle

      Fidgeting During Homework

      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.

      Goals of a Sensory Diet

      benefits of a sensory diet
      Have you ever had a professional mention the term “sensory diet”?  Have you wondered why a sensory diet would be used with kids?  This post describes the goals of a sensory diet for kids with sensory processing needs. 
       
      This resource on how to create a sensory diet is a good place to begin when it comes to creating a sensory plan that helps kids thrive and function in their daily tasks.
       
      This related resource on breaking down goals is another tool you’ll want to add to your therapy toolbox.
      Why do kids need a sensory diet to help with sensory processing problems?
       

      Sensory strategies that are motivating can be a big help for some kids. Try these train themed sensory activity ideas.

      Why Use a Sensory Diet?

      To begin, read this blog on what is a sensory diet. You’ll discover that sensory diets are a commonly known strategy for addressing
      sensory needs.  The term “sensory diet” was coined by Patricia Wilbarger in 1984 to explain how certain sensory experiences
      can improve occupational performance and help to remediate disruption of the sensory processing systems.  
       
      When it comes to benefits, a sensory diet is a means to adjust sensory input in relation to an individual’s
      needs.  
       
      There’s more to it, though. 
       
      Sensory diets don’t need to be a strict set of prescribed structured activities for every child.  They ARE a meaningful set of strategies for developing sensory programs that are meaningful, practical, carefully
      scheduled, and controlled in order to affect functioning.  
       
      We use sensory diets for many reasons: 
       
      Specific needs- While a sensory diet offers specific sensory input at times in preparation for periods of poor regulation, the optimal sensory diet becomes a sensory lifestyle, in which the individual has a “bank” of sensory strategies at their disposal and can use those tools in preparation before a meltdown or crash occurs.
       
      Individualized needs- No two individuals are alike. And, no two individuals will experience the same sensory needs. As a result every sensory diet will differ in sensory input, timing, and various other factors. Sensory diet activities provide appropriate sensory input based on the needs of an individual. 
       
      Balance- Just as a healthy diet consists of a variety of foods, a sensory diet is a balanced set of sensory information that allows an individual to function.  A person cannot survive on broccoli alone. Similarly, a child cannot function with only one type of sensory activities.
       
      Sensory diets are not just for kids with identified sensory issues.  We all need a diet of sensory input. 
       
      Position in Space- Our bodies and minds instinctively know that varying sensory input allows us to function appropriately.  Neuro-typical children naturally seek out a variety of proprioceptive, vestibular, and tactile sensory input.  Children that struggle because of underlying issues or developmental concerns may show difficulties with fine motor, gross motor, sensory processing, self regulation, executive function, creativity, and general life skills. It’s through a process of identifying specific sensory processing needs that these areas can be impacted. 
       
      Routines and Transitions- Having a better understanding of transitions, routines, and schedules may allow children to know what to expect in their day. A sensory diet offers this opportunity.
       
      Confidence- When we offer children strategies that support their needs, they thrive. This is true for children of all abilities and skill levels. Involving kids in movement based and sensory activities allows them to connect with others, and learn about the world around them, how their body moves and interacts in daily tasks, and this offers confidnce and further skill-building, as well as overall competence.
       
       
      Regulation Needs- As a result, they are able to accept and regulate other sensory input such as a seam in their shirt, a
      lawnmower running outside their classroom, or the scent of chicken cooking in the
      kitchen.
       

      Why Sensory Diets?

       
      Studies support the use of active participation in multi-sensory activities for at least 90 minutes per week to improve occupational performance and autism symptoms and behaviors (Fazlioglu & Baran, 2008; Thompson, 2011; Woo & Leon, 2013; Wuang, Wang, Huang, & Su
      2010).  
       
      Children who have a toolbox of sensory activities available to them for daily use may benefit from prescribed sensory activities.  These activities can be a part of and incorporated into the day in a natural way.


      Related Read: Here are more sensory-based tricks and tips that help with meltdowns.


      What is a sensory diet?

       
      A sensory diet is a set of activities that are appropriate
      for an individual’s needs.  Specific and individualized activities that are specifically scheduled into a child’s day are used to assist with regulation of activity levels, attention, and adaptive responses.  
       
      Sensory diet activities are prescribed based on the individual’s specific sensory needs.   Just as there are no two people that are alike, there are no two sensory diets that are alike.  
       
      Every sensory diet will meet the specific needs whether in activity, position, intensity, time, sensory system, or type.  Additionally, a sensory diet can be modified throughout the day and based on variances in tasks.
       
      A sensory diet needs to be specific with thoughtful regard to timing, frequency, intensity, and duration of sensory input.
       
      Goals of a sensory diet


      Goals of a sensory diet are to:

       
      1. Provide the child with predictable sensory information
        which helps organize the central nervous system.
      2. Support social engagement, self-regulation, behavior organization, perceived competence, self-esteem, and self-confidence.
      3.  Inhibit and/or improve modulation of sensation within daily routines and environments.
      4. Assist the child in processing a more organized response
        to sensory stimuli.

      Add these resources to the ones you can find here under sensory diet vestibular activities to meet the sensory needs of all kids. 

       
      Reference:
      Fazlioglu, Y., & Baran, G. (2008). A sensory integration therapy program on sensory problems for children
      with autism
      . Perceptual and Motor Skills, 106, 415–422. http://dx.doi.org/10.2466/PMS.106.2.415-422
       

      Read more on sensory processing information here:

       
      Sensory processing red flags for parents to help identify sensory needs in kids
       
       

      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.