sensory processing

Understanding Sensory Dysregulation

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

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

Sensory dysregulation

Sensory Dysregulation

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

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

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

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

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

what is sensory dysregulation

WHAT IS SENSORY DYSREGULATION?

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

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

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

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

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

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

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

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

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

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

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

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

WHAT DOES DYSREGULATION LOOK LIKE?

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

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

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

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

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

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

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

SENSORY DYSREGULATION IS NOT: 

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

Not sensory dysregulation:

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

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

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

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

Sensory Dysregulation Symptoms

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

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

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

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

WHAT ARE THE SYMPTOMS OF DYSREGULATION

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

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

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

HOW CAN YOU support Sensory Dysregulation?

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

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

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

Tactile Sensory Input:

Heavy Work/ Propceptive Sensory Input:

Vestibular Sensory Input:

Combined Sensory Input:

Deep Breathing Activities:

Mindfulness:

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

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

The Sensory Lifestyle Handbook
The Sensory Lifestyle Handbook

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

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

dysregulated nervous system

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

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

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

NERVOUS SYSTEM BASICS

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

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

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

Understanding the stress response

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

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

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

Dysregulation and Trauma

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

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

CAUSES OF DYSREGULATION

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

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

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

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

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

EMOTIONAL/BEHAVIORAL DYSREGULATION CHANGES

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

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

TREATMENT FOR DYSREGULATION

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

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

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

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

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

What Does It Mean When a Child Is Dysregulated?

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

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

Why Can’t They Just Listen or Calm Down?

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

So What Should I Do Instead?

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

1. Focus on Regulation First, Not Correction

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

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

2. Use Sensory Strategies to Regulate the Body

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

Try:

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

Read more about heavy work activities here.

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

3. Offer a Low-Stimulation Environment

If possible, reduce sensory input:

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

4. Don’t Over-Talk

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

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

5. Once Regulated, Then Reflect

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

You can now:

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

Common Questions About Helping a Dysregulated Child

How long does it take to regulate?

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

Is dysregulation a behavior problem?

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

How do I know what will help my child?

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

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

How to Prepare for the Next Dysregulation Moment

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

Tools to have ready:

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

Explore our popular resources:

Get Ongoing Support Inside The OT Toolbox Membership

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

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

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

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

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

Weighted Vests and Compression Garments

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

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

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

Weighted Vests for Kids and Deep Pressure Tools

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

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

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

What Does a Weighted Vest Do for Kids?

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

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

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

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

When to Use a Weighted Vest for Kids

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

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

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

Other Deep Pressure Tools and Proprioceptive Strategies

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

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

Weighted clothing Research review versus clinical observation

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

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

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

Research on weighted vests and compression clothing

Research on weighted vests and Compression Vests

(Research review by Sydney Thorson OTR/L)

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

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

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

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

How Do I Know Which Research to Trust?

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

What does it mean to be clinically significant? 

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

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

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

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

Best Evidence for Weighted Vests

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

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

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

Results (Denny et al., 2018)

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

Should Occupational Therapists Use Weighted Vests? 

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

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

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

Best Evidence for Weighted Compression Vests 

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

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

Weighted Vests and Autism

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

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

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

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

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

Should Occupational Therapists Use Compression Vests? 

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

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

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

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

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

(Clinical experience by Victoria Wood, OTR/L)

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

How does a weighted blanket work?

How a weighted vest works

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

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

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

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

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

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

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

What about research?

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

Do sensory strategies such as a weighted vest work?

  • (In my opinion) weighted clothing works.

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

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

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

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

  • The placebo effect of weighted garments:

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

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

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

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

  • Do no harm.

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

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

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

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

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

What works for one may not work for another. 

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

How to use compression garments and weighted blankets

How to safely use a weighted or compression vest/garment

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

After about 20 minutes you no longer notice it. 

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

A few tips for weighted clothing:

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

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

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

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

3. Collect data.

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

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

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

Compression Vest Alternatives

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

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

Alternatives to compression vests may include:

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

Have you used any of these compression tools?

Frequently Asked Questions About Weighted Vests for Kids

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

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

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

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

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

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

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

Victoria Wood, OTR/L is a contributor to The OT Toolbox and has been providing Occupational Therapy treatment in pediatrics for more than 25 years. She has practiced in hospital settings (inpatient, outpatient, NICU, PICU), school systems, and outpatient clinics in several states. She has treated hundreds of children with various sensory processing dysfunction in the areas of behavior, gross/fine motor skills, social skills and self-care. Ms. Wood has also been a featured speaker at seminars, webinars, and school staff development training. She is the author of Seeing your Home and Community with Sensory Eyes.

AND

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

How to Support Sensory Issues with Hair Brushing

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Sensory hair brushing

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

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

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

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

Sensory Hair Brushing

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

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

Sensory Hair Brushing Tips

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

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

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

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

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

Tip # 2: Turn hair brushing into a Game 

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

Tip # 3: Use Role Play in Hair Brushing 

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

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

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

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

Tip # 4: Let Your Child Do it Themselves

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

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

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

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

Tip # 5: Use a Wide Tooth Comb 

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

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

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

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

Tip # 6: Hold Hair Close to the Scalp 

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

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

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

Tip # 7: Use a Timer 

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

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

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

Tip # 8: Use a Social Story 

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

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

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

Implementing Tips for sensory issues and hair brushing

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

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

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

Looking for more resources?

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

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

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

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

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

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

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

Sensory Hair Brushing Troubleshooting Guide

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

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

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

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

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

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

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

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

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

Sensory Diet Routine: Prep > Brush > Calm

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

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

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

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

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

Sensory-Friendly Hair Tool Recommendations

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

Sensory Processing Disorder Checklist

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Picture of a checklist and magnifying glass. Text reads sensory processing evaluations

We’ve created a sensory processing disorder checklist as a tool for sensory processing needs. Having resources like this sensory processing and self-regulation checklist will support sensory needs in individuals of all ages.

Sensory processing disorder is a condition where the brain misinterprets sensory information so that the body responds in atypical ways. Sensory processing disorder can be broken down into different categories, but one thing is clear: interpretation of sensory input is “off”.

Printable Sensory Processing Disorder Checklist

Below, you will find a list of common sensory responses that might be seen with sensory processing disorder. Use this sensory processing disorder checklist to better understand responses to sensory input. It will be helpful to read this sensory processing disorder chart to get a bigger picture on this umbrella term.

Sensory checklists for each sensory system, great for identifying red flags for sensory processing disorder.

I see evidence of sensory processing challenges everywhere. Though not all of them should be classified as disorders. Sometimes it is ok to be a seeker or an avoider for our safety, wellbeing, career, or comfort. A person who is sensitive does not necessarily have a disorder until it affects their daily life. I do not like a lot of textures, however, I am functioning well in my day to day life. 

Here are a few other examples of sensory red flags that are not damaging:

  • Certain athletes feel a drive to exercise. They must do it for their well being. Perhaps their arousal level is off, and exercise provides the modulation they need.  
  • Football players love crashing and bumping.  Is it possible they are sensory seekers, driven to engage in this sport?
  • Goldilocks had a hard time finding the right porridge, bed, and chair.  Maybe she was sensitive to texture, taste and temperature. Eventually she found the right situation that suited her needs. She did not have a meltdown or shutdown in the process.
  • In The Old Hat, New Hat Book Papa Berenstain had a hard time finding the right hat. Too twisty, too twirly, too beady, too bumpy.  In the end he decided on his familiar hat.  This might be classified as a disorder if he “needed” a new hat and could not get one. We see this often with children having to get new shoes. Change is hard. 
  • What professions can you see might be tactile seekers?  Gardeners, artists, potters, masseuses, and chefs?
  • Who is likely to be avoiding stimuli when choosing their profession? People who choose to work at home, solitary workers, librarians, a spa manager, or an accountant?
  • Is it fair to say that people who choose high energy jobs are seekers or sensory integrated?  Nurses, teachers, taxi drivers, OT/PTs?  Maybe.  Perhaps like me, they are not seekers or well integrated, but driven to help.  I am exhausted mentally and physically at the end of the day.  My profession is probably toxic for me, but important enough that I keep going.

When looking at all the red flags in diagnosing others, it is important to judge the impact the difficulty is having on life. This level of difficulty will determine who needs sensory processing treatment, who needs accommodations, and who is doing just fine.

The picky eater who lives on two foods and is not getting adequate nutrition is worth taking a look at. A child who is so sensitive to textures that he can not find anything to wear to school, or gets naked everyday in public, is struggling. The child whose meltdowns are so significant, they interfere with their daily life, needs some intervention. 

In my career I have seen the whole spectrum of sensory processing difficulties. I have worked with children so impacted that it is a wonder they are surviving. On the other hand, I have evaluated children who are just quirky, not atypical. I remember trying to explain this to a parent. Her son was just quiet and introverted.  He liked chess and robotics.  He had a small social circle, but had friends and was doing well in school.  Not everyone needs treatment or “fixing”.  We all are not suited to be gardeners, football players, or electricians.  

When looking at sensory difficulties, we need to focus our attention on the impact.  This is why our goals are not often simply “improve sensory processing”.  In the examples above with the picky eater and the child who will not wear clothes, the goals would focus on increasing food intake, and decreasing tactile aversion so the student can wear something to school.

Sensory Processing Disorder and Early Intervention

I talk a lot about education and early intervention. Help stem the flow of a problem before it gets too big.  Educate large groups of people about a topic and treatment, so it can have a trickle down effect.  One of the key factors in working with people is understanding. In my book, Seeing your Home and Community with Sensory Eyes, I spend time in each chapter helping the caregiver or recipient of the information understand what is happening with sensory struggles. I describe why your child may be screaming, kicking, refusing, or melting down in each setting.  Then we look toward communication, treatment, and accommodation.  It is available here on the OT Toolbox, in digital format or on Amazon (affiliate link) in print if you prefer.

Sensory processing Disorder Test

Using a sensory processing disorder checklist is just one step in completing a SPD test or assessment. It’s important to start somewhere and getting information from parents, educators, and others who know and love the child or individual is a key step in moving in the right direction with a sensory processing disorder evaluation. We want to see what’s really happening and what’s impacting function so the checklist portion is really important.

A checklist for sensory issues can be part of a screening tool. This gathers so much information and can really drive the evaluation process.

Other sensory processing assessment tools include observation, questionaries, and then the standardized assessment performed by an occupational therapist. The evaluating OT will use one of several sensory processing assessments to create a clinical picture that is part of the skilled evaluation process for SPD.

Picture of a checklist and magnifying glass. Text reads sensory processing evaluations

Sensory Processing Evaluations

Here are some of the most common evaluations that can be used to assess sensory processing. These sensory processing disorder tests do can be used along with other sources of information to get a bigger picture of what’s going on.

Sensory Integration and Praxis Tests (SIPT)– This test is appropriate for children aged 4 months through 8 years, 11 months. It’s a very comprehensive assessment. The SIPT does require extensive training to administer.

Sensory Profile 2– This assessment is appropriate for birth-14 years, 11 months. It is a comprehensive evaluation and it has a school companion form for the child’s teacher to complete.

Sensory Processing Measure-2 (SPM-2)– This evaluation is appropriate for children aged 4 months-87 years. It is a quick assessment and it has a home and a school form that can be used for a comprehensive look at the child across environments.

Evaluation in Ayres Sensory Integration® (EASI)– This evaluation is appropriate for children aged 3 years through 12 years. It’s based on Ayres Sensory Integration® and it’s a very comprehensive eval. Examiners do need to be trained in order to do this evaluation.

Structured Observations of Sensory Integration (SOSI-M)– This assessment is appropriate for children aged 5 years to 14 years.

Here are a few other sensory processing assessments to be aware of:

Short Sensory Profile (SSP): 3–15 years

Sensory Experiences Questionnaire (SEQ 3.0): 5 months – 6 years

Sensory Rating Scale (SRS): 0–3 years

SensOR Inventory (SensOR): 3–55 years

Sensory Processing Measure (SPM): 3–10 years

Infant/Toddler Sensory Profile (ITSP): 0–36 months

Diagnostic Interview for Social and Communication Disorders (DISCO): All ages

Adolescent/Adult Sensory Profile (AASP): Adolescent and adult ages

Working in the sensory realm is difficult and confusing. There can be 1001 combinations of reasons a person is having difficulty, and just as many possible solutions.  Once you find a solution, it may only work a handful of times. Broaden your OT Toolbox with treatment ideas, checklists, and resources.

Speaking of OT Toolbox, our website is packed with valuable resources. Yes you can go onto AI and get a quick answer, but it will not be full of resources, hands on activities, and fun! 

With sensory processing disorder, input from each of the sensory systems can be interpreted by the brain in different ways. Kids can hyper-respond or overreact to sensory input. Or, they can hypo-respond, or under-react to sensory information.

Sensory processing disorder can be seen in children or on adults.

These sensory processing disorder checklists are broken down by sensory system

Sensory Processing Disorder Checklist

Putting it all together – Let’s look at all of the sensory systems in a list:

  • Visual System (Sight)
  • Auditory System (Sound)
  • Tactile System (Touch)
  • Gustatory System (Taste)
  • Olfactory System (Smell)
  • Proprioceptive System (Position in space)
  • Vestibular System (Movement)
  • Interoceptive System (Inner body)

Typically, sensory dysregulation within these three systems present in many different ways.  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 differences 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.

Sensory processing disorder checklists for responses seen to sensory input.

Sensory Processing Disorder Symptoms

It can be overwhelming when you start looking into various symptoms in sensory processing disorder. But if you are wondering about specific signs of SPD in your child, it can be helpful to have a comprehensive checklist of various areas that impact learning, play and functioning. 

The comprehensive list of sensory signs and symptoms listed below are helpful to spot an issue in your child, but more so can help you pinpoint a starting point with helping your child so you can support their needs.

Sensory Processing Disorder checklists for each sensory system

red Flags for Tactile Dysregulation

Tactile defensiveness, or what is sometimes described as tactile differences, refers to differences in how an individual experiences and responds to touch-based sensory input. This can include avoiding certain textures or, for some, actively seeking out tactile sensory experiences.

When we use terms like disabilities, dysregulation, differences, or challenges, or our goal is not to label an individual as having a deficiency or to pathologize sensory differences. Sometimes you may even hear the term dysfunction. When these terms are used, the goal is to describe sensory preferences and needs that may be impacting participation in everyday activities.

It is important to recognize that sensory processing is a spectrum of diverse experiences. Some sensory responses may create barriers to functional skills, such as self-care, play, or learning, not because there is something “wrong” with the person, but because their sensory system may require additional support or accommodations. Using this lens allows us to be neuro-affirming: we are not trying to “fix” or “normalize” an individual’s sensory experiences, but to understand and support their sensory needs so they can engage meaningfully in their environment.

Tactile defensiveness refers to avoidance of certain textures or the seeking out of tactile sensory input. These indicators can mean a sensory issue with the tactile sensory system.

Consider the sensory checklist based on the tactile system:

Hyper-responsiveness of the tactile sense may present in a child as over-responsiveness or overreaction to tactile sensation. This looks like:

  • Overly sensitivity to temperature including air, food, water, or objects
  • Withdrawing when touched
  • Refusing certain foods because of food texture issues
  • Dislike of having face or hair washed
  • Dislikes of hair cuts
  • Dislikes of having fingernails cut
  • Excessively ticklish
  • Avoidance to messy play or getting one’s hands dirty
  • Avoidance of finger painting, dirt, sand, bare feet on grass, etc.
  • Clothing preferences and avoidances such as resisting shoes or socks
  • Annoyance to clothing seams or clothing textures
  • Resistance to hair brushing
  • Over-reactive to unexpected touch
  • Overreactions to accidental or surprising light touches from others
  • Avoids affectionate touch such as hugs
  • Avoids washing hands at the sink
  • Difficulty with clothing fasteners like buttons, zippers, and belts
  • Challenges in the shower or bathtub with soap, washcloths preferences, and soap textures
  • Refuses to use glue

Hypo-responsiveness of the tactile sense may present in a child as under-responsiveness or under-reaction to tactile sensation. This may look like:

  • Seeks out tactile sensory input
  • Bumps into others
  • High pain tolerance
  • Stuffs food in mouth
  • Licks items or own skin
  • Not aware of being touched
  • Seems unaware of light touch
  • Startles easily when touched
  • When getting dressed, doesn’t notice clothing that is twisted
  • Tendency for self-abusiveness: biting self, rubbing self with heavy pressure, head-banging, pinching self, etc.
  • Doesn’t notice a runny nose, messy face, or messy hands
  • Puts items in the mouth
  • Lack of personal space
  • Runs into other children without noticing
  • Has difficulty maintaining space in line; bumps into others without noticing
  • Falls out of chair
  • NEEDS to touch everything
  • Uses a tight pencil grip on the pencil
  • Writes with heavy pencil pressure
  • Tears paper when cutting with scissors
  • Unintentionally rough on siblings, other children, or pets
  • Always touching others or things
  • Seeks out messy play experiences
  • Prefers to rub or feel certain textures
  • Difficulty with fine motor tasks
  • Craves touch
  • Doesn’t seem to notice unexpected touch
  • Constantly playing in the soap or water at the sink

red Flags for Proprioception Dysfunciton

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

Hyper-responsiveness of the proprioception sense may present in a child as over-responsiveness or overreaction to proprioceptive sensation. This may include postural insecurity. This may look like:

  • Uses too little pressure when writing or coloring
  • Prefers soft or pureed foods
  • Appears lethargic
  • Bumps into people or objects
  • Poor posture, slumps in their seat
  • Poor handwriting
  • Inability to sit upright when writing or completing desk work; Rests with head down on arms while working
  • Poor awareness of position-in-space
  • Frequent falling
  • Clumsiness
  • Poor balance
  • Poor body awareness
  • Poor attention
  • Poor motor planning
  • Uses extreme force during tasks
  • Challenged by clothing fasteners ( how much force to use with fastening buttons, zippers, and belts, or snaps)

Hypo-responsiveness of the proprioceptive sense may present in a child as under-responsiveness or underreaction to proprioceptive sensation. This looks like:

  • Uses excessive pressure when writing or coloring
  • “Jumper and crasher”- seeks out sensory input
  • Can’t sleep without being hugged or held
  • Bumps into people or objects
  • Seems aggressive
  • Grinds teeth
  • Walks on toes
  • Chews on pencils, shirt, sleeve, toys, etc.
  • Prefers crunchy or chewy foods
  • Cracks knuckles
  • Breaks pencils or crayons when writing or coloring
  • Pinches, bites, kicks, or headbutts others
  • Difficulty with fine motor skills
  • Poor handwriting
  • Poor awareness of position-in-space
  • Stomps their feet on the ground when walking
  • Kicks their chair or their neighbors chair in the classroom
  • Frequent falling
  • Clumsiness
  • Poor balance
  • Constantly moving and fidgeting
  • Poor attention
  • Uses extreme force
  • Has unexpected bruises
  • Seeks out wrestling games

red Flags for Vestibular Differences

Vestibular dysregulation refers to differences in how an individual perceives and responds to movement, balance, and spatial orientation. This may look like avoidance of certain types of movement (such as swinging or climbing), or an increased need to seek out movement experiences (like constant spinning or jumping). When describing vestibular needs or sensitivities, it is important to approach this language with care. When we see red flags related to vestibular challenges, we can acknowledge that these sensory differences may affect a person’s comfort, safety, and ability to participate in daily activities.

Recognizing vestibular differences through this lens allows us to support each individual’s unique sensory profile without the goal of “correcting” or changing who they are. Instead, we aim to create environments, strategies, and opportunities that honor sensory needs and promote functional engagement. A neuro-affirming approach respects that sensory processing differences are part of human diversity, and that with the right supports, individuals can thrive in their own way.

The Vestibular Sensory System is the sense of movement and balance, and uses the receptors in the inner ear and allows the body to orient to position in space.  The vestibular system is closely related to eye movements and coordination.  Vestibular sensory input is a powerful tool in helping children with sensory needs.  Adding a few vestibular activities to the day allows for long-lasting effects.  Every individual requires vestibular sensory input in natural development.  In fact, as infants we are exposed to vestibular input that promotes a natural and healthy development and integration of all systems. 

Vestibular dysregulation and problems with the Vestibular Processing System can present as different ways:

  • Poor visual processing
  • Poor spatial awareness
  • Poor balance
  • Difficulty with bilateral integration
  • Sequencing deficits
  • Poor visual-motor skills
  • Poor constructional abilities
  • Poor discrimination of body position
  • Poor discrimination of movement
  • Poor equilibrium
  • Subtle difficulties discerning the orientation of head
  • Trouble negotiating action sequences

Hyper-responsiveness of the vestibular sense may present in a child as over-responsiveness or overreaction to vestibular sensation. This look may look like:

  • Experiences gravitational insecurity
  • Overly dizzy with motions
  • Resistant to moving activities such as swings, slides, elevators, or escalators
  • Fear of unstable surfaces
  • Unable to tolerate backward motions
  • Unable to tolerate side to side motions
  • Illness in moving vehicles
  • Avoids swings or slides
  • Gets motion sick easily
  • Appears “clingy”
  • Refuses to move from the ground (i.e. jumping or hopping activities)
  • Difficulty/fear of balance activities
  • Refusal to participate in gym class
  • Refusal to try playground equipment
  • Fearful on bleachers or on risers
  • Fear or dislike of riding in elevators or escalators
  • Fearful of movement
  • Dislike of spinning motions
  • Avoids chasing games
  • Overly fearful of heights
  • Nauseous when watching spinning objects
  • Poor posture
  • Easily fatigued
  • Poor coordination
  • Low muscle tone
  • Poor motor planning
  • Fearful when a teacher approaches or pushes in the child’s chair
  • Clumsiness
  • Poor attention
  • Difficulty or fearful on stairs
  • Fearful during situations of constant motion
  • Struggles or fearful on ladders
  • An extreme dislike of high places
  • Refuses to sit on or try a bike

Hypo-responsiveness of the vestibular sense may present in a child as under-responsiveness or underreaction to vestibular sensation. This may look like:

  • Constant movement including jumping, spinning, rocking, climbing
  • Craves movement at fast intervals
  • Craves spinning, rocking, or rotary motions
  • Poor balance on uneven surfaces
  • Constantly fidgeting
  • Increased visual attention to spinning objects or overhead fans
  • Bolts or runs away in community or group settings, or when outdoors or in large open areas such as shopping malls
  • Difficulty maintaining sustained attention
  • Impulsive movement
  • Constantly getting up and down from desk in the classroom
  • Walks around when not supposed to (in the classroom, during meals, etc.)
  • Loves to be upside down
  • Head banging
  • Hypermobile or all over playground equipment
  • Leans chair back when seated at a desk
  • Loves spinning
  • Rocks self-back and forth when seated
  • Poor posture
  • Poor coordination
  • Poor motor planning
  • A deep need to keep moving in order to function
  • Frequent falling
  • Clumsiness
  • Poor balance
  • Poor attention
  • Always in constant motion
  • Prefers being in high places

Red Flags for Visual SYSTEM Dysregulation

Visual dysregulation refers to differences in how an individual processes and responds to visual input, such as light, movement, patterns, or cluttered environments. Some individuals may be more sensitive to bright lights, busy visuals, or fast-moving scenes, while others may seek out visual stimulation through watching spinning objects or moving their eyes in specific ways. When we use the term dysregulation to describe these sensory experiences, it is not to imply a problem or deficit, but to acknowledge that visual processing differences may influence an individual’s comfort, attention, and participation in everyday tasks.

Taking a neuro-affirming perspective, we recognize that sensory differences, including those in the visual system, are a natural part of human variation. Our goal is not to “normalize” visual responses but to support individuals by adapting environments, offering accommodations, and providing strategies that help them engage meaningfully in their world. By understanding and respecting visual sensory needs, we can better empower individuals to navigate their surroundings in ways that feel safe and supportive.

Eighty percent of the information we receive from our environment is visual.  When perception of this information is not processed correctly, it can create an altered state that influences many areas:  eye-hand coordination, postural reflexes, and vestibular processing are all influenced and reliant upon the visual system. 

The visual system is the sensory system that most individuals rely upon most heavily for daily tasks.  Visual information is perceived by cells in the back of the eye.  These cells (rods and cones) relay and transfer light information into information that is transferred to the central nervous system.  These photoreceptors are able to perceive day time vision and night time vision, with adjustments to sensitivity of light intensity.  They are able to respond to different spectrum of color and differentiate color information.  The rod and cone cells, along with the retina, process a great deal of visual information in the neural structure of the eye before transmitting information to the central nervous system. 

The relay of information from the eyes to the central nervous system are made up of three pathways.  Pathways project to different areas of the brain and allow for:

  1. Processing and recognition of faces/shapes/motion (the “what” and “where” of objects)
  2. Integration of information in order to coordinate posture and eye movements
  3. Oculomotor adaptation.

Hyper-responsiveness of the visual sense may present in a child as over-responsiveness or overreaction to visual sensation. This may look like:

  • Complains of lights being too bright
  • Unable to tolerate certain lighting such as fluorescent overhead lights
  • Struggles with sudden changes in lighting
  • Challenged by bright or flashing lights
  • Colorful lights “hurt” the eyes
  • Complains of headaches in bright light
  • Complains of the “glow” of unnatural lighting
  • Distressed by light sources
  • Sensitive to light
  • Sensitive to certain colors
  • Distracted by cluttered spaces
  • Avoids eye contact
  • Trouble with puzzles
  • Frustration at the movies
  • Difficulty reading
  • Difficulty finding objects in a busy drawer

Hypo-responsiveness of the visual sense may present in a child as under-responsiveness or underreaction to visual sensation. This looks like:

  • Attracted to spinning objects
  • Difficulty with visual perception
  • Difficulty with eye-hand coordination
  • Difficulty with reading and writing
  • Holds or presses hands on eyelids in order to see flashing lights
  • Squints or presses eyelids shut
  • Flaps hands or objects in front of eyes
  • Holds eyes at the movies

red Flags for Auditory SYSTEM Dysregulation

Auditory dysregulation refers to differences in how an individual perceives and responds to sounds in their environment. This may include heightened sensitivity to certain noises, difficulty filtering out background sounds, or a strong preference for certain auditory experiences. Some individuals may cover their ears, avoid noisy environments, or become overwhelmed in spaces with unpredictable sounds, while others may seek out calming or repetitive auditory input. When we use the term dysregulation in this context, it is not to suggest that there is something wrong with the person, but rather to acknowledge that their auditory processing needs may impact comfort and participation in daily life.

A neuro-affirming approach recognizes auditory processing as a diverse experience, not a flaw to be corrected. Our role is to honor and support each individual’s auditory needs by offering accommodations, adapting environments, and providing tools that help them engage in ways that feel safe and manageable. By understanding these sensory differences, we can foster inclusion and respect for all sensory profiles.

Receptors for the auditory system are located in the inner ear and are responsible for receiving vibration from sound waves and changing them to fluid movement energy.  Information is projected to the central nervous system and transmits sound frequency as well as timing and intensity of sound input.  The auditory system is integrated with somatosensory input in order to play a role in controlling orientation of the eyes, head, and body to sound. 

Hyper-responsiveness of the auditory sense may present in a child as over-responsiveness or overreaction to auditory sensation. This may look like:

  • Startles easily to unexpected sounds
  • Dislikes noisy places
  • Overly sensitive to speakers on radios
  • Fearful of smoke detectors, overhead speakers
  • Shushes others or asks others to stop talking
  • Holds hands over ears
  • Sensitive to certain sounds such as lawnmowers or the hum of the refrigerator
  • Easily distracted by sounds and background noise
  • Hums to block out background noise

Hypo-responsiveness of the auditory sense may present in a child as under-responsiveness or underreaction to auditory sensation. This looks like:

  • Seems to be unaware of sounds
  • Holds radio speakers up against ears
  • Doesn’t respond to alarms
  • Makes silly sounds at inappropriate times or frequently
  • Mimics sounds of others
  • Talks to self
  • Difficulty locating sounds, especially when in a noisy environment
  • Hums in order to hear the sound of humming

red Flags for Gustatory System Dysregulation

Gustatory dysregulation refers to differences in how an individual experiences and responds to taste and oral sensory input. This can include strong preferences or aversions to certain flavors, temperatures, or textures of foods and drinks. Some individuals may seek out intense flavors like spicy or sour foods, while others may avoid specific textures or have a very limited range of preferred foods. When we use the term dysregulation in this context, it is not intended to pathologize sensory preferences, but to describe how these differences may influence eating habits, nutritional intake, and participation in mealtime routines.

Viewing gustatory processing through a neuro-affirming lens allows us to respect individual sensory needs and preferences without the goal of “fixing” them. Instead, the focus is on understanding how these sensory differences impact daily life and finding supportive strategies to promote positive mealtime experiences. This might include offering a variety of sensory-friendly food options, gradually expanding food exploration in a safe and supportive way, and working collaboratively with families to honor each child’s unique sensory profile.

The gustatory system perceives input through the tongue.  Taste cells in the mouth perceive five sensations: salty, sweet, bitter, sour, and savory.  The gustatory system is closely related to the sense of smell and proprioception.  How we perceive taste is deeply influenced by the sense of smell. 

While many children with sensory needs have a tendency to chew on their shirt collars or pencils as a sensory strategy in order to seek proprioception needs, the behavior may occur as a result or as a reaction to under-responding to oral input.  Other children may seek out intense taste sensations and in that case put non-edible items into their mouth to satisfy that sensory need.  Still other children may over-respond or under-respond to certain flavors or taste sensations.  For those children, it is common to experience food refusal related to texture or taste.

Hypersensitivity to oral sensory input may present in a child as over-responsiveness or overreaction to gustatory sensation. This looks like:

  • Dislike of mixed textures (cereal in milk or chunky soup)
  • Resistant to trying new foods
  • Avoids certain textures
  • Avoids straws
  • Avoidance of specific food or drink temperatures
  • Picky eating
  • Preference for bland foods
  • Avoids temperature extremes (unable to tolerate hot or cold foods)
  • Prefers foods that do not touch or mix on their plate
  • Use of only a specific spoon or fork or no utensil at all
  • Intolerance to teeth brushing.
  • Anxiety or gagging when presented with new foods
  • Drooling

Hypo-responsiveness of the gustatory sense may present in a child as under-responsiveness or underreaction to gustatory sensation. This may look like:

  • Licking objects
  • Bites others
  • Chews on clothing
  • Hums all the time
  • Prefers a vibrating toothbrush
  • Prefers spicy foods
  • Stuffs food into cheeks
  • Prefers food very hot or very cold temperature

red Flags for Olfactory System Dysregulation

Olfactory dysregulation refers to differences in how an individual perceives and responds to smells in their environment. Some individuals may be highly sensitive to certain scents and may become overwhelmed, nauseous, or distressed by everyday smells such as perfumes, cleaning products, or certain foods. Others may seek out strong or specific scents as a way to self-regulate. Using the term dysregulation here is not meant to label these sensory responses as a problem, but to acknowledge that olfactory processing differences can affect comfort, attention, and participation in daily routines.

A neuro-affirming perspective recognizes that variations in how we experience smells are part of natural sensory diversity. The goal is not to eliminate these differences, but to provide support that respects individual needs. This might include adapting environments to minimize triggering scents, offering preferred calming smells, and helping individuals develop strategies to navigate scent-rich settings more comfortably. By understanding and honoring olfactory sensory needs, we can foster more inclusive and supportive environments.

The olfactory system, or the system that enables the sense of smell, has receptors in the tissue of the nose that are connected by pathways to the brain.  Connections occur via two pathways, one being a direct route to neurons in the brains and the second being a path that passes near the roof of the mouth.  This channel is connected to the taste of foods.

There is some evidence indicating that the sense of smell is more associated with memory than the sense of vision or the other senses.  The connection of the olfactory sense to the emotional part of the brain and previous experiences, as well as hypersensitivity or hyposensitivity to smells can cause anxiety or sensory related breakdowns in children with sensory processing difficulties. 

Hyper-responsiveness of the olfactory sense may present in a child as over-responsiveness or overreaction to olfactory sensation. This may look like:

  • Overly sensitive to smells
  • Notices smells others don’t
  • Anxious around certain smells
  • Holds nose in response to certain scents
  • Challenged in the shower or bathtub, with overwhelming preferences and disliking certain scents

Hypo-responsiveness of the olfactory sense may present in a child as under-responsiveness or underreaction to olfactory sensation. This may look like:

  • Smells unusual items like paper or certain materials
  • Prefers strong scents

Red Flags for Interoceptive System Dysregulation

Interoceptive dysregulation refers to differences in how an individual perceives and interprets internal body signals, such as hunger, thirst, fatigue, pain, temperature, or the need to use the bathroom. Some individuals may have difficulty recognizing or responding to these signals, while others may experience them as overwhelming or confusing. When we describe interoceptive dysregulation, it is not to suggest a deficit or problem within the individual, but to acknowledge that these sensory differences can impact self-awareness, self-care, emotional regulation, and participation in everyday routines.

A neuro-affirming approach respects that interoceptive experiences vary widely among individuals and are a natural part of sensory diversity. Rather than aiming to “correct” these differences, the goal is to provide support and tools that help individuals better understand and respond to their internal cues in a way that feels right for them. This may include using visual supports, developing body awareness activities, or building self-advocacy skills. By honoring interoceptive needs, we can help foster greater comfort, autonomy, and engagement in daily life.

The interoceptive sensory system is an area that most people are not as familiar with.  This system is connected to amygdala, the emotional system, the limbic system, our emotional awareness, our feelings, and subconscious arousal.  Receptors for the interoceptive system are in our organs and skin.  The receptors relay information regarding feelings such as hunger, thirst, heart rate, and digestion to the brain.  This is the foundation to sensations such as mood, responding to the moods and emotions of others (co-regulation), emotions, aggression, excitement, and fear and in turn, promotes the physical response of our bodies. 

Physical responses include functions such as hunger, thirst, feelings, digestion, heart rate, and body temperature.

Hyper-responsiveness of the interoceptive sense may present in a child as over-responsiveness or overreaction to interoceptive sensation. This may look like:

  • High pain tolerance
  • Distracted and overwhelmed by feelings of stress
  • Distracted or overly sensitive to sensations of stomach digestion
  • Distracted or overly sensitive to sensation of heart beat
  • Always hungry or thirsty
  • Eat more and more often to avoid feelings of hunger
  • Unable to sense the feeling of being full; overeats or overdrinks
  • Overwhelmed by feelings of sadness, anger, happiness, etc. and unable to respond appropriately
  • High urine output
  • Use the bathroom more often than necessary to avoid feelings of a full bladder or bowel
  • Distracted by changes in body temperature
  • Distracted and overly sensitive to sweating
  • Overly sensitive to feeling ticklish or itchy
  • Overly sensitive to cold or heat
  • Overly sensitive to signs of illness
  • Fearful of vomiting

Hypo-responsiveness of the interoceptive sense may present in a child as under-responsiveness or underreaction to interoceptive sensation. This may look like:

  • Low pain tolerance
  • Poor or low response to interoceptive stimuli
  • Doesn’t know when to go to the bathroom
  • Never says they are hungry or thirsty
  • Does not drink or eat enough
  • Difficult to toilet train
  • Never complains of being cold or hot (always wears shorts in the winter or pants in the summer)
  • Never complains of sickness
  • Difficulty falling asleep
  • Unable to identify feelings of stress
  • Unable to identify specific feelings and appropriate responses

Sensory Checklists, explained

There is a lot to think about here, right? Taking a giant list of common sensory processing disorder lists and knowing what to do with that list is complicated. What if you had strategies to address each sensory system’s over-responsiveness or under-responsiveness so you could come up with a sensory diet that helps kids function?

In The Sensory Lifestyle Handbook, I do just that.

The Sensory Lifestyle Handbook

Sensory processing is broken down by sensory system so you can understand what you are seeing in the sensory responses listed above. Then, you can use the lists of sensory activities to help the child complete functional tasks while they get the sensory input they need to focus, organize themselves, and function.

The sensory activities are presented as meaningful and motivating tasks that are based on the child’s interests, making them motivating and meaningful.

You can get the Sensory Lifestyle Handbook and start building a sensory diet that becomes an integrated part of each day’s daily tasks, like getting dressed, completing household chores, school work, community interaction, and more.

Get your copy of The Sensory Lifestyle Handbook here.

Sensory checklists in early intervention

In young children, sensory issues can present leading to the early intervention process. Having a sensory processing disorder checklist on hand can help relieve some of the questions parents have about development and whether a behavior or action is typical or not.

Characteristics of sensory issues show up during these young years. You may see frustration or meltdowns due to unexpected touch.

You may identify tactile defensiveness even in the infant years when babies pull away from heavy input of a cuddle or wrapped blanket. You may notice sensory preferences in the way of seeking out a pacifier for comfort (long beyond the typical pacifier stage). You may even identify distress with certain aspects of sensory input as listed in the sensory processing checklists above.

A few helpful resources are listed below:

Meltdowns– This blog post covers temper tantrums verses sensory meltdowns.

This blog post on early intervention strategies for sensory differences covers important information for sensory needs during the infant to 5 years range.

Sensory integration at the playground – Exploring different sensory input areas at the playground can help identify sensory challenges in young children.

A Final Note on Examples of Sensory Processing Dysregulation

This extensive list of sensory red flags is meant to act as an educational tool for parents, educators of children.

As occupational therapists, we strive to support children and their “team” of parents, caregivers, family, and educators with resources and information that will serve the individual child so that they can function in everyday life tasks. 

The purpose of this sensory processing disorder checklist is to help parents and professionals who interact with children become educated about particular signs of sensory processing differences.

A checklist is not to be used as the absolute diagnostic criteria for labeling children with sensory processing disorder. It is simply a resource to be used as a starting point when identifying distress symptoms to explore further. 

If you have difficulty understanding your child’s sensory preferences, sensory avoidances, use this sensory processing disorder checklist as a starting point and reach out to a pediatrician and pediatric occupational therapist.

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

Sensory Summer Camp at Home

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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.

Also be sure to check out the resource we’ve added to our shop: Create Your Own Summer Camp Side-Business. This is a printable workbook that walks you through every step of setting up a paid Summer Camp. You can use this process for year-round paid playgroups, handwriting tutoring, or any themed group.

The Summer Camp & Tutoring Side Business Workbook gives you everything you need to plan, price, and launch your own skill-based program, perfect for OTs, PTs, and SLPs who want to use their expertise in a fun, flexible way.

Sensory Summer Camp

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

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


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

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

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

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


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

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

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

Grab the Spring Occupational Therapy Activities Packet HERE.

summer occupational therapy activities for kids

n the Summer OT packet, you’ll find:

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

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

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

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

 

Occupational Therapy Summer Camp

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

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

An occupational therapy summer camp can focus on an area of function: sensory play experiences, handwriting, shoe tying, use of typing programs, 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

Set up Your Own Summer Camp

What’s next? Actually taking the steps to create your own Summer side-gig! If you’re ready to take the leap and turn your camp idea into something real, the Summer Camp & Tutoring Side Business Workbook is your perfect next step. Created specifically for OT, PT, and SLP professionals, this printable guide walks you through everything you need to set up and run your own skill-based summer program. It walks you through everything you need to know about this process, from planning and pricing to registration forms, waivers, and activity templates.

Whether you’re thinking about a handwriting bootcamp, sensory playgroup, or life skills club, this workbook helps you put your ideas into action, on your schedule, with your expertise, and without the overwhelm.

This workbook was inspired by my own experience starting a sensory playgroup while juggling work and mom life. I built it on my own terms, brought my kids along, and created fun, meaningful experiences that supported real skill development, and made extra income while doing it.

Now it’s your turn! Check out the Summer Camp Guide Workbook here.

Inside the workbook, you’ll find:

  • Program planning worksheets
  • Budget and pricing calculator
  • Activity planners
  • Registration and intake forms
  • Legal/safety templates (like waivers)
  • Ideas for promotion, themes, and scheduling
  • …and everything you need to confidently launch a camp, playgroup, or tutoring program this summer.

Whether you want to run handwriting bootcamps, sensory skill groups, or one-on-one sessions, you don’t need a full course or new certification. You just need a starting point. This is it.

Grab the workbook here.

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

The Sensory Lifestyle Handbook
The Sensory Lifestyle Handbook

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

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

Play Tunnel Activities

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

Let me explain…

How Play Tunnels Help Kids

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

Tunnel for Occupational Therapy

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

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

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

Play Tunnels and Sensory

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

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

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

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

Tunnel activities using pool noodles

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

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

Fabric tunnel for proprioceptive input.

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

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

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

Play tunnel activities

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

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

tunnel activities for preschoolers

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

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

tunnel activity for toddlers

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

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

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

DIY Play TUnnel Ideas

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

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

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

Regina Allen

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

How to Create a Sensory Diet

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steps to create a sensory diet

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

steps to create a sensory diet

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

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

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

How to Create a Sensory Diet

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

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

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

 

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

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

What is a sensory diet? 

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

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

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

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

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

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

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

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

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

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

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

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

Why Create a sensory diet?


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

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

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

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

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

Make a Sensory Diet Template

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

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

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

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

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

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

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

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

Steps to Create a Sensory Diet

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

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


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

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

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

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

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

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

Make notes on things such as:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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


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

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


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

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

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


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

Get The Sensory Lifestyle Handbook here.

Using a sensory diet in various environments

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

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

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

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

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

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

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

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

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

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

Clothing Sensitivity Red Flags

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Image reads "sensory issues and clothing" with picture of a turtleneck sweater, scarf, wool socks, and jeans

This blog post on clothing sensitivities in sensory processing is an older blog post that we’ve had on the site for a long time. We’ve updated this with some considerations that we as the occupational therapist might have when supporting the individual with sensory needs.

Image reads "sensory issues and clothing" with picture of a turtleneck sweater, scarf, wool socks, and jeans

Sensory Issues with Clothing

You might know a child who HATES that tag in the back of their shirt. Maybe the seam of socks need to be lined up “just right”.  Maybe you know a student who only wears shorts no matter the weather. All of these clothing preferences might be a red flag related to a clothing sensitivity and sensory processing issues.

We might all have a sensory issue with clothing at one time or another…

Do you hate certain fabrics? Or do turtleneck sweaters itch and scratch? Maybe the tightness of yoga pants around your waist is aggravating. All of us, at one time or another, have probably experienced some preference or sensory issue with clothing, whether it’s the tightness, the fabric, or something else. All of those tactile defensiveness tendencies and proprioceptive sensations are technically “sensory”.

Clothing sensitivity can mean we need to take a closer look at sensory issues with clothes and they specifics about the clothing: textures, fabrics, tag location, etc.

Sensory friendly clothing can make all the difference in the world to the kiddo that struggles with these intricacies that you or I may not even notice! Even taking a moment to consider how clothing fasteners impact the sensory system can have a huge impact.

A clothing sensitivity related to specific clothing preferences is a common red flag related to sensory processing disorder.

Clothing Sensitivity Disorder

We all prefer certain textures of clothing, however, when clothing sensitivities or the touch discrimination (sensory touch) prevents one from wearing clothing or an extremely strict preference in clothing, there may be more to look at. Tactile defensiveness can impact daily self-care and functional performance in wearing weather-appropriate clothing. Take a look at the clothing sensitivity list below.

Because sensory processing challenges present differently in each child, there will be no list of clothing preferences that is the same for every child. There will also be no completely exhaustive list of red flags related to sensory processing issues or one that can indicate specific sensory issues.

However, it is possible to notice sensory needs related to clothing preferences and clothing sensitivity. The red flags listed below don’t necessarily mean that a child has a sensory processing disorder, only that a more intense look at the child might be needed. If a child seems to have a number of clothing sensitivities, a full evaluation by an occupational therapist may be needed.

Here are tips for getting sensory kids to wear winter clothing.


Does any of this sound familiar? 

 

Clothing sensitivity red flags

Below are some examples of clothing sensitivities. These sensory issues with clothes may impact children, adults, or anyone in between.

An individual who prefers to wear only one type of texture is not something to be concerned with. Similarly, the student who wears shorts all winter long can get by with learning in the classroom without interference. The main consideration is when clothing sensory issues interfere with daily tasks and safety, including personal hygiene considerations.

Consider these sensory clothing red flags:

  • Prefers a specific clothing material (e.g. only cotton or only lightweight fabrics)
  • Child is bothered by seams
  • Is bothered by tags
  • Dislikes sleeves hitting wrists
  • Dislikes hems of pants hitting ankles
  • Wears only shorts even in very cold weather
  • Wears only pants even in very hot weather
  • Prefers clothing without buttons/snaps/zippers/ties
  • Sensitive to collars hitting neck
  • Unable to tolerate shoes
  • Prefers only certain socks or shoes
  • Dislikes when socks slide down in shoes
  • Prefers feet to be totally uncovered or totally covered
  • Unable to tolerate a belt or tight waistband
  • Dislikes underwear or prefers only a certain type of underwear
  • Bothered by seams in underwear
  • Bothered by length of underwear
  • Prefers tight clothing
  • Unable to tolerate jeans
  • Hates coats
  • Prefers heavy layers of clothing
  • Complains of “itching skin” with certain materials or types of clothing
  • Complains of clothing tickling the skin
  • Has meltdowns when it’s time to get dressed in the morning

Need more information on all things sensory?  Grab this free sensory processing disorder information booklet. Its’ perfect for those new to sensory processing or for passing on to parents, grandparents, teachers, and caregivers of children with sensory struggles. 

What clothing sensitivities have you seen?  This list could go on and on. As we all know…kids like to keep us on our toes! 

For the individual with clothing sensitivities, using preferred textures and cut of clothing is a means to support the individual’s preferences. Check out our resource on sensory clothing for specific ideas.

One other thing to consider is the impact a tool like a weighted vest or compression garment can have on meeting sensory needs. It’s something to consider.

Clothing Sensory Issues

Depending on preferences, there can be various textures that one tries to avoid. Certain textures can feel uncomfortable, itchy, scratchy, or even painful. These are the most common sensory textures:

  • Rough or scratchy textures, such as coarse fabrics or rough surfaces
  • Fuzzy or hairy textures on sweaters
  • Textures that hold in body heat: flannel materials, thermal materials, or polyester
  • Textures that are tight or constricting
  • Shirts with tight necks or turtlenecks
  • Clothing with course seams
  • Clothing with scratchy or long tags

Sensory Issues with Clothes List

Want a printable list of our sensory issues with clothes (listed above)? The printer-friendly list is ready to go! Enter your email address into the form below and the resource will be delivered to your inbox. This sensory issues with clothing printable is also found inside our Member’s Club. Head to the free printables toolbox and then select sensory.

Clothing Sensitivity List

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    Do we all have sensory problems with clothing?

    After reading this article and gathering information, I realize that my clothing struggles check all the boxes listed as red flags.  See if you can relate to my list of do’s and don’ts:

    • I don’t like jeans. I have owned hundreds of pairs trying to find the right pair (which means that jeans day at work is not a celebration, but a chore). Sometimes I put on a pair of jeans in the changing room, and they feel ok.  Until I get them home, or worse, arrive at my office wearing the new pair. 
    • I can wear something ten times and find it ok.  The 11th time, it feels awful. I have no idea why.  Once it feels awful, there is no going back and trying again.  Into the give away box it goes.
    • There have been days that I am so uncomfortable that I run out at lunch to buy something better to wear.
    • When I was on my teaching circuit I left several dresses in hotels with “free” signs on them.  After class I ducked into the local Marshalls or TJMaxx to restock.
    • When I find something I like, I tend to buy several of them. This works well until I decide I can not wear them anymore. Then I have nine pairs of shorts in different colors to dispose of. 
    • Pants have to be just the right length, no ankle pants for me.  Same with shirts.  Those ¾ length sleeves?  Definite no. 
    • No wool, puffy jackets, microfiber, tight sleeves, v-neck shirts, lace that touches the skin, tight neck shirts (turtlenecks??)…  This is just the start of the list.
    • Accessories? Headbands, hair ties, necklaces, bracelets, watches, hats, scarves, and other accessories can become bothersome as the day wears on, if it is not aggravating when you first put it on. 

    How have I survived?  Luckily I have a voice and a choice. I am old enough to pick what I want and get rid of it when it “does not feel right.”  Fortunately I have the money to do this. I do not tend to buy expensive things in case they don’t work out.  I try to bring extra clothing options when I travel, and keep an extra set of clothes in the car. The voice I have helps me describe how I feel, or why I need to change clothes in the middle of the day. Luckily my spouse has become accustomed to my quirks and understands when I say something does not “feel right”.

    Sensory Issues and Clothing Tags

    When you think about clothing red flags, do you focus only on tags?  That is the common misconception. Clothing sensitivity is so much more than pesky tags.  To make it worse, there is a ton of trial and error that goes on before the right combination of clothes is found. 

    Sensory Clothing Recommendations

    Recently I have made some great additions to my sensory clothing line up: (Amazon affiliate links below)

    • Bombas makes great socks. Make sure you size up so the toes are not too tight
    • New Balance sneakers have a wide toe box. Again size up so there is room to move
    • Woxers make soft boxer shorts for women. No tags, seams, pinching, or exposure. The only issue is trying to wear these with jeans as they tend to bunch up.
    • Land’s End makes the most comfortable pajamas (again size up)
    • Triblend cotton is the right amount of stretch
    • Soft leggings go well under dresses to minimize potentially scratchy fabric touching

    “Sensory”, like everything else, is on a spectrum. Having sensory sensitivities or quirks is only a problem when there is something you have to wear or do, that you can not.

    Students who have to wear certain uniforms, and adults that have difficulty wearing specific work clothes, can struggle if they have clothing sensitivity. Many students in private schools (and their parents) face a daily struggle to wear the designated outfit. I have been fortunate enough to have a flexible dress code during my career. 

    How to help my child with sensory clothing sensitivities?

    Our job as therapists is to support the child or client with clothing sensitivities. We can support those needs when it’s a request. Maybe the individual wants to start to wear a certain type of material.

    Maybe there are behavioral issues at play.

    Clothing sensitivity becomes an issue when someone can not wear anything, takes their clothes off in public, refuses to put anything on, or has undue stress when selecting or wearing clothing. Pickiness like mine is aggravating at times (and expensive), but it is not debilitating. 

    Maybe a student needs to wear a uniform to school.

    As sensory sensitivities come to light, certain companies are making strides to design clothing that feels right. These range from affordable brands at Target to high end designers.  Of course this does not mean that everything from these brands is going to feel right.

    There will be some trial and error to find the right size and fit.  French Toast and other clothing designers have adapted school uniforms.  A search for sensory friendly clothing can help you get started.

    Maybe it’s weather related. I think as therapists, we’ve all seen the kids that wear shorts to school all winter long, even when you live in a colder or northern climate.

    Here are some ways to support individuals with sensory clothing sensitivites:

    Change the texture- Wearing soft, familiar clothing underneath less comfortable fabrics can minimize direct contact with the skin.

    Layer clothes- For example, a cotton undershirt can be worn beneath a sweater or other uncomfortable fabric​.

    Sensory and itchy tags- As a mom, I’ve removed hundreds of “itchy” tags from my own kids’ shirts and sweatshirts. All it takes is a pair of scissors. Cut off the tags right above the seam. You can also use a seam ripper to totally remove the tag, if some kids still can’t stand the feel of the remaining tag. I’ve noticed that in recent years, many shirts have a dotted line on the tag to help you cut it out from the shirt.

    Alter seams- Another common issue with clothing sensitivities is the feel of seams. You can iron the seam down and that can help. Or, I’ve seen this work before; use fabric glue and glue the edges of the seam down. You can also cut excess fabric from the edges of the seams. One last thing to try is sewing a thin strip of satin or soft fabric along the seam.

    Fabric softener- Another trick that can work is to use fabric softener. This helps with tougher materials like jeans. You can also run the clothing through multiple wash cycles can soften clothing fibers, making them less abrasive against the skin. Clothes that are washed multiple times tend to feel softer, which can reduce discomfort.

    Trouble with elastic bands- If you’ve worn a pair of tight pants before, then you know this issue. it can help to snip a few threads and adjust or remove tight bands around wrists, ankles, or waistbands that might feel restrictive.

    As you struggle with your child to get them dressed in the mornings, consider all the variables about clothing. It is so much more than tags and seams. Start a dialogue using sensory language to help your child describe their likes and dislikes. Try to understand what is going on and make changes where you can. Anxiety and being out of sync will make the symptoms worse.  Be sure to address self regulation as a whole.



    Clothing sensitivity red flags related to sensory processing disorder or sensory struggles in kids
     

     

    Kids may experience preferences or a clothing sensitivity when they have sensory processing disorder or sensory issues.
     
    These red flags are related to clothing sensitivities that may be an indication of sensory challenges in kids.
     

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

    Sensory Meltdowns

    by
    sensory overload and sensory meltdowns

    Overcoming sensory meltdowns can be a real challenge. For parents in a household where sensory challenges are common, having an understanding of what’s really going on with self-regulation and sensory processing is even better. Today, I have information on sensory overload meltdowns as well as a powerful tool for addressing this sensory need in families, so that the child struggling has resources and strategies available to them. Understanding meltdowns is one of the first steps in addressing sensory challenges. A sensory meltdown is sensory overload in action! Another way to look at this is sensory dysregulation that has reached a point where the individual erupts.

    sensory overload and sensory meltdowns

    Sensory Overload

    There is a lot to consider when it comes to sensory meltdowns. Think of it like a volcano that is building up under the ground. We might not suspect that below the surface, things are building up and brewing a storm where we see the explosion. Just like that volcano, sensory input might be building and building.

    Then, there might be Overstimulation anxiety for potential overload…it’s a cycle!

    We see sensory overload and then we have the meltdown.

    Many things can led to sensory overload, especially in the school environment:

    1. Noisy classrooms
    2. Busy hallways
    3. Visual noise or visual clutter
    4. Fireworks
    5. Fire alarms
    6. Noisy buses
    7. Smells from the cafeteria
    8. Crowded spaces
    9. Bright or flashing lights
    10. Loud music or sound effects
    11. Strong odors (perfumes, cleaning products)
    12. Scratchy or uncomfortable clothing
    13. High-pitched noises (whistles, sirens)
    14. Sudden or unexpected touches
    15. Television or computer screens
    16. Chaotic environments (malls, playgrounds)
    17. Multiple people talking simultaneously
    18. Heavy traffic noise
    19. Vibrations from machinery or vehicles
    20. Intense weather conditions (strong wind, heavy rain)
    21. Sports crowds or pep rallies
    22. Cluttered spaces
    23. Physical constraints (tight spaces, restraint in seats)
    24. Unstructured play areas
    25. Overwhelming choices (large menus, toy options)
    26. High-demand situations (tests, performances)
    27. Interpersonal conflicts
    28. Physical exertion without breaks
    29. Changes in routine or unexpected schedule changes

    Auditory sensitivities and sensory needs can impact learning because of sensory overload. This is where the school based OT comes in. Having a sensory diet or sensory solution to the auditory input can support sensory needs before meltdowns occur.

    Sensory meltdowns, information on self-regulation and sensory processing, as well as questions that parents have about meltdowns.

    Sensory Meltdowns

    I’ve shared before the difference between a sensory meltdown vs a tantrum…but that defining line can be hazy when it comes to sensory overload.

    I’ve also shared many meltdown tips and tricks to address sensory meltdowns in children, as well as coping tools and sensory strategies that can help children.

    There are also many sensory diet tools and resources here on this website, which can be valuable resources for the child with sensory processing challenges.

    But all of these self regulation strategies, resources, and tools can be inconsequential if you are missing an important piece of the sensory puzzle.

    Understanding what’s really going on behind a meltdown is the key component to helping children who struggle with sensory overload.

    There’s more; Once you’ve got a handle on really understanding a meltdown and the specifics on what might cause them, it’s important to know how to help the child that does launch into meltdown mode.

    Because, even with all of the understanding in your back pocket, there will still be those moments where a meltdown is inevitable. So, having the resources and tools available to help a child debrief after a meltdown is crucial.

    Debriefing with your child after a meltdown is such an important step for both of you. Having the ability to compose oneself following a meltdown and really understand what might have caused that overload empowers your child so that they can discover their own self-regulation strategies. What an empowering concept, right?

    Not only that, but getting an understanding along with your child of that sensory meltdown gives you both specific strategies and tactics to help overcome those sensory meltdowns the next time they might occur. You can define and discover their triggers. 

    All of this makes sense, right? But if working as a pediatric occupational therapist has taught me anything, it’s that addressing feelings of overwhelm with sensory processing take some time.

    Parents often have questions about sensory meltdowns. Understand sensory meltdowns and resources to help.

    Sensory Questions

    There are so many common questions that parents have about sensory processing and sensory meltdowns. Below are listed some common sensory questions that parents have. Sometimes just knowing you are not alone in your questions and concerns is helpful! So, those questions that oftentimes come up include:

    Parents often times feel overwhelmed or stressed with how to respond to their child’s meltdowns. If this sounds familiar, you might be questioning if your child’s behavior is sensory or if it’s defiant behavior. 

    Parents wonder if the behaviors their child has is a temper tantrum or if it is a response to sensory overload and having a meltdown.

    Many times, parents see meltdowns that seem to come out of nowhere. You can’t seem to figure out what the triggers are. Where do you even start?

    Or, maybe you know your child’s meltdowns are sensory related, but nothing you’ve tried seems to work. You wonder if maybe you’re Googling the wrong things or if there is something you’ve missed.

    Parents often feel like their child is just trying to get attention, and that it’s behavioral rather than sensory related.

    Another question that parents often have is regarding the aggressive behaviors they see from their child. What can cause a child to act out so physically with hitting, spitting, head banging, biting, scratching, and yelling? These actions are physically and emotionally exhausting for both you and your child.

    Still other questions that parents have regarding meltdowns is how to better understand their child and help them feel accepted?

    Parents often wonder how they can better recognize the signs of sensory overload so they can prevent it from happening in the first place.

    A big question parents have is how they can stay calm in the moment when their child is in the midst of a meltdown. How can they help their child without “losing it” themselves.

    Sometimes, just knowing that others have the same questions is so helpful.

    Overcoming Sensory Meltdowns

    If any of these questions sound familiar, I’ve got a resource for you. The thing is that sensory overload is one of the leading causes of sensory meltdowns, but it is far from the only cause. And, actually, there are sound principles that can help children in the midst of a meltdown.

    There are tools you can have in your back pocket so you can address meltdowns when they are happening, and can shorten the duration and intensity of a meltdown. You can even help your child to recognize what’s going on when a sensory meltdown occurs.

    Part of the strategy to get the answers to better understand exactly what’s going on behind meltdowns is to get to the root of the sensory needs.

    This course can help you feel confident and overcome meltdowns with proven sensory integration tips, tools, and strategies to help your student self-regulate and give you both a toolkit of ways to minimize sensory related issues and even catch them before they escalate.

    Sensory Overload Meltdown

    To better understand what’s happening in a sensory overload meltdown, it helps to understand sensory integration.

    This refers to the organization of sensation for use within the brain and body. Our body and sensory systems give information to our brain on the body in the environment.

    The brain organizes all of that information it gets from the sensations. When the sensations flow in a well organized manner, the brain forms all sorts of perceptions, behaviors, and learning can occur. We can participate in the world around us.

    However, there’s more to it. The nervous system operates best at an optimal arousal state. This means that the nervous system is able to attain, maintain, and regulate that information so we can complete meaningful and functional tasks. When the brain is not able to organize the incoming sensory information, it can become too much for the brain and body.

    As a result, we see sensory compensations. The body attempts to compensate for organizing the information in ways that look different, but work for the individual. There may be sensory defensiveness. However, sometimes neurodiverse responses to the information isn’t sustainable and we see overload. This is the sensory meltdown.

    A few tools we have is a school sensory room, or a sensory diet to plan for sensory needs.

    This is a very simplified explanation that explains a sensory overload meltdown.

    Check out the blog comments below to discover common questions about about sensory meltdowns.

    Sensory Meltdown Strategies

    There are many ways to support the individual and their sensory needs before sensory overload and meltdowns occur.

    • Preparing for the event- talking about what is going to happen at the fireworks event or celebration
    • Using noise cancelling headphones or earbuds
    • Sensory diet tools like deep breathing exercises or weighted blankets to regulate and organize sensory needs
    • Sensory chaining techniques
    • Using sensory friendly clothing
    • Earplugs
    • Chewlery
    • Personal space away from crowds

    Would you like to use some strategies designed to offer organizing input? Our sensory strategies resource has some great ideas.

    Free Classroom Sensory Strategies Toolkit

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