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.
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.
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.
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.
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:
Play Connect Four with pieces on one end and the game played on the other end.
Assemble puzzles with pieces on one end and then transported through the tunnel to the other end.
Clothespins attached on end to transport and place on the other end. You can use clothespins with letters to spell words.
Push a large ball or pillow through the tunnel.
Crawl backwards from one end to the other.
Slither through the tunnel (rocking body left and right) to get from one end to the other.
Scoot through the tunnel using hands and feet or even crab walk through the tunnel.
Recall letters, shapes, or words from one end and highlight on paper at the other end.
Recall a series of steps to complete a task at the other end.
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.
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.
Push a car through the tunnel to drive it and park it at the other end.
Build a Lego structure by obtaining blocks at one end of the tunnel and transporting to the other end to build.
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.
Crawl over pillows or cushions placed inside or outside of the tunnel.
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.
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
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.
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.
Create a tunnel by crawling under tables or chairs.
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.
Use large foam connecting mats and assemble a tunnel.
Use tape or yarn and string to alternating walls down a hallway to crawl under.
Use sturdy pieces of foam board positioned or connected together to make a tunnel.
Use an elongated cardboard box. Sometimes you can get large boxes at an appliance, hardware, or retail store.
Stretch a sheet or blanket over furniture and crawl.
Simply place a sheet or blanket on the floor and have child crawl under it (a heavier blanket works well).
Place a therapy mat inside a series of hula hoops.
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.
Sew a fabric tunnel (if you have that skill).
Use pop up clothes hampers connected together after cutting out the bottoms.
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 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!
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.
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.
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.
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.
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:
Analyze/Identify
Strategize
Sensory Diet Template/ Apply Sensory Strategies
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 dysfunctional behaviors are 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.
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.
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!
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.
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
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.
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 muchto the incoming information. One reaction is to avoided it to, remain at baseline.
Under-responsiveness may look like: sensory seekingbehaviors 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
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!
If you have tried everything, and are feeling a bit lost, you are not alone! Sensory dysregulation is tricky. It should be considered alongside many other aspects of why a child reacts a certain way. In addition to behavior, emotions, and self-regulation; history, habits, trauma, and mental status can have a powerful influence on actions, too.
Keep trying – some things may feel like a roadblocks but there are specific action strategies you can use!
The Sensory Lifestyle Handbook walks you through sensory processing information, each step of creating a meaningful and motivating sensory diet, that is guided by the individual’s personal interests and preferences.
The Sensory Lifestyle Handbook is not just about creating a sensory diet to meet sensory processing needs. This handbook is your key to creating an active and thriving lifestyle based on a deep understanding of sensory processing.
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.
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.
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
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.
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.
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.
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.
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.
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.
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.
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.
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
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.
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, dysfunction 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 dysfunctions typically present with other delays. Development of motor coordination, fine motor skills, gross motor skills, social-emotional skills, behaviors, executive functioning skills, language, and learning are all at risk as a result of impaired sensory processing.
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.
red Flags for Tactile Dysfunction
Tactile defensiveness, or tactile dysfunction 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
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
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 Dysfunction
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 dysfunction 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 Dysfunction
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:
Processing and recognition of faces/shapes/motion (the “what” and “where” of objects)
Integration of information in order to coordinate posture and eye movements
Oculomotor adaptation.
Hyper-responsiveness of the visualsense 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 Dysfunction
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 auditorysense 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 Dysfunction
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)
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 Dysfunction
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 olfactorysense 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 Dysfunction
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 interoceptivesense 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?
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.
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.
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 Dysfunction
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 dysfunction.
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.
For a comprehensive look at sensory processing throughout every day activities, try our Sensory Lifestyle Handbook.
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.
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
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.
Intense weather conditions (strong wind, heavy rain)
Sports crowds or pep rallies
Cluttered spaces
Physical constraints (tight spaces, restraint in seats)
Unstructured play areas
Overwhelming choices (large menus, toy options)
High-demand situations (tests, performances)
Interpersonal conflicts
Physical exertion without breaks
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
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.
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.
Would you like to use some strategies designed to offer organizing input? Our sensory strategies resource has some great ideas.
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.
Whether it’s the classroom, home, or day to day life…coping strategies for kids are needed. Coping strategies are mechanisms or tools to adjust and respond to emotions, stressors, and unbalance so that one can function and complete daily occupations, or everyday tasks. Coping tools help to balance and regulate a person. Coping strategies can look different for every individual and that’s why this giant list of coping skills will be powerful in building a toolbox of strategies for kids (or teens and adults!)
the strategies that we’ve shared here are great for adding to a budget sensory room in the school environment, or a calm down corner at home.
What are Coping Strategies
We all need coping strategies! It can be difficult to cope with stress or worries as a child. Most of the time, it can be hard to just figure out what is going on with the mood swings, frustration, behaviors, and lack of focus. Most of these problems can be a result of a multitude of problems!
And, helping kids to understand the size of the problem is part of this because then we can help them know how to cope.
From emotional regulation concerns, to sensory processing issues, to executive functioning struggles, to anxiety, communication issues, or cognitive levels–ALL of the resulting behaviors can benefit from coping strategies.
It’s not just overstimulation anxiety or worries that causes a need for sensory-based coping strategies. Emotional regulation, an unbalanced sense of being, stress, situational or environmental issues…the list of concerns that would benefit from sensory coping tools could go on and on.
Incorporating sensory strategies and sensory play into a coping toolbox can help kids with a multitude of difficulties. Try using some of these ideas in isolation and use others in combination with one or two others. The thing about coping strategies is that one thing might help with issues one time, but not another.
Coping Strategies for Kids
One thing to remember is that every child is vastly different. What helps one child cope may not help another child in the same class or grade. Children struggle with issues and need an answer for their troubles for many different reasons. The underlying issues like auditory processing issues or low frustration tolerance are all part of the extremely complex puzzle.
Other contributions to using coping strategies include a child’s self-regulation, executive functioning skills, self-esteem, emotional regulation, and frustration tolerance. That makes sense, right? It’s all connected!
Coping Skills for Kids meet needs
Coping skills are the tools that a person can use to deal with stressful situations. Coping strategies help a us deal with occupational unbalance, so that we can be flexible and persistent in addressing those needs.
Coping skills in children can be used based on the needs of the individual child. Also, there is a lot to consider about the influence of factors that affect the person’s ability to cope with areas of difficulty. Likewise, feedback from precious coping efforts relates to the efficacy of a coping plan. (Gage, 1992).
Coping skills in kids depends on many things: wellness, self-regulation, emotional development, sensory processing, and more.
Having a set of coping skills benefit children and adults! Every one of us has stress or worries in some manner or another. Children with sensory processing issues, anxiety, or social emotional struggles know the stress of frustration to situations. It’s no surprise that some of these issues like sensory processing disorder and anxiety are linked.
Research on wellness tells us that child well being is dependent on various factors, including parental resources, parental mental health, parental relationship quality, parenting quality, father involvement, family types, and family stability. What’s more is that taking a look at the overall balance in a family and the child can provide understanding into things like stress, frustration, anxiety, and overwhelming feelings. The wellness wheel can help with getting a big picture look at various components of overall well-being.
Coping Flexibility
In fact, studies tell us that coping flexibility may be an important way to investigate coping. Coping flexibility, or an individual’s ability to modify and change coping strategies depending on the context, can be impacted by executive functioning difficulties including flexible thinking, working memory, impulse control, emotional control, and self-monitoring.
And, having more coping strategies in one’s toolbox coping may be an important precursor to coping flexibility, especially because having flexibility in coping abilities can only be obtained if an individual is able to access and use different coping strategies. It’s the chicken or the egg concept!
Another study found that children who used problem solving or constructive communication were better able to manage stress and that those who used maladaptive strategies like suppressing, avoiding or denying their feelings, had higher levels of problems related to stress. It makes sense. The most effective coping strategies are ones that adapting to the stressors rather than trying to change the stressors.
So, how can we help with stress and frustrations? One tool is having a set of sensory coping strategies available to use in these situations.
Types of coping skills
All of this said, we can break down coping skills for kids into different types of coping strategies that can be added to a coping toolbox:
Physical- exercise, movement, brain breaks, heavy work are some examples. Physical coping strategies might include pounding a pillow in frustration, using a fidget toy, running, yoga.
Sensory- While there is a physical component to sensory coping strategies (proprioception and vestibular input are just that: physical movement…and the act of participating in sensory coping strategies involves movement and physical action of the body’s sensory systems) this type of coping tool is separated for it’s uniqueness. Examples include aromatherapy, listening to music, mindfulness (interoception), and sensory play.
Sensory strategies that are motivating can be a big help for some kids. Try these train themed sensory activity ideas to get your creative juices flowing.
Emotional- Thinking about one’s feelings and emotions is the start of emotional regulation and social development. Acting out feelings, talking to a friend or teacher…communication is huge!
These social skills activities are a great way to build awareness of self and others and can double as coping tools too.
Communication- Talking about feelings, talking to others, writing in a journal, singing. Have you ever just had to “vent” your feelings about a situation? That ability to “let it all out” is a way to process a situation and talk through solutions, or find common ground in a situation.
List of Coping skills
1. Move- Get up and run in place, jog, do jumping jacks, or hop in place.
2. Fidget tools in school– Use learning-friendly fidget tools, perfect for the classroom or at-home learning space. Here is one desk fidget tool that kids can use while learning.
3. Talk- Talk about it to a friend, talk to an adult, or talk to a teacher.
4. Snuggle- Grab a big cozy blanket and pile pillows around you to build a fort of comfort! The pressure from the blanket and pillows provides proprioceptive input.
5. Take a bath or hot shower.
6. Blow bubbles. The oral sensory input is organizing.
9. Pound play dough. Try a heavy work dough like this DIY marshmallow proprioception dough.
10. Use a keychain fidget tool. This is a DIY fidget tool that kids can make while building fine motor skills. Attach it to a belt loop, backpack, or even shoe laces for circle time attention.
11. Exercise. This alphabet exercise activities can be helpful in coming up with exercises for kids. Use the printable sheet to spell words, the child’s name, etc. This alphabet slide deck for teletherapy uses the same letter exercises and offers exercises for each letter of the alphabet. Use it in teletherapy or face-to-face sessions or learning.
17. Listen to the sounds of the ocean on a soothing sounds app or sound machine.
18. Count backwards. Try walking in a circle while counting or other movements such as jumping, skipping, or hopping.
19. Drink a cold drink.
20. Drink a smoothie. There are proprioceptive and oral motor benefits to drinking a smoothie through a straw. Here are rainbow smoothie recipes for each color of the rainbow.
21. Squeeze a stuffed animal.
22. Listen to music.
23. Hum a favorite song.
24. Blow bubbles.
25. Chew gum.
27. Tear paper for fine motor benefits and heavy work for the fingers and hands.
28. Smash and jump on ice cubes outdoors. Jumping on ice is a great activity for incorporating prioprioceptive sensory input.
29. Journal. The Impulse Control Journal is an excellent tool for self-awareness and coming up with a game plan that works…and then keeping track of how it all works together in daily tasks.
30. Guided imagery.
31. Think of consequences.
32. Stretch.
33. Go for a walk.
34. Write a story or draw a picture. Sometimes it helps to crumble it up and throw it away!
35. Blow up balloons and then pop them.
36. Take a time out.
37. Animal walks.
38. Imagine the best day ever.
39. Swing on swings.
40. Name 5 positive things about yourself.
41. Draw with sidewalk chalk. Drawing can relieve stress.
43. Add movement- This monster movements slide deck uses a monster theme for core strength, mobility and movement breaks. It’s perfect for teletherapy and using as a coping strategy.
Brain breaks are a powerful and effective way to address regulation needs, help with attention, and impact learning into the classroom or at home as part of distance learning.
The impact of emotions and changes to routines can be big stressors in kids. They are struggling through the day’s activities while sometimes striving to pay attention through sensory processing issues or executive functioning needs. Brain breaks, or movement breaks can be used as part of a sensory diet or in a whole-classroom activity between classroom tasks.
This collection of 11 pages of heavy work activity cards are combined into themed cards so you can add heavy work to everyday play.
Coping strategies for kids printable
Want a printable list of coping tools for kids? This list of coping skills can be printed off and used as a checklist for building a toolbox of strategies.
Get the printable version of this list. It’s free!
Coping strategies can come in handy in many situations:
When saying “calm down” just isn’t enough…
When a child is easily “triggered” and seems to melt down at any sign of loud noises or excitement…
When you need help or a starting point to teach kids self-regulation strategies…
When you are struggling to motivate or redirect a child without causing a meltdown…
When you’re struggling to help kids explore their emotions, develop self-regulation and coping skills, manage and reflect on their emotions, identify their emotions, and more as they grow…
Gage, M. (1992). The Appraisal Model of Coping: An Assessment and Intervention Model for Occupational Therapy, American Journal of Occupational Therapy, 46, 353-362. Retrieved from : oi:10.5014/ajot.46.4.353 on 5-24-27.
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.
If Christmas mindfulness is something you would like to achieve this holiday season, we’ve got a seasonal strategy for you. This deep breaths Christmas tree is a deep breathing exercise that is sure to be a go-to Christmas season mindfulness activity that supports self-regulation needs for kids and families. Use this holiday sensory tool along with our breathing star.
Christmas Mindfulness
This time of year, most of us knee deep in holiday planning, prep work, and to-do lists! Having a few mindfulness for kids tools up your sleeve is a good idea this time of year. Today, I wanted to provide some tips on mindfulness during the holidays.
For our kids with self-regulation needs or emotional regulation challenges that impact learning, emotions, anxiety, or worries, the holiday season can be a time of even more concern.
Over the holidays, school and routines are off. There may be late nights at holiday parties, parents out for work events, unfamiliar family and friends visiting, new sights and sounds. All of this sensory input and environmental input can put a regulation system on overdrive.
Then, in the school environment, there may be school parties, special events, and special themed days. The classroom Christmas party (or winter party) can be cause for sensory overload for some kids. Picture a classroom full of excited children at the end of a semester. The noises, sights, and environmental input can be just too much.
In the community, there is holiday music, crowds, and a sense of excitement in the air. This can be a reason all its own for Christmas mindfulness tools.
Then imagine the child with regulation needs at a family party with unfamiliar guests, a scratchy sweater, strange smells, and lots of noise. A Christmas mindfulness tool that the child can pull out and use to ease worries or stressors can be a great strategy for this time of year.
Kids are barraged by schedule changes, anticipation of holiday events, later bedtimes, holiday travel, parent/teacher stress, increased sugar…and more. They feel these big feelings and can “lose it”, seemingly at the drop of a hat. Children can melt down in front of our eyes. This time of year perhaps especially, there is SO much going on inside those little bodies and minds. Focusing on mindfulness and coping strategies can help.
I mean, think about it this way: We as adults are totally stressed out by deadlines, shopping lists, travel, extended family, holiday budgets, and the never-ending to-do lists.
Think about our kiddos with sensory struggles. They are bombarded by lights and music, hustle and bustle in the grocery store, shopping mall, and even by the neighborhood lights. The later bedtimes and influx of sensory input is a challenge to process for them. It’s overwhelming and exhausting.
Think about our students with praxis or motor issues. There are crowds to navigate, auditorium stages to maneuver and they need to do it FAST. There are schedules to maintain and growing to-do lists!
And that’s just the beginning. All of our kids…no matter what their strengths or needs be…struggle with the change in routines, the adult stress, anticipation, holiday projects, gift giving issues, that extra sugar from holiday sweets, itchy holiday sweaters and scratchy tights, or mom’s stress from holiday traffic.
That “iceberg” of underlying issues and concerns is a holiday version that leads to emotional breakdowns, poor coping skills, and sensory meltdowns.
Now, think about the kiddo with executive functioning challenges. They can’t plan ahead or prioritize tasks when they have a holiday letter to write, a classroom sing-along to practice for, and Grandma’s house to visit next weekend. It’s hard for them to function when their routine is off kilter and anticipation is high.
There are so many benefits to mindfulness, and supporting kids in this way makes a huge impact. Having a few Christmas themed mindfulness strategies on hand could make all the difference when it comes to experiencing all that this season has to offer.
When we think about the holidays from the perspective of a child. Having a set of mindfulness activities for kids is a great way to fill their toolbox with strategies they can use each day.
Essentially, the post urges us to be mindful of the child’s thought process, emotions, and coping strategies this time of year.
Holiday Mindfulness
Below, you’ll find a printable Deep breathing Christmas tree printable that kids can use to support regulation needs. It offers relaxation breathing as a sensory tool.
Print off the sheet and trace along the arrows as the user breathes deeply in and out. This calm and centering visual tracking paired with deep breathing can help the user to focus with mindful breathing.
Mindful breathing is helpful in calming heart rate, easing anxious thoughts, and helping the user to focus on one thought rather than the many thoughts that may be running through their head.
You can even pair the visual Christmas mindfulness breathing tool with visualizations.
Ask the user to visualize a calm space with a lit Christmas tree in a dimly lit room.
Ask the user to visualize a calm space rather than the hustle and bustle that may be happening around them.
Invite the user to imagine deeply breathing in the scent of a Christmas tree and breathing out the same scent as they empty their lungs.
Invite the user to picture the worry and anxiety slowly releasing from their body as they move down the slopes of the Christmas tree.
Pair the deep breathing with thoughts of things that remind you of peace and love (for example) for with each breath.
For each layer of the tree, kids can concentrate on one thing, person, or aspect of the holidays that they are grateful for. Thinking about whatever it is that you are grateful for is a simple way to pair the benefits of slow deep breaths with intentional thoughts.
Then, show the user how to carry over this Christmas mindfulness strategy using a real Christmas tree.
After using the printable Christmas tree deep breathing exercise, they can look at a real Christmas tree and trace the lines of the tree’s sides with their eyes as they breathe in and breathe out.
Ask them to trace an imaginary Christmas tree, or triangle shape on the palm of their hand using the pointer finger of their other hand.
This becomes a Christmas mindfulness tool that they can use any where and any time even without the printable exercise.
Christmas COping Tools
This holiday season, I wanted to fill your toolbox with the tools your little one (or client/student) needs to thrive.
These are the strategies and tips we can use to slow down, take a deep breath, and recognize the underlying issues going on behind behaviors, meltdowns, and frustrations.
Because when you have the tools in place, you have a blueprint for success in the child.
Here are some holiday tools that can help both YOU and a CHILD struggling with all that this time of year brings…
Christmas Mindfulness
This is a coloring page. Use it as a handout or home program. Kids can color it in and work on fine motor skills, too!
Use the Christmas mindfulness handout with kids as a group or individually. You can set this up in several ways. Ask them fist to list out some things they are grateful for. Then, quietly say an item with each breath break.
As a mindfulness group activity, use the Christmas tree graphic and explain that they will be pairing deep breathing with a focus on love or peace. Come up with a list of things the group loves about the holidays. As you work through he deep breathing exercise, the children in the group can focus on things that brings them peace personally.
Or, you could invite the child to think in their head about some things that remind them of the holidays and then with each breath in, they intentionally concentrate on that thing/person/idea.
More Christmas Mindfulness Strategies
Here are more coping tools for kids that focus on addressing underlying needs so that kids can function. Use these strategies as part of a sensory diet or within the day.
The thing about mindfulness is that the tools that support needs will differ for every individual. During the holiday season, there are ways to support mindful needs with the holidays in mind:
All of these are self-regulation strategies with a holiday theme and can be a powerful tool when it comes to supporting emotional and sensory needs during the holidays.
Mindful Christmas
Having a mindful Christmas can mean being aware of stressors or things that add a sense of dysregulation.
During the holiday season, the connection between mindfulness and self-regulation becomes even more crucial, especially for children and therapy providers navigating the potential stress, anxiety, and worries associated with this time. Mindfulness practices offer a valuable toolkit for managing these challenges:
Stress Reduction: The holiday season can bring added stress, but mindfulness provides a means to cultivate a calm and centered state, helping both children and therapy providers navigate and mitigate holiday-related stressors.
Emotional Regulation: Mindfulness practices, tailored for children and therapy providers, become essential tools for recognizing and regulating emotions heightened by holiday-related pressures. This contributes to a more emotionally balanced experience.
Anxiety Management: Mindfulness techniques, such as mindful breathing or guided imagery, can be powerful allies in managing anxiety. They provide a practical and accessible way for children and therapy providers to alleviate anxiety during the holiday hustle.
Worry Coping Strategies: The mindfulness approach of observing thoughts without judgment is particularly helpful in addressing worries. Children and therapy providers can utilize mindfulness to create a mental space to acknowledge concerns and develop effective coping strategies.
Enhanced Focus and Presence: Mindfulness helps maintain focus on the present moment, preventing holiday-related worries from overwhelming the joy of the season. This is especially beneficial for therapy providers supporting children, ensuring they are fully present during sessions.
Cultivating Resilience: Mindfulness fosters resilience by promoting adaptability and acceptance. This quality becomes crucial during the holiday season, where unexpected changes or challenges may arise for both children and therapy providers.
Empathy and Connection: Mindfulness practices that emphasize compassion and empathy contribute to a sense of connection. Therapy providers can incorporate these practices to create a supportive and understanding environment for children navigating holiday stressors.
By integrating mindfulness into therapeutic approaches, therapy providers can empower children with valuable self-regulation tools, fostering a positive and mindful experience during the holiday season. The practices not only address immediate stressors but also contribute to building resilience and coping skills for the long term.
Free printable Christmas Mindfulness Printable
Want to grab our Christmas tree mindfulness deep breathing exercise? Enter your email address into the form below. This printable is also available inside The OT Toolbox Member’s Club. Members can log in and head over to our Mindfulness Toolbox where we have this and other Christmas mindfulness printable exercises.
Print off this Christmas breathing activity and start supporting skills. This Christmas coping skills activity can be used on the go while out and about this holiday season, at a family get together, or during school assemblies for the holiday season.
Wishing you a thriving, stress-free, and functional holiday season for you and those kiddos you serve!
You will also want to grab a copy of our breathing star, which can be paired with our Christmas mindfulness tool.
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.
Looking for done-for you therapy activities this holiday season?
This print-and-go Christmas Therapy Kit includes no-prep, fine motor, gross motor, self-regulation, visual perceptual activities…and much more… to help kids develop functional grasp, dexterity, strength, and endurance. Use fun, Christmas-themed, motor activities so you can help children develop the skills they need.
This 100 page no-prep packet includes everything you need to guide fine motor skills in face-to-face AND virtual learning. You’ll find Christmas-themed activities for hand strength, pinch and grip, dexterity, eye-hand coordination, bilateral coordination, endurance, finger isolation, and more.
Parents of young children may notice sensory red flags, or sensory preferences in their children that bring up a few questions. For parents of toddlers, this can be a gut feeling that milestones may be delayed, regressing, or “off”. Below, we’re covering red flags related to sensory, including toddler behavior red flags that might indicate a need for consultation with a pediatrician. Let’s go deeper…
Sensory red flags can help parents recognize their child’s’ sensory processing issues. These gut feelings can help kids to get the sensory input they need for independence and functioning.
One consideration is overstimulation anxiety. Worrying about the sensory input from different experiences because there are sensory stimulants that impact function is one example of a sensory red flag.
Sensory Red Flags
Sometimes parents just know there is something “off” with their child. That deep, inner gut feeling is what lets us know that there is just something different about the way their child interacts, processes information, or performs in daily tasks.
That ability to recognize gut feelings allows us to know there is an unsuspected ear infection in our toddler or it might be the one red flag that nags at us during sleepless nights that something bigger is going on with our child.
You might have heard it said before: Mom’s always have that gut feeling about their child. Well, sometimes that inner voice can be a loud scream that a child has sensory issues or it can be a quiet nagging sense that there are underlying sensory processing problems.
Below, you’ll find common and more unique “gut feelings” that might indicate a sensory processing problem in children. These are the quieter indications that might make you furl your eyebrows or question a behavior that your child seems to show over and over again.
Use these sensory processing red flags as a way to put the whole picture together for your child. Any one behavior or tendency that shows up with your child may be a meaningless coincidence, however if a child presents with several items on the list below, it may be necessary to speak to your child’s pediatrician.
Use these sensory processing red flags to ease that gut feeling that you have and seek out the information or help that is needed for your child.
Identifying sensory issues can mean there is a need not being meant. These sensory red flags are just some things to consider. One or two items on the list may not mean anything. Seeing many of the red flags listed below may mean that a consultation with your child’s pediatrician is in order.
Sensory Processing Red Flags
Get a free printable checklist version of this list below.
My child has specific behaviors during his/her day.
My child has strange tendencies.
My child seems different in many ways than other children his/her age.
My child has trouble “switching gears”.
My child has trouble with transitions.
My child seems “off” during outings such as the grocery store, church, or doctor’s offices.
My child has trouble in social situations such as holiday get-togethers, birthday parties, or classroom free time.
My child doesn’t seem confident.
My child prefers certain textures, sounds, sights, tastes, scents, positions, or movements.
My child avoids certain textures, sounds, sights, tastes, scents, positions, or movements.
My child doesn’t act like other kids.
My child gets upset by confined spaces.
My child gets upset by certain sounds like lawnmowers.
My child is difficult to calm down at times.
My child wakes up at “full speed” and doesn’t stop all day.
My child can not control the volume of his/her voice.
My child can not stop jumping/spinning/bouncing/crashing.
My child strictly avoids jumping/spinning/bouncing/crashing.
My child is drawn to specific repetitive motions or activities.
My child strictly avoids specific repetitive motions or activities.
My child seems to have a problem that is difficult to pin point.
My child seems to struggle to keep up with other kids.
My child has no fear.
My child has extreme fears.
My child seems withdrawn at times.
My child doesn’t seem to notice details.
My child seems overly preoccupied with details.
My child doesn’t seem to notice when they fall and get hurt.
My child doesn’t notice dangerous situations (age-appropriately).
Do any of these gut feelings sound familiar? There are many red flags on the list above that are conflicting signs of different problems. Not every concern that is noted above will be seen of every child with sensory processing difficulties.
Parents of toddlers are often the first to notice when something seems different or “off” with their child’s behavior. When we refer to toddler behavior, remember that we are referring to the way that the toddler acts or behaves in any given situation.
Toddler Behavior Red Flags
When therapists refer to “behavior” in the context of a toddler’s development or therapy, they are typically talking about the observable actions exhibited by the child in various daily situations. This includes how the child responds to their environment, interacts with others, and manages their emotions and impulses. There is a lot going on in toddlerhood that we can observe!
While it’s essential to remember that children develop at their own pace, there are signs that may prompt parents to seek guidance or evaluation from a healthcare professional.
Here are some common toddler behavior red flags that might be connected to sensory needs and preferences:
No interest in daily functional tasks such as dressing, feeding, etc.
Fearful of stimuli
Repetitively seeks out stimuli
Difficulty managing certain foods or textures
Sensitive to sensory stimuli such as lights, sounds, or textures
Aggression
Behind on several developmental milestones like walking, speaking words, etc.
Delays in language or speech
Frequent meltdowns that are out of proportion for typical toddler development
Little to no gesture use in communicating wants or needs
Regression in previously acquired skills such as self-care, language, or social skills
Self-injury
The parent questionnaire for guardians of toddlers can include some of the sensory red flags listed above, however it is geared toward the typical toddler development that happens in the 1-3 age range. This may be a time when sensory red flags become apparent to parents and guardians.
A parent questionnaire for a toddler well visit, particularly when assessing developmental milestones and potential signs of Autism, may include questions related to various aspects of a child’s behavior, self-care skills, and communication. These could be related to sensory processing needs, which impact functional performance and typical development at this age.
Here are some sample questions that could be included:
1 Communication: Some children with sensory needs may struggle with social skills and communication, which can impact their ability to understand, participate in daily activities, follow self-care instructions, etc. Communication support and social skill development may be necessary. Being aware of these milestones is important.
Is your child using words to communicate their needs and desires?
Can your child follow simple instructions, such as “give me the ball” or “come here”?
Does your child make eye contact when interacting with others?
How often does your child engage in babbling or attempts to speak?
2. Social Interaction: Social skills and sensory red flags go hand in hand. For more information, check out our social skills checklist.
Does your child show interest in playing with other children or adults?
Does your child respond to their name when called?
Is your child able to imitate simple gestures or actions, like waving goodbye?
How does your child react to new people or unfamiliar situations?
3. Behavioral Concerns: For some, activities like rocking, hand-flapping, or spinning objects may provide a calming or organizing sensory input. Noticing these behavioral habits can be a predictor of sensory needs.
Are there any repetitive behaviors or unusual movements that you’ve observed in your child?
Does your child have intense reactions to sensory stimuli (e.g., lights, sounds, textures)?
How does your child handle transitions or changes in routine?
Are there any specific fears or phobias that your child exhibits?
4. Self-Care Skills: Taking a look at age-appropriate self care skills in children, (or the ability to complete functional tasks like dressing, potty training, feeding, etc.) is important because at the toddler age, there should be an interest in “doing things myself” or becoming more self-sufficient. A sensory red flag may mean that there sensory sensitivities and preferences that impact the child’s ability to notice or perform age-appropriate self-care tasks independently.
Is your child showing interest in self-care tasks like dressing themselves, feeding, or potty training?
How well is your child able to use utensils and drink from a cup?
Can your child independently perform basic self-care tasks, such as washing hands or brushing teeth?
5. Play and Imagination: Play is the work of the child but when sensory needs predominate, play can seem habitual or repetitive as a means to support sensory preferences. This can offer a sense of predictability and comfort to some children. Noticing these play preferences may convey their needs, sensory preferences, or discomfort.
Does your child engage in imaginative play, such as pretending to cook, play house, or use toys to represent real-life scenarios?
Is your child interested in a variety of toys and activities appropriate for their age?
How does your child explore their environment and play with objects?
6. Sleep Patterns: Sleep hygiene impacts functional performance of the whole family and sometimes during the Toddler years, we see a change in these habits, possibly related to sensory needs.
What is your child’s sleep routine like? How many hours does your child sleep at night?
Does your child have difficulty falling asleep or staying asleep?
What is your child’s typical diet like? Are there any aversions or strong preferences?
Is your child able to self-feed with utensils, or are they still primarily using their hands?
8. Safety Concerns- Do “sensory” considerations seem to impact direction following, the child running off in a crowded space, not listening about touching the stove or outlets, seeming to seek out unsafe situations, or other safety aspects?
Are there any safety concerns or behaviors that you find challenging to manage?
Does your child engage in any repetitive or potentially harmful behaviors?
It’s important to remember that these questions serve as a screening tool and not a diagnostic tool. If parents have concerns about their child’s development or behavior, they should discuss them with their healthcare provider for a thorough evaluation and appropriate guidance. This may be part of an indicator for exploring early intervention for Autism or other developmental needs.
Every child is different, but the concerns noted above will be indications to seek out more information and issues that should be brought up to your child’s pediatrician.
Be sure to check out our resource, our sensory processing disorder chart, to better understand how differences impact kids in different ways.
Get a free printable checklist version of our sensory red flags checklist below.
You may also be interested in the free printable packet, The Classroom Sensory Strategy Toolkit.
The Classroom Sensory Strategy Toolkit is a printable packet of resources and handouts that can be used by teachers, parents, and therapists. Whether you are looking for a handout to explain sensory strategies, or a tool for advocating for your child, the Classroom Sensory Strategy Toolkit has got you covered.
And it’s free for you to print off and use again and again.
In the Classroom Sensory Strategy Toolkit, you’ll find:
Fidgeting Tools for the Classroom
Adapted Seating Strategies for the Classroom
Self-Regulation in the Classroom
105 Calm-down Strategies for the Classroom
Chewing Tools for Classroom Needs
45 Organizing Tools for Classroom Needs
Indoor Recess Sensory Diet Cards
red flags checklist
Print off a copy of our Sensory Red Flags checklist. This printable tool can be a helpful resource when it comes to noticing and identifying sensory considerations that impact day to day functional performance.
To get the printable, enter your email address into the form below. You will receive a handout via email.
As always, if you suspect an area of need, consult with your child’s physician for individualized information and recommendations. This sensory red flags checklist and the toddler red flags list in this blog post is for informational and educational purposes only.
This red flags checklist is also available inside our Membership Club, along with all of the printable downloads available on The OT Toolbox website. Level 2 members can also access over 1500+ resources, sensory activities, handouts, ebooks, and much more.
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.
For more information on sensory processing, development, and how to incorporate sensory needs and preferences into daily life, check out our ebook, 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.