sensory

April Occupational Therapy Calendar

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April OT calendar

If you are looking for OT activities for the month, then you are in luck with this April occupational therapy calendar! April is occupational therapy month and here, you’ll find an Occupational Therapy calendar for your therapy planning.

April occupational therapy calendar for planning OT sessions

April Occupational Therapy Calendar

Not only will you find a great calendar of activities for OT sessions, but we’ve included other therapy ideas and activities for OT month, and all of Spring!

I have a HUGE resource for you that will carry you throughout the rest of Spring with treatment ideas and activities that are designed to meet the needs of many common goal areas.  This resource is perfect for planning a month or a season of therapeutic activities for kids.

If you’ve seen the last few months’ calendars (Check them out, if you missed them: January, February, & March), then you will see that this month’s calendar is just a bit different.  

Other Spring-related activities that will go well with this activities calendar include:

I’ve found that I completely love coming up with themed activities that are designed to address many needs of children receiving (or who need to receive) Occupational Therapy services.  I’m enjoying this monthly calendar so much that I decided to take it a bit further.


For April’s calendar, I decided to provide MORE ideas, more ways to develop necessary skills, and more ways to cover many more systems of development. 


This month’s calendar is essentially going to rock your OT kiddo’s socks!

April occupational therapy calendar for therapy planning


Activities based on the Pyramid of Learning

This month, I’ve decided to create a huge resource for your OT treatment activity ideas.  

Each month’s calendar is such a valuable resource of OT ideas, and this month is no different, except that it has a TON more ideas to address many areas of deficits that typically present in kids receiving OT services.  I’ve got Spring themed activities that can be modified to meet the needs of your child.   

Williams & Shellenberger Pyramid of Learning

Each activity in this month’s OT calendar takes into account, the Williams and Shellenberger Pyramid of Learning.  

The activities are designed so that they allow for proper sensory experiences in order to adjust for the child’s needs and presenting areas of difficulty.

Based on the Pyramid of Learning, the activities are designed to meet the foundations of sensory needs in order to work on higher tasks that present as difficulties in functional skills.  

The pyramid uses a triangle illustration to depict the central nervous system at the base of sensory systems as a support and underlying tier to sensory motor skills, perceptual motor skills, and cognition.

Using the visual of the pyramid of learning in activity development, we can see how integration of the sensory systems as a part of the CNS impact development, functioning, and intellect.

Let’s take a closer look at the pyramid of learning before exploring how the activities in our April calendar cover these areas.

Base of the Pyramid of Learning

The base of the pyramid is the Central Nervous System. Above that is the second tier, which identifies the body’s sensory systems. These systems include:

  • Tactile (touch)
  • Vestibular (balance)
  • Proprioception (knowing where their bodies are in space)

Note that these three are at the base of they other sensory systems. This is an important concept covered in our book, Sensory Lifestyle Handbook.

Then comes the other sensory systems:

  • Olfactory (smell)
  • Visual (vision)
  • Auditory (hearing)
  • Gustatory (taste)

Sensory Motor Development Tier of the Pyramid of Learning

Next is the sensory motor development level. This area includes body awareness, reflex maturity, sensory screening abilities, postural stability, bilateral integration, motor planning.

These areas of development are closely related to the sensory systems. They are also essential to functional participation in essentially every functional task we perform throughout the day.

Note that there are three areas of sensory motor development on the base of this tier:

  • Postural security (confidence in maintaining certain postures to prevent falling)
  • Awareness of two sides of the body (bilateral integration)
  • Motor planning (ability to plan their movement)

Then, above those three areas are three more areas of sensory motor development. This relationship is also discussed in our book, The Sensory Lifestyle Handbook.

  • Body scheme (body awareness through movement)
  • Reflex maturity (having developed reflexes, for safety purposes)
  • Ability to screen input (knowing what sensory experiences are important to pay more attention to)

Perceptual Motor Development Tier of the Pyramid of Learning

Above the sensory motor level is the perceptual motor development tier. Perceptual motor skills rely and build on sensory motor abilities. These skill areas are smaller and more distally presented in relation to the internal systems. While built heavily on the sensory systems and motor abilities, these areas allow us to take in information about the world around us. It allows us to use that information to move and perceive what is happening in our world.

This connection is essential to function and occupational performance.

This is easy to conceptualize when you think about the areas that make up this level:

  • Eye-hand coordination (when they use what they see to guide the movement of their hands)
  • Ocular motor control (locating and fixating on something in their environment)
  • Postural adjustment (adjusting their posture to maintain balance)

Then above those three areas of motor control areas are three additional perceptual motor skill areas of development:

  • Auditory language skills (hearing and speaking appropriately)
  • Visual-spatial perception (identifying what is seen in space)
  • Attention center functions (maintaining attention to tasks)

Cognition Intellect Tier on the Pyramid of Learning

At the top of the pyramid of learning stands the cognition or intellect tier. This area begins with daily living skills and behaviour at the base of the top tier, followed by academic learning.

  • Daily living activities (such as eating, toileting, bathing)
  • Behavior
  • Academic learning

What does the pyramid of learning tell us?

The very clear visual graphic of a pyramid shows us exactly how cognitive and learning abilities are based on sensory, motor, and perceptual development. These underlying areas are essential to functioning, behaviors, or the way we act and behave in any given situation, and learning.

In order to move and participate in functional tasks, development in bilateral coordination, motor planning, and vision, proprioception, and tactile systems is necessary. In order to learn, auditory language development, oculomotor skills, the ability to screen input, and vestibular, visual, auditory, and proprioceptive input is necessary.

Every functional task could be filtered down to identify underlying areas that impact one’s ability to perform specific tasks. And the entire pyramid builds upon itself, so that each task includes all of the skills and developmental areas under it as a whole pyramid.

April Activities Based on Underlying Skill Areas

And what I like best about this month’s calendar, is that the activities can be adapted in several different ways so that the resource calendar can be used over and over again in coming months.

You’ll find many ideas in our Spring occupational therapy activities post.

When you combine the calendar with the Spring Occupational Therapy Activities booklet, you’ll discover many ways to add movement, sensory movement, perceptual movement, and learning to Spring-themed activities.

In fact, there are 109 activities in this book using all of the combinations of activities.  

This month’s calendar is a little different that the last few calendars.  I’m including a schedule of sensory activities but it does not include specifics to perform each day’s task.  

You’ll need the Spring Occupational Therapy Activities ebook in order to complete each day’s activity.  You will be guided through sensory activities that meet many different goal areas.    

This ebook will carry you through the next few months as you work on each task and it’s breakdown of variant activities.    It’s all included in the ebook:  

Spring Occupational Therapy activities booklet
Spring Occupational Therapy Activities booklet

Get your guide to the this Spring’s Occupational Therapy activities today!  Use it all Spring long as you go through each task outlined in the book.

April Occupational Therapy calendar of activities

You will be able to grab the printable calendar by entering your email address into the form at the bottom of this post.

  1. Subscribe to our newsletter and grab your April calendar. It’s free!
  2. Buy the Spring Occupational Therapy Activities ebook.
  3. Play your way through the next few months with Spring-y activities that are broken down into several different goal areas.

FREE April OT Activity Calendar

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    April Occupational Therapy Activities for Home Carryover

    The month of April is a meaningful time to highlight the occupational therapy profession and the impact it has on helping individuals participate in everyday life. Recognized by the American Occupational Therapy Association (AOTA), this month celebrates how occupational therapy practitioners support people in building skills for independent lives through engagement in meaningful daily activities.

    For parents and caregivers, April is the perfect opportunity to bring occupational therapy activities into the home. Simple, intentional activities can reinforce skills children are working on in therapy sessions and help support carryover in real-life situations.

    Why Home Carryover Matters in Occupational Therapy

    One of the most important parts of occupational therapy is helping children apply skills outside of therapy sessions. Practicing activities at home allows children to build consistency, confidence, and independence in natural environments.

    Occupational therapy activities at home can support:

    • Fine motor skills (writing, cutting, dressing)
    • Sensory processing and regulation
    • Coordination and motor planning
    • Executive functioning and routines

    When families are involved, children are more likely to generalize skills into their daily routines.

    Easy Occupational Therapy Activities to Try at Home

    Here are simple, effective activities families can use to support development at home:

    Fine Motor Activities

    • Use tongs or clothespins during snack time
    • Practice buttoning, zipping, and dressing skills
    • Build with small blocks or beads

    Sensory Activities

    • Create sensory bins with rice, beans, or sand
    • Use movement breaks like jumping or animal walks
    • Try calming strategies like deep breathing or heavy work

    Daily Living Skills

    • Help set the table
    • Practice pouring drinks or preparing snacks
    • Organize toys or personal items

    These types of activities naturally support the goals addressed in occupational therapy sessions.

    Celebrating Occupational Therapy in April

    Throughout April, the occupational therapy community celebrates the work of therapists, assistants, and families who support participation and independence. Events such as the AOTA annual conference and professional gatherings like an expo highlight new ideas, research, and strategies that support best practices in the field.

    The work of occupational therapy extends far beyond the clinic. It impacts homes, schools, and communities every day.

    Sharing Occupational Therapy Ideas on Social Media

    April is also a great time to share ideas and inspiration on social media. Parents, teachers, and therapists can highlight meaningful activities, success stories, and simple strategies that support development.

    Using hashtags like:

    • #occupationaltherapy
    • #OTmonth
    • #OTactivities
    • #pediatricOT

    can help connect with others and spread awareness about the value of occupational therapy.

    Supporting Caregivers and Families

    Occupational therapy is most effective when it includes collaboration with caregivers. By sharing simple activities and strategies, therapists empower families to support their child’s development in everyday routines.

    Even small changes, like adding a fine motor task during play or incorporating movement into transitions, can have a big impact over time.

    Bringing OT Into Everyday Life

    The goal of occupational therapy is to help children participate fully in their daily lives. By incorporating simple activities at home, families can support skill development in a natural, meaningful way.

    April is the perfect time to reflect on how occupational therapy supports growth, independence, and participation, and to take small steps toward building those skills every day.

    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.

    DIY Light Box for Tracing

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    Child tracing letters with a pen on a light table. Text reads DIY light table for tracing

    This DIY light box for tracing is an easy light box we put together in minutes. All you need is an under the bed storage container and a string of lights to make a tracing tool that kids will love. There are benefits to tracing and this tool is a fun way to build fine motor skills and visual motor skills as a visual motor skill leading to better handwriting.

    Amazon affiliate links are included in this blog post. As an Amazon Influencer, I earn from qualifying purchases.

    DIY Light Box for Kids

    A DIY light box is a simple and effective tool that can be used for learning, play, and creativity. Light boxes provide a bright surface that makes it easier to see lines, shapes, and images for tracing or visual exploration. You can easily create a light box at home using materials like a plastic storage bin, LED lights, and a translucent lid.

    This type of setup is especially helpful for kids because it makes activities more engaging and visually clear. A homemade light box can be used for tracing, drawing, sensory play, and even early writing activities.

    DIY Light Box for Tracing

    A DIY light box for tracing is perfect for helping children practice handwriting, drawing, and visual motor skills. The light shining through the surface allows kids to clearly see letters, shapes, or pictures placed underneath a sheet of paper.

    This makes it easier for children to trace lines accurately, which supports motor planning and control. A DIY tracing box can be used for tracing alphabet letters, numbers, shapes, and simple drawings. It is a great tool for kids who are just beginning to learn how to write or who need extra visual support.

    Sensory Light Box and Tracing Table Ideas

    A sensory light box adds an extra layer of engagement by combining visual input with hands-on exploration. Kids can place different materials on the light surface, such as colored shapes, beads, or translucent objects, to explore how light changes the appearance of items.

    You can also use your light box as a tracing table by placing worksheets or drawings underneath paper. This creates a bright, inviting workspace that encourages focus and creativity. Sensory light boxes are especially helpful for children who benefit from visual and tactile learning experiences.

    Can You Make Your Own Light Box?

    Yes, you can absolutely make your own light box at home with simple materials. Many DIY versions use:

    • A clear or translucent storage bin
    • LED strip lights or push lights. You can also use a tablet or studio lights (a video ring light found at many stores)
    • Wax paper or parchment paper (to diffuse light)
    • A flat surface lid

    By placing lights inside the bin and covering the top with a translucent surface, you can create an affordable and functional light box. This DIY option works well for home use, classrooms, or therapy settings.

    Can I Use My iPad as a Light Box?

    Yes, an iPad or tablet can be used as a simple light box alternative. By increasing the brightness and displaying a white screen, the tablet can provide enough light for basic tracing activities.

    However, there are some limitations. Tablets are smaller than most light boxes and may not provide as much working space. They are also more delicate, so supervision is important. A tablet can be a convenient option for quick tracing tasks, while a DIY light box offers a larger and more durable surface for regular use.

    Reduce glare by upping the brightness when placing the tablet inside the plastic bin.

    Specific Tracing Activity Ideas

    Using a DIY light box for tracing opens up many opportunities for learning and skill development. Here are some beginner-friendly tracing ideas that parents, teachers, and therapists can start using right away:

    Letter Tracing

    Place alphabet worksheets under paper and have children trace uppercase and lowercase letters. This supports handwriting development and letter recognition.

    Shape Tracing

    Use simple shapes like circles, squares, triangles, and stars. This helps build pre-writing skills and visual motor coordination.

    Name Tracing

    Write a child’s name in large letters and have them trace over it. This is a motivating way to practice writing.

    Picture Tracing

    Trace simple pictures such as animals, vehicles, or objects. This supports creativity and drawing skills. Make sure you use white paper to see the objects.

    Line and Pattern Tracing

    Use straight lines, zig-zags, curves, and waves to build control and precision needed for writing.

    Number Tracing

    Practice forming numbers by tracing over large, clear models.

    Themed Tracing Pages

    Create seasonal or themed tracing sheets (weather, holidays, animals) to keep activities engaging.

    Why Use a DIY Tracing Box?

    A DIY tracing box makes learning more interactive and accessible. The light helps children see lines more clearly, which can reduce frustration and improve accuracy. This tool supports fine motor skills, visual tracking, and hand-eye coordination while making writing practice feel more like play.

    DIY light box for tracing

    A light box is a fun activity, and one you see in preschool classrooms, as it’s intended for hands-on play and exploring the senses. But did you know there are many benefits to using a light box for tracing (and other exploring play)?

    How to Make a DIY Light Table for Tracing

    This DIY Light Box was something I’ve seen around Pinterest and have wanted to try for a while…Once we had our Christmas lights outside, I thought we would definitely be doing this project after we pulled all of the lights back in.  So, after we brought the Christmas lights in from the outside bushes, this was easy to put together for a cold evening’s play!

    You need just two items to make a DIY light table:

    (Amazon affiliate links)

    1. Strand of white Christmas lights
    2. Clear, plastic under-the-bed storage bin

    Important: The under the bed storage bin needs to be made of clear plastic or have just a slight opaque color to the plastic. Also, the top should be smooth. Many storage bins have textured surface or a white surface. The flat, smooth lid is important for sensory play as well as tracing with paper on the DIY light table. This brand (affiliate link) is a good one to use.

    Instructions to make a DIY light box:

    1. Plug in the lights.
    2. Place them into the bin.
    3. Either cut a hole in the base of the bin for the lights to go through or cut a small notch into the lid so the strand of lights can go under the lid.

    To make this homemade light box safer and not use plug in lights, you can use battery operated button lights (affiliate link) inside the storage bin. Or, there are many battery operated LED lights available now too. These are a great idea because many of them have a color-changing capability and can be operated from an app on your phone.

    IMPORTANT: This homemade light box project should always be done under the supervision of an adult. The lights can get warm inside the bin and they should be unplugged periodically.

    This is not a project that should be set up and forgotten about. The OT Toolbox is not responsible for any harm, injury, or situation caused by this activity. It is for educational purposes only. Always use caution and consider the environment and individualized situation, including with this activity. Your use of this idea is your acceptance of this disclaimer.

    I put all of the (already bundled-up) strands of Christmas lights …seriously, this does not get much easier…into an under-the-bed storage bin, connected the strands, and plugged in!

     

    DIY light box for tracing

    A DIY light box made with Christmas lights
     

    Once you put the top on, it is perfect for tracing pictures!
     
    Tracing on a DIY light box
     
     

    Tracing pictures on a light table

     
    This is so great for new (or seasoned) hand-writers.  They are working on pencil control, line awareness, hand-eye coordination…and end up with a super cool horse picture they can be proud of!
     
    Use printable coloring pages and encourage bilateral coordination to hold the paper down. You can modify the activity by taping the coloring page onto the plastic bin lid. 
     
    Tracing a picture on a DIY light table
     
     Big Sister LOOOOVED doing this!  And, I have to say, that she was doing the tracing thing for so long, that we had to turn the lights off because the bin was getting warm. 
     
     
     
    trace letters on a light table
     

    Other ways to use a DIY Light Table

     
    We went around the house looking for cool things to place on top of the bin.  Magnetic letters looked really neat with the light glowing through…Baby Girl had a lot of fun playing with this.
     
    You can add many different items onto the DIY light table:
    • Magnetic letters (the light shines through them slightly)
    • Sand for a tracing table- We cover how to use a sand writing tray in another blog post and all the benefits of tracing in a sensory medium. With the lights under the tracing area, this adds another multisensory component to the learning.
    • Shapes (Magnatiles would work well)
    • Feathers
    • Coins
    • Blocks
    • A marble run
     
    letters on a light table
     
    What a great learning tool…Shapes:
     
     
    Letter Identification, spelling words:
     

     Color and sensory discrimination:
     
     
     
    …All in a new and fun manner!  We had a lot of fun with this, but have since put our Christmas lights back up into the attic.  We will be sure to do this one again next year, once the lights come back out again 🙂
     

    Please: if you do make one of these light boxes, keep an adult eye on it, as the box did warm up…not to burning warmth, but I would worry about the lights becoming over heated.  This is NOT something that kids should play with unsupervised!

    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.

    Working on fine motor skills, visual perception, visual motor skills, sensory tolerance, handwriting, or scissor skills? Our Fine Motor Kits cover all of these areas and more.

    Check out the seasonal Fine Motor Kits that kids love:

    Letters Fine Motor Kit
    Kit de motricidad fina de verano
    Summer Fine Motor Kit
    Outer Space Fine Motor Kit
    Space Fine Motor Kit
    Spring fine motor kit
    Valentines Day fine motor kit
    winter fine motor kit
    Winter Fine Motor Kit

    Or, grab one of our themed Fine Motor Kits to target skills with fun themes:

    Want access to all of these kits…and more being added each month? Join The OT Toolbox Member’s Club!

    Tactile Defensiveness

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    Tactile defensiveness and what you need to know about tactile sensitivities

    Today, I have an update on a very old blog post for a specific reason. This fake snow messy sensory play activity is a valuable tool in addressing tactile defensiveness, or tactile sensitivity. In general descriptions, this simply means an over-sensitivity to touch, or over-responsiveness to touch sensations. For kids with sensory issues, this can be a very big deal. Tactile defensiveness can mean poor tolerance to certain clothing, textures, food sensitivities, closeness of others, wearing socks or the feel of seams or clothing. Sensitivity to these touch sensations can look like many different things! Today we are discussing all about tactile sensitivity, what that looks like in children, and a sensory challenge that can be used for tactile sensitivity.

    If you are looking for more information on sensory processing, start here with our free sensory processing information booklet.

    tactile sensitivity sensory challenge with fake snow

    What is Tactile Defensiveness

    I briefly explained the meaning of tactile defensiveness above, but let’s break this down further.

    The tactile system is one of our 8 sensory systems: touch, taste, smell, sight, hearing, proprioception, vestibular, and interoception. The sense of touch is a very big piece of the whole picture.

    The Tactile Sensory System is one of the earliest developed senses of the body, with studies telling us this sensory system begins to develop at around 8 weeks in utero. The sense of touch completes its development at around 30 weeks in utero when pain, temperature, and pressure sensations are developed.

    Understanding Tactile Defensiveness

    Tactile defensiveness is often discussed within the broader concept of sensory modulation, which refers to how the nervous system organizes and responds to sensory information.

    In some individuals, the nervous system reacts more intensely to everyday sensations than expected. This pattern is often described in the research literature as sensory over-responsivity, a type of sensory modulation difficulty in which reactions to sensory input may be stronger, last longer, or feel overwhelming compared to what the situation typically requires.

    It is important to understand that this is not simply a matter of a child noticing sensations more easily than others. Current understanding suggests that the nervous system itself is responding with a heightened emotional, physiological, and behavioral reaction to certain stimuli.

    In other words, the child is not choosing to overreact; their nervous system is reacting in a way that signals discomfort or threat.

    Some clinicians and organizations have begun using the term heightened sensory responsivity when discussing these patterns. This language reflects a shift toward more respectful and person-centered terminology. While the research base still frequently uses the term sensory over-responsivity, both phrases are generally referring to the same nervous system pattern, an amplified response to sensory input.

    What Is Tactile Defensiveness?

    When this heightened response occurs specifically in reaction to touch, it is commonly referred to as tactile defensiveness. Children who experience tactile defensiveness may react strongly to everyday sensations that others barely notice. Clothing seams, tags, certain fabrics, unexpected touch, or messy textures may trigger discomfort or distress.

    The word “defensiveness” is helpful because it reflects what the child’s nervous system is doing. Instead of interpreting touch as neutral or pleasant information, the brain may interpret it as something that needs to be protected against. The body then moves into a defensive response, which can look like pulling away, avoiding certain clothing, refusing messy play, or becoming upset when touched unexpectedly.

    How the Nervous System Contributes

    The tactile system plays an important role in helping the brain determine whether touch is safe, alerting, or potentially threatening. For some children, this system sends signals that lead the brain to respond quickly and intensely to certain types of touch. As a result, everyday sensory experiences, such as getting dressed, standing in line, or participating in art activities, can become challenging.

    When the nervous system reacts in this way, children may appear sensitive to textures, avoid certain fabrics, dislike grooming routines, or become distressed when their skin is touched unexpectedly. These responses are not simply behavioral choices; they reflect how the child’s nervous system is processing sensory input.

    Types of touch

    The skin performs unique duties for the body, based on different types of touch input, and tactile sensitivity can be considered to occur in the various aspects of touch. These types of touch include: light touch, pressure, discrimitive touch, pain, temperature.

    Most importantly for our ancient ancestors, especially, the skin protects and alerts us to danger and discriminates sensation with regard to location and identification. This is important because touch sensations alerts us to both discrimination and danger. These two levels of sensation work together yet are distinctively important. And furthermore, the skin is the largest and the most prevalent organ.


    Touch discrimination- Discrimination of touch allows us to sense where on our body and what is touching us. With discrimination, we are able to
    discern a fly that lands on our arm. We are able to sense and use our fingertips in fine motor tasks. We are able to touch and discern temperatures, vibrations, mount of pressure, and textures and shapes of objects.

    Danger perception– The second level of the tactile system alerts us to danger. It allows us to jump in response to the “fight or flight” response
    when we perceive a spider crawling on our arm. With this aspect of touch, we are able to discern temperature to ensure skin isn’t too hot or cold. We can quickly identify this temperature or sharpness of an object and quickly move away to avoid burning, freezing, or sharp objects.

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

    Sensitivity to touch can mean over responding to touch input in the form of textures, temperatures, or pressure. Touch sensitivities mean that the body perceives input as “too much” in a dangerous way. The touch receptors that perceive input are prioritized because the brain believes we are in danger. The body moves into a state of defensiveness, or safe-mode in order to stay safe from this perceived danger. This is tactile defensiveness.

    What does Tactile Defensiveness looks like?

    Hyper-responsiveness of the tactile sense may include a variety of things:

    • Overly sensitivity to temperature including air, food, water, or
    • objects
    • Withdrawing when touched
    • Avoids certain food clothing textures or fabrics
    • Dislikes wearing pants or restrictive clothing around the legs
    • Refusing certain foods due to food texture issues
    • Dislike of having face or hair washed
    • Dislikes hair cuts
    • Dislikes having fingernails cut
    • Dislike seams in clothing
    • Excessively ticklish
    • Avoidance to messy play or getting one’s hands dirty
    • Avoidance of finger painting, dirt, sand, bare feet on grass, etc.
    • Avoids touching certain textures
    • Clothing preferences and avoidances such as resisting shoes
    • Resistance to nail clipping, face washing
    • Resists haircuts, hair brushing
    • Dislikes or resists teeth brushing
    • Overreacts to accidental or surprising light touches from
    • others
    • Avoids affectionate touch such as hugs
    • Dislikes closeness of other people

    As a result of this avoidance, development in certain areas can be delayed, in a way that functional performance of daily tasks is impacted. What you see in as a result of a poorly integrated tactile sensory system:

    • Delayed fine motor skills
    • Rigid clothing preferences
    • Behavioral responses to tasks such as putting on shoes or coat
    • Impaired personal boundaries
    • Avoids tactile sensory activities
    • Poor body scheme
    • Difficulty with praxis
    • Poor hand skill development

    More information on sensory processing of each of the sensory systems and how that impacts daily life can be found in The Sensory Lifestyle Handbook. You’ll also find practical strategies for integrating sensory diets into each part of every day life, in motivating and meaningful ways. Check out The Sensory Lifestyle Handbook for moving from sensory dysfunction to sensory function!

    Supporting Children with Tactile Sensitivities

    Understanding tactile defensiveness as a nervous system response helps shift the focus from correcting behavior to supporting regulation. When adults recognize that a child’s reaction is rooted in sensory processing, they can begin to create supportive strategies that gradually build tolerance and comfort with different tactile experiences.

    Occupational therapy approaches often include providing predictable sensory experiences, respecting the child’s comfort level, and introducing new textures in ways that feel safe and controlled. Over time, this supportive approach helps the nervous system learn that touch can be experienced without triggering a defensive response.

    Recognizing tactile defensiveness through this lens helps parents, educators, and therapists respond with understanding, empathy, and effective support strategies that promote participation in daily activities.

    How to help with tactile sensitivity

    There are ways to help address these areas, so that the child is safe and can function and perform tasks in their daily life. While addressing tactile sensitivities doesn’t mean changing the child’s preferences, it can mean understanding what is going on, what the child does and does not prefer in the way of sensory processing, and it can mean providing tools and resources to help the child.

    This should involve an occupational therapist who can take a look at sensory processing and integration and make specific recommendations.

    Some strategies that can impact tactile sensitivity include:

    • Understanding the child’s sensory systems, and integration in the daily life of the child. Grab the Sensory Lifestyle Handbook to read more on sensory diets that are meaningful and motivating. These are sensory activities that can be integrated right into tasks like baths, tooth brushing, hair brushing, dentist visits, clothing changes, etc.
    • Take a look at clothing sensitivity red flags for areas of sensitivity to clothing that stand out for the individual child.
    • Read more on proprioception and the connection of heavy work input as a calming and regulatory tool for sensitivities.
    • Work on touch discrimination with activities at the level of the child.
    • Provide verbal input to warn the child prior to light touch
    • Provide visual cues and schedules for tasks that must be completed such as tooth brushing or hair brushing.
    • Trial tactile experiences at a graded level, introducing various sensory experiences in a “safe space” at a just right level for the child.

    Tactile Defensiveness Sensory Activity

    That’s where this messy sensory play activity comes in. By taking out the “messy” part of this sensory experience, children who dislike messy play or touching certain textures can explore the sensory activity and challenge tactile exposure. In this way, they are experiencing a new and novel texture (temperature and squishy, messy experiences), but at a safe level, or “just right” level for them.

    This snow sensory play activity has the opportunity for tactile challenges, but it uses a plastic bag to contain the actual mess, allowing for a mess-free sensory experience, at different grades of texture exposure.

    Fake snow for sensory play

    Fake Snow Recipe

    We made fake snow one recent weekend, when we had a big cousin sleep over.  There were six kids aged five and under staying overnight at our house.  I had this activity planned for us to do together, (because I procrastinated ) and had to get it together to take to a Winter Festival at our church the next day.  It was a fun messy play idea for indoor snow.

    We’ve made this fake snow before and I have the recipe listed on our Messy Play Day post.  

    This fake snow is easy, because it includes only 2 ingredients:

    • Toilet paper
    • Ivory soap

    With these two ingredients, there are many opportunities for tactile sensitivity challenges, and each child can experience sensory exploration at a level that suits their preferences. Some children may enjoy experiencing the dry texture of the toilet paper. (See the kids below…they sure enjoyed this texture.)

    Other children may prefer (or avoid) the tactile experience of touching and manipulating the squishy, warm soap texture.

    Others may tolerate mixing the two textures together.

    Still others, may prefer none of these textures. In this case, move to the last level of this tactile experience, which is placing the fake snow into the plastic baggie. Then, they can squeeze and touch the sensory fake snow with a barrier in place. they will still experience the warm temperature and firm, heavy work of squeezing through their hands, but they will experience this sensory input in a “safe” level with that plastic bag barrier.

    Fake Snow Dry sensory Bin

    Step 1: Tear the toilet paper into shreds. Keep this in a bin or large container. We used an under-the bed storage bin because I was making a large quantity of fake snow for our Winter Festival.

    We shredded the toilet paper and the kids had a BLAST! It started out so neat and kind.  Tearing the toilet paper is a fantastic fine motor activity for those hands, too. It offers heavy work input through the hands which can have a regulating, calming impact on the joints of the hands. This can be a nice “warm up” exercise for the tactile challenge of exploring and manipulating the dry toilet paper texture.

    For kids with tactile sensitivities, this might be “too much” for them to handle. Try using tongs and ask them to explore the toilet paper shredding sensory bin to find hidden items. Some of the paper cards and winter words in our Winter Fine Motor Kit are great additions to this sensory bin.

    How to make fake snow using toilet paper for a fun sensory challenge to the hands.
    Kids can make fake snow for a tactile sensory experience.

     And then turned in to this.  

    Use toilet paper in a dry sensory bin for tactile sensitivity and fine motor strengthening.

      And this.  

    Slightly off-course in our sensory bin, but of course it did.   Why wouldn’t it when you have 6 cousins together?  ((Ok, that part of this post was NOT mess-free…the end result is mess-free. I promise.)) So, then we popped the Ivory soap into the microwave…

    Fake Snow Wet Sensory Experience

    Step 2 in the tactile sensory experience is the wet fake snow portion. Following the fake snow recipe, we popped a bar of ivory soap into the microwave and ended up with a cloud of sensory material.

    Ivory soap in the microwave for a tactile defensiveness sensory challenge and to use in making fake snow.

    Children can touch and explore this sensory material for a warm, sensory experience.

    Step 3 in the tactile challenge is mixing the dry material with the wet material. This can definitely be a challenge for those with tactile defensiveness or touch sensitivities.

    If it is too much of a sensory challenge, invite the child to mix with a large spoon or to touch with a finger tip.

    Other children may enjoy this part of making fake snow. The melted soap can be mixed with the toilet paper…to make fake snow!    

    How to make fake snow with ivory soap and toilet paper

     

    Fake Snow Sensory Play for Tactile Sensitivities

    THIS is the mess-free part that many children with tactile defensiveness may enjoy. 🙂

    Simply place some of the fake snow material into a zip top plastic bag. You can tape the top shut to keep the material in the bag.

    By manipulating the fake snow in a safe sensory manner, kids get exposure to a calming warm temperature. This is one low-level challenge to the tactile system. The warm temperature is a calming, regulating aspect that can be powerful in self-regulation.

    Children can also squeeze, manipulate, pound, and spread the fake snow within the plastic baggie. This offers heavy work input through the hands and upper body in a way that is calming and regulating.

    By placing the fake snow into a bag for sensory play, kids are exposed to tactile experinces in a way that may help with tactile discrimination by incorporating the proprioceptive sense.

    Challenge motor skills further by adding items such as foam snowflake stickers, glass gems, and glitter.  This was so much fun for my crew of kids and nieces and nephews and I hope it’s a tactile experience you get to play with as well!

    Make fake snow for a mess free sensory experience that kids with tactile defensiveness will enjoy
    Fine motor sensory experience with fake snow.

     

    Products mentioned in this post:

    The Sensory Lifestyle Handbook

    The Sensory Lifestyle Handbook– The Sensory Lifestyle Handbook is your strategy guide for turning sensory diets and sensory activities into a sensory lifestyle.

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

    winter fine motor kit

    The Winter Fine Motor Kit– Done-for-you fine motor plans to help kids form stronger hands.

    This print-and-go winter fine motor kit includes no-prep fine motor activities to help kids develop functional grasp, dexterity, strength, and endurance. This 100 page no-prep packet includes everything you need to guide fine motor skills in face-to-face AND virtual learning. Includes winter themed activities for hand strength, pinch and grip, dexterity, eye-hand coordination, bilateral coordination, endurance, finger isolation, and 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.

    Valentine’s Day Occupational Therapy Activities

    by

    Here, you’ll find Valentine’s Day Occupational Therapy Activities that you can use this time of year to help kids develop skills. This is the time of year that red and pink hearts are everywhere, so why not use the theme of love and friendship in therapy interventions with fun Valentines day activities? Add these heart crafts, and love ideas to your therapy toolbox to work on things like fine motor skills, regulation, scissor skills, and more, all with a Valentine’s Day theme!

    Be sure to grab these printable Valentine’s Day cards, too!

    Use these valentine's day occupational therapy activities in therapy planning, classroom activites, and to work on skills like handwriting, fine motor skills, scissor skills and other developmental areas.

    Valentine’s Day Occupational Therapy Activities

    There are so many love and heart themed activities here on The OT Toolbox. Over the years, we’ve done a lot of fun activities that double as a skill building strategy. Check out these ideas and pick a few to add to your therapy line up and plans over the next few weeks. Some of these hear crafts and sensory ideas or games would make great additions to a Valentine’s Day party that builds skills, too!

    One great tool is our Valentines Day I Spy activity for visual motor and fine motor skill-building.

    Valentine’s Day Occupational Therapy Activities for Kids

    Valentine’s Day is the perfect time to weave meaningful sensory and motor activities into classroom lessons or therapy sessions. 

    These Valentine’s Day occupational therapy ideas can build skills like fine motor precision, emotional regulation, sensory processing, and more, all while celebrating the season of love and connection. I like these ideas for school based OT, or outpatient clinical services. You can use them with early intervention or older ages, as well. We tried to pull together ideas that blend fun with functional development.

    Valentine Sensory Bin Ideas for Therapy and Play

    A well-designed Valentine’s Day sensory bin is a classic tool that supports tactile exploration, calming sensory input, and fine motor development. 

    • Try filling a bin with red and pink rice or shredded paper, then add small heart-shaped erasers, mini clothespins, plastic rings, or paper hearts for sorting and tweezing. 

    • For a valentines sensory bin that encourages self-regulation, include soft textures like felt hearts, fuzzy pom-poms, and scented items like lavender sachets. 
    These are good ideas for valentine activities for preschoolers are great for early learners working on grasping skills and visual scanning. Add clues or tiny hidden objects for a scavenger hunt twist.

    Creative Valentine Crafts for Skill Building

    February crafts offer so many ways to support motor planning, bilateral coordination, and visual motor integration.

    • For kindergarten valentine crafts, try a torn-paper heart collage using tissue or construction paper to strengthen hand muscles.
    • Another fun project: use lacing cards shaped like hearts to practice bilateral coordination and dexterity. 
    • Add a twist by turning the craft into a personalized scavenger hunt, kids find materials based on color, texture, or size, then use them in their final creation.

    Valentine STEM Activities for All Ages

    We love the multisensory learning that happens with STEM activities and incorporating this into the holiday with Valentine STEM activities will spark curiosity and coordination. 

    • Use candy hearts to build towers or bridges, count and graph colors, or create heart-themed mazes with magnets and paperclips.
    • These activities challenge executive functioning, planning, and sequencing while offering a creative way to integrate academic concepts. 
    • Add ingredients like baking soda and vinegar to explore fizzy heart experiments. These hands-on activities are ideal for preschoolers through early elementary ages.

    Valentine Party Games with a Therapeutic Twist

    Turn typical valentine party games into skill-building opportunities. Try a heart bean bag toss to target gross motor coordination and core strength. 

    • Play musical hearts with a playlist of songs to practice motor timing and auditory processing. 
    • Use card games like memory matching with heart symbols or emotion faces to build cognitive and social-emotional skills. 
    • Add a blanket fort in the living room for calming play or a personalized scavenger hunt with heart-shaped paper clues to encourage movement and direction-following.

    Creating Meaningful Valentine Experiences at Home or School

    Valentine’s Day is a chance to create memorable valentine’s day experiences that foster connection. 

    • A cozy picnic on the floor with heart-shaped snacks, pizza, and dessert can turn into a fun bonding moment. 
    • Use fairy lights, soft blankets, and candles (battery-operated for safety) to set the tone for a movie night that feels like a special event. 
    • These ideas provide quality time, encourage emotional bonding, and offer calming sensory input. 
    • For mom or caregivers, setting aside space for self-care, even five minutes of deep breathing or stretching, can be a powerful model for children learning to regulate themselves.

    Free Valentine’s Day Printables

    We love to create multi-purpose free worksheets and printable activities that support development. Worksheets can get a bad rap, but we at The OT Toolbox attempt to create occupational therapy worksheets that focus on play as a function.

    When we can use a printable founded in play, the user is performing a daily occupation that is important to them, and the play is both the tool and the skill that is being developed. That’s why these Valentine’s Day worksheets are so loveable!

    Conversation Heart Sort– Print off this sorting worksheet for a fine motor activity with conversation hearts.

    Valentine’s Day Hat Craft– Print off this hat template and work on coloring skills, scissor skills, and executive functioning to build and create the Valentine craft.

    Valentine Hole Punch Cards– These free pintables are perfect for occupational therapy Valentine parties. Use the printable activity to build skills in eye-hand coordination, hand strength, bilateral coordination, arch development, visual scanning, and more.

    Heart Deep Breathing Exercise– Print off this heart poster and use it to develop skills in mindfulness, self-regulation, and even proprioception through the chest and upper body. It’s a very calming activity that can be a great addition to the sometimes chaos and unexpected situations in a classroom Valentine’s Day party. use it to support sensory needs at a Valentine’s Day party!

    Valentine’s Day Activity Sheet– This printable tool is a great activity that can be used to develop many different skills depending on the needs of the individual. Use a single activity sheet to target: visual scanning, visual memory, visual peripheral skills, form constancy, fine motor skills, eye-hand coordination, dexterity, pencil control, motor planning, coloring and more.

    Valentine Matching Alphabet Cards– Cut out these love letter cards and match uppercase to lowercase letters. These cards are used for cursive letters to build skills in letter recognition, visual discrimination, and more.

    Valentines Fine Motor Worksheet– Print off this Valentine worksheet and build motor skills in many ways. have fine motor races with small objects like beads or mini erasers. Use tweezers to move items along the path. Work on pre-writing lines by using the paths on a vertical or diagonal. Work on a vertical plane to build core strength and shoulder stability. Use the sheets to practice letter formation by writing in the circles. There are so many ways to play and develop skills with a heart theme!

    More Valentine’s Day Activities

    That’s not all! Use the activity ideas below in planning OT sessions, or in Valentine’s day parties that also build skills.

    One thing I love about holiday events this time of year is that kids are excited about Valentine’s Day activities. It’s fun, friendly, and full of kindness and empathy. However, there are so many ways to develop skills with the old-fashioned Valentine fun:

    • Cut out paper hearts- Cut hearts from cardstock or construction paper for more resistance
    • Fold paper hearts in half- This is great for bilateral coordination, hand strength, pinch strength, eye-hand coordination, motor planning, and visual perception.
    • Stick heart stickers on paper- Add small targets by drawing dots and placing the heart stickers on the dots. This is great for fine motor precision and eye-hand coordination. Place the paper on a vertical surface and further develop core strength and balance.
    • Write on Valentine’s Day cards- what a functional and fun way to work on handwriting and to teach kids to write their name.
    • Make a Valentine’s Day box- Don’t worry about the fancy Pinterest V-Day boxes! Some of those require way too much parent help. Help a child wrap the box in wrapping paper (anther great functional life skill!) and then cut out hearts or draw right on the box.
    • Make a Valentine’s Day snack– Work on executive functioning skills, direction following, fine motor skills, and more.

    Valentine’s Day Therapy Slide Decks

    Working virtually? Use a done-for-you therapy slide deck. These are therapist-created and designed to meet the needs of a variety of levels of users. Adjust the slides and therapy activities to meet your needs and the needs of the learners you are working with.

    If you are needing occupational therapy teletherapy resources, check out the hands-on Valentine’s Day activities below. They are great for February parties and therapy at home activities for this time of year, too.

    Valentine’s Day Sensory Activities

    From sensory bottles, to discovery activities, to heart painting and more, these sensory play activities can be a fun way to help kids develop skills through the senses. How can you use these Valentine’s Day occupational therapy activities in sessions or at home?

    Valentines day sensory bottle for self regulation and sensory processing or visual processing

    Valentine’s Day Sensory Bottle– Use this sensory bottle activity as a way to build fine motor skills while kids help to create the sensory bottle and add materials. Then use it in self-regulation, sensory processing needs as a calm down bottle. Sensory bottles are fantastic to work on visual processing skills like visual discrimination, figure-ground, and other visual perceptual skills.

    Olive You Thumbprint Craft– Fingerprint art is a great way to work on finger isolation, an essential fine motor skill that kids need to manipulate items and improve pencil grasp. Here is more information on how fingerprint art improves fine motor skills. Add this artwork to a card or Valentine’s Day craft for fine motor fun.

    Valentines Day play dough to build fine motor skills

    Valentine’s Day Play Dough Activity– Use a recycled chocolates box in a play dough activity that builds skills like strengthening of the intrinsic muscles and arches of the hands. This is a fun Valentine’s Day activity that can be used in classroom parties or in the therapy room to build skills.

    Bilateral coordination activity for valentines day

    Bilateral Coordination Heart Sensory Tray– Use sand, rice, or other sensory bin material to create a bilateral coordination and visual motor activity for kids. They can work on eye-hand coordination, motor planning, and other skills. The point of the activity is to establish direction and orientation relative to the child’s body.  The movement activity addresses hand-eye coordination in different visual fields, promotes spatial awareness and visual discrimination, addresses left and right awareness, improves peripheral vision, promotes body awareness and coordination with specialization of the hands and eyes, and works on gross motor movement skills.

    Valentine’s Day Fine Motor Activities

    Try these Valentine’s Day fine motor activities in your occupational therapy interventions or home programs. The activities here are fun ways to help kids develop hand strength, dexterity, precision, grasp development, and motor control.

    Be sure to check out the Valentine’s Day Fine Motor Kit. In the 25 activity printable kit, you’ll fine hands-on activities to build fine motor skills. Activities include coloring and cutting cards, pencil control sheets, heart crafts, Valentine’s Day write the room activities, hole punching exercises, and so much more. Grab the Valentine’s Day Fine Motor Kit here.

    Visual perception activity and heart maze for valentines day

    DIY Heart Maze- Look out visual motor skills…this heart maze is one you can make and print off for your whole caseload. Adjust the use according to your kiddos. Children can place objects like paper hearts, mini erasers, etc. on the hearts in the maze to double down on fine motor work, or color in the hearts to work on pencil control. This maze is a visual processing powerhouse. Find more information on visual processing here.

    Fine motor heart activity

    Teeny Tiny Sprinkle Heart Activity– This is a fine motor activity that builds precision and dexterity in the hands. It’s a fine motor workout kids can use to build hand strength and endurance for fine motor tasks. Use it in math centers to work on one-to-one correspondence and counting or sorting.

    Heart fine motor and eye hand coordination activity

    Heart Eye-Hand Coordination Activity– Work on eye-hand coordination and fine motor skills tongs and heart s cut from cardboard. If you are like me, you have a ton of delivery boxes coming to the house. Use those boxes in a fine motor skills building activity. Write numbers or letters on the hearts to make it a sorting, math, or spelling activity.

    heart keychain made with salt dough

    Salt Dough Keychain– This is a fun heart craft that goes along with the children’s book, “The Kissing Hand”. Use it to help kids work on fine motor skills, and hand strengthening. This keychain craft makes a great Valentine’s Day gift idea too!

    Valentines Day crafts

    One Zillion Valentines Book and Craft– Pairing a book with therapy or when working on skills with kids is a fun way to open up conversation, problem solving, and strategizing to create a project or activity based on the book. This Valentine’s Day book for kids is just that. One Zillion Valentines is one children’s book that pairs nicely with a fine motor craft for kids.   Kids can work on fine motor skills, motor lanning, direction following, and executive functioning skills while folding and making paper airplanes, and the cotton clouds in this fun craft idea.

    Valentines day handprint art

    I Love Ewe Handprint Craft– Use a handprint art activity as a tactile sensory experience. Pair scissor skills, pencil control, direction following, and copying skills to work on various areas needed for handwriting and school tasks. Pls, this makes a great Valentine’s Day craft or addition to a card!

    Valentines Day activities to build skills for kids
    valentines day color sorting fine motor activity

    Valentines Day Color Sorting Fine Motor Activity– Grab a couple of cookie cutters and some beads. This is a fine motor activity that kids can use to build skills like in-hand manipulation, separation of the sides of the hand, finger isolation, open thumb webspace, and more.

    love bugs valentines day crafts

    Love Bugs Crafts– Work on fine motor skills, scissor skills, direction-following, eye-hand coordination, bilateral coordination, and more with these cute bug crafts for kids.

    valentines day sensory bin

    Valentine’s Day Sensory Bin– There are so many benefits to using a sensory bin in building fine motor skills. Pour, scoop, and stir with the hands for a tactile sensory experience. Using a sensory bin can be a great way to work on visual perceptual skills like figure-ground, visual discrimination, and other essential visual processing areas. Find and ovate objects or add a learning component by writing sight words or math problems on hearts. This is an open-ended activity that can be used in so many ways.

    valentines day books

    I Love You Books for Kids– These Valentine’s Day books for kids are a fun way to combine books with crafts or love themed activities. Use them to work on copying words or sentences for handwriting practice. The options are limitless. What love and heart themed books would you add to this list?

    Valentines day activities to build fine motor skills
    heart play dough

    Valentine’s Day Crayon Play Dough– Use play dough to work on so many areas: hand strength, arch development, separation of the sides of the hand, endurance, eye-hand coordination…But have you ever had trouble getting a a really vivid red play dough when using food coloring? The answer to the red play dough problem is using vivid crayons! Here is our crayon play dough recipe that gives you the brightest colors, perfect for using in Valentine’s Day play dough activities!

    heart craft to work on fine motor skills like scissor skills

    Heart Bookmark Craft– This is such a fun and easy Valentine’s Day craft to use when working on scissor skills with kids. The strait lines of the bookmark and curved lines of the heart make it a great activity for kids just working on the basics of scissor skills.

    Valentines day craft for kids

    Heart Butterfly Craft- Work on scissor skills, handwriting, and fine motor skills to make this fun card. The directions to make this Valentine’s Day craft are over here on a guest post we did for Hands On as We Grow. Use this fun craft with a group. It’s a great Valentine’s Day party idea!

    Valentines Day craft for kids to work on fine motor skills and scissor skills

    Valentine’s Day Tea Craft– This Valentine’s Day craft is a fun way to work on scissor skills, handwriting, and fine motor skills. Kids can make this craft as a gift for friends or parents and work on skill development, too.

    More Valentines’ Day Activities

    Try some of these other ideas:

    Valentine’s Day Sensory Bin with Fine Motor Paper

    Valentine’s Day Snacks for Kids

    Valentine’s Day Goop Painting

    Valentine’s Day Fine Motor Sparkle Craft

    Crunchy (Sensory Diet!) Heart Tortilla Snack

    Teach Buttoning with Heart Buttons

    So, what are your favorite ways to work on skills with a holiday theme? Try some of these heart activities at Valentine’s Day parties, at home when making cards for loved ones, or in therapy planning! Have fun!

    Want to add more Valentine’s Day activities and movement tools to your skill-building?

    he Valentine’s Day Fine Motor Kit is here! This printable kit is 25 pages of hands-on activity sheets designed to build skills in pinch and grasp strength, endurance, eye-hand coordination, precision, dexterity, pencil control, handwriting, scissor skills, coloring, and more.

    When you grab the Valentine’s Day Fine Motor Kit now, you’ll get a free BONUS activity: 1-10 clip cards so you can challenge hand strength and endurance with a counting eye-hand coordination activity.

    Valentines Day fine motor kit

    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.

    Understanding Sensory Dysregulation

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

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

    Sensory dysregulation

    Sensory Dysregulation

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

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

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

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

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

    what is sensory dysregulation

    WHAT IS SENSORY DYSREGULATION?

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

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

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

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

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

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

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

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

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

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

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

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

    WHAT DOES DYSREGULATION LOOK LIKE?

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

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

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

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

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

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

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

    SENSORY DYSREGULATION IS NOT: 

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

    Not sensory dysregulation:

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

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

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

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

    Sensory Dysregulation Symptoms

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

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

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

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

    WHAT ARE THE SYMPTOMS OF DYSREGULATION

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

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

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

    HOW CAN YOU support Sensory Dysregulation?

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

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

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

    Tactile Sensory Input:

    Heavy Work/ Propceptive Sensory Input:

    Vestibular Sensory Input:

    Combined Sensory Input:

    Deep Breathing Activities:

    Mindfulness:

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

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

    The Sensory Lifestyle Handbook
    The Sensory Lifestyle Handbook

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

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

    dysregulated nervous system

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

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

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

    NERVOUS SYSTEM BASICS

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

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

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

    Understanding the stress response

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

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

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

    Dysregulation and Trauma

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

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

    CAUSES OF DYSREGULATION

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

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

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

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

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

    EMOTIONAL/BEHAVIORAL DYSREGULATION CHANGES

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

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

    TREATMENT FOR DYSREGULATION

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

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

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

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

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

    What Does It Mean When a Child Is Dysregulated?

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

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

    Why Can’t They Just Listen or Calm Down?

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

    So What Should I Do Instead?

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

    1. Focus on Regulation First, Not Correction

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

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

    2. Use Sensory Strategies to Regulate the Body

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

    Try:

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

    Read more about heavy work activities here.

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

    3. Offer a Low-Stimulation Environment

    If possible, reduce sensory input:

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

    4. Don’t Over-Talk

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

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

    5. Once Regulated, Then Reflect

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

    You can now:

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

    Common Questions About Helping a Dysregulated Child

    How long does it take to regulate?

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

    Is dysregulation a behavior problem?

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

    How do I know what will help my child?

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

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

    How to Prepare for the Next Dysregulation Moment

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

    Tools to have ready:

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

    Explore our popular resources:

    Get Ongoing Support Inside The OT Toolbox Membership

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

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

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

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

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

    Therapy for Picky Eaters

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    food therapy for extremely picky eaters

    In this blog post, we are covering therapy for picky eaters. Occupational therapists and speech therapy practitioners often cover extremely picky eating in therapy sessions, but how do they know where to begin with food therapy? Let’s cover specifically how to help extremely picky eaters, food for picky eaters, and therapy suggestions for extremely picky picky eating disorder.

    Therapy for Picky Eaters

    Fifty years ago, feeding therapy this would not have been a popular topic. Children ate what was provided, like it or not.  Sometimes parents would spare the child and leave the offending objects off of the plate. More often than not, children over the age of four were expected to eat what everyone else was eating.

    Fast forward to 2022. There has been a huge rise in allergies, picky eaters, and problem feeders. How to help extremely picky eaters  has become the forefront of many occupational therapy sessions and referrals.

    There has been a marked rise in food sensitivity (gluten intolerance, lactose intolerance) or allergies to certain foods.  This goes hand in hand with the rise of anxiety, illness, ADHD, autism, and poor immune response. 

    Understanding Picky Eating in Young Children

    Picky eating is a common concern among parents of picky eaters, especially during early childhood. It’s not unusual for a toddler to reject unfamiliar foods or stick to a very limited range of favorites. While many children outgrow picky eating, others may need additional support from professionals such as pediatricians or psychologists to ensure they’re receiving the right treatment and nutritional balance.

    Picky Eater List

    There is a difference between oral motor skills that impact feeding abilities and a child’s picky eating. Foods that make the “picky eater’s list” might include certain food texture issues, food mixtures, food sensory issues like crunchy foods, and even foods that require utensils. 

    A short list of some foods that are not on the plate of extremely picky eaters might include:

    • Sandwiches
    • Rice
    • Chicken breast or other meats
    • Carrots
    • Cheese
    • Sauces
    • Vegetables
    • Fruits

    Obviously this is a short list and any number of foods, food types can be on a picky eater list. Any other number of foods or food combinations

    Looking at this list, you can see the limitations in nutrients, vitamins, proteins, and brain-building foods that are missing from the plate of an extremely picky eater.

    It is not productive to get stuck in the “why is my child a picky eater”, but move forward to “what can I do about picky eating”.  I am not just an experienced feeding therapist, I too had two picky eaters who survived on 3-4 different foods in their second and third year of development.  

    In order to help my daughters, I had to remove my thoughts impacting how I approached tackling that picky eater list for each child. That includes putting aside parenting/worry/anxiety/they’re starving persona, and put on my therapist hat.  I am happy to report they are thriving adults who eat a huge variety of foods!

     NOTE*The term, “learner” is used throughout this post for readability and inclusion. Not all picky eaters are children. This information is relevant for students, patients, clients, preschoolers, kids/children of all ages and stages or whomever could benefit from these resources. The term “they” is used instead of he/she to be inclusive.

    When to Seek Support

    If picky eating interferes with a child’s diet over an extended period or leads to issues like constipation or significant weight loss, it’s important to consult a pediatrician.

    In some cases, psychologists can help address the sensory, behavioral, or emotional components of picky eating. These professionals may work alongside occupational therapists to explore strategies that support healthy eating habits in young children.

     How to help extremely picky eaters 

    To learn how to help extremely picky eaters, it is important to define it first.  

    Picky eating is different from problem feeding.  Often, but not always, extremely picky eating is actually a problem feeding disorder. This has recently been renamed Avoidant Restrictive Food Intake Disorder ARFID.  ARFID is not classified with eating disorders such as anorexia and bulimia, as persons with ARFID or problem feeding do not restrict their intake due to body image.

    The term picky eating includes:

    • Selective eating habits
    • Eats 10-20 different foods (preferred foods)
    • Will often eat more if hungry
    • Not missing entire food groups
    • Can often be bribed or rewarded for good eating
    • Can be distracted into eating
    • Adds new foods to their diet

    Problem feeding (extremely picky eating) refers to:

    • Refusal to eat
    • Rigid eating habits (no food touching, specific brand, same plate, cut a certain way)
    • Eats less than 10 different foods
    • Will starve before they eat unwanted foods
    • Missing entire food groups 
    • Behavioral reactions: gagging, vomiting, crying, anxiety, refusal to sit at the table
    • Increased sensitivity to the taste and/or texture of foods
    • No amount of rewards, bribing, punishing will magically make this go away
    • Does not recognize hunger
    • Food jags, will lose foods once eaten regularly

    What is the difference between picky eating and problem feeding?                

    The picky eater will survive.  They are likely to consume at least one meat, fruit, and vegetable and a bunch of carbs.  

    Continue to put out expected foods on the plate and encourage tasting of new foods.  The problem feeder on the other hand, is not consuming enough calories, or getting the right nutrition.  

    A person surviving on four foods often gets tired of one of them, eating only three foods now.  This is more of a dire situation and the treatment is complicated.

    If you have a problem feeder, seek treatment from a therapist who is certified or has attended classes in feeding therapy.  There is a lot that can go wrong working with problem feeders.

    The Sequential Oral Sensory course, Beckman Oral Motor Therapy, and Mealtime Miseries are popular courses. Having this information can help in identifying whether extremely picky eating is related to sensory or oral motor difficulties.

    Therapy for Extremely Picky Eating

    After viewing the list, if you feel the learner is more of a picky eater, there are several strategies that can help.

    Following a feeding evaluation, feeding therapy can begin. Start a structured feeding problem including the following:

    1. Feeding Therapy Interview

    Interview the caregiver to determine the following:       

    • What foods the learner eats – a specific list will determine texture, variety, color, or patterns. Are all the foods crunchy? Are they all brown?
    • How many foods the learner eats – less than 10 is a problem, 10-15 is picky, and above 20 is average. Count two different cookies as two items, two cereals as two items.
    • Medical history – Is there a history of reflux, G-tube, or NG-tube, swallowing issues?
    • Time frame for eating – A typical meal should last 20-30 minutes for a child.
    • Where the learner eats – Does the learner eat at the table or in front of the television? Do they run around the room catching a bite here and there?
    • Behavioral reactions during meal times – Does the child flee the table? Turn their whole body away from the food, vomit, cry, refuse to open their mouth, gag, spit out food?

    Record information from caregivers and look for clues to feeding issues, other than the exhibited behavior. The person may have a history of reflux that makes eating very uncomfortable.  They may have been verbally abused and shamed during mealtime, making eating an unpleasant experience. Perhaps the child has never had structure or routine during meal time, thus not making eating a priority. 

    2. Planning for Feeding therapy

    Start treatment planning                

    Begin with the provided list of preferred foods to determine what foods to try first.  A Food Inventory Questionnaire can be used for this step.

    If the learner eats: crackers, pancakes, waffles, bread, and dry cereal, they may have a preference for white/brown foods that are dry. Some are crunchy foods and some are soft foods, but all are dry. 

    The next in order would be another dry brown food such as toast, bagel, cookie, or different type of cracker. 

    Once the child tolerates more brown dry foods the next texture in the same color family would be a banana or plain macaroni. 

    For the learner who eats only purees or smooth foods like pudding, yogurt, and baby food, the next step would be to try different flavors of yogurt or pudding. For a learner who only eats smooth foods, it is important not to vary the texture yet. After the child tolerates this texture, then a trial of applesauce may work.

    Adding flavor choices and additional nutrients can be found in sauces or dips. While this can be a source of refusal for some kids, others prefer dips such as ketchup or ranch dressing.

    Take a look at what the individual is gaining from these dips. Both can be high in sodium and that salt intake is preferred. Can you offer other foods to dip into the preferred choices?

    Think about other similar options that may offer a similar sensory input through texture or taste:

    • butter for pasta rather than sauces
    • pizza sauce in place of ketchup

    3. Feeding Therapy Treatment session              

    Ask the learner or their caregiver to provide two favored foods and 2-3 non favored foods. Having preferred foods decreases anxiety as  the child is not presented with a plate of non favored foods.  

    It is important for the learner/caregiver to provide the food.  Possible allergic reactions are diminished, as the caregiver is more aware of the learner’s diet. There may be cultural or dietary foods that the family prefers.

    It doesn’t do any good for the therapist to work for weeks on waffles and applesauce, if the family does not offer these foods.

    Food presentation – Present all foods on the plate in small portions, or a choice of two options with small bites of each. Avoid huge piles of non-preferred food, as it increases anxiety or sensory aversion.

    Divided plates help ease anxiety, as do small portions. It can help to present the food as snacks, using a snack plate or small tea plate.

    Food exploration- Start to encourage eating, or at least food exploration.  Have the learner look at the food, touch the food, touch it to their face, give a kiss, give a lick, take a bite, chew, and swallow. This resource on sensory touch can offer more information and strategies to support tactile exploration.

    There are 27 steps to eating from being in the same room as the food, to chewing and swallowing it.  This makes learning to eat new foods challenging. 

    Offer food options- Allow the child to touch foods or use their fingertips to pick up and eat or taste the foods. In some cases, muscles and coordination are not appropriate for utensil use, limiting options.

    Read about suggestions to improve how to hold a spoon and fork.

    Offer various food temperatures. Consider the sensory input offered by cooked carrots vs. raw carrots. 

    Offer various food cuts. Consider the amount of force needed to bite baby carrots vs. shredded carrots.

    Food Therapy Progression

    Food therapy interventions are about progressing through with small incremental changes to food offerings with observation and food challenges. Some food therapy goal banks are included below.

    Learner is able to:

    1. Be in the same room as the food, then in the same area as the food.
    2. Sit near the food, then in front of the food without turning away.
    3. Look at food, touch the non preferred item, smell the food.
    4. Touch  the food to face, then lips, then give it a kiss.
    5. Lick the food, take a bite and spit it out, chew the food with the option to take it out.

    While presenting and working on the feeding portion, observe for signs of oral motor issues that might indicate oral motor development considerations.

    • Does the learner chew from side to side or munch up and down?
    • Do they have good lip closure?
    • Do they have an intense gag reflex?
    • Can they move the food around effectively?
    • Can they bite into the food?

    4. Carryover of Therapy for Picky Eaters

    The ultimate goal is to carryover skills achieved in therapy sessions into a functional environment. Discuss techniques with caregivers and encourage them to try the same foods later in the day.

    Remind them to be calm and not emotional during feeding time. The goal is to have fun with food and find mealtime enjoyable.

    For more information on how to help extremely picky eaters, I have also published a helpful resource book (Amazon affiliate link) Seeing your Home and Community with Sensory Eyes for to understand different environments that may be impacting the eating habits of your child/clients, including the cafeteria, kitchen, restaurants, and more.  

    Feeding and toileting are two of the most frustrating, anxiety producing stages of childhood. Children start to exert their free will at this stage and can no longer be forced to do certain things.

    Encourage parents, educate yourself on this topic, and spread the word, so problem feeding does not continue to rise along with other scary diagnoses. 

    This post is part of a series on feeding disorders/picky eating. Other resources you will find helpful include:

    Safety and Health Concerns

    Parents should also be aware of the risk of choking, particularly if children avoid certain textures or refuse to chew foods properly. Offering bite-sized pieces and observing during meals is key to safety, especially when introducing new items into the rotation. Constipation can also become a problem for children with limited diets, making fiber and hydration critical areas to monitor.

    Building Confidence at the Table

    Support from parents of picky eaters is essential. Offer a consistent routine around mealtime, serve familiar and unfamiliar foods together, and avoid pressuring your child to eat. Sometimes the stress of focusing on the “next meal” can escalate picky eating behaviors. Patience and gentle encouragement go a long way in helping children gradually expand their food preferences.

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

    Weighted Vests and Compression Garments

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

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

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

    Weighted Vests for Kids and Deep Pressure Tools

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

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

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

    What Does a Weighted Vest Do for Kids?

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

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

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

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

    When to Use a Weighted Vest for Kids

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

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

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

    Other Deep Pressure Tools and Proprioceptive Strategies

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

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

    Weighted clothing Research review versus clinical observation

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

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

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

    Research on weighted vests and compression clothing

    Research on weighted vests and Compression Vests

    (Research review by Sydney Thorson OTR/L)

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

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

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

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

    How Do I Know Which Research to Trust?

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

    What does it mean to be clinically significant? 

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

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

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

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

    Best Evidence for Weighted Vests

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

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

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

    Results (Denny et al., 2018)

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

    Should Occupational Therapists Use Weighted Vests? 

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

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

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

    Best Evidence for Weighted Compression Vests 

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

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

    Weighted Vests and Autism

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

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

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

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

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

    Should Occupational Therapists Use Compression Vests? 

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

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

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

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

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

    (Clinical experience by Victoria Wood, OTR/L)

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

    How does a weighted blanket work?

    How a weighted vest works

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

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

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

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

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

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

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

    What about research?

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

    Do sensory strategies such as a weighted vest work?

    • (In my opinion) weighted clothing works.

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

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

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

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

    • The placebo effect of weighted garments:

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

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

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

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

    • Do no harm.

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

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

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

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

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

    What works for one may not work for another. 

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

    How to use compression garments and weighted blankets

    How to safely use a weighted or compression vest/garment

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

    After about 20 minutes you no longer notice it. 

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

    A few tips for weighted clothing:

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

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

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

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

    3. Collect data.

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

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

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

    Compression Vest Alternatives

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

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

    Alternatives to compression vests may include:

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

    Have you used any of these compression tools?

    Frequently Asked Questions About Weighted Vests for Kids

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

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

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

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

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

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

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

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

    AND

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

    What you Need to Know about Interoception

    by
    Interoception and mental health

    Interoception is a sensory term you may not have heard of before…but you have certainly felt or been impacted by the processing of our interoceptive sense! Internal feelings of hunger, fatigue, thirst, body temperature, digestion, and other internal systems offer a certain “feeling”, right? This is your interoception sensory system at work! Here, we’re covering everything you need to know about this complex sense, and taking a detailed look at how interoception impacts function.

    Interoception and mental health

    How Interoception Affects Mental Health

    One thing that I wanted to share is some information I’ve been hearing about on various podcasts. It seems like, recently, there is an upshift in environmental input that we’re all trying to process. It’s the never-ending distractions of notifications, more visual clutter, constant notifications, and an overwhelming stream of opinions coming from every direction. With the increase in phone use and social media scrolling, many people are tuning outward instead of inward. We’re checking for reactions, updates, and validation from others, instead of pausing to notice how we feel inside.

    This constant outward focus chips away at our ability to notice internal cues like hunger, fatigue, anxiety, or even calm. The result is a kind of sensory and emotional overload that leaves our nervous systems in a chronic state of activation. When the brain is flooded with external sensory information and social comparison, there’s less space to process our own internal signals.

    Over time, this can impact emotional regulation, self-awareness, and mental health, especially in children whose brains are still developing. Helping kids tune into interoceptive signals is one way we can start to counterbalance that overload and support their emotional and cognitive well-being.

    That’s where emotional health and interoception comes in.

    Interoception, the ability to sense internal signals like hunger, heart rate, or the need to use the bathroom, is foundational to emotional health and mental well-being. When the brain accurately interprets signals from the body, it helps a person understand their emotional state, manage stress, and make decisions that support regulation. For kids with ADHD or executive functioning challenges, the connection between brain development and interoceptive awareness is especially important.

    Difficulty noticing or interpreting internal cues can lead to emotional outbursts, anxiety, or trouble with impulse control. One thing I heard in a recent podcast is the mind-body connection. This is where the vagus nerve plays a key role: it links the brain to many internal organs and helps regulate the body’s stress response.

    Part of it is just being more aware of our internal ticking. Strengthening interoceptive awareness through body-based strategies supports the development of the prefrontal cortex. This is the part of the brain responsible for attention, planning, and self-control. By focusing on interoception, we’re supporting body awareness AND laying the groundwork for improved executive functioning and emotional regulation.

    Interoception sensory input impact regulation, modulation, and function.

    Let’s talk more about what interoception is…

    Interoception The 8th sense

    Did you know that the five senses we were taught in school is not actually a complete list of a human’s senses? In fact, there are 7 or 8 senses that humans experience, depending on who you ask.

    Understanding our many senses helps us comprehend how we and others experience the world around us. For the sense we are highlighting today, it is how we understand what is going on inside of us. Check out this post on the OT Toolbox regarding Multisensory Learning: Emotion Activities.

    Definition of the interoception sense

    Interoception is the sense of oneself; it is the ability to understand the body’s physical signals that tell you when you are hungry or full, thirsty or quenched, hot or cold, scared or calm, etc.

    Interoception refers to the body’s ability to identify and process internal actions of the organs and systems inside the body. This lesser-known sensory system helps you understand and feel what’s going on inside your body. You can then make essential decisions about eating when you are hungry, drinking when you are thirsty, going into the restroom when you need to toilet, and other physical actions.

    There are nerves throughout the body that send these signals to the brain to help regulate the body, and promote homeostasis. 

    Some of these signals require a conscious act, like drinking water when we are thirsty, while others are non-conscious, like sweating when we are hot.

    Interoception comes into play when we consciously realize, “Oh, I am sweating because I feel hot, I should take off my jacket to cool down.” 

    Information on interoception, this blog post covers the definition of interoception, and interoception sensory strategies.

    How Does Interoception Impact Function? 

    Interoception can be thought of as a mind-body connection. Having a strong interoceptive sense would mean that you have a strong sense of the physical self, and what you need to promote comfort at any given time.

    Being able to confidently act on your body’s needs, makes everything a bit easier. You are likely able to make it to the bathroom before an accident, eat food before you feel light-headed, and stop eating before you feel sick. 

    But what about individuals who are not able to accurately process the bodies internal signals? They may find it more challenging to be potty trained, have a healthy diet, or emotionally regulate. 

    The ability to understand and respond to our body’s needs is a huge factor in our independence. If we don’t quite know what our bodies need, it makes everyday activities much more challenging, and focus on school or work tasks may dwindle. 

    Interoception even has to do with how our body moves, the action of bones in the skeleton, bone growth (growing pains have a lot of “pain” that is felt internally for kiddos who are rapidly growing! Be sure to check out this related blog on bone names to help tach kids about this concept.

    Functionally, interoception impacts so many areas of everyday tasks:

    • Eating
    • Drinking
    • Sleep
    • Toileting
    • Getting dressed (putting on temperature-appropriate clothing, or taking off clothing before becoming overheated)
    • So many more considerations!

    Interoception and Emotion 

    Interoception has a strong connection to emotional processing because of the physical way that we experience emotions. Our muscles clench when we are angry, quiver when we are scared, and relax when we are calm.

    Likewise, the stomach may feel upset when we are nervous, and one might get a headache from frustration. People with good interoception can relate these physical feelings to emotions. 

    If a person sensory processing differences, the signals from the body may not be accurately represented or relayed to the brain. They may be muddied or confusing, leading to a misunderstanding of what the body is trying to tell the brain. Because of this, a tickle may feel like pain, or a person may not know why they are experiencing discomfort. 

    Without interoception, labelling emotions is then a bit more challenging, as well as understanding how to remedy undesired feelings.

    Children may act out in aggression, cry or scream uncontrollably, or show other signs of sensory dysregulation, potentially due to a lack of interoception. 

    If you know a child who has multiple characteristics of reduced interoception, like potty accidents, over/under eating, and emotional dysregulation, they may benefit from therapeutic intervention to improve their body awareness. 

    The interoception system plays a part in feelings and emotions, too.

    When we feel anxious or worried, we might feel a tenseness about us. Our heart rate might speed up, and we feel that anxiety coursing through our systems.

    But for the child with difficulty expressing these feelings, they can’t tell us what they are feeling on the inside. They don’t have the words to identify specific interoceptive feelings they are having.

    Others might not recognize a racing heart. They might not realize that physical implication of anxiety or worry because they can’t actually feel their racing heart (when it is very much racing).

    When one feels anxious about a situation or an idea, we can help them to focus on their heart beat. We can help them take deep breaths to calm down. This focus on how their body is responding can help their internal state match the environment.

    Other ways to help with interoceptive identification include habit and routines to help us feel organized. When we know what to expect, we feel a lot more organized. The body is able to modulate better.

    As we increase the challenge, we have to also increase our supports. We can use some external organizational strategies (deep breaths, awareness, mindfulness, heavy work, routines) to help compensate for the lack of internal ability to organize ourselves.

    When we are disorganized, this is where we can fall apart. We have to be mindful ahead of time, and be accommodating and accepting of immature nervous systems, whether this is with our children, our spouse, or ourselves.

    Tips for Improving Interoception 

    There are all sorts of activities you can do with children to help increase their interoception skills. Below you will find tips for improving interoception, including mindfulness, and children’s books on topics like emotions, potty training, and problem solving. 

    • Modelling how you understand your bodies signals may also help – be sure to emphasize how you are feeling, and what you will do about it! 
    • Mindfulness – the act of intentionally connecting to oneself and/or the world around them. This can help an individual get “out of their head” and feel more grounded in the present moment. By doing so, it may improve self-awareness and a positive mood. Mindfulness is not just great for improving interoception – see this article for more information
      • This video guides a progressive muscle relaxation. Intentionally contracting and releasing muscles brings more awareness to the physical body, and deepens the connection that we feel to it.   
      • Here we have another video that guides mindfulness, in the form of a “body scan”. It also adds a great piece of education for children on what it means to understand their bodies signals, and why it is important. 
      • The OT Toolbox has this great list of more active ways to explore mindfulness through gross motor play. 
    • Focus on awareness- So often, parents, children, clients, educators, and even professionals are not aware of ALL of the ways that the interoceptive sense impacts everyday functioning, learning, and daily participation in everything one does throughout the day. Educate, educate, educate! Then, bring that awareness to a full circle with activities that take the concept of interoception in daily tasks home. For example, you can cover how sleep is impacted by interoception and incorporate a few of our hibernation activities. Without interoception, animals that hibernate would not instinctively know to fill up on foods before winter and to keep eating even when they may feel full. Then that sleep that allows them to slumber through the winter is in effect. It’s all related!
    • Try calm down toys– Use a variety of supports in the form of play to support regulation needs. This can offer heavy work, regulating movement, or calming input.

    Books to Improve Interoception

    Below are Amazon affiliate links to resources and books on interoception and internal states.

    • We Listen to Our Bodies is a book that follows a young girl as she feels emotions through her day. The physical representations of emotions are highlighted in ways that are familiar to young children.
    • For a similar read pick up this book, that follows a boy and his day full of feelings at the zoo! 
    • Time to Pee by Mo Williams is a great book that helps kids understand how to respond when they have that ‘funny feeling’ in their tummies. 
    • I Feel… activity books have been praised by therapists for their ability to make learning mindfulness fun! The activity book linked here focuses on sickness in the body and what it feels like to be sick in different ways. 
    • The OT Toolbox has a great resource called the Sensory Lifestyle Handbook to tie sensory processing together
    • For more children’s books on mindfulness to elicit peace and calm, check out this resource:
    Sensory lifestyle handbook- How to create a sensory diet

    While interoception is new and lesser known, it is an important sense to have.

    3 Easy Interoception Exercises

    Here are 3 simple, OT-informed interoception exercises you can add to your blog post to help kids or adults build awareness of internal signals connected to mental health and emotional regulation:

    1. Heartbeat Check-In

    Purpose: Build awareness of internal rhythms
    How to do it:

    • Sit or lie down in a quiet space.
    • Place your hand on your chest or wrist and try to feel your heartbeat.
    • After some light movement (like running in place or doing 10 jumping jacks), stop and notice the change in heart rate.
    • Ask: Can you feel your heart beating faster? What does it feel like inside your body?

    This builds connection between physical exertion and interoceptive feedback which helps the brain tune in to emotional states like anxiety or excitement.

    2. Breath Awareness with Temperature Shift

    Purpose: Increase mindfulness of breath and physical sensations
    How to do it:

    • Take a slow breath in through your nose and out through your mouth.
    • Place your hand in front of your lips and notice the temperature of your breath as you exhale.
    • Alternate between fast and slow breathing.
    • Ask: What do you feel? Warm air or cool air? How does your body feel when you breathe slowly vs quickly?

    Noticing temperature, speed, and rhythm of breath can help kids understand when they feel calm vs overwhelmed.

    3. Stomach Signals Scan

    Purpose: Tune into hunger, fullness, and emotional gut feelings
    How to do it:

    • Before a snack or meal, pause and ask: What do you feel in your stomach? Is it growling? Empty? Full? Comfortable?
    • After eating, check in again: How does it feel now?
    • Practice describing the sensations with emotion words too: Does nervous feel like butterflies? Does sad feel like a heavy feeling?

    This exercise helps strengthen the connection between body cues and emotional labels. This is critical for emotional regulation and self-awareness.

    What do you think? Would these simple interoception exercises help you?

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

     

    Calm Down Corner

    by
    Calm down corner ideas for calming sensory strategies.

    For young (and old) children, a great calming classroom tool that supports learning, social participation, and school tasks is the calm down corner. A calming corner in the classroom can be a great sensory strategy to support emotional regulation needs in students. It’s a place to calm or re-organize in a personal bubble, meeting regulation needs so learning can happen. Let’s go over fun calm down corner ideas to support various regulation needs in the classroom.

    Calm down corner ideas and tips

    As a pediatric OT, I love easy activities that I can use over and over again. One of my favorites are my heavy work activity cards that I can print off and use different themes based on the time of the year. Stock your calm-down corner with visual supports like our Heavy Work Activity Cards, which offer quick movement options for sensory regulation.

    They are a great addition to calm down corner ideas like the ones below!

    Calm down corner ideas for calming sensory strategies.

    Calm Down Corner

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    A classroom calming area can include a variety of movement and sensory based activities or tools. 

    • A place to sit: A visual space for a child to sit in their calming area, that is large enough for one child only. This could be a bean bag chair, a cushion or a pillow. These soft spots will help make the cozy corner comfortable so children feel they can stay as long as they would like. There are so many options when it comes to Flexible Seating tools – bean bag chair, movement seat, deflated beach ball seat, couch, soft chair, floor mats, large pillows
    • Soft surfaces – yoga mat, gymnastics mat, or soft rug
    • Headphones – with or without music, sound machine
    • Visual schedule of sensory strategies
    • Emotions Playdough mats can be a great tool for a calm down corner.
    • Things to look at – books, magazines, pictures, lava lamp (refrain from electronics that have a screen, as they are alerting)
    • Calming corner printables and other visual calming strategies – Check out these calming sensory stations for Spring
    • Timer – visual timers with countdown options are great
    • Preferred sensory items such as tactile toys, chewing items, plushies, fidgets, etc.
    • Books: Looking through picture books of all kinds, helps to give children something to do, while keeping their minds calm. Most of the time that children are interested in using a cozy corner, is when they are feeling overwhelmed. These Zones of Regulation books that talk about different feelings and support regulation and processing through feelings such as sad, scared, angry and more. These empathy and friendship books are another tool to consider. Place the books in a basket or a shelf for easy access. 
    • Emotional Supports: Visual and tactile supports help people of all ages, but it is essential to have a visual space in the classroom for preschoolers to retreat to when they need time to calm down. Soothing Sammy makes creating this area simple and makes it a positive experience for children. This adorable golden retriever has his calm down house which can be placed in the cozy corner, with items that help children calm down using their sensory system. As they calm down, they can use the visuals included in the kit to explain to other children and adults how they are feeling and what they need support with.
    • Stuffed Animals or Baby Dolls: When feeling lonely, sad, scared or overwhelmed, having access to baby dolls or adorable stuffed animals makes the space less lonely. Additions such as baby doll blankets, bottles and other caretaking tools, allow children to comfort others as they work on comforting themselves. 
    • Personal space: Adding a privacy cover or even simply a boundary to the cozy corner space helps children not to be distracted by other aspects of the environment. Placing fabric, cloth or other child-safe covers over the cozy space allows children to feel like they are in charge of their own space. Some child care centers place the cozy areas in small tents, (Amazon affiliate links) canopies (affiliate link) or wooden privacy cube like this one. (affiliate link)
    • A feelings check in could be a great addition to this space. The child could enter the calm down area and identify how they are feeling and then use strategies to support those needs.

    This list is just the beginning! A calm down corner can include any item from the list above or classroom sensory diet strategies, based on the needs of the individual student.

    This article on supporting self regulation in preschoolers offers valuable information on this topic.

    Calm down corners can be quiet soothing areas to decompress for certain learners, while others need a more active calm down area in classrooms.

    How to Add movement to a calm down corner

    There are many different ways that children can calm down. Movement is one of the most beneficial and complicated ways to manage feelings and emotions.

    There are two different types of movement patterns that support the sensory system.

    Both of these types of movement activities increase awareness of where a body is in space, calms the central nervous system and regulates emotions in an amazing way. Movement is complicated as it can be alerting and calming. Picking the right activity for the desired outcome is tricky, but effective.

    Help your learner understand what they need for self regulation, rather than bouncing all over the calm down corner.

    How is movement calming?

    Have you noticed that children seem to pay attention longer after moving around for a while? This isn’t just because they are tired after completing an active task. Children and adults are able to attend for longer periods of time when movement breaks are embedded into their daily schedules due to the sensory benefits it provides.

    For adults that have desk jobs, it is widely known that every 20 minutes, they should stand up. This not only helps blood flow, but also awakens the body. When children are engaged in circle time, implementing movement based activities within circle (like freeze dancing, jumping and marching) is beneficial to improving attention.

    Movement has many benefits, including helping calm down when feeling overwhelmed with emotions. 

    When the sensory system becomes overstimulated due to internal feelings and frustrations, some people are quick to seek out movement activities to calm down. Adults may go for a walk or run, chew gum, lift weights or kick a ball. This strategy directly affects proprioceptive input.

    There are many ways the body processes movement. This impacts the central nervous system in different ways.

    • Proprioceptive inputs is one of the ways the body processes movement. It tells the brain where the body is in space. Proprioception is guided by skin, muscle, and joint receptors in the body, to connect to the brain through the nervous system. In this way, a person knows where their body is in space, and what the body is doing, without needing to watch the body parts move. A great example of proprioception, is being able to walk down the stairs without looking at ones legs or feet
    • Heavy work, or tasks that involve heavy resistance, offers input to the muscles, joints, and connective tissue, and is essential to regulating the sensory system
    • In this article on neuroplasticity, evidence suggests the sensorimotor cortex that governs proprioception is not fixed, and can be changed through external manipulation.
    • Vestibular movement, like proprioception, also helps alert us where our body is in space. This system operates through the inner ear, passing information to the brainstem, affecting many areas of the body. If a person starts jumping, rocking to music, or dancing to calm the body, it activates the vestibular system. This article on vestibular activities does a great job explaining this system.

    more about the vestibular system

    Receptors in the inner ear, found in two structures (the otolith organs and the semicircular canals), respond to linear/angular/rotational movement, gravity, head tilt, and quick movement changes. 

    The receptors in the ear, provide information to the central nervous system about the body’s position in space. Information is used to:

    • control posture, eye, and head movements
    • correct the eyes with head and body movements
    • muscle tone and postural adjustments
    • perceive motion and spatial orientation, and integrates somatosensory information

    Through the vestibular and proprioceptive systems, the body processes information about where it is space, interprets movement patterns, and recognizes touch and joint pressure. These senses greatly impact the ability to calm down by triggering pressure points through movement (such as rocking or swinging). 

    When a child (or adult) becomes upset or overwhelmed, it is helpful to utilize the vestibular and proprioceptive systems as intervention tools. This helps a person calm and self regulate, in order to process their feelings and problem solve. 

    Because children often need sensory strategies to self regulate, having a designated calm down area set up in the home/classroom makes redirecting children to the appropriate calming activities much easier.

    The Soothing Sammy program is a great way to encourage children to take part in creating their own calm down corner through a story about a dog, Sammy, a golden retriever. As children help build Sammy’s calm down area to use when overwhelmed, they are gently taught that it is okay to have a variety of feelings. As children look through the book, they learn how to use objects in their calm down corner when needed, including drinking water, wiping their face with a cloth, jumping on a small mat (proprioceptive and vestibular input) and much more. 

    There are so many items that we can add to a calm down corner and every calm down corner will be different based on individual children’s needs. In the Soothing Sammy curriculum, there are recipes for lavender bubbles, slime, tactile fidgets, paint, and others.

    Proprioception Calm Down Corner Ideas

    Here are some great proprioceptive strategies to include in a calm down corner:

    • Calming Corner Printables- Print off the sensory stations listed below. These support heavy work needs (and vestibular input)
    • Jumping mat or small trampoline. When children jump, they put pressure on their joints 
    • Weighted blanket. Weighted blankets provide deep pressure over the entire body, making this activity one of the an effective whole-body proprioceptive strategies to help children calm down
    • Watering plants. Lifting a watering can, can impact joints all over the body. As children stoop down to pick up the watering can, moving it over plants of different heights, they are getting great input
    • Weighted ball. Lifting and rolling over a weighted ball increases proprioceptive input in the hands, arms, shoulders, and core. 
    • Play Dough. Squishing, squeezing and pulling apart playdough or clay, increases proprioceptive input in hands and small joints. 

    Some of these activities can be alerting or calming, therefore some trial and error may be needed.

    Vestibular Calm Down Corner Ideas

    Movement with changes in positioning can be calming as well. Think slow, rocking movements. Here are some Vestibular strategies to include in a calm down area:

    • Farm Brain Breaks – These simple, yet fun activities, provide visual ways to complete vestibular activities
    • Calming Corner Printables- Movement like yoga poses or those offering brain breaks can be just the calming input needed.
    • Swinging – Help your child move and sway in different directions with an indoor or outdoor swing. A Sensory Swing for modulation is an amazing way to provide an option to swing in a home or preschool setting
    • Trampoline – Provide a small trampoline for your child to jump on. (Amazon affiliate link:) This toddler trampoline with handle is perfect for indoors spaces
    • Dancing – Any type of movement to music, including freeze dancing or shaking instruments (such as a tambourine, bells, maracas) or using scarves, are wonderful additions to a calm down corner
    • Yoga Poses – There are several themed yoga poses perfect for children. Add a yoga book or cards like these Unicorn Yoga Poses to any calm down area

    calming corner printables

    One tool to add to a calming corner or calming space is a printable that offers a visual designed to promote calming and organizing self-regulation. These calming corner printables are easy to print off and start using right away.

    Over the years, we’ve created seasonal sensory paths, or sensory stations that support regulation needs. We’ve received wonderful words of thanks and feedback letting us know how loved these sensory stations have been.

    Check out each of these seasonal calming corner printable packets. Pick and choose the ones that support your needs in the classroom, therapy clinic, or home:

    1. Summer Sensory Stations
    2. Fall Sensory Stations
    3. Winter Sensory Stations
    4. Christmas Sensory Stations
    5. Spring Sensory Stations

    Additionally, other calming corner printables might include deep breathing posters. We have many free deep breathing exercises on the website, including:

    Finally, a brain beak printable like our popular alphabet exercises makes a great wall poster for a calming corner of the classroom.

    Keep in mInd about setting up a calming corner in classroom

    Calm down areas should incorporate all the senses, as every mood, trigger, situation and response is different. Equally important is the co-regulation aspect, which relates to responding to the mood and behavior of those around us, or the peers that may be present in a classroom or home setting.

    By utilizing a variety of calming tools in a calming corner, or calm down space within the classroom, children will be able to identify what they need, the moment they need it, while still engaging in active learning.

    It can be daunting and complicated providing for the needs of all of your different learners, however, by incorporating vestibular and proprioceptive materials in a calm down corner, children are able to use these powerful movement strategies when they need them the most, all while taking a multisensory approach to academics.

    Sensory Corner

    We’ve covered ways to set up a calming area, but what if you really want to feature the cozy aspect of a sensory space in a classroom or home? A sensory corner is very much the same concept, with different terminology. The key to a calm down space is incorporating sensory components within these areas.

    Research shows that having a designated space for children to have alone time in, during their school day, is a way to support emotional development and independence, while also teaching children that it is okay for their friends to take a break.

    When combining visual, tactile and other sensory components into the design of a cozy area, children will independently seek it out when they need a break from their peers. 

    in the classroom is a cozy or quiet space for one child to spend time independently when they feel like they need a break from the regular commotion of a preschool day. This area can be used to take a sensory break, to calm down when they are feeling upset or overwhelmed, or to just take a break. 

    This area should be accessible for all children at any time of the school day. This area is best used when it is at the child’s level, is situated in an area of the classroom that is far away from the busier/louder areas of the classroom, and includes sensory supports to encourage calming and peaceful experiences. 

    Whatever you call your safe space, and however you set it up, what matters most is your intention.

    Sensory corners

    Why Use a Sensory Corner?

    A calming corner or a sensory corner may be used for many various reasons.

    There are hundreds of reasons why children might need to take a break from other children in the classroom. They may feel sad, overstimulated or just need time to recharge.

    This may include:

    • Feeling overstimulated in the classroom
    • Overwhelming feelings
    • Needing to recharge or refocus
    • Having a bad day
    • Changes in routines
    • Feeling “out of sorts”
    • Worried about a home situation
    • Worried about a friend situation or social situation
    • Worried about a test or project in the classroom
    • Sadness about home situations
    • Missing family or pets
    • Not sure what to expect or what is expected of them

    Remember that the goal of the sensory corner is to offer a safe space, or to give children a place to calm down, feel safe, and regroup when they are overcome with big emotions at school.

    One thing to consider is that a calm down area of the classroom can be effective at the start of the school year due to transitions in the classroom when a new classroom may mean a lot of unexpected sensory input. This is a great addition to back-to-school sensory activities that support students of all abilities.

    Where to put a cozy area:

    When looking at an indoor preschool classroom set up, there are many centers that are utilized by children throughout the day. The key is to avoid adding visual noise, or visual clutter when adding a cozy area to the classroom.

    Some of the busiest areas include the circle time/gross motor area, the block area and the art areas. These areas tend to attract groups of children at once and aren’t the best spaces to put next to a calming area. 

    The library, dramatic play and animal/science areas, tend to be more quiet spaces in the classroom. Each of these spaces will support a calmer environment to build a calm down area. When deciding what wall or area to place the calm down spot, keep in mind the following environmental components:

    • Is there a window nearby that will give off too much light?
    • Are there large gross motor/sensory spots that are noisy?
    • How many pictures are on the wall, and are they soothing?
    • What are the colors of the walls by the calming area, and are they overstimulating? 
    • Is the space adequate for one child, or will more children try to encroach on their alone time? 
    • Can this space be easily visible by a teacher doing active supervision?
    • Is this space near high traffic areas, like the entry door or bathroom?

    Many spaces may feel like the perfect spot for a calm down space inside the classroom. You know your kids the best and where they spend most of their time. As the school year progresses, there may be times where you want to move your calm down area to a better spot, and that’s okay! 

    Outdoor sensory corner ideas

    Outdoor Sensory corner Ideas

    Don’t forget about the outside as an option for a calm down space! We know the many benefits of outdoors as a calming area, so simply going outside is a great option for calming the mind and body while organizing (or regulating) the sensory motor systems. The outdoors is one way to add free sensory motor options to the classroom.

    We’ve covered outdoor sensory diets before, and this is a great article to start with when considering an outdoor sensory space for home or classroom use. In fact, we love to select specifics for the home too, when it comes to sensory diets in the backyard. Even the playground or recess is a sensory calm down space for some kids.

    Kids need quiet spaces while they are playing outdoors also. When setting up an outdoor learning environment, make sure to incorporate some independent areas in a shady area of the playground. These spaces could be near the garden, near a book reading area, under a nice shade tree or near a swing. You can even add an outdoor sensory swing as a calming option.

    When setting up an outdoor area as a sensory corner for classroom breaks, consider what science says: Research on outdoor sensory play tells us that playing outdoors supports development, but there are emotional benefits as well as benefits to learning.

    Some components to think about when setting up your outdoor calm down area include:

    • Is it sunny or shady?
    • Is it near an area where children will be running quickly?
    • Is it near a highly trafficked area, like a parking lot, walkway or door?

    Quiet cozy areas should be available for children at all times. It isn’t a punishment corner, rather a space that children can “take a break” when they need it.

    Here are 5 simple ways to incorporate cozy spaces outdoors so children have the opportunity to play on their own when needed. 

    1.Place to Sit: The first step to creating a safe space is for children to have a space to be on their own. You can create this in a similar way with an area rug or cushion like the indoors, or you can create something with more of a visual “splash” like these calming spaces in children’s swimming pools. 

    2. Gardens: Nature is a great accessory to a cozy nook area outside. Consider creating a cozy nook with a variety of plants. Adding trellis’s and arches where different vegetables and flowers and grow over a child’s safe space, incorporates natural colors and healthy foods into the safe space that children will spend their time. Sensory gardening is also a great option for a sensory break from the classroom that fosters learning!

    3. Swings: Attaching a child safe swing to a tree provides a sensory rich safe space where children have the opportunity to have quiet time and self soothe. There are so many sensory swing options including a hammock swing and a platform swing. 

    4. Individual Art Space: Child initiated process art in nature can be a calming and essential experience that supports children when they are overwhelmed or overstimulated. A simple way to create this individualized space is by attaching an easel to a fence and offering different mediums to use with the easel (markers, paint, chalk.) Some of these creative painting ideas are fun to try in a sensory calm down space.

    5. Sensory Table: A small sensory table or a sensory bucket is a wonderful way to encourage individual calming time while outside. You can add a variety of different materials to the sensory tub, or offer options of 5 or six sensory buckets. This could include bubbles and wands, sand, goop or some more of these sensory bin ideas. Another idea is to set up a nature table. You could even use a picnic table with a sand writing tray on top where users draw in the sand on the table surface.

    Best Practice for Calm Down Corners

    No matter what you call them: calm down corners, cozy corners, or sensory corners…and no matter where they are located: indoors or outdoors, in the home, or in the classroom, these sensory spaces are a valuable tool for promoting self-regulation and emotional well-being.

    They provide a dedicated space for students to practice calming techniques and engage in activities that help them manage their emotions. Calming corners may include tools such as breathing exercises, visual aids with coping strategies, mindfulness activities, and calming sensory items like stress balls or visual timers…or any item that offers a sense of peace.

    The key is to create an environment that is quiet, comfortable, and free from distractions, allowing students to recharge and regain focus when needed!

    If you are setting up a calm down corner for your classroom as you gear up for a new school year, be sure to check out our resource on back-to-school sensory activities as an addition to your classroom calming area.

    Heavy Work Activities for Calm Down Corners and Self-Regulation

    Including heavy work in a calm-down corner can help children reset their bodies and minds during times of dysregulation. The resistance and pressure involved in heavy work helps to activate the proprioceptive system, which is known to reduce anxiety and improve self-regulation. Use our Heavy Work Activity Cards in your calm-down space to give kids structured, calming options they can choose independently.

    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.