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Problem Preschool Behaviors

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preschool behaviors

Today, we’re covering problem behavior in preschoolers, including behaviors that impact learning and development because of participation in preschool activities. Every preschooler, family, and classroom is different. With the uniqueness embedded into an Early Childhood Classroom, it isn’t uncommon for teachers to have some run-ins with concerning behavior. This blog will teach you the five steps to creating a behavior plan for managing preschool behaviors, which encourages positive interactions with parents and children. 

Problem behaviors in preschool and what's the behavior trigger for preschoolers

The uniqueness of every family and child plays a role in each preschool classroom. Every teacher has expectations. All classrooms are set up differently, and the environment can change, based on the activities and people who are present. Understanding how to support children and their families, while teaching children academic, social, and emotional skills, can be daunting for preschool teachers. 

examples of challenging preschool behaviors

Some of examples of challenging behaviors in preschoolers include:

  • Hitting, scratching, slapping, grabbing
  • Biting, spitting, chewing on non food items, licking
  • Kicking others
  • Bolting out of the classroom or other setting
  • Refusing to work, refusal to cooperate, talking back
  • Yelling, screaming, crying
  • Tantrums – Check out this post on the OT Toolbox to better understand meltdown vs. tantrum behavior

This is just the tip of the iceberg. Do any of these behaviors sound familiar? 

What causes challenging behaviors in preschool?

Before covering strategies to address behaviors that impact learning and the development of skills, it is important to understand why we may see challenging behaviors in the preschool setting.

Based on these Kindergarten readiness standards of emotional readiness, 5-6 year old children are expected to know how to calm down, listen to teachers, follow directions, take turns with peers (this is a great resource on turn taking), and transition between activities throughout the school day. 

When a child enters preschool, they typically haven’t had much experience with some of these tasks. Some young children adapt well to the social and emotional expectations of a large group situation, while other children need extra support. 

Preschool behavior triggers

Behavior Triggers

There can be a multitude of reasons why problem behaviors occur in the preschool setting. Just some of the behavior triggers that lead to common issues in the preschool setting include these causes:

  • Having a new routine (potty training, time change, or differing work schedules of parents are some examples) throws off the child’s ability to self regulate
  • Experiencing a change in home environment (a new baby added to the family, moving to a new home, or other home changes)
  • Not getting enough sleep (check out this article on sleep hygiene)
  • Too much screen time
  • Developmental changes in the preschool age range

Breaking these underlying areas down, it is possible to see three common factors that may trigger a behavioral response between the ages of 3-5 years.

As a related read, check out our fine motor activities for preschoolers as a way to support development during the yearly childhood stage.

Common causes of preschool behaviors

There are three common causes behind preschool behaviors: basic needs need met, environmental issues, or the behaviors of others (peers). Let’s explore each of these common causes of preschool behaviors.

Three common triggers of preschool behavior outbursts:

  • Basic needs (hunger, sleep, thirst, temperature) Is the child hungry, tired or overwhelmed? Is it close to snack time or nap time? Did the child drink enough water while they were playing outside? Basic needs affect everyone differently. Children tend to be sensitive to bodily changes. Medical issues may affect basic needs. Make sure to be in contact with parents about any sort of change in a child’s health. This includes toileting challenges (constipation), new medications they may have been given, and allergy concerns.
  • Environment (changes to routine of the environment, home situation, transportation, changes to the classroom environment: lights, sounds, smells, temperature, distractions, unexpected changes).
  • Behavior of others (behavior of peers, behaviors and actions of adults, parents, caregivers, educators, and behaviors of others in the classroom: other children making noise, someone provoking them, someone else having a tantrum). These friendship activities for preschool can help with this area of social emotional learning.

Triggers of challenging behavior in the preschool age range can be compounded by several of these considerations occurring at one time. Additionally, preschoolers can struggle with communication to let others know what is happening in their world.

How to support challenging preschool behaviors

How to support challenging preschool behaviors

Children learn best from consistency. This pertains to social and emotional expectations, both at home and in the classroom.

Talking to families about concerns regarding their child’s behavior, is one of the hardest conversations that a teacher can have.

By creating a 5 step behavior plan with the family, educators can support children, while also demonstrating to families that they are there to help by teaching their child how to interact and engage with their peers. 

5 Step Behavior Plan for Preschoolers

Here are the 5 steps to complete when creating a behavior plan for a child. Going through these steps, you’ll see that addressing emotional regulation, getting to the root of underlying causes and considerations, creating an age-appropriate plan, including play-based strategies or tools to support development in these areas.

As always, the concept of the “iceberg” of underlying considerations is upheld.

1. Determine the cause of the behavior

There are many different causes of a child’s behavior. Parents and teachers can track the behavior of a child, gathering data using an ABC chart. This refers to antecedent (what happened before the behavior started), behavior (what that child did), and the consequence (how did the child and adult respond to the behavior.) 

When observing children to understand the cause of their behavior, make sure to pay close attention to the common behavior triggers addressed and listed above. Getting clear on what’s causing the visible behavior is essential.

*Keep track of children that are known to have sensory sensitivities (Here are some questions to ask yourself when monitoring the environment:

  • Have you changed anything in the room?
  • Has the weather been different (humid, rain, snow, extra cold or hot)?
  • Is it really bright and sunny, or gloomy and foggy?
  • Does the child have any sensory sensitivities such as clothing, sounds, being touched?
  • Have you changed the classroom routine?
  • Has the child touched or engaged in a sensory rich experience they may not have liked (finger-paint, sensory bin, slime, play dough)?
  • Is the classroom too loud or very busy?
  • Check if the child is wearing something new/uncomfortable (do their shoes fit? Is there a scratchy tag on their clothes? Is their diaper too tight?)
  • Here is a great post on working with children with sensory differences.

2. Talk to parents and caregivers

Once you have narrowed down the cause of the behavior, make a plan to meet with the child’s caregivers (parents, grandparents, daycare staff) to go over your findings. Include any member of their team who spends a great amount of time with this child.

Documented evidence and observations from the ABC chart will give you concrete examples of what is happening, and why. 

When starting the conversation with the family, begin by describing the child’s strengths. Share their child’s favorite activity to do at school, who their friends are, and one great thing they did that week.

Next, show the family the ABC chart, explain what behaviors you want to change, and what new behaviors you would like the child to do instead.

Encourage the family and other caregivers to share their observations of the child at home, and out in the community. 

3. Create goals to improve preschool behaviors

After sharing what you are going to work on with their child, include the team in goal setting, allowing caregivers to share what they would like their child to do. As you write these goal, phrase the goals in a positive way, showing what you expect from the child.

As with all goals, make sure they are measurable and attainable. For goal setting tips, check out this post on using a goal ladder.

Make an appointment for a follow up meeting with the family, so you can check in on how the child is doing at home, at school, and out in the community. 

For example:

  • Jackie will use her words when she wants to use a toy 80% of the time. 
  • Mark will participate in circle time for 10 minutes with supports such as breaks, sensory fidgets, alternative seating without leaving the area.
  • Trent will transition from outside to inside time on her own without maladaptive behaviors or needing to have physical support. 

Next, it’s time to come up with a way to support the child in meeting these goals. 

4. Establish interventions for challenging preschool behaviors

As you determine the interventions to be used at school, share them with the family, encouraging them to use the same interventions at home and in the community.

Children thrive on consistency. When receiving the same messages and intervention techniques at home and school, children will learn the behavior faster. They will learn to carry over the behaviors from one setting to the next.

Three common interventions to include in a preschool behavior plan:

  • Create a calm down corner with tools for emotional regulation- Children tend to become overwhelmed, losing control of their emotions, when they don’t have a positive way to calm down. Soothing Sammy teaches children how to calm down, using visual and tactile tools, while supporting a positive image of feelings. As children learn how to manage their feelings, they are able to communicate and problem solve in different situations.
  • Sensory diet for the classroom – When children become frustrated due to sensory difference, a sensory diet for the classroom and home works wonders, by giving children the tools to cope with their struggle. This list, created by occupational therapists, includes practical strategies easily implemented in any preschool classroom.
  • Utilize Visual and Auditory Cues for Transitions- Children who are overwhelmed or frustrated, don’t always hear what others are saying to them. These transitions for children can be a challenge. The use of visual schedules, visual prompts, and auditory cues remind children what is expected of them, when they aren’t able to process what is said. Using visual tools such as a picture schedule, first/then chart, or picture exchange cards (PEC), while keeping directions clear and simple can help. Adding an auditory prompt, such as a bell or clapping, to signify it is time to clean up, gives children multisensory ways to receive a direction. 
  • Try calm down toys based on the child’s interests.

Check out this visual cue resource for use in daily activities, sensory diets, PECs, and visual supports.

5. Preschool Behavior Plan Follow through 

When following through with a preschool behavior plan, the next steps are important. This follow through looks like many things.

Talking with parents and caregivers, make sure that you follow up with a second meeting to discuss the child’s progress. This is important, as it gives the parents the ability to weigh in on the next steps, the teachers to provide parents with constructive feedback of how their child is doing, and an opportunity to discuss a referral to specialists if needed.

Some of the most common specialist referrals are:

  • Audiologist for a hearing evaluation
  • Occupational therapist for sensory, behavior, motor skill concerns
  • Speech therapist for language delays
  • Early Intervention for developmental delays
  • Behavior therapist for more intensive behavior needs
  • Pediatrician for concerns about medically based delays (including autism, ADHD, nutrition, sleep, or gastrointestinal issues)
  • Note: teachers need to be cautious when suggesting referrals to other professionals, offering possible diagnoses, or alarming caregivers.

check out these other great resources from the OT Toolbox to support behavior

Creating a behavior plan helps parents and teachers work together regarding preschool behaviors. Providing an environment that includes consistency, open communication, and sensory supports, will give every child a supportive environment they need to thrive. This five part behavior plan blueprint includes strategy ideas, goal creation tips and resources for behavior tracking. A behavior plan is an essential component of a healthy classroom.

Jeana Kinne is a veteran preschool teacher and director. She has over 20 years of experience in the Early Childhood Education field. Her Bachelors Degree is in Child Development and her Masters Degree is in Early Childhood Education. She has spent over 10 years as a coach, working with Parents and Preschool Teachers, and another 10 years working with infants and toddlers with special needs. She is also the author of the “Sammy the Golden Dog” series, teaching children important skills through play.

5 Tips for Completing a Feeding Evaluation

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feeding evaluation

An integral part of an occupational therapy feeding evaluation is the food questionnaire or checklist. This is the foundation for building your learner’s food repertoire based on their likes and dislikes. When discussing preferences with the parent and child, the more details they are able to provide, the smoother the sessions will go.

Feeding evaluation tips

How to Do a Feeding Evaluation

The first step to a feeding evaluation is often a comprehensive Food Inventory Questionnaire. By understanding what a child is and is not eating helps the therapist to better understand food preferences in the way of food texture issues, flavors, colors, tec.

The food inventory is a great tool for consistent data collection. Accurate data collection will helpful be able to provide a just right challenge. Before beginning any feeding program, it is important to become educated on feeding therapy, treatment, and problem areas in a thorough feeding assessment. This guide will provide a basic understanding of sensory versus oral motor feeding concerns.

Check out the tips below to help guide your discussion.

When Planning a Feeding Evaluation, Provide Questionnaires Ahead of Time 

The first tip we as OTs love to recommend refers to the pre-referral information. It’s so helpful to get that background information ahead of time.

If at all possible, try to provide a feeding assessment checklist or questionnaire ahead of time, or ask the parent to come prepared with a list of foods that their child does or does not like. This is SUPER important, because asking a parent during the feeding evaluation, does not typically go well.

It is likely that you will not get a complete picture, or the parent will forget some key pieces of information–such as what brand of cereal their child eats or be so overwhelmed they claim their child eats “nothing”.

Not all of the problems presented will be sensory food issue related. There are times when they stem from an oral motor deficiency. It is important to be able to spot the difference before beginning treatment.

During a Feeding Evaluation: Ask About Food Jags 

Tip number 2 when it comes to feeding evals refers to food jags. As parents, you’ll want to tell your therapist about these! And evaluating therapists: make sure you ask if food jags are present.

What is a Food Jag?

The term “food jag” is fairly new term referring to a preference toward a couple of foods, eating them all of the time; suddenly stopping eating a once highly preferred food, refusing to add it back into their repertoire. A food jag refers to the case of children only eating one type of food or a small number of food items. Some common food jags include:

  • The child that only eats chicken nuggets, crackers, and French fries (all foods are consistent in taste and texture.
  • The child that only eats Goldfish crackers, dry cereal, and crackers (all foods are bland, have some crunch, but are thin in width
  • The child only eats yogurt tubes or yogurt smoothie drinks (the consistency and sweetness of the yogurt flavors are satisfying)

Food jags include any small group of limited food selections. These food limitations can change over time.

You’re looking to see if this has happened over the course of the child’s feeding history as it may be indicative of trauma (i.e.-choking), emergence of sensory processing difficulties, and feeding developmental milestones that occur in leaps and stages.

This is also common in people who do not eat a variety of foods. They get tired of eating the same three foods over and over. Food jags can happen to people who eat a variety of foods also, but generally people have other foods to put in its place.

For instance, I may eat peanut butter and jelly sandwich every day for three weeks, then get tired of it. That is fine because I can switch to yogurt, or ham, or turkey. A person with limited food choices loses a preferred food and does not have anything to replace it with.

If you notice a trend of food jags in the child’s history, make sure that you provide education on how food jags occur and how to prevent food them, before they leave the evaluation. 

Complete a Sensory Evaluation of Food- Review Each Food Category 

Tip number 3 for a comprehensive feeding evaluation refers to the sensory aspect of feeding. We really want to break down various foods by category and consider the sensory contributions of the different types of food. Considering how different food is based on sensory factors can open doors for offering new foods in therapy interventions. Just explaining that to parents can turn on a lightbulb!

Even if the parent fills out a feeding assessment checklist/questionnaire and hits all the food categories, fruits, vegetables, starches, dairy, protein (meat, eggs, nuts) and other (snack foods), make sure that you go through the list with the family.

When you review each category, even briefly, it may spark the parent to remember something regarding the child’s eating patterns. 

Consider the sensory evaluation of food including differences in types of food categories, and how there can be minute or vast sensory differences in foods based on preparation (cooked in the oven or cooked in the microwave, different brands (drier consistency vs. saltier flavor), or types of foods (spaghetti pasta vs. smaller elbow noodles).

A food evaluation should take the sensory evaluation of foods into consideration for each meal.

Questions to ask regarding food preferences:

For example, if the parent reports that their child eats noodles, you might want to ask what kind of noodles.

  • Do they eat only elbow noodles?
  • All types of noodles?
  • And all varieties of noodles-egg noodles, veggie noodles, rice noodles? 

Another example of food variables is seen in fruit.

  • Fruit can be whole, peeled, fresh or comes in a container.
  • Apples can be peeled, sliced, or presented whole.
  • How does the child eat them?
  • Mandarin oranges come in syrup or can be freshly peeled. Which does your learner prefer?

If the parent reports that their child is very specific or limited on how they will eat their food, this is a starting place for pushing their food limits and boundaries in the first couple of sessions.

Ask About Brands 

Tip number 4 for completing a food eval is to consider different brands of foods that the child does and does not eat. This tip ties into Tip #3 when discussing the categories of foods. You want to know if the child will only eat a specific brand of food. This is common with cereal, snack foods, pizza, and pastas such as macaroni and cheese. It can happen with all foods, so it’s good to ask.

This may indicate that the child has challenges with processing novel experiences and may be easily distressed by change, from a sensory perspective. It also indicates that the child is very rigid in their thinking and expectations for mealtimes.

You will need to build confidence and trust, as something as small as changing brand of cereal might be a big leap.

during feeding evaluation: Ask About Temperature 

Tip #5 for feeding evaluations is to think about the temperature of foods.

Another aspect to the sensory evaluation of food is the temperature of preferred foods. Ask how the child likes their food served–hot, cold or room temperature. While this may not seem like a big deal, but it can be for a child who is already struggling with introducing new foods and experiences into mealtimes.

It’s also a very personal preference, and by knowing that preference, you have an increased understanding of the child which leads to trust, and eventually a broadened food repertoire.

Sometimes the issue at hand is not the food at all. It is the learner’s difficulty getting it into the mouth. There are many choices when it comes to spoons, bowls, plates, cups, and serving ideas.

Check out some of these ideas to see if these may help your learner with self feeding or trying new food challenges.

Feeding therapy is complicated

Feeding therapy is complicated. Without the right knowledge and tools, therapist/parents can make the problems worse. Take time to get educated on correct feeding therapy techniques. In the meantime, feel free to engage your learner in messy play. This is a great first step to understanding and tolerating new foods.

Other areas to consider in a feeding assessment include:

  • Anatomical considerations of the mouth and tongue
  • Mobility of the jaw, tongue, lips, and cheeks
  • Positioning and body posture
  • Body awareness
  • Developmental progression of oral motor skills
  • Muscle considerations and issues that impact musculature (digit sucking, extended use of bottle or pacifier, reverse swallow/tongue trust, tongue, chewing habits, lip closure, vertical chewing during food prep stage,
  • Structural abnormalities (teeth alignment, tongue tie, palate, tonsils, lip symmetry, etc.)
  • Movements and range of motion in mouth, cheeks, lips, jaw: Jaw Thrust, Exaggerated Jaw Movements, Jaw Instability, Jaw Clenching, Tonic Bite, Jaw Retraction, Tongue Retraction, Tongue Protrusion, Stability Bite
  • Alignment of teeth
  • Presence of gagging or choking on foods
  • Speech skills
  • Sleep habits (sleeping through the night, snoring, light sleeper/heavy sleeper) Support sleep hygiene and even addressing newborns not sleeping through the night as sleep has a role in feeding routine and schedules.
  • Tooth Grinding
  • Phases of food swallow- Oral preparation, Oral Propulsion, Pharyngeal phase, Esophageal phase
  • Vision and Visual motor skills
  • Tone and musculature of the body-impacting range of motion, posture, etc.
  • Fine motor skills

You’ll want to contact a pediatric occupational therapist who is experienced in feeding evaluations, including the oral motor aspect of food assessments.

Feeding Evaluations in the School Setting

While feeding evaluations are not typically done in the school setting for various reasons, there can be some components of feeding that a school based OT will address.

Specifically, the educational model of school based occupational therapy services simply means that feeding aspects may not impact the educational participation of the student. It will definitely depend on the specific needs of the individual, so there isn’t a one size fits all definition to feeding and schools.

For one thing, not all school based therapists are proficient in feeding therapy, and some aspects should be addressed in an outpatient setting under the medical model. And, feeding therapy and interventions can be pretty intensive, and are typically covered by insurance. While feeding is in the scope of occupational therapy’s practice, the risk for carryover, aspiration, and safety protocols for swallowing is simply too great. Feeding is an area of intervention where collaboration and carryover is essential, so the school cafeteria just might not be the safest place for this!

Some areas of feeding that might be addressed in the school setting include:

  • OT can make accommodations for the child like where they sit or who is near them
  • If gag reflux is present when sitting in the cafeteria, then maybe other accommodations are needed and OT can support this area.
  • OT can provide calming strategies before, during, and after eating.
  • OT absolutely can work with the student to make sure they can open food and lunch containers
  • OT can provide seating opportunities for balance and posture when eating lunch
  • OT can offer suggestions for getting on and off the cafeteria benches or lunch table seats, especially if motor planning is an issue.
  • OT can support the self regulation and social aspects of feeding in the school cafeteria.

To address these areas and if you need information on how to request an OT eval in schools, start with our related blog posts.

Food Inventory Tool- A Parent Report Screening Tool

Use the Food Inventory Tool- A Parent Report Screening Tool to incorporate into feeding evaluations to ensure successful feeding therapy.

This tool provides the therapist with a data sheet for a child’s repertoire allowing for consistent data collection over the course of feeding treatment. It also provides the therapist with a professional looking tool and talking point during the initial feeding evaluation to ensure that a comprehensive list of foods the child eats is gathered to support successful feeding therapy.

Click here to get a copy of the Food Inventory Tool- A Parent Report Screening Tool.

Contributor: Kaylee is a pediatric occupational therapist with a bachelors in Health Science from Syracuse University at Utica College, and a Masters in Occupational Therapy from Utica College. Kaylee has been working with children with special needs for 8 years, and practicing occupational therapy for 4 years, primarily in a private clinic, but has home health experience as well. Kaylee has a passion for working with the areas of feeding, visual development, and motor integration.

*The term, “learner” is used throughout this post for readability, however this information is relevant for students, patients, clients, 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.

 

Weighted Vests and Compression Garments

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research vs clinical experience on weighted blankets and compression garments.

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

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

What do weighted blankets do and research vs. clinical experience

Weighted clothing Research review versus clinical observation

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

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

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

Research on weighted vests and compression clothing

Research on weighted vests 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?

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.

Sensory Processing Disorder Chart

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sensory processing disorder chart

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

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

Gaining an understanding sensory processing disorders can have a vast difference in supporting clients, patients, parents, and the entire team involved with children or students who struggle with daily functional tasks as a result of sensory processing differences.

The neurodiversity make us who we are, but understanding how this all works together is pivotal.

For more information on sensory integration, please check out our resource on Ayres Sensory Integration as a tool for understanding the theory behind sensory processes. It can make all the difference in gaining a full picture of the nervous system.

Sensory Processing Disorder Chart

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

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

Let’s look at each of these areas:

Sensory discrimination disorders– 

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

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

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

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

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

Sensory modulation disorder

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

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

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

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

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

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

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

These kids have problems regulating response to sensory input. 

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

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

Sensory Based Motor Disorder

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

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

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

Sensory Processing Disorder Considerations

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

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

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

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

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

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

Impaired Bilateral Motor Coordination

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

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

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

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

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

Tactile Defensiveness

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

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

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

Gravitational Insecurity

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

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

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

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

The Sensory Systems

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

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

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

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

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

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

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

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

Putting it all together

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

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

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

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

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

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

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

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

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

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

Sensory Chart

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

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

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

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

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

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

Free Sensory Processing Disorder CHART

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    More Sensory Processing Information

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

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

    Small World Play Ideas

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    small world play

    There is just something about small world play as a sensory play activity that supports skill development. Occupational therapy and play go hand in hand. When kids participate in small work play, they are building skills in creativity, fine motor skills, sensory exploration, communication, self-confidence, and so much more. Here, you’ll find small world play examples and ideas to support development in these areas.

    small world play

    Small World Play

    Before we go further, let’s cover exactly what we mean by small worlds.

    A small world is a play activity on a small scale. Kids interact with the miniature toys, small sensory tables and use imaginative play to explore and pretend on a smaller scale.

    A small world can be set up in a variety of ways:

    • In a sensory bin
    • In play dough
    • On a train table or other low table
    • In a cardboard box
    • In a low tray
    • On the ground

    One way to think about small worlds is a fairy house: Kids set up a fairy house area under a tree or in a corner of the yard. They can move and manipulate items to use in pretend play: natural material or commercial fairy houses, small objects like pebbles, sticks, bark, and fairy objects. These items are all part of the fairy small world.

    Why Set up a Small World Play Area?

    When kids play in a small world, they develop many areas. Additionally, small world areas offer children in small groups opportunities to experience parallel play in a joined environment so children can see various creative play ideas.

    Most likely to develop is fine motor skills, but other areas can develop, too:

    • Precision
    • Eye-hand coordination
    • Finger isolation
    • Hand strength
    • Visual motor skills

    small world play ideas

    There are items your can use from around the home to use in small worlds. Here is a list of items to gather when creating a little world:

    • Container: bin, box, sensory table, etc.
    • River rock
    • Mini figures: animals, farm sets, train sets, dolls, etc.
    • Sand
    • Fake flowers
    • Craft materials
    • Play dough
    • Beads
    • Sensory dough or slime

    The options are basically limitless when it comes to setting up a small area. Use the examples below to spark more ideas.

    Small World Play Examples

    Our kids love small world play.  We’ve done so many activities that involve little worlds of imagination and pretend.  Small world activities foster language development, story telling, self-confidence, fine motor skills, sensory exploration, and more. 

    Outdoor small world– We set this activity up under the base of a tree. Use materials like sticks, flowers, rocks, pebbles, roots, grass, etc.

    Fairy small world– set up a fairy pretend area in a sand box. Use items like craft houses, rocks, and even glittery items.

    Cardboard box pretend play– Use a cardboard box for a pretend play area.

    Bug small world– Use plastic bugs and a sensory bin to pretend.

    Construction Sensory Table by Preschool Powol Packets  

    Camping Small World by Fantastic Fun and Learning  

    Erupting Volcano Science Dino Play by Adventures at Home with Mum  

    Toddler Tuesday: Sensory Sink by Teaching Mama  

    Dinosaur Volcano Science Sensory Bin by Little Bins for Little Hands   You also might like:

    Dinosaur Small World Activity

    Small World Play Dough Farm

    Animals at the Lake

    Bunny Small World Play

     
     
     
     
     

    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 Fidget Toys

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    Diy fidget toys

    These DIY fidget toys are homemade fidgets that kids can make. Use these fidget items to help kids pay attention and focus in the classroom or home. Add these ideas to your occupational therapy toys that support kids through play while targeting self-regulation skills.

    Kids can use these DIY fidget toys to help with attention and sensory needs in the classroom or at home.

    DIY Fidget Toys

    Fidget toys are in the hands of many school-aged kids.  Students without sensory or attention needs are playing with fidget toys on the playground, on the school bus, and in the classroom.  You can find spinner fidgets, and so many other fidget toys in many stores and online, but what about the DIY version?

    The thing about some store-bought fidget tools is that they are noisy and call attention to the user. Fidget toys have become more popular in recent years, allowing those that truly need them for meeting sensory and motor needs to be more mainstream.

    In fact, using a few of these games with paper clips are good ways to fidget with the fingers using everyday materials.

    However, that can be another issue when a student has a fidget tool in the classroom. It can draw attention to the student because other students see the itm as a toy rather than a tool to support learning.

    Coming up with quiet fidget toys that help the child meet their sensory and movement needs without creating more noise or attention in the classroom can be tricky. Here are more ideas for quiet fidget toys for the classroom.

    So what is the obsession with these fidget toys?  

    The fidgets are intended to provide kids with a means to occupy their hands so that they can focus during tasks that require attention.  There are many children who need fidget tools in order to complete work.  Most of us know the feeling: the urge to doodle when talking on the phone or the tendency to tap a foot during a lengthy work meeting.  

    Fidgeting is a tool that helps us to actually pay attention and focus on the task at hand in many situations. Fidgeting during homework or in the classroom is a common behavior. 

    Diy fidget toy for kids to use when learning
    Make a DIY fidget toy using beads and a craft stick.

    DIY Fidget Toys

    Affiliate links are included here.


    You have probably seen kids (and maybe your own kids) spinning these spinner fidget toys.  

    The fidgets that are in every school and classroom these days are beneficial to some students.  For others, they are a cool new toy.  For those that require a fidget tool to focus or attend, or have sensory needs requiring the hands and fingers to move, other fidget toys may work just as well. 

    keychain fidget toys
    Keychain fidget toys can be a great way to add movement inexpensively.


    Fidgeting during work stimulates the brain, allowing a child to complete school work or homework.

    Fidgeting is mindless play or touching fingers, pencils, hands…anything that allows a person to focus on the task at hand. Kids that are fidgeting are seeking calm, and focus so that their brain can complete a task.

    The problem is when the brain’s urge to fidget distracts a child from school tasks. They might be so wiggly and moving that they just can not sit still and focus in a functional manner. Fidgeting can be managed with less distracting techniques which can allow the child to accomplish the homework, and move on to other things.

    Calming weighted fidget toys for kids
    Use a glove to make a weighted fidget tool for kids. Here are the instructions for this DIY fidget tool.

    Homemade Fidget Toys for Kids

    Here are a variety of DIY fidgets that can work for kids in the classroom or at home:

    How to Make Fidget Toys

    Getting kids involved with making homemade fidget toys is part of the fun. There are fine motor benfits involved in this process, too.

    1. First, select the type of DIY fidget you would like to use to meet specific needs.
    2. Next, select materials. You may need pipe cleaners, beads, balloons, or nuts and bots.
    3. Prepare a work space. Set out the materails on a table or desk.
    4. Students can select the materials they would like to use.
    5. Create a fidget tool using the materials.

    The nice thing about fidgets is that with the growth of YouTube as a resource, there are many videos on how to make fidget toys out there. Use one of those available videos as your inspiration, or use the materials you have on hand.

    If one thing is for certain, it is possible to make a DIY fidget toy using anything!

    homework fidget toys
    Try these suggestions for homework and classroom fidget tools.

    What are your favorite DIY fidget toys?  Do you have any favorite tools that work for your child, student, or client?

    fidget tool or a fidget toy? 

    Here is your disclaimer on the wording of this blog post…

    The term fidget toy is very well known these days, with the popularity of spinner fidgets.  However, there is a distinction between a fidget toy and a fidget tool.  When there is a therapeutic need for a product, it is a tool.  A therapy tool is one that helps meet goals, results in independence through intervention.  Something that looks like a toy can be a tool for the child with sensory needs, fine motor challenges, attention difficulties, or any other problem areas.  

    Fidget tools are those that help kids cope, meet sensory needs, and get the input they need so they can focus, pay attention, and move. In this blog post, I am using these terms interchangeably, for best search results. In other words, people complete a Google search for fidget toy, not a fidget tool, and I want this information to be found on Google so that the kids who need a fidget tool are well-served!

    These DIY fidget toys are a perfect addition to the classroom to address sensory and attention needs in kids.

    Need to add DIY fidget toys to a sensory diet? Wondering how to integrate a sensory diet into everyday tasks? A sensory lifestyle may be more of what you are looking for! DIY fidget toys fit right into a sensory lifestyle with ease and flexibility.

    Read all about how to create a sensory lifestyle here:

    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.

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

    Sensory Summer Camp at Home

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    sensory camp for summer

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

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

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

    Sensory Summer Camp

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

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


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

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

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

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


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

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

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

    Grab the Spring Occupational Therapy Activities Packet HERE.

    summer occupational therapy activities for kids

    n the Summer OT packet, you’ll find:

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

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

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

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

     

    Occupational Therapy Summer Camp

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

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

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

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

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


    Outer Space Summer Camp at Home Ideas


    Circus Summer Camp At Home Ideas

    Sensory Handwriting Camp

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

    Sensory Space Camp | My Mundane and Miraculous Life


    Sensory Olympic Games Camp | Growing Hands on Kids


    Sensory Nature Camp | Putting Socks on Chickens

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

     

    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.

    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.

    Summer Sensory Stations

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    Summer sensory activities

    Today’s sensory resource is a self-regulation tool that is very popular among therapy professionals and educators: an all-new Summer Sensory Stations set! This set of printable sensory path activities are nice because they can be printed off, laminated (or placed in a page protector sleeve), and hung in a hallway. We’ve received so much great feedback about out other seasonal sensory stations that this summer version was a must! Add this resource to your Summer occupational therapy activities.

    You’ll want to check out the other sensory station printables at the bottom of this post.

    Free summer sensory stations for a DIY sensory path or self-regulation tool with a summer theme.

    Summer Sensory Stations

    A DIY sensory path can include a few quick stops to add deep breathing, mindfulness, proprioception, vestibular input, eye-hand coordination, crossing midline, and whole-body movement.

    And that’s just what this set of summer themed sensory stations includes!

    The movement-based stops offer users to take a break at various stations and integrate movement, coordination, and visual input with deep breathing, and heavy work.

    What a great way to add a quick brain break between activities or to get ready for a therapy session!

    In this summer themed set of activities, you’ll find a printable page for each “station” or stop along the sensory path:

    Bee path infinity loop-

    The first page in the summer sensory path kit is a bee infinity loop, which is great for mindfulness, deep breathing, crossing midline, eye-hand coordination.

    Tracing the infinity loop offers an opportunity for mindfulness through the summer bees’ paths as they move along the loop. This creative way to foster visual attention, self-regulation, self-awareness, coping skills, and concentration is fun for summer! By tracing the loop, hand-eye coordination and mindfulness allow the user to be more present in the moment, and more aware of themselves.

    Some users may stand on an uneven surface while doing this activity to challenge balance and visual skills. Think about adding a gymnastics mat, slant board, balance pod, or other uneven standing surface.

    Others may want to kneel or do a lunge while completing this activity to further challenge balance and coordination skills. The nice thing about the printable sensory station is that it can be raised or lowered on the wall easily.

    Leap like a dolphin-

    The next page in the sensory paths for summer is a “leap like a dolphin” activity. It’s a powerful activity for vestibular input, motor planning, and proprioceptive heavy work

    Proprioception offers a way to “wake up” the joints and muscles in the body. This leaping activity can be done from a standing, kneeling, or from the floor. Proprioceptive input from the muscles and joints provides information about body position, weight, pressure, stretch, movement and changes in position in space, so this leaping activity adds a summer theme!

    Beach ball wall push-up-

    Next in the Summer Sensory Stations kit is a beach ball wall push up page. Add whole body proprioceptive input through the upper extremity: shoulder girdle, elbows, wrists, and arches of the hands. Plus wall push ups are a great strength and stability exercise for the core.

    You can modify this activity to place it lower on the wall for a lunge position, or even can do the wall push-ups from a seated position to challenge seated balance. This is a great motor and sensory opportunity for wheelchair users.

    Seashell trace and breathe printable-

    Users love our spiral path deep breathing exercises. There is so much heavy work benefit to filling and emptying the lungs as a self-regulation strategy.

    Follow the circular path from the crab to the seashell while breathing in. Then follow the path again to breathe out. This visual offers a deep breathing exercise for filling and emptying the entire lungs, which is a great interoception and proprioception exercise for mindfulness and self-regulation.

    Summer Sand Squats-

    Finally, the last page in the Summer Sensory Stations printable is a summer-themed squat exercise.

    Users can do a certain number of repetition of squats along with the visual for a balance activity and coordination exercise. This visual is left open-ended but you could challenge users to pick up an object from the floor for more balance opportunities, or you could ask them to move their hands or keep their vision on an object for visual attention, etc.

    How to Use these Summer Sensory Stations

    Using these Summer sensory path stations is simple:

    • Print off the pages.
    • Laminate them or slide them into a page protector sleeve. This way the sheets can easily be cleaned with a spritz of cleanser or disinfectant spray.
    • Hang the pages in a hallway to create a DIY sensory path. Or, hang them in a corner of a room to make a sensory calm down corner.

    You can use these stations as a brain break, a scheduled sensory diet activity, a calm-down activity, or a transition activity for routine sensory input. The stations are great because they can be used with all individuals, making them perfect for a groups of children at a sensory summer camp (or any type of summer camp!) or meeting individual needs during therapy sessions.

    Want these Printable sensory Stations?

    Enter your email address into the form below. You’ll receive an email containing the PDF file. This resource is also available in our Member’s Club, where members can head to the dashboard and click a download button to immediately access the printable along with hundreds of other resources…no need to enter your email address!

    Want to add this resource to your therapy toolbox so you can help kids thrive? Enter your email into the form below to access this printable tool.

    This resource is just one of the many tools available in The OT Toolbox Member’s Club. Each month, members get instant access to downloadable activities, handouts, worksheets, and printable tools to support development. Members can log into their dashboard and access all of our free downloads in one place. Plus, you’ll find exclusive materials and premium level materials.

    Level 1 members gain instant access to all of the downloads available on the site, without enter your email each time PLUS exclusive new resources each month.

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    Free Summer Sensory Stations

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      Looking for more Sensory Stations?

      Check out these other themed sensory station printables:

      Colleen Beck, OTR/L 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.

      Shirley Temple Popsicles Recipe

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      Shirley Temple popsicle

      Today’s Shirley Temple popsicle recipe is a cool treat for summer, but also a great way to get kids busy in the kitchen cooking and developing skills. We’ve shared a ton of cooking with kids recipes, and this 7up popsicle recipe is even better because its an alerting sensory food that can be a great sensory tool for this time of year.

      Shirley temple popsicles are a sensory food. Use lemon lime popsicle treats to wake up the mouth!

      Shirley Temple Recipe

        I wanted to share a sweet treat with you  today that my kids ( and the neighborhood kids) love. Who doesn’t love Shirley Temples? These are in popsicle form and are oh so good. I hope you enjoy!   

      When I was a little girl, there was a seafood restaurant in the town we lived in called Neptune’s Galley. I have no idea if that restaurant is still in business or not, but I remember it vividly. There was a huge statue of Neptune on the roof of the building and it was dark and nautical on the inside. I have to admit, I do not remember the food that was served there.

      I remember first being introduced to Shirley Temple’s!

      At the time, my favorite movie just happened to be Shirley Temple in The Little Princess. And my daddy knew that and ordered me a Shirley Temple to drink…and the rest is history.

      I think I requested that drink at every restaurant  we ate in for the next five years after that!

      In case you didn’t know, a Shirley temple drink is a kids’ drink that has 7up, Sprite, or other cool and refreshing fizzy drink. You add a touch of cherry, and maybe another fruit juice, and you’ve got yourself a kid-friendly drink that is a huge hit.

      Therapy Benefits to Make these Popsicles

      Not only are these popsicles a fun treat, there are also benefits to getting kids involved in the actual preparation process.

      Pour and Scooping Activity- The best thing about making a Shirley temple drink with kids is that it’s an easy recipe. There are only a few ingredients, but children can pour and scoop the food items, working on so many fine motor skills. By pouring and scooping the ingredients, you address bilateral coordination, crossing midline, eye-hand coordination, strength, graded motor control, motor planning, and much more.

      Fine Motor Skills- We’ve covered the benefits of fine motor development during cooking in the past, and this is a great starter recipe to try with kids…they get a huge reward in the end- a refreshing Shirly Temple popsicle!

      Executive Functioning Skills– Another benefit to making this Shirley Temple recipe is to add executive functioning skills while following the directions to prepare the recipe.

      Shirley temple popsicle on a plate

      Shirley Temple Popsicles Recipe

      Cold, bubbly Sprite, grenadine and a cherry on top. Oh, how I loved getting that pink-tinted drink brought to me. I felt so grown up!

      Flash forward 20 years. My boys and I were at Red Robin and I introduced them to Red Robin’s Shirley Temples.

      Ummm, they were not impressed. I guess it is a girl thing. They ended up with root beer floats. But I was determined to get them to like them!

      So last week I set out to make Shirley Temple Popsicles.

      At first I tried with just Sprite and maraschino juice. Eh. Then I added cherries to the mix. Still not right. So, after a few trial and errors, I added fresh orange juice, sprite, cherries and cherry juice. Perfect. And the boys ate them all.

      So here is to nostalgia. And Shirley Temple!

      Ingredients:

      • 2 cups Sprite or 7-Up soda
      • 1/2 cup fresh orange juice ( it took about 3 medium oranges to get the juice I needed)
      • Grenadine (I find this in the aisle with the margarita mix, etc)
      • Maraschino cherries

      Directions:

      1. In a large mixing cup, combine the soda and the orange juice. Set aside.
      2. Fill popsicle molds with maraschino cherries. (Mine were smaller molds, so I used 3 cherries in each mold.)
      3. Add about a teaspoon of grenadine to each mold. (You could use the cherry juice in the bottle of cherries, if there is enough, in place of the grenadine)
      4. Add the soda and orange juice mixture to each mold, about 2/3 full. Don’t fill to the to the top of the molds. It will expand after freezing.
      5. Place tops on popsicle molds and freeze.

      Sensory Food

      This popsicle recipe is a great sensory food, because of the alerting factor the cool ice pop offers to the mouth. We talked a lot about the benefits of sucking and alerting or calming properties of cool and warmth on this website in the past.

      In fact, our post on using a sports bottle as a self-regulation tool shares information on the sensory receptors in the mouth and jaw. It is these receptors that register the cool, alerting temperature of a popsicle.

      The cold temperature alerts, or “wakes up” the mouth. This can be a great sensory strategy to use for achieving attention or focus. It can help to regulate a child’s sensory needs when they are feeling lethargic or overly run-down.

      Not to mention that during the hot summer months, a cold popsicle is the perfect treat!

      However, there’s more to it than that. Sucking on a popsicle engages proprioceptive input through the muscles and joints in the mouth and jaw. Essentially, the popsicle is a strategy to offer heavy work through the mouth. So, a popsicle can actually be calming, too. It really depends on the child as well as the situation.

      Think about a hot and humid summer day. A popsicle and a moment of chill-out time can help a child to calm down, re-group, and regulate their senses.

      As an added benefit, a popsicle can be a great tool to use in oral motor exercises.

      Lemon Lime Popsicle

      Important to note about this recipe is that you can use Sprite or other pop or soda that contains lemon lime flavoring as one of the main ingredients.

      The lemon-lime flavor is very alerting, as they are citrus foods. This flavoring in the popsicle “wakes up” and alerts the taste buds and acts as sensory input.

      One tip: If you are concerned with the sugar intake, or want to find a lower sugar version, consider using low calorie lemon lime drink or 7-UP ten as an alternative to the lemon lime popsicle treat.

      So? What do you think? Let us know if you make Shirley Temple popsicles and use them to develop skills!

      Colleen Beck, OTR/L 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.

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