SENSORY SENSE

The JumpTherapy Blog:
Sensory Processing, Motor and Social Skills Resources
for Parents of Special Needs Children

Enlisting a ‘Chef’

Your child’s OT will plan an individualized sensory diet

Your Child’s Personal ‘Chef’
What should I expect from the OT?
An occupational therapist (OT) can design an individual routine of activities for your child that fits his exact needs and schedule. The OT will do the activities with your child during therapy sessions, and show you how they should be done, so s/he can also do them at home with your supervision.
 
Can I plan my child’s sensory diet?
If you aren’t able to see a therapist, try doing some sensory activities on your own with your child. Just realize that if it doesn’t work, it doesn’t mean that a sensory diet doesn’t work. It most likely means that you need an OT’s help to develop a unique activity plan for your child. They have training in working with sensory children that most people don’t have.
 
How does the OT work with my child?
Pediatric occupational therapists who specialize in working with children with Sensory Processing Disorder have the skill, knowledge, and experience to evaluate your child from multiple perspectives, see what sensory activities s/he gravitates towards, and work with you to create (and fine-tune) an individualized sensory diet.
 
The OT usually begins by ascertaining your child’s “concern areas” of sensory hypo- (under) and hyper- (over) reactivity. So you will need to supply very detailed information on how your child reacts and responds to different things throughout the day (see next section). OTs also make their own observations. 
 
Using their observations and yours, OTs develop strategies to help up-regulate or down-regulate your child’s concern areas. The OT determines the amount, type, and frequency of sensory input and activities your child needs in order to function at his or her optimal level. This becomes a sensory diet providing “just right” challenges to help your child move into a “just right” state to focus and function well.
 
Also, very often children are more willing to try new things if they’re asked to by someone other than a parent — that’s one more reason why an OT can be an invaluable part of your child’s sensory support team.
 
How can I help?
Nobody knows your child’s routines and sensory challenges like you do. So you need to provide the OT with a lot of information (if this seems overwhelming, pay close attention to your child’s daily patterns and journal them for at least a week):
 
General sensory background and information:
– What situations and stimulations over-arouse your child?
– What situations and stimulations make your child lethargic?
– What generally works to wake up (alert) your child?
– What generally works to calm your child?
– What have you tried that has not worked?
– Which activities, tasks, etc., are difficult for your child?
– Which activities or environments cause the most negative or unfocused behavior?
– Which activities or environments cause distress?
– What triggers a complete meltdown?
– Which environment/s best allow/s your children to focus, learn, or work?
– Which environment/s best allow/s your children to play?
– Which environment/s best allow/s your children to rest or sleep?
– What time/s of day are your child’s ‘best’ time/s?
– What time/s of day are your child’s ‘worst’ time/s?
– Are there any patterns that you notice?
– What is your child’s favorite activity? 
– What is your child’s least favorite activity? 
 
Keep track of specific incidents that occur that interfere with your child’s daily routine:
– Where were you?
– What time was it?
– What specifically triggered the incident?
– Exactly what reaction/behavior did your child have?
– How long did the reaction last?
– Did it interfere with your child eventually getting the task done (such as doing homework, going to bed, etc.)?
 
Keep track of what brought the incident to a close:
– What made the behavior stop? 
– Was there a sensory experience or activity that helped? If so:
– How long did it take to work?
– How did your child react to the activity?
– Did your child conclude the helpful activity on his own or did you stop it?
– How did your child react/behave after the activity ended?
– Did the activity interfere with your child performing the original task afterward?
– Does your child have trouble with transitioning in general?
 
What other observations do you have for the OT?
If you share all the information you possibly can with the OT, it will be easier for him/her to plan out a specific, individualized sensory diet for your specific, individual child.
 
What will the OT do with this information?
The OT helps you determine whether you need an activity to fill a sensory need so your child is able to focus, or if your child needs a modification to the environment in order to be able to function optimally. 
 
The OT will help you identify exactly:
– what sensory activity or input your child is “missing” and how you can provide it.  
Then the OT will suggest a few similar activities that provide comparable input to what your child is craving, and explain how these activities can be adapted for home or for school.
 
– what sensory activity your child is avoiding and how you can remove or adapt it, or prepare your child to tolerate the activity if there is no other option.
Then the OT will suggest a few similar activities that can be substituted for the ones your child wants to avoid; offer ideas for modifications to make the original activity tolerable to your child; suggest ways to prepare your child for an activity that can’t be avoided; and go over with you what you can do at home or at school to achieve this.
 
The OT will set out all the specific, unique ingredients that make up your child’s daily sensory diet.
 
But that’s not all
Now it’s time to road-test the sensory diet and modify it as needed. The OT developed this custom diet, and it’s up to you (and your child) to 
A) actually implement the sensory diet every day; and 
B) monitor how it’s working and what needs to be adjusted if your child still isn’t functioning at his/her peak potential.
 
It’s a balancing act
Sensory diets are not a one-time solution. You and the OT will need to work closely together to tweak the diet; adding, subtracting, and changing items and activities, until you find a winning combination.  
 
Be aware that what works now may not work next month (or even tomorrow). This is why communication with your child’s OT is so important. I have ‘my’ parents check in regularly via email between visits to let me know what is and what isn’t working so I can help them fine-tune the program. Also, since kids change a lot — even from month to month — I want to be able to suggest further options as soon they are needed.
 
In order for a sensory diet to be successful, the OT and parents must communicate and  collaborate effectively; and the family (and school) must be consistent about following through.
 
You need to field-test the strategy a few times
The same sensory activity or strategy can work differently at different times of the day, and in different environments or situations. Also, what doesn’t work today may work tomorrow, even in the exact same context. It depends on your child’s sensory processing on that day, in that moment, which is affected by many different variables. So you will want to try an activity or modification at least three times before you conclude that it doesn’t work.
 
Sometimes an activity not only won’t help, it may even make the situation worse. That’s why you need to be prepared with another activity if the first one doesn’t succeed. The activities need to be different but comparable; they need to provide the same type of missing sensory input in different forms. Remember, even if an activity doesn’t work, you’ve learned something which you can apply to later situations. 
 
The puzzle starts to come together
Eventually you will see patterns,  and you will learn what usually works for what you’re trying to accomplish (calming or alerting). You’ll be able to anticipate an oncoming trouble spot so you can head it off by providing an appropriate activity in advance. Being proactive means that your child can continue smoothly with her day without being derailed by sensory needs that prevent her from focusing. Once a child gets to the point of a meltdown, it’s much harder to get him back on track than it is to prevent the meltdown in the first place. If you make a sensory diet a natural part of your daily routine, your child is less likely to reach meltdown point.
 
In practice, sensory activities are fun for you and your child to do together
The good news is, it may seem like a lot of work to you, but your child thinks s/he is just having fun. Every child, “sensory” or not, benefits from creative play with his parents. And you get to spend time with one of your favorite little people, perhaps using fun toys and products, perhaps “only” using your imagination and creativity.
 
Looking ahead:
Of course it takes work, consistency, and persistence, but it all pays off when you see your child regulating sensory input more efficiently — and thriving. In the next post, we will discuss what goes into creating a sensory diet.
 
Have you noticed any patterns in your sensory child’s moods and behaviors? Please share your thoughts in the comments section below. Also, let me know there or via email what topics you would like to discuss or hear more about. 
 
Feel free to share or quote from this blog (with attribution, please, and if possible, a link), and to repost on social media.
 
 
I look forward to hearing from you!
 
 

All the best,
Miriam

About Miriam:
Miriam Skydell MS, OTR/L is a pediatric OT with 30 years experience and a strong commitment to empowering every child and every family with the skills, confidence and emotional stability necessary for a meaningful, independent life. In addition to her Masters degree from NYU (1986) and membership in the AOTA (American Occupational Therapy Association), Miriam is a licensed Interactive Metronome®,  HWT (Handwriting Without Tears®), and TLP (The Listening Program®) provider.

Miriam performs preschool screenings, contracts experienced OTs, PTs and STs to schools, helped implement the HWT curriculum, and lectures extensively for parent and support groups and at teacher conferences for public and private schools throughout New Jersey. Through her private practice in Fair Lawn, Miriam Skydell and Associates, established in 1995, Miriam has helped countless children with a wide range of diagnoses improve functional living skills, manage the impact of sensory processing dysfunction, and meet their individual potentials.

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