SENSORY SENSE

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Balancing and fine-tuning a sensory diet

boy screaming w yoga ball
How to plan an sensory diet that works:

– Coordinate sensory activity with sensory need
The OT selects activities that meet your child’s sensory needs at the current developmental time. For example, if your son is constantly chewing on his sleeve or collar, his OT might suggest you try activities such as eating chewy or crunchy snacks, drinking a thick liquid through a straw, and blowing bubbles. If your daughter always wakes up too over-stimulated to eat breakfast and get dressed, and instead jumps around on the bed and wakes up her younger sister, her OT might suggest a different jumping activity, such as a brief session on a mini-trampoline in another room, to release her energy without disrupting her sister.
 
– Your child’s behavior clues you in
As in the scenarios above, your child is actually showing or telling you what sort of input s/he needs. Other examples could include rocking in her chair when she’s over-excited; hugging you tightly when he needs to feel more physical contact and pressure; crashing into people and objects. 
 
The OT observes these behaviors, or you tell him/her about them, and the OT suggests activities and strategies that provide the same type, or category, of input, in a more appropriate way. 
 
So the rocking child could take a break in an actual rocking chair before she overturns her four-legged chair; the tight-hugger could wear a compression shirt and get frequent cuddles from his parents; and the crasher could crash into a pile of pillows for a sensory break.
 
– Recognize, and steer away from, stressful input 
Your child is also showing you which forms of input are disorganizing or distressing for his or her sensory system. Is he covering his ears in noisy places? Does she get agitated in crowds? Does he scream when you brush his hair? Is she disorganized when she wears loose-fitting clothing? 
 
The OT observes these behaviors as well, or hears about them from you, and analyzes them to determine what other similar activities or situations may also trigger distress, and advises you of strategies to manage or avoid them.
 
– Use strategies that take into account your child’s age and the context
You want to keep your child’s day running smoothly, so the OT takes into account:
• Using strategies that are age-appropriate and doesn’t make your child stand out from his or her peers (your teenager should be chewing gum, not carrying around a chewy tube)
• Blending strategies and activities into your child’s natural routine and the normal flow of the school day (if everyone else is sitting down doing math problems, your third-grader shouldn’t be doing jumping jacks)
• Using “same but different” activities and strategies that are context-appropriate — your child can use different sensory strategies at home or in another private environment than she can in school or other community environments (your fifth-grader can use a weighted blanket at home and wear a tight undershirt and leggings in public under other clothing)
 
– Utilize a range of sensory activities every day 
Your child needs more than one kind of sensory input so the OT plans a carefully balanced program that includes multiple categories and combinations.
 
For example, a daily routine for a young school-age child might include:
 
Morning:
– His father helps him wake up
– He gets rid of his excess energy by jumping on a mini-trampoline for five minutes
– He eats some dry crunchy cereal and drinks a fruit and protein smoothie through a straw
– He gets dressed
 
School:
– His mother takes him to school a few minutes early so he can run around in the playground before line-up
– The teacher’s aide guides him through an OT-planned mid-morning sensory break in the hall outside the classroom
– At recess, the playground monitor makes sure he does plenty of running around and hanging from monkey bars
– At lunch, his meal includes beef jerky (chewy) and carrots (crunchy) 
– His teacher gives him an unobtrusive activity break, having him erase and wash the blackboards
– At snack time, he eats fruit leather (chewy) and a few pretzels (crunchy) 
 
After school:
– He goes to a playground for heavy body work 
– He eats a snack that gives him more oral work
– He sits calmly and does his homework
 
Dinner:
– He helps with meal preparation by mixing the salad ingredients together
– He helps set the table, including balancing tableware on a tray from kitchen to table
– He eats a healthful meal which includes both crunchy and chewy foods
 
After dinner:
– Family time, which includes making clay sculptures
– He takes a warm bath with a calming lavender essential oil and quiet music
– His mother gives him a massage/back rub while reading to him in a dimly-lit room
– After a big hug and kiss he falls asleep
 
Regulate input
Children almost always benefit if they can follow their sensory diet (or an appropriate modification of it) at school. As we noted before, children can’t learn if they can’t focus, and they can’t focus until their sensory needs are met. Work with your child’s OT and teacher to develop a schedule and accommodations that work both for your child and for the classroom routines. Have the teacher try to keep the timing of a sensory activity break consistent from day to day. If your child has an IEP, or a 504 plan, certain activities and accommodations could be added to the plan. 
 
Put your child in the driver’s seat 
Your job is to help your child recognize what is going on with her body, and become capable of taking ownership to correct the situation on her own. So remember to use the sensory diet cards and keep in the habit of using The Alert Program®’s “How Does Your Engine Run?”® terminology. 
 
It’s really useful to incorporate the ‘engine’ language into the sensory diet routine, so your child can easily express to you, “My engine is running high; my body needs to jump to get rid of some energy” or “My engine is running low; let’s put on some loud music and dance.”
 
Tweaking the sensory diet to make it work smoothly
One of the most difficult aspects of managing SPD is recognizing when your child is over- or under-reactive at a particular time, and then providing her with “just-right” sensory input so she doesn’t overload. Once she melts down or shuts down, it’s harder to get her back to a just-right state than if you can head it off before it happens.
 
You will need to watch your child closely before, during, and after sensory diet activities and share your observations with your child’s OT. Record in detail any behavior changes; if possible, immediately after a sensory activity. The OT can modify the program as needed.
 
Areas of modification include:
– Frequency of the sensory input: How often a child needs to perform sensory activities in order to stay organized varies for each child, and even varies for the same child at different times. 
 
– Intensity of the sensory input: Should she do leg lifts with or without weights on her ankles?
 
– Duration of the sensory input: Should he jump for three minutes or five?
 
– Accuracy of fit of the sensory input: How closely do the sensory activities come to meeting her actual sensory needs?
 
– Timing of the sensory activities: It’s best to use the sensory strategies before activities or situations that usually challenge your child. For example, your child needs to be calm in order to pay attention in class, so it helps to perform the sensory activities before the learning task; ideally in the ten minutes before sitting down to focus.
 
– Incorporation of the sensory activities into daily life and play: It’s important to integrate the sensory diet into every aspect of everyday life.
 
– Consistency of the sensory diet: It’s important to perform the sensory activities every day, as close to possible at the same time.
 
The sensory diet needs to grow along with your child 
As your child’s brain develops and his sensory processing needs change, his sensory diet will need to be updated to provide age- and environment-appropriate types and frequency of activities, and to modify strategies to meet these changing needs.
 
Immediate and lasting effects of a sensory diet
You will be glad to know that the effects of a sensory diet, especially when combined with professional intervention, are usually both immediate AND cumulative. The sensory activities that alert or calm your child are not only effective in the moment; they also help change your child’s nervous system so that in the future she is better able to:
    • tolerate challenging sensations and situations 
    • regulate her emotions and alertness in order to increase her attention span
    • reduce unwanted or inappropriate sensory behaviors
    • handle transitions 
 
Recommended reading
These two books are really helpful:
“Raising a Sensory Smart Child: The Definitive Handbook for Helping Your Child with Sensory Processing Issues,” by Lindsey Biel and Nancy K. Peske
and
“The Sensory Processing Disorder Answer Book: Practical Answers to the Top 250 Questions Parents Ask,” by Tara Delaney
 
Looking ahead:
Next time, we will discuss ways to make a sensory diet fit into your child’s school day.
 
Do you feel that you get good support from your child’s school? Please share your thoughts in the comments section below. Also, let me know there or via email what other 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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