Category Archives: Sensory

Investigate evidence-based sensory integration strategies and therapeutic tools designed to help individuals of all ages regulate sensory input, enhance emotional regulation, and improve behavior, attention, and participation across a variety of environments.

Practical and Effective Strategies to Improve Self-Regulation: Recap

Events & Conferences, Sensory Regulation, , ,

Jocelynn Wallach, MS, OTR/L‘s September 15th Saturday Seminar entitled: Practical and Effective Strategies to Improve Self-Regulation and Executive Function Skills, was a two hour presentation filled with useful and immediately applicable information. She shared valuable insights and information with the 51 captivated attendees!

With a wealth of over 40 years of pediatric experience in her distinguished career, Jocelynn provides innovative occupational therapy services for children in the Westwood, MA Public School System. In addition to her school-based practice, Jocelynn manages her private practice, Capable Hands and Associates. In addition, she has lectured nation-wide, taught college level courses, and provides training sessions and professional development courses for parents, therapists, instructional aides, and therapists in a variety of settings.

Jocelynn’s learning objectives for her seminar included reviewing the meaning of self-regulation and executive function skills based on the work of A. Jean Ayres, Lucy Jane Miller, Peg Dawson, and Richard Guare. Based on their body of work, she concludes that “self-regulation, which is the end result of well developed sensory integration and effective sensory processing, is the basis upon which higher level executive function skills can develop.”

Jocelynn provided an excellent review of neurological function to illuminate the relationship between self-regulation and executive function skills. She then proceeded to highlight the developmental stages of self-regulation and executive functioning from infancy through adolescence. She discussed “red flag” behaviors that might be observed when a sensory processing disorder and/or executive function dysfunction is present. The following website was recommended to help parents and school personnel have a better understanding of learning processes, insights into difficulties, and strategies for responding: Misunderstood Minds.

To make classrooms and home more conducive to learning, Jocelynn provided a number of useful recommendations with guidelines for calming and guidelines for alerting. She advocated for examining the child’s environment closely and the importance of trying out different environmental changes to determine their effectiveness. For example, simple seating adaptations can make a world of difference. Jocelynn shared her “Seating Options Data Collection” system to help determine what works and what does not work for a particular student.

Activities and apps for helping students improve executive function skills in areas of planning, organization, time management, task initiation, etc. were discussed. Several examples of useful apps she uses include: for self-regulation – Pocket Pond, Fireworks, Pot Smash – Zen; for sustained attention – Monster Hunt, SIMON – I Say Pro, Eye Frenzy; and for planning – Voice Thread, Sticky Notes, Doodle Buddy. Some materials she suggested for therapeutic motor breaks include: Bungee Jumper, Thera-band activities, Rapper Snappers, Safety Grip Scooter Board, Drive Thru Menus, and How Does Your Engine Run?, to name just a few!

Jocelynn is a skilled and generous presenter who is very knowledgeable, as evidenced by a rapt and engaged audience. She has developed practical strategies, activities, and data collection methods to improve self-regulation and executive function skills that are designed to ensure student school success.

Attendees provided extremely positive feedback about Jocelynn’s seminar:

“Jocelynn is a great presenter and shared information that is relevant to our daily OT sessions, along with how to support teachers and provide strategies for class use!” – Amy H., Occupational Therapist

“A lot of tools, examples, and resources provided. Love the apps shown during the seminar!” – Vanessa C., Occupational Therapy Grad Student

“Very informative. Lots of suggestions. A review and a new way to look at things. Got my brain thinking. Good presentation.” – Anonymous, Teacher

“It was very comprehensive! Loved it!” – Patricia O., COTA

“Thank you so much for sharing! Just so fantastic. Wonderful, inspiring; gave me realistic ideas to hit the ground running. Thank you. So excited to share this with teachers & staff I work with!” – Tara G., Occupational Therapist

Thank you, Jocelynn!

Filomena Connor, MS, OTR/L
September 15, 2018

Tips to Help Special Needs Kids Tolerate Grooming and Hygiene

Daily Living, Sensory, ,

Occupational therapists are the “ADL specialists” on a treatment team. Building independence in self-care isn’t always the problem we are addressing.  For younger kids or multiply challenged children of any age, simply tolerating experiences like nail cutting, haircuts and face washing can be the hardest part of the day. Helping children and their families to make grooming and hygiene less of an issue can improve children’s sense of safety and control.  It can even build the relationship between caregivers and children.

When evaluating a child’s aversion to ADL’s, look to the comprehensive OT evaluation.  While the Sensory Profile or the SPM will highlight specific challenges in oral or tactile domains, looking at a child’s level of motor, visual-perceptual and behavioral functioning provides a more complete picture of the child.  Postural issues, issues with endurance, attention, or identifying unique behavioral/emotional expression of frustration will suggest potential treatment pathways or complications.

Prior to Grooming And Hygiene Activities:

Directly address sensory-based issues in a comprehensive manner.  Use of the Wilbarger Protocol, creation of a sensory diet and selecting tools to desensitize aversive response can support even the most agitated child. Brief activity on a Therapy Ball can increase postural activation while modulating arousal prior to ADL’s. Other children benefit from other oral/facial input before tooth brushing or having their face washed.

Wilbarger Therapressure Brush
Wilbarger Therapressure Brush

During ADL’s:

The use of sensory and behavioral activities can help increase and lengthen tolerance.  Some children benefit from sitting in a Beanbag Chair during grooming to provide calming input and postural stabilization.  A visual timer supports a child to understand that the activity will end and provides an objective measurement.  This could reduce the child’s use of whining or aggression directed at the caregiver.   A Weighted Lap Pad can be helpful calming input to an agitated child.  Children with sensory seeking as well as sensory sensitivity often prefer a weighted object with texture.

Bean Bag Chair
Bean Bag Chair

Time Timer
Time Timer

Weighted Turtle
Weighted Turtle

Sit Tight Weighted Lap Pad
Sit Tight Weighted Lap Pad

When the ADL Task is Completed:

Aversive responses can continue long after a child demonstrates minimal or no observable aversive response in a treatment session. Why?  Because children are more than a stimulus-response cycle. They develop a sense of anticipatory anxiety and have habitual reactions that can be triggered even without sensory input.

Replacing old behaviors with more functional new habits may require slowly adapting ADL routines to decouple sequences that elicit aversion.  An example of this would be allowing a child who is agitated during feeding to briefly play with washable items after a meal but before cleaning his hands.  Any residual agitation from distressing feeding experiences could dissipate partially or totally before the caregiver uses deep pressure input to wipe the child’s hands.

Supporting children for ADL tolerance and eventual independence requires us to use our task analysis and evaluation skills in creative and complex ways.  Building tolerance and independence is our initial goal, but successfully navigating daily ADL experiences will have wide-ranging effects. Improving grooming and hygiene experiences helps families feel calmer around ADL’s in general, improves communication, and deepens trust between caregivers and children.

Guest Blogger: Cathy Collyer, OTR, LMT, PLLC

Cathy Collyer, OTR, LMT has treated children with neurological, orthopedic and sensory processing disorders for over 20 years. She is the author of The Practical Guide To Toilet Training Your Child With Low Muscle Tone. Learn more about her work at tranquilbabies.com.

Brain Gym: Using the Figure Eight in OT

Motor & Movement, Sensory, , , ,

I came across Educational Kinesiology in the early 1990s when searching for tools or techniques to help heal from a chronic illness. Little did I know that it would become an integral part of much of my OT practice. I began with Brain Gym I and II and loved the fact that the two trainers in South Africa were experienced occupational therapists trained in both SI and NDT.

Brain Gym is wonderful for assisting with goal setting, whole brain learning, stress release, and re-patterning. Although there is a specific process to follow, many of the exercises are both beneficial and transferable into a regular OT session. One that I use a lot is the Lazy 8 – a figure eight that lies on its side like the infinity sign.

What is the Brain Gym figure eight used for?

In Brain Gym terms, the Lazy 8 turns on or activates the eyes while also crossing the mid-line.

It can be used to improve ocular motor function, which assists with reading, and crossing the mid-line improves integration between the two hemispheres of the brain.

The repeated action of the Lazy 8 is also very calming. It can be used in several different formats – using the eyes, drawing the figure of 8 in the appropriate orientation, and in motion, as we shall see shortly.

The Lazy 8 can also be carried out as a motor activity, having the client walk, skip, or run around a figure eight. I love to use two hoops placed side by side on the floor to provide a visual cue. Varying the space between the hoops elongates or enlarges the figure eight. Make it more fun by having the client clap while moving around the figure of eight in time to music.

For added motor integration, combine the cross crawl with the Lazy 8. This often has to be carried out in stages:

  • Having the client carry out their cross crawl while standing until they are sufficiently at ease with the exercise
  • Upgrade to carrying out the cross crawl while walking on a straight line
  • Upgrade further to doing cross crawls while walking a figure eight

When I first began using components of Brain Gym in my treatment sessions, I would often make up my own worksheets. I am delighted to discover that Therapro has a range of products that bring the figure eight into practice for all occupational therapists. Two examples include:

The development of these tools shows how Brain Gym is becoming accepted as a beneficial modality to use within OT. It also provides an added level of professionalism, which is important for anyone who is skeptical of either how Brain Gym combines with OT or the extent to which OT itself is a recognized profession.

Once clients are familiar with the Lazy 8 through either Trace the 8s or Race the 8s, introducing the Alphabet 8 helps improve their motor memory. The Alphabet 8 incorporates lower-case letters with the Lazy 8 and is wonderful as a pre-writing activity to enhance work to meet writing goals. It’s designed for English letters but, with some creativity and practice, cursive letters for Hebrew can also be used. Note, I am not sufficiently familiar with other alphabets to know how well they can be used in the Alphabet 8.

I mentioned earlier the benefit of improving a sense of calm. The rhythmic movement of drawing or moving in the Brain Gym figure eight pattern is a wonderful addition to your toolbox for assisting clients in need of stress management and improving relaxation.

Guest Blogger: Shoshanah Shear

Occupational Therapist, healing facilitator, certified infant massage instructor, freelance writer, author of “Healing Your Life Through Activity – An Occupational Therapist’s Story” and co-author of “Tuvia Finds His Freedom”.