Tag Archives: sensory strategies

Sensory strategies are techniques used to help children manage responses to sensory input, such as sounds, textures, or movement. These strategies support self-regulation, attention, and participation in learning environments. They are essential for helping children stay calm, focused, and engaged throughout the day.

6 FAB Strategies to Improve Pediatric Therapy Behavior

Sensory, , ,

By John Pagano, Ph.D., OTR/L

  1. Increase structure – Especially with students (e.g. sensory seekers) who trash your therapy room getting increasingly dysregulated, increase the structure. One way is by starting the session with all the toys locked up, and listing or assembling pictures of all the activities the client will do in order, before starting the session. Praise the client and check off each activity after they complete it and clean up, then unlock and begin the next activity. Another option for motivating clients when developing the activity list is to alternately have them choose the first activity and the therapist chooses the next one. Groups can also be structured with pictures listing the activities in order, or by having group members draw and review a praxis comic depicting the group activities in sequential order.
  2. Preferred Activities & Choices – Clients will work better if given choices between 2 or more activities, and presented with tasks they like to do. To assure that therapeutic goals are addressed you can present 2 choices addressing the same therapeutic goals (e.g. for deep pressure to reduce arousal offer wheelbarrow walking or wall pushups).
  3. Alternate seated with preferred gross motor tasks – For evaluation and treatment sessions it is often helpful to alternate seated fine motor writing tasks with preferred gross motor activities.
  4. Intersperse Easy – Instead of giving 10 challenging tasks, help improve the client’s motivation and effort in trying challenging new tasks by presenting 5 new tasks (covering all the concepts in the original 10 tasks you were going to teach), and alternating so every other task is something the client likes to do and has mastered, then reinforce him for doing it correctly.
  5. Reduce distractions – Especially in groups or the classroom, minimize problematic sensory distractions to improve attention. Study carols help minimize visual distractions, while noise canceling headphones are useful for auditory distractions. It often helps to give the teacher noise canceling headphones to help a student who has difficulty behaving appropriately due to the loud sound of fire drills.
  6. Increase sensory stimulation of challenging therapy tasks – Particularly for students who are under-responsive it can be helpful to add sensory input that accentuates therapy and academic tasks. This can be done by highlighting important print, plus signs, emphasizing the guide lines of the paper, or simultaneously having the student listen to and read a story.
  7. Getting clinic clients to leave – Many skilled clinic therapists who use sensory integration strategies have a problem getting clients to leave when their session ends. While it’s a compliment showing the client enjoys and can learn better during therapy, it’s a problem because the therapist has another client waiting and aggressive behavior in the clinic is bad for business. Think about this ahead, and if it is a problem structure the last task in a special room with only the door leading outside unlocked. Use this as a last activity room with their parent present (a good place to review home programs), give five and two minute warnings, do deep pressure calming sensory activities, then escort them out and give them a prize if they leave appropriately.
John Pagano PhD OTR/L, presenter for Therapro's webinar 6 FAB Strategies to Improve Pediatric Therapy Behavior

John Pagano, Ph.D., OTR/L is an occupational therapist who developed FAB Strategies® to help students with complex behavioral challenges. He just completed his first book called FAB Functionally Alert Behavior Strategies.  Dr. Pagano has been presenting FAB Strategies® workshops internationally for over twenty years, and is known for his humorous interactive presentations.  

He will be offering a free Therapro webinar on Tuesday, 10/29/19:  Integrating Behavioral, Sensory, & Mindfulness Interventions in your Pediatric Therapy and a seminar at Therapro on Saturday, 11/16/19: Advanced Treatment Strategies for Youth with Complex Behavioral Challenges. For more information about these events, please refer to the Therapro website at www.therapro.com and click on the News & Events tab.

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.