Learning Center

What is Occupational Therapy?

Occupational Therapy is a holistic health profession focused on improving functional performance in every day life, across the lifespan. The field of Occupational Therapy is well-grounded in the science and knowledge that engagement in meaningful activity supports health, happiness, and interactive balance with the environment. Occupational Therapists are creative masters at the art of individualizing specific therapeutic activities to maximize functional performance in such lifelong developmental occupations of playing, learning, completing daily routines (self-care, eating, sleeping), self-regulating, and participating in leisure skills. Of particular concern for the pediatric occupational therapist is sensory processing (organizing and integrating information received from the 7 senses), and how each individuals sensory profile impacts adaptive functioning in areas of motor sequencing and self-regulation. Occupational Therapists value the process of interaction, engagement, relationship and connection, throughout the therapeutic use of activity, and the therapeutic use of self. “Yes, I Can!” is the voice of Occupational... read more

What is Sensory Processing?

“We Live on the Leash of Our Senses” – D. Ackerman, “A Natural History of the Senses”   Sensory processing is the earliest form of processing that takes place in the brain. Processing of sensory information is a delicate neurological interaction between brain and body, known as sensory integration or sensory processing. Simply said, it is making sense of the world. Sensory processing was first described in 1968 by occupational therapist and neuroscientist, Jean Ayres, Ph.D. Sensations are perceived, organized and interpreted by the nervous system, so that our body and mind can adapt to the world from minute to minute. We experience the world through 7 senses, 5 that we are consciously aware of (looking, listening, tasting, smelling and touching) and 2 that we are unconsciously aware of (balance/movement and body position). The 3 senses most essential to our daily functioning are the silent interactions, the ones we take most for granted: the tactile (touch) system, the vestibular (balance/movement) system, and the proprioceptive (body position) system. Each of us processes sensory information differently, somewhere on a continuum of responsivity, and it is our own unique and individual sensory profile that influences how we respond to everyday sensations, impacting our temperament, our behavior, our social interactions, emotional development, motor skills, learning abilities, leisure activities, and even our career preferences. How we respond to sensations (sensory modulation), how we perceive/discriminate sensations (sensory discrimination), and how we sequence actions/interactions (motor-planning) are the processes that make sensory integration possible, and enable us to glide through the day consumed by our thoughts rather than consumed by our... read more

What is Sensory Processing Disorder (SPD)?

“Turn on the radio, then turn it up as loud as it will go. Until it hurts your ears. Put 150 watt light bulbs in every lamp in one room, and turn them all on. Put on a pair of pants backwards and somebody else’s shoes that are too small. Shove a stiff hairbrush down the back of your shirt, so it is poking at you, and driving you crazy. Now clean the kitty litter, change the dirty baby diaper, or scoop up the dog mess in the yard, and sit it square in the middle of the table, so it wafts. Sit at your table with a food you absolutely gag on, in a chair with one leg missing. Now, snack on that food you hate. How many seconds can you stand the music that loud? The lights so bright? Those shoes so tight? And what is that smell!? Imagine if you cannot stop this. You cannot have a moment, ever, without feeling like you do right now. Now imagine you are just a little kid, who does not know that it isn’t like this for every body. Now, imagine you are an adult who has no idea why they feel this way.” –M. Morris   Sensory processing disorder was previously known as sensory integration dysfunction (SID) initially researched and defined by Jean Ayres, PhD, Pediatric Occupational Therapist. As with other developmental disorders, the exact cause is not yet known, however research suggests the causes of SPD are most probably more biological than environmental, although environmental and medical influences certainly impact sensory processing in all of us, inclusive... read more

Who Diagnoses Sensory Processing Disorder (SPD)?

“Just as we are what we eat, we live what we sense.”   SPD can best be diagnosed by an occupational therapist who has advanced training, experience, and expertise in sensory processing theory and sensory integration practice, both evaluation and treatment. The comprehensive sensory processing evaluation by the occupational therapist should provide information as to the severity of the sensory processing struggles, what area(s) of sensory processing are most impacted (modulation, discrimination or motor-planning), and what senses are involved. Once diagnosed, children benefit from a treatment program of Occupational Therapy (OT) utilizing a sensory integrative (SI) approach, which acknowledges and utilizes strengths throughout the process of facilitating... read more

What is the Art of Therapy For Supporting Children With Sensory Processing Struggles?

SPD is typically treated with a program of occupational therapy (OT) conducted within a sensory rich environment. Appropriate OT can change the neurological functioning in children with SPD so they can manage their responses to sensations and behave in a more functional manner. Successful OT enables them to take part in the normal activities of childhood such as playing with friends, enjoying school, eating, dressing, sleeping, and self-regulating. The most effective treatment is tailored to the needs of the individual child. Preliminary research data supports decades of anecdotal evidence that occupational therapy is the most effective intervention for improving and maximizing sensory processing. The Occupational Therapy environment is always sensory-rich, and well-planned for each individual child. The therapist guides each child through play-based activities that are covertly structured, provide the just-right challenge, result in success, and continue to carry each child up the developmental ladder. By treating the lower levels of the brain processing first (ex. sensory functions, developmental milestones, motor coordination, sensory processing, sequencing), then working up to higher cortical tasks (ex. reading, writing, math, complex problem solving, self esteem, sensory integration) we give the child the building blocks and developmental skills to access higher cortical functioning for the rest of their life. Sensory-based occupational therapy sessions are designed to be fun! The joy of engaging, sharing and mastering the just-right challenge, amidst relationship and connection is a critical component of therapy. Once the child responds to sensation in a more appropriate functional way, generalization occurs to the environment beyond the therapy setting. Ideally, therapy should be family-centered, so parents can become advocates for their child in all... read more

What is Autism Spectrum Disorder (ASD)?

“Honor your child’s unique sensory profile which contributes to his/her unique individuality. There is no one else like him on the planet, so enjoy!”    The diagnosis and classification of Autism Spectrum Disorder is constantly in flux, as defined by the American Psychiatric Association’s Diagnostic and Statistical Manual (DSM). After a 14 year process, the new DSM-5th revision was released in 2013. The new DSM-5 diagnostic criteria for Autism Spectrum Disorder (ASD) has changed in 5 ways: Previous subcategories on the Autism Spectrum were eliminated, including Asperger Syndrome (AS), Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS), Autistic Disorder, and Childhood Integrative Disorder. All those subcategories are now folded into one broad term of Autism Spectrum Disorder (ASD). The 2 new categories of autism symptoms are: social communication impairment (must exhibit 3 deficits in this area) and restricted interests/behaviors (must exhibit at least 2 symptoms in this area). With the second category, sensory hyper-reactivity or sensory hypo-reactivity is a new symptom. Symptoms can be present currently or reported in past history. In addition to the diagnosis, each person evaluated will also be described in terms of any medical conditions (seizures, gastrointestinal problems, etc), the presence of language and/or intellectual disability, and any existing genetic causes (Fragile X Syndrome, Rett Syndrome, etc.) The new DSM-5 also added a separate disability called Social (Pragmatic) Communication Disorder (SCD) allowing for a diagnosis of social communication difficulties without the presence of repetitive/restricted behaviors. The DSM-5 states that “Individuals with a well-established DSM-4 diagnosis of Asperger’s Syndrome (AS) or Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS) should now be given the diagnosis of Autism Spectrum Disorder (ASD)... read more

What is a Non-Verbal Learning Disability (NVLD)?

“The foundations of non-verbal reasoning are body movements, the ability to touch, to feel, to manipulate, and to build sensory awareness of relationships in the physical world.” – Jane Healey, “Endangered Minds”   Non-Verbal Learning Disability is a diagnostic label given to individuals whose learning profile reflects missing pieces that have not been gathered through the sensory systems. NLD can be misleading, as individuals present with strengths in the verbal area, and struggles in the non-verbal domain. Verbal/language skills are well-developed in areas of vocabulary, auditory memory, attention to detail, and rote memory. Challenges are present in non-verbal areas of visual-spatial/organizational abilities, sensory, motor coordination, social judgment, and executive functioning. The child with an NLD profile can resemble other diagnoses, specifically Asperger Syndrome (AS) and Attention Deficit Disorder (ADD/ADHD), although the crux of a non-verbal learning disability is visual-perceptual struggles coexisting with social pragmatic difficulties and attentional difficulties. A non-verbal learning disability can be identified through neuropsychological testing, particularly when performance scores are significantly lower than verbal scores, with a 12 point or more discrepancy usually significant. Occupational Therapy evaluation can help determine if visual-perceptual performance is in fact an area of need, and may be significantly lower than verbal... read more

What is Attention-Deficit/Hyperactivity Disorder (ADD/ADHD)?

“People who spend more time playing video games have more attention problems, and individuals who are more impulsive or have more attention problems subsequently spend more time playing video games.” (Swing et al, 2010)   Attention and focus is dependent upon many factors, inclusive of environment, level of interest, task demand, stress level, fatigue, nutrition, and overall processing abilities. Although attentional difficulties can exist independently, it is important to rule out underlying processing difficulties that may be contributing to end-product attentional difficulties, inclusive of Speech and Language evaluation, occupational therapy evaluation, neuropsychological evaluation, and most importantly feedback from school/teacher, who sees the child on a daily basis, over time, in a learning environment. The formal diagnosis of ADHD is a clinical diagnosis, usually by medical/psychology professionals, through reports of history, home questionnaires, school questionnaires, and observation. ADHD can best be described by symptomotology of inattention (initiating, sustaining, and shifting attention), hyperactivity (sometimes), and impulsivity, with several diagnostic subcategories more explicitly defining specific functioning in these areas.  Organizational skills are also compromised and it is difficult for the individual to demonstrate and access his/her skills and abilities. Studies by the SPD Foundation found that 50% of children with Attention Deficit Hyperactivity Disorder (ADHD) have coexisting Sensory Processing Disorder (SPD). If a child struggles with sensory processing skills, then this shows up as in-attention, distractibility, fidgeting, inability to sit still, and poor visual focus. Of 500 pediatric occupational therapists, physical therapists, and speech and language pathologists 2/3 had seen children with deficits processing and integrating sensory information who had been misidentified as having Attention Deficit Hyperactivity Disorder. This finding is significant, given that... read more

What is Motor-Planning and Related Dyspraxia?

“Motor planning is to the physical world, what language is to the social world. This is how we communicate with the environment.” -Jean Ayres “To understand what it is like to have a motor problem, imagine wearing a suit that controls your movement. Each time you try to move in one direction, the suit moves you randomly in another direction.” -S. Greenspan and S. Wieder   Motor-planning (praxis) is the adaptive response that depends upon efficient sensory processing, specifically sensory discrimination. Motor-planning is the process of deciding what your body has to do and then doing it. It involves conceiving, planning, sequencing, executing, and remembering motor actions, inclusive of bilateral integration praxis, constructional praxis, visual-motor praxis, and oral-motor praxis. Good muscle tone and muscle strength promotes proprioceptive awareness for motor-planning. When motor-planning is efficient, sequenced movements are executed smoothly. With practice and repetition, we no longer have to think about how to motorically sequence a task (i.e. swimming, driving, riding a bike, dressing, forming words, tying shoes, etc.). Once the task becomes automatic, we move on to master another motor-planning task. Dyspraxia is defined as difficulty with motor-planning/sequencing motor tasks, which can affect a child’s ability to engage in a wide variety of activities, including gross-motor, fine-motor, visual-motor, and oral-motor actions, as well as social and play interactions. These actions and interactions do not develop easily, efficiently, nor automatically, with repetition and practice needed each and every time. The sensory-integrative approach to occupational therapy supports motor-planning skill, in all area of motor... read more

What is Fine-Motor/Visual-Motor Development and Related Dysgraphia?

Fine-motor/visual-motor development is the developmental process of utilizing the arms, hands and fingers for skillfully reaching, grasping and manipulating objects and tools. As with gross-motor development, fine-motor development begins to develop the first day of life. Fine-motor/visual-motor incoordination and developmental delays are frequently related to overall dyspraxia (difficulty motor-planning) as well as underlying sensory processing challenges. Fine-motor/visual-motor dyspraxia is most frequently demonstrated by difficulty with bilateral/unilateral hand skills such as establishing dominance, manipulating, buttoning, shoe-tying, folding, cutting, coloring, drawing and tracing. Occupational Therapy support for fine-motor dyspraxia often involves designing and creating appropriately graded developmental activities that provide enhanced sensory feedback to improve fine-motor accuracy, speed and skill. Dysgraphia is an extension of dyspraxia, with motor-planning/sequencing difficulties compromising handwriting skills. Dysgraphia can be evidenced by the following: slow and labored copying and writing, poor spatial planning on paper, difficulty thinking and writing at the same time; illegible printing/cursive despite time and attention given to task; inconsistencies in quality of writing including case, size, shape, slant and spacing. Strategies for dysgraphia are frequently related to compensations and accommodations, including: word processing, oral exams, structural outlines, reducing copying demands, extra time, and various writing... read more

What is Nature Deficit Disorder (NDD)?

“The lover of nature is he who’s inward and outward senses are truly adjusted to each other.”  – Ralph Waldo Emerson   Vitamin N (Nature) is the mind-body-nature environment and enhances our physical and emotional health. Our sensitivity to nature is essential to our survival. New research indicates that our sensory processing is improved through direct interaction with nature. Natural environments support attention, creativity, social interaction, emotional connection, and learning. Our growing disconnection from nature dulls our senses and blunts our sensory processing. The more high tech we become, the more we need the natural balance of nature. Exposure to “green space” results in significant improvement of attention, impulse control, and organization. Nature not only has attention restorative benefits, but also activates all the senses to enhance multisensory learning. (Faber-Taylor A 2001, Kuo, 2004) An ideal way to escape sensory overload is to engage and retreat to the sight, sounds, smells, touch, and movement of the natural world.        ... read more

Does Sensory Processing Disorder (SPD) Coexist With Other Diagnoses and Struggles?

“Comorbidity” is when two or more “disorders” co-exist in one person, frequently inter related, and often difficult to differentiate one from another. SPD scientists and parents alike are keenly interested in understanding the relationship between SPD and: Attention Deficit Disorder (ADHD), Autism Spectrum Disorder (ASD), Attachment Disorder (AD), Nature Deficit Disorder (NDD), Post Traumatic Stress Disorder (PTSD), and Anxiety Disorder (AD), as well as the sensory processing deficits that coexist with many other specific diagnoses as Fragile X Syndrome, Tetra X Syndrome, Williams Syndrome, and Prader-Willi Syndrome. Research indicates that 75% of children with autistic spectrum disorder (ASD) also have Sensory Processing Disorder (SPD). However, the reverse is not true, in that most children with SPD do not have an autistic spectrum disorder.  Studies by the SPD Foundation found that 50% of children with Attention Deficit Hyperactivity Disorder (ADHD) have coexisting Sensory Processing Disorder (SPD). There is a high correlation between Sensory Processing Disorder (SPD) and Anxiety Disorder (AD), given that sensory sensitivities put a child/adult at higher risk of experiencing anxiety.  Sensory Processing Disorder (SPD) and Obsessive-Compulsive behaviors often co-exist, given that sensory sensitivities (lack of internal organization) results in a greater need for child/adult to be controlling of his/her external environment. There is a high correlation between primary Post Traumatic Stress Disorder (PTSD) and secondary Sensory Processing Disorder (SPD), given that traumatic sensory stress secondarily puts a child/adult at higher risk of experiencing sensory over responsivity, sensory-avoiding, and sensory anxiety. There is a high correlation between primary Nature Deficit Disorder (NDD) and secondary Sensory Processing Disorder (SPD), given that the disconnect from the natural world disconnects children... read more

What Diagnosis Best Reflects Me and/or My Child: LD, SPD, ASD, PTSD, ODD, ADD/ADHD, TD, NDD, NVLD, AD, or Bipolar?

I frequently think about having formal standardized testing completed during some day in the near future, to assess my overall learning profile. I wonder what my test scores would be? I wonder how they would be interpreted by the clinician that I chose to do the formal standardized testing? I wonder what diagnosis I would be given? And what if I chose to have the same formal standardized testing repeated the following week with the same clinician or perhaps with a different clinician? I wonder if my test scores would be in a similar range? I wonder if interpretation of standardized test scores by the second clinician would be similar, at least in part? I wonder if the diagnoses would be similar or related? Absolutely, many of us do clearly fall into specific diagnostic categories according to the DSM-5 criteria, specifically when defined symptomotology persists over time as described by many, and definitively impacts functioning across all environments. That said, on Monday, I struggled to attend because I couldn’t sleep all night. On Tuesday, I was lacking in executive functioning because our kitchen is being torn apart for renovation. On Wednesday, I was oppositional and defiant because my parents decided to divorce after 35 years of marriage. On Thursday, I was anxious because my sister is sick in the hospital. On Friday, I was preoccupied with thoughts about my Dad, so couldn’t remember anything nor participate fully in any learning activities. Saturday was a great day because it was just a great day, and I was 100% available to access and demonstrate my strengths! Can I have the testing... read more

What is Self-Regulation and Related Self-Regulatory Struggles?

Self-regulation is the ability to get oneself into an optimal state of alertness to do what needs to be done in any given situation. It is the ability to modify actions and adapt to situational and task demands. This includes regulating one’s sensory needs. To successfully self-regulate, three critical neurological components must be integrated: sensory processing, executive functioning, and emotional regulation. Self-regulation is an end-product skill, best evidenced by the ability to regulate attention, activity level, impulse control, frustration tolerance, organization, and social-emotional actions interactions. Self-regulation is strongly influenced by sensory processing of information, particularly modulation (regulation) of sensory information. If a child can not modulate/regulate the level or intensity of incoming sensory information, than most often he/she will struggle to modulate/regulate such output as attention, physical activity, impulse control, social activity, emotional activity and behavioral activity. Symptoms of regulatory difficulties (sensory and behavior coexisting) most usually changes over time, with different manifestations at different ages. First and foremost, self-regulation can be supported through developing the underlying sensory processing foundations during sensory-based occupational therapy. Not surprisingly, the child is better able to modulate output (attention, impulse control, activity level, emotional connection, social interaction) as he/she improves his/her ability to modulate sensory input. Self-regulation is also supported through a ‘sensory diet’, which is a person’s daily sensory experiences. Just like diets comprised of food, diets comprised of sensation need to be individualized so they are a good match for each person’s particular person’s needs and challenges. Performance and interactions for all of us are improved with a rich sensory diet, with the variety of daily sensations unknowingly influencing our functioning... read more

What is Executive Functioning?

“Just 9 minutes of viewing a fast-paced television cartoon had immediate negative effects on 4-year-olds’ executive function. Can you imagine how many hours of fast-paced video games impacts executive functioning?” – Angeline Lillard, PhD and Jennifer Peterson, BA   Executive functioning is the organizational aspect of sensory processing, or the library of our brain. Children with underlying sensory processing difficulties frequently will struggle with these higher level organizational abilities, which is not surprising given the difficulties organizing and integrating the incoming sensory information from the seven senses. Some manifestations of executive functioning challenges include: difficulty shifting attention, difficulty initiating/prioritizing/completing work, difficulty with flexible thinking, difficulty organizing actions and tasks to demonstrate skills, difficulty with generalization, and difficulty with decision-making and problem-solving. At any age, efficient executive functioning can be supported through direct instruction, visual supports, explicit feedback, organizational aids, task breakdown/‘chunking’, and sequencing through the use of numbers or pictures, visual schedules, and time organizers. Executive functioning abilities are end product skills, secondary to each individual’s sensory processing and overall learning... read more

What is Muscle Tone?

Muscle tone is the firmness and tension in a muscle, with vestibular processing responsible for developing the postural muscle tone of both flexor and extensor core musculature. Muscle tone is not the same as muscle strength, but the firmness and tension in a muscle allows us to hold a muscle position with stability, control, skill, and endurance. Low muscle tone (or hypotonia) is present when muscles lack firmness and tension. Without optimal muscle firmness, the joints are “loose”, hyper mobile and lack stability. Individuals with low muscle tone do not get good feedback from those muscles about movement because the muscles are “looser”, resembling a slack elastic band. Low muscle tone in core musculature can compromise postural stability, ribcage stability/breathing, and core strength. Low muscle tone in and around the mouth can compromise speech articulation, and result in drooling, pocketing food, and the need for increased oral-motor input. Low muscle tone in the lower extremity can compromise gross-motor skills, and result in compensatory movement patterns (w-sitting, turning feet out, foot slapping, toe walking) and the need for increased vestibular and proprioceptive stimulating gross-motor movement activities. Low muscle tone in the upper extremity can compromise upper extremity/fine-motor skills, and result in compensatory movement patterns (shoulder hiking, posturing of hands, fixing hands at midline, fist grips) and the need for increased touch and proprioceptive stimulating fine-motor activities. Activities to support low muscle tone, core strength, and proximal stability would include such activities as on-elbows position, jumping activities, knee-walking, crawling games, weight-shifting, sustaining postures (i.e. Simon Says), vertical chalkboards, oral-motor whistles and games, and so much... read more

What is the Significance of the Mouth, Oral-Motor Development, And Oral Supports?

           Oral-motor development is impacted by many inter-related factors including sensory over responsivity, sensory under responsivity, immature suck-swallow-breathe synchrony, and low oral-motor muscle tone. Oral hypersensitivity can be manifested in a hyperactive gag reflex, difficulty tolerating oral sensations, and being a picky/problem eater. Oral hyposensitivity can be manifested in difficulty with lip closure, overstuffing food, decreased speech articulation, and drooling. Oral-motor development occurs through experiences and activities involving suck, blow, bite, crunch, chew, lick, as well as taste, temperature, texture, size and form, all of which supports control of motor, oral, respiratory, and eyes. It is the changes and combination of activities that promote integration and functional oral-motor skills needed for speech production, postural control, eye-hand coordination, binocular vision, deep respiration, and self-regulation. Respiration and slow deep breathing helps children (and adults) feel relaxed and calm. Deep abdominal breathing, rather than shallow (chest) breathing reduces tension, influences posture, focuses attention, supports speech production and supports digestion. Inhaling slowly through the nose and exhaling fully out through the nose is best practice. The longer the exhalation the better the inhalation and the more supportive breathing is. Laughing and crying changes respiration to bring it into balance. Beneficial home activities include blow toys, bubble activities, whistles, straw drinking, and deep abdominal breathing. Balloon blowing is an excellent activity to deepen the breath! The temporo-mandibular joint is one of the strongest in the body. If a child’s body needs to move, and if their biological body is calling out for some heavy work and resistance and they can not get it, they will chew. If your child is an... read more

What Is the Difference Between Picky Eaters and Problem Eaters?

Eating is dependent upon environment, nutrition, and development, and is a very complex task of sensory integration, which we so easily take for granted. Eating involves sensory integration of tactile textures, visual colors, varying temperatures, gustatory flavors, olfactory smell, sound sensitivity, and oral-motor control. One swallow involves 26 muscles and 6 cranial nerves to coordinate the process. Sensory over sensitivity and resultant over responsivity contributes to problems with eating. Sensory under sensitivity and resultant unresponsivity contributes to problems with eating. Many children are picky eaters, but differentiating picky eaters from problem eaters is important. The family-centered SOS (Sequential-Oral- Sensory) approach to feeding was developed by Kay Toomey, Pediatric Psychologist, and addresses problematic feeding behaviors. The E.A.T (Eliminate, Add, Try) approach is also recommended for poor... read more

Nutrition Fuels Our Brains As Well As Our Bodies

“Let food be our medicine and medicine be thy food.” – Hippocrates   Good nutrition impacts the developing child’s brain and body, and supports attention, behavior, learning and self-regulation. Lack of water is the #1 trigger of daytime fatigue. A mere 2% loss is body water can trigger fuzzy short-term thinking. Children need 4-6 glasses of water per day, so should have a water bottle available to them at all times. Protein deficiency can result in muscle weakness, slowed responses, mood instability and attention problems. 1/3 of each meal should be a good quality protein (preferably organic) choosing from eggs, beans, cheese, fish, meat, poultry, nuts, and some seeds. Quantity is recommended to be palm-size. With children it can be helpful to serve the protein first, telling the child “We need to eat ‘brain food’ first, then we can eat our energy food’ (carbohydrates)”. Vitamin deficiency impacts the brain, as each vitamin (A, B complex, C, D, and E) plays a different but critical role in brain functioning. Every day, children should eat from as many parts of the color spectrum as possible. A daily multivitamin-multimineral supplement is important for children of all ages. Check out Environmental Working Group at ewg.org to view the top 10 “dirtiest” fruits and vegetables that should be bought organic whenever possible. Mineral deficiencies can trigger sensory abnormalities (especially auditory and taste), as well as motor restlessness, tics, weakened immune system, and appetite loss. Calcium, magnesium, and zinc are the minerals most important to neurological functions. A diet of highly refined and processed foods are most likely deficient in minerals. A daily multivitamin-multimineral supplement... read more

How is Rhythm, Sound and Music a Sensory Tool?

Sound is processed through the single sensory receptor in the cochlea of the inner ear, having similarities in location, structure and function with the older more primitive vestibular movement sensory system, which has 5 sensory receptors in the inner ear. Both sound processing (through the cochlear sensory system) and movement processing (through the vestibular sensory system) occurs at a sub cortical, unconscious level, whereas higher level auditory processing occurs at a cortical cognitive level. The cochlear system in the inner ear processes higher frequency vibrations or sound, giving us information about self and place, informing us “I am here. This is there.” The only difference between movement and sound is the velocity of the vibration. We feel sound all the time. It is a movement experience. Sound supports movement and movement supports sound, with both the sound and movement systems supporting the visual system. Music and rhythm influences brain function and body organization. Rhythm is the link between the vestibular system and the auditory system. 60 beats per minute provides rhythm similar to the rhythms of heartbeat, sucking and walking. Music has a vibrational impact on energy and alertness, self-regulation, organization, motor-planning, respiratory patterns, and emotional state. Sound is a powerful modulator. Some sounds are alerting while other sounds are calming. What sounds are rhythms support a calm balanced state in you or your child? What sounds increase a sense of overload? Although the music one loves is usually the most therapeutic, it is important to be aware that when over stimulated, one usually needs calming music and when one is sluggish and under aroused, one usually needs stimulating... read more

What Are Transition Difficulties?

Transitions involve novelty, and novelty involves adapting to new sensory information. Each time we enter a new environment, a new activity, a new demand, a new social situation, each and every one of us has to organize and integrate all the incoming sensory information across all 7 sensory systems. For some of us it is easier and more automatic than for others, frequently dependent upon optimal sensory processing.  If transitions are difficult, visual reminders are extremely helpful. This can be as simple as a sequence of pictures, words or objects representing each transition. Using a visual time timer (red shows the amount of time left) is also helpful, so your child can begin to modulate the passage of time, and prepare him/her for the transition ahead. All children benefit from routines, external organization, structure, and predictability. Start each morning with a visual outline of the schedule for the day, highlighting any changes that may be different. For younger children, shorter lengths of time will be beneficial. As the child completes a task, have him/her take the symbol off to indicate “all done.” Discuss and/or write simple ‘social stories’ about how to handle unexpected events to help support adapting to change.      ... read more

Is Technology A Brain Drain?

“Our future is a race between the growing power of technology and the wisdom with which we use it.” – Stephen Hawking, 2015   Remember our childhoods? Play was rolling down hills, climbing trees, building forts, impromptu ball games or tag, riding our bikes, playing in the sandbox, and endless hours of imaginative play. Play was about having free unstructured independent time to creatively challenge our bodies and our brains. Times have changed for sure, due to many reasons. Technology being one. While adults mostly rely on technology for efficiency in their work and home lives, children now rely on technology mostly for play. As children spend increasingly more time connecting with technology, they are disconnecting from play, nature, and relationships at a very rapid pace. While the allure and excitement of technology continues to advance, our children are being enticed into an addiction that we know very little about, and therefore can not possibly see the future ramifications. What we do know is that TV and videogame addiction has causal links to increases in sensory-motor delays, attentional struggles, learning disabilities, sexual promiscuity, depression and anxiety, addictions, aggression, obesity disorders and sleep disorders to name a few. (Rowan, 2015). Extended periods of time in front of a flickering screen and less time spent in independent unstructured play affects the attention span of children. There are two kinds of attention, the involuntary attention or startle reflex we share with animals, and the voluntary, sustained attention required for complex tasks. Electronic games (and television) rely on the startle reflex with sudden changes in size, sound, or actions which irresistibly draws our attention... read more

What Is The Vestibular System and Why Is It A Pivotal Sensory System?

  The vestibular system in the inner ear is the grand modulator and integrator of all the sensory systems, because all other sensory systems are processed in relation to basic vestibular information. The vestibular system is stimulated through movement involving linear movement (forward-backward), oscillation (up-down movement), inversion (head upside down) and rotary movement (rotation). The vestibular system in the inner ear provides us with information about movement, gravity and changing head position, and gives us information about self and place, orientation of our bodies in space, and our overall relationship to earth. Accurate processing of vestibular information is evidenced by good muscle tone, optimal postural control, good balance, eye stability, modulation of attention, and self-regulation of calming and behavioral control. The vestibular movement system is the most powerful of sensations. Despite our unconscious awareness of this kind of sensory information, vestibular movement has long-lasting effects on learning, behavior and attention. The vestibular system has strong neurological connections with the auditory system, with both systems being in close proximity as well as related in their evolutionary function of detecting vibration. The vestibular system is the “ear of the body” (low frequency vibrations known as movement) and the auditory system is the “ear of the environment” (high frequency vibration known as sound). The vestibular system also has strong neurological connections with the visual system, best evidenced by the reflexive eye movements (visual nystagmus) that are elicited by rotary movement. Optimal vestibular functioning supports development of eye movements inclusive of visual tracking, visual locating, visual scanning, and visual focusing. Delayed vestibular maturation correlates significantly with low muscle tone, diminished core strength and postural... read more

Why Is the Proprioceptive Movement Sense As Important As the Vestibular Movement Sense?

“When sensory input is balanced with movement output, the energy body is at its optimal state for learning.” – Cris Rowan, OTR, Pediatric Occupational Therapist   The proprioceptive movement receptors are located in our muscles, joints, ligaments, tendons and connective tissues. The propriceptive receptors are fired by deep-pressure and heavy work of any kind, inclusive of pushing, pulling, weight-bearing, lifting, jumping, climbing, and “crashing”. Proprioception is easily taken for granted because it is an unconscious sense to most of us. It tells us how to automatically move our muscles and joints effectively and efficiently to do what we need to do. Good proprioception supports motor coordination, motor-planning, and the ability to grade movement with smoothness and fluidity. Children with proprioceptive dysfunction may push too hard, write too hard, play too hard. They may be crashers, movers, and shakers, full off endless energy. They may play too rough, struggle with body awareness, and demonstrate difficulty with motor control. Proprioceptive movement activities are always organizing and never over stimulating. Recurring proprioceptive movement activities are known serotonin boosters, easily depleted by stress. Proprioceptive movement activities provide calming input to the body. As with using fitness equipment, weights at the gym, or running, the “just-right” feeling is around 2 hours after the workout. Planned therapy activities and sensory-diet activities at home can do the same. Movement is stimulation the brain craves, so always have plenty of movement opportunities available for children. When in doubt, move, move,... read more

The Importance of Childhood Play

“We are meant to play throughout life. Whether it is through physical activity, social interaction, competition, adventure, music or art, our need to play is hard-wired into our brains.” – Stuart Brown, M.D.            Childhood play involves all the senses. Simple, unstructured childhood play is the best possible gift that can be given to each and every child. Play maximizes the foundations needed for learning, motor development, cognition, emotional development and social skill, regardless of each individuals neurological wiring, age, developmental level and overall learning profile. Pretend play involves thinking abstractly, the key to most of what we do in the world. If we can not think abstractly, we can only react, rather than plan. Emotional feelings are expressed through childhood pretend play, all of which need only be acknowledged and listened to, rather than answered, fixed or discussed. The most common emotional themes expressed through childhood pretend play include: nurturance and dependency, pleasure and excitement, curiosity, power and assertiveness, anger and aggression, limit-setting and containing feelings, fears and anxieties, love and empathy, and control. Play is the most important work that children... read more

10 Simple Ways To Support Your Child’s Attention

Provide activities throughout the day that use a high level of energy. Offer oral supports during tasks requiring sustained attention (chewing gum while doing homework, having a water bottle always available) Talk, and listen to your children Establish a consistent schedule Establish consistent and effective limits Limit television and video games Offer frequent and appropriate praise Have reasonably high behavioral expectations Engage in activities together. Maintain a good sense of... read more

20 Simple Ways To Calm Your Child

Soften the lights. Give a hug or give yourself a hug. Minimize visual and auditory stimulation, particularly alerting activities. Create a cozy “chill out” space or “time-in” space or a “relaxation space.” Be aware of temperature and make adaptations accordingly… open a window, turn on a fan, remove a sweatshirt. Be sure the child hasn’t over-heated. Hum along to a song or hum your own tune. Enjoy soft, slow, rhythmical background music, particularly with no words. Repeat an affirmation rhythmically, such as “It’ll be okay. It’ll be okay, it’ll be okay…..” (no other talking on ANYONE’S part until everyone is very calm.) Dampen extraneous noises by closing the door or putting headphones on or removing oneself to quiet environment. “Swaddle” by rolling in a blanket or curling up under heavy blankets. Have someone cuddle, rub or rhythmically pat the back firmly. Apply deep pressure with cushions or bean bag chair. Sit in a rocking chair, bouncy chair, or on a ball chair. Jumping activities, inclusive of jump roping, jumping jacks, or trampoline-jumping. Do wall or chair push-ups. Suck on hard candy, lollypop, or milkshake. A straw requires increased sucking. Chew on crunchy foods, like carrot sticks, apples, goldfish or pretzels. Blow whistles and march to music. Blow bubbles. Deep Breathing….. ahhhhh.   – From “Integrations” Bright... read more

10 Simple Ways To Support Your Child’s Sensory Processing

           Children love to jump and jumping can be helpful in calming and alerting children. Try a mini-trampoline, mattresses, jump-roping, or a hoppity-hop. A large exercise ball can be used to roll on, sit on, bear weight on, or watch TV on. Playing with resistive mediums gives greater feed back about the sensory systems. Use play dough, clay, beeswax, moon sand, and kitchen activities. Playing, drawing, and writing on a vertical surface is one of the greatest power tools for supporting visual attention, sensory feedback, hand development, and finger skill. Try a variety of seating options to support attention to the relevant task at hand, whether it is homework or mealtime. This might include a gel cushion, rocking chair, beanbag chair, or rotating chair. External structure, organization, predictability and familiarity supports sensory processing. Swimming is a total sensory experience. The weight and pressure of the water against the body can be relaxing and increases body awareness. The mouth supports focused attention, which is why children often times chew on non-food items (jewelry, shirtsleeves, pencil). Replace with more appropriate oral activities, such as sugarless gum, water bottles, straws, and healthy snacks. Provide small, safe, self-enclosed spaces to retreat and calm. This might include small tents, homemade ‘forts’, and/or pillow corners. Stress depletes the neurotransmitter serotonin, while deep-pressure sensations enhances it. Other serotonin boosters include peaceful music, nature, sunshine, natural lighting, cuddling pets, and relaxation... read more