Kristin Otero, OTR/L, MSOT Kristin Otero, OTR/L, MSOT

Sensory Approach to Home

So we’ve talked about sensory processing in previous posts; But we wanted to add some tips for different situations parents may be experiencing!


This is applicable to:

  • Autism Spectrum Disorders

  • SPD (Sensory Processing Disorder)

  • ADHD, Down Syndrome

  • Cerebral Palsy

  • Developmental Delays

  • Motor Delays

  • Gifted and kids who are Twice Exceptional

  • Anxiety

  • Typical children


Just as an overview, kids should typically get a thorough evaluation, and/or neurology consult before being diagnosed. Many children who are SPD and are sensory seekers/cravers, or those with poor postural control may look like they have ADD/ADHD. The issue at times doesn’t stem from the attention. A lot of the times we think these kids are acting out, not listening, or not paying attention. We notice when they get sent to principal's office, trouble with virtual learning, or get labeled the “behavior kid.” But looking deeper into the underlying issue with the help of healthcare professionals will have a more thorough diagnosis.


In order to help children feel more balanced we can create a Sensory Lifestyle Previously termed a “Sensory Diet,” it’s how you incorporate the sensory tools that you have into every day life. Every child is different, so depending on the child’s sensory processing we advise activities and strategies, but its best to learn through trial and error what works best for the child you are working with.


How does Sleep affect your Child? 

Sleep can be very important, keeping consistent bedtime routines, comfortable bedding. You can add some calming music or lights, try to have them sleep in their own bed, tents over the bed can be calming, as well as body pillows.

What about Diet?

You are what you eat. If you have concerns about your child’s limited food repertoire or “picky eating” seek out a therapist who is trained by Dr. Kay Toomey SOS Approach to Feeding. It’s suggested that children need at least 10 sources of protein, 10 fruits or vegetables, 10 other/starches for a total of at least 30 different foods 

Dinner time tips: 

  • Family style dinner 

  • Make Eating Fun! 

  • Try different textures, colors, smells

  • Have something preferred for after the child touches or tastes a new food

  • Always present a protein source, fruit or vegetable, and starch at every meal/snack, plus one preferred food 

  • Don’t allow your child to “food jag” eat the same foods over and over again 

  • If they have chicken nuggets on Monday, they can’t have them again until Wednesday


OT’s Role:

Among the psychosocial conditions, anxiety disorder is the third prevalent mental disorder affecting children aged 3-17 years (CDC, 2019). OT’s are a great resource for therapy for implementing evidence-based mental health promotion, Emotional Regulation, Executive Functioning, Mindfulness, Yoga, etc.

Calming Strategies: 

  • Taking Deep Breaths 

  • Drinking through a straw 

  • Sucking on hard candy 

  • Taking a break 

  • Lowering the lights 

  • Calming music 

  • Warm bath 

  • Talking in soft voice 

  • Slow linear swinging/rocking 

  • Chewing gum 

  • Deep pressure/hugs/weighted vests, blankets


Mindfulness is defined as a mental state achieved by focusing one's awareness on the present moment, while calmly acknowledging and accepting one's feelings, thoughts, and bodily sensations. This is used as a therapeutic technique. This is all about living in the moment and taking every moment just as important as your last. 

Want to know more? Email us!


References

Aguilar, Del; Esposito, Phil (2019) “Sensory Processing Disorder and Praxis Skills in Children With Learning Disabilities” The American Journal of Occupational Therapy, Vol. 73, No. 4 2. Liotta-Kleinfeld, Lorry; Beros, Lynsey; Boyer, Andrea; Boggus, Taylor; Ruff, Madeleine; Little, Mary; Sollman, Rachael (2020) “Incidence of and Relationship Between Tactile Sensitivity and SelfRegulation in Six- to Eight-Year-Old Children” The American Journal of Occupational Therapy, August 2020, Vol. 74 3. 

Lin, Mei-Ling PhD, OTR/L; Nasser, Alyse; Molina, Cayla; Smith, Emma; and Millar, Kristin (2020). “Mental-Health Benefits of a Mindfulness-Based Prevention Program on Elementary Schoolchildren” The American Journal of Occupational Therapy, August 2020, Vol. 74, Supplement 1 4. 

Mulligan, Shelley; Schoen, Sarah A.; Miller, Lucy Jane; Valdez, Andrea; and Magalhaes, Deborah (2019) "The Sensory Processing 3-Dimensions Scale: Initial Studies of Reliability and Item Analyses," The Open Journal of Occupational Therapy: Vol. 7: Iss. 1, Article 4. 5. 

Orley Templeton, OTD, OTR/L1, Lori Charney, OTD, OTR/L1, Heather Bennett, MS2, Molly Betz, MS3, Kelly Byrne, MS, OTR4, Jame Duffy, MS2 (2019). “The Effect of Sensory-Based Strategies and Social-Skill Training on Social Skills Among Preschool Children With Autism Spectrum Disorder” The American Journal of Occupational Therapy, Vol. 73, No. 4


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Kristin Otero, OTR/L, MSOT Kristin Otero, OTR/L, MSOT

What Parents Need to Know About School Based OT

First, what is OT?

American Occupational Therapy Association describes it as a health profession in which therapists and therapy assistants help individuals to do and engage in the specific activities that make up daily life. For children and youth in schools, occupational therapy works to ensure that a student can participate in the full breadth of school activities—from paying attention in class; concentrating on the task at hand; holding a pencil, musical instrument, or book in the easiest way; or just behaving appropriately in class.

How does it apply to school?

We work with kids of all abilities. Some diagnoses include ADHD, Autism Spectrum Disorder, Sensory Processing Disorder, and in general; children having a hard time participating in the classroom. We can work with children inside the classroom (push-in) or outside the classroom (pull-out). Most kids that I provide OT to will already have had an Individualized Education Plan (IEP) that has been receiving services from a young age, and has a system in place that will support them to succeed in schools. Others may receive OT because they are having a specific problem in school. We also work in a team based profession to collaborate with interdisciplinary members, providing consultation to teachers about how classroom design affects attention, why particular children behave inappropriately at certain times, and where best to seat a child based on his or her learning style or other needs. A child might also be referred for OT for other reasons like motor skills, cognitive processing, visual or perceptual problems, mental health concerns, difficulties staying on task, disorganization, or inappropriate sensory responses.

Occupational Therapists tend to be the handwriting experts in school based settings because we specialize in fine motor and visual perceptual skills. OT looks at the child’s skills and other problems (including behavior), in addition to his or her visual, sensory, and physical capabilities. We also take into account the school, home, and classroom environments to find ways to improve the handwriting. 

Students with disabilities have been able to benefit from occupational therapy at school since the 1975 passage of the Individuals with Disabilities Education Act (IDEA), and even more recently In 2004, the reauthorization of IDEA extended the availability of occupational therapy services to all students, not just those with disabilities, in order to fully participate in school (AOTA).


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Kristin Otero, OTR/L, MSOT Kristin Otero, OTR/L, MSOT

Clothing Preference for Sensory Sensitivity

Last week we spoke about how sensory processing may affect clothing choices; we want to go a little more in depth about it this week. As with many things, there is a spectrum of choices when it comes to the clothing we wear. Some like clothing fitted, others like them loose. Let’s go more in depth about those that enjoy clothing that are on the light side.


What do you mean by spectrum?

In terms of preferences for sensory processing; there is sensory seeking and sensory avoidant. In other words, there are some people that like clothing to feel like they're really present with extra pressure, and those that don't want to feel any pressure on their skin. Those are the two extremes, and most people fall within the spectrum that lies between the two.


Tactile Defensiveness

Have you ever had a child that cannot handle shirt tags? They find it itchy, and always feel like the tag is there, this is the sensitive end of the spectrum for sensory processing when it comes to clothing. They might also have difficulty with hair cuts, ticking may be overwhelming, they might be picky about certain textures, and they might like to keep their hands clean. Tactile defensiveness is basically an over-sensitivity to touch.

Some Tricks

This might make your child’s dressing routine difficult, and they might be repeating one item that is hanging on by a thread because it gets used so much. 

  • One trick is to layer with the favorite fabric on the closest layer to their skin. 

  • Depending on their preference, those with clothing sensitivities will like the light and soft type of fabric that makes it feel like it’s not on your skin. 

  • You can also desensitize the specific areas that bother the child with deep touch, massage, or gently pressing around the area with a hand held vibrator. 

  • Try second hand clothing that’s a little more worn in. 

  • Moisturizing the skin may help, making the skin a little more sensitive. 

  • Buying sensory friendly clothing with brands that understand clothing sensitivities

As always, we are here to help you with any questions. If this is a topic that you would like to explore more, email smplytherapy@gmail.com to speak to us!

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Kristin Otero, OTR/L, MSOT Kristin Otero, OTR/L, MSOT

Sensory Processing Relating to Clothing

We’re talking about something that everyone deals with to some degree, but may have not taken much notice… sensory processing as it relates to clothing! Just like picky eating relates to how we process our environment- the texture, flavor, or color choices in food; children may be picky about the clothes they wear. 

If we’re being honest, most of us choose clothing differently whether it’s based on texture or how it makes you feel, and may be able to think back to their childhood when it was a little more “picky.” But for some kids, it may go to the extreme due to sensory processing difficulties. 

Prevalence 

Sensory processing disorder affects about 8.3% of 8 year olds internationally (Jussila et al., 2020), and 1 in 20 to 1 in 6.25  in the US (Ahn et al., 2004; Ben-Sasson et al., 2009), some experts say as much as 10% of kids. For children with ADHD; it’s as much as 40-60%, so children on the Autism spectrum and those with ADHD may be at higher chance of having difficulty with sensory processing. 


Many children may not get a diagnosis, or have issues with sensory processing that affects their ability to perform daily activities. It may just be a quirk that allows them to function in society without too much difficulty, but clothing can still be something that assists feeling more balanced. Some children prefer tighter clothing, others want clothing to feel very light. With this; parents may find a pattern with their clothing shopping if their sensory processing takes priority over different styles and trends. 

If your child is having trouble with tolerating clothing, and it’s affecting their participation in school or daily activities; We’re happy to help you understand and talk to you about it. Please feel free to email us at smplytherapy@gmail.com


References

Jussila K., Junttila M., Kielinen M., Ebeling H., Joskitt L., Moilanen I., et al. . (2020). Sensory abnormality and quantitative autism traits in children with and without autism spectrum disorder in an epidemiological population. J. Autism Dev. Disord. 50, 180–188. 10.1007/s10803-019-04237-0 [PMC free article] [PubMed] [CrossRef] [Google Scholar]

Ahn R. R., Miller L. J., Milberger S., McIntosh D. N. (2004). Prevalence of parents’ perceptions of sensory processing disorders among kindergarten children. Am. J. Occup. Ther. 58, 287–293. 10.5014/ajot.58.3.287 [PubMed] [CrossRef] [Google Scholar]


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Kristin Otero, OTR/L, MSOT Kristin Otero, OTR/L, MSOT

What is Sensory Diet?

A sensory diet is a set of activities that make up a sensory strategy and are appropriate for an individual’s needs. These are specific and individualized activities that are scheduled into a child’s day and are used to assist with regulation of activity levels, attention, and adaptive responses. It has nothing to do with food!

Why use a sensory diet?

It can be very motivating for a child and help them participate in activities. It's a means to adjust sensory input in relation to an individual’s needs. Based on the the child, we will prescribe some activities to incorporate into your routine. As we evaluate what activities are meaningful and motivating for your child, we will curate a child centered approach that is unique to your child.

Just as a healthy diet consists of a spectrum of foods, a sensory diet is a balanced set of sensory information that allows an individual to function. A person cannot survive on broccoli alone. Similarly, a child cannot thrive with only one type of sensory activity.

This goes for adults and children alike; we all need different types of input in order to feel balanced; part of the reason quarantine restrictions are not great for most individuals. Our bodies and minds instinctively know that varying sensory input allows us to function appropriately. However; children may have a harder time regulating and identifying what their bodies need. That's when OT's come in.

Studies support the use of active participation in multi-sensory activities for at least 90 minutes per week to improve occupational performance (Fazlioglu &Baran, 2008; Thompson, 2011; Woo & Leon, 2013; Wuang, Wang, Huang, & Su2010).

GOALS OF A SENSORY DIET ARE TO:

Provide the child with predictable sensory information which helps organize the central nervous system. Support social engagement, self-regulation, behavior organization, perceived competence, self-esteem, and self-confidence. Inhibit and/or improve modulation of sensation within daily routines and environments. Assist the child in processing a more organized response to sensory stimuli.

If you want to learn more, schedule a free consult with us here

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Kristin Otero, OTR/L, MSOT Kristin Otero, OTR/L, MSOT

What is Sensory Processing?

What is Sensory Processing?

It's a normal brain function that allows us to take in a wide variety of information and transform it into an adaptive response. 

5 senses, or 8?

There's Auditory, Olfactory (smell), Gustatory (taste), Tactile (touch), and Vision. But there's also Vestibular, Proprioception, and Interoception.

What are the last 3?

  1. The Vestibular system receptors are in the inner ear, it influences balance and movement

  2. The Proprioceptive system receptors are located in muscles and joints to know where your body is in space (minus vision)

  3. Interoception is emotional self-awareness

How does this affect behavior?

Sensory Processing is crucial to discuss when evaluating a child as the vestibular, proprioceptive, and tactile systems develop in utero and along with sound and vision, lay the foundation for all the other skills to develop.

For Example: When a child is learning to ride a bike. 

  • The vestibular system assists: balancing his body on the bike in midline

  • Proprioception: to position himself properly, keeping their feet on the pedals and chest upright

  • Vision: for navigation, and following the bike path

  • Hearing: for safety of other bike riders or something in motion that can collide 

The senses must accurately and quickly detect any imbalance. After a few falls and learning how to coordinate movement, their sensory processing for  weight shifting becomes more accurate.

*Fun Fact: There are blind people that are fully capable of riding a bike with increased sensory processing of the other senses, check out the podcast Invisibilia- How to Become Batman.

Sensory Processing difficulty signs:

  • Without reliable information about body position clumsy, distracted or awkward

  • Using too much or too little force for writing, clapping, marching or typing

  • Picky Eating/sensitivities to food textures, may cause gagging

  • Handwriting Difficulties

  • Excessive fear during ordinary movement activities

  • Difficulty with certain textures of clothing

  • Fear of swings, or reacts poorly to sudden movements/touches/noises/bright lights

  • Behavior problems

  • Can’t sit still

  • Thrill seeking

  • Doesn’t recognize personal space

  • Chewing on things

  • Doesn’t recognize when face is dirty or nose is running

  • Problems sleeping

Treatment:

Coping strategies and highly customized sessions with an Occupational Therapist is typically the treatment for SPD. Treatment addresses their sensory needs and introduces stimuli without making your child feel overwhelmed. This will help your child cope, and learn how to deal with adverse stimuli in everyday life more independently and with less trouble.

If you have more questions, please email me at smplytherapy@gmail.com or schedule a free consultation with me here.

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Kristin Otero, OTR/L, MSOT Kristin Otero, OTR/L, MSOT

Why Is My Child a Picky Eater?

However, if you are noticing that your child is struggling to try new foods and is extra picky, this should trigger a red flag.

Many kids can be picky eaters. However, if you are noticing that your child is struggling to try new foods and is extra picky, this should trigger a red flag. For many parents (especially first time parents), many food related symptoms may seem to be ordinary. After all, parents make daily attempts trying to get picky eaters to eat healthy and nutritious meals. The unusualness in these symptoms depends on the frequency, intensity and disruption of everyday life. These disruptions may lead parents to seek medical evaluation.

 Food related sensory processing issues or sensory processing disorders can be due to many reasons:

  • Oversensitive to sensations of the different textures of food - This is known to Occupational Therapists as oral defensiveness. Typical reactions include gagging on solid food, strong flavors or lumpy textures

  • Oversensitive to smells – Here’s a fun fact, most people can only taste 5 flavors (bitter, sweet, sour, salty, umami), the other complex flavors are attributed to smell. When your child experiences sensory processing disorders they may seek bland food as a result

  • Sensory seeking children may dislike bland or soft foods, and seek crunchy, high texture or highly flavored

  • Sensory based motor disorders may avoid foods that take high coordination to eat, these children may have difficulty using utensils

  • Children with poor muscle tone (muscle weakness due to neurological reasons) may have trouble with chewing, or oral motor coordination, may prefer foods that doesn’t need to be chewed

 Not all finicky eaters mean that there’s a problem. Here are some ways to address picky eating:

  • Figure out what is causing the picky eating - if your child is gagging or vomiting- this is your child’s brain warning them of danger. It’s best to seek an OT as a result of over-responsiveness to sensations, and cannot be overridden by reason

  • Baby steps – create a list of foods they do enjoy and what nutrients they may be lacking. Some questions to consider - are there any ways to update current foods with a healthier brand, is there any way to change the presentation of a the food to give it a friendlier appearance?

  • Respect your child’s response - this is important to build trust. We would advise against tricking your child into eating something they are refusing, or sneaking it into an item that doesn’t allow your child to choose accepting it

  • Offer, don’t force! - Allow the child the autonomy to choose or try something. Again, by building trust with your child and letting them accept foods slowly will increase their food choices. You get to decide what to serve and when. Your child gets to decide whether to eat it, and if so, how much.

  • Set Guidelines and routines – When a routine is set (as much as possible), it helps  to decrease anxiety associated with mealtime, and increase feeling of control for your child

  • Encourage your child to experiment with adverse foods! - Not necessarily at mealtimes, but during play/free time to improve relationship with food

  • Old with the new - Offer the familiar and loved foods with new foods. Introducing new foods without any familiar foods might increase defiant behaviors and result in your child withdrawing from trying anything

  • Trial - It can take about 15 tries of a food for kids to accept it. Any interactions (sight, touch, smelling) with the food is a step in the right direction and is increasing exposure

 Of course, there is more than one way to address sensory processing issues and each child is different. If you have more questions, please feel free to reach out to us at Smplytherapy@gmail.com or schedule a consultation here.

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Kristin Otero, OTR/L, MSOT Kristin Otero, OTR/L, MSOT

What is Occupational Therapy and When do you need it?

Occupational therapy (OT) teaches people of all ages how to adapt to everyday life.

True of False? - Occupational Therapists help people find jobs.

This is absolutely false.

I’m Kristin, Founder of SmplyTherapy, Welcome to my page and blog. Having been in the field of Occupational Therapy for many years, I’m very aware that there are many people who do not know exactly what Occupational Therapy is. If you’re here, you must be curious if Occupational Therapy is right for you or your loved one. First, I want to take you through some basics about Occupational Therapy.

What is Occupational Therapy

Occupational therapy (OT) teaches people of all ages how to adapt to everyday life. According to The American Occupational Therapy Association, Occupational therapy is the only profession that helps people across the lifespan to do the things they want and need to do through the therapeutic use of daily activities (occupations). Occupational therapy practitioners enable people of all ages to live life to its fullest by helping them promote health, and prevent—or live better with—injury, illness, or disability.

 Common occupational therapy interventions include:

  • Helping children with difficulties or behavioral problems to participate fully in school and in social settings

  • Assisting people who are recovering from injury to regain everyday skills

  • Providing support for older adults experiencing physical and cognitive changes

 Who are Occupational Therapy Practitioners?

Occupational therapy practitioners (also may be called Occupational Therapists or OTs) are healthcare professionals with a holistic perspective who uses evidence-based practice that is deeply rooted in science and research to promote a patients' functional capability to accomplish their daily routines.

OTs have vast training and understanding of how to treat the whole body by combining neurological principles, anatomical / physiological concepts, and psychological perspectives.

 How does Occupational Therapy work?

Typically, Occupational Therapy services will involve:

  • Individualized evaluation in which a client’s needs are assessed. The evaluation may take place in your home, workplace or a child’s school

  • Therapy plan and goal setting designed for you (or your children’s) needs and limitations

  • Customized intervention to improve the person’s ability to perform daily activities and reach the goals

  • Outcomes evaluation to determine is goals are being met and / or make changes to the customized plan

Who needs Occupational Therapy?

Often times, people simply do not receive the help they need in order to improve their lives because they are not sure what they need.

I speak with many young or first time mothers who may recognize their young children are more fussy than others but do not know where to go to seek help other than their pediatrician. Often, the parents may be referred to an Occupational Therapist who can help to evaluate and get the proper support for their children. Occupational therapy has been known to help children with ADHD, juvenile arthritis, and autism.

However, Occupational Therapy isn’t just for children. Anyone who struggles to do everyday tasks may benefit from it. If you have any of the health issues below, you may consult your doctor and see if occupational therapy can help you:

  • Arthritis and chronic pain

  • Stroke

  • Brain injury

  • Joint replacement

  • Spinal cord injury

  • Low vision

  • Alzheimer’s disease

  • Poor balance

  • Cancer

  • Diabetes

  • Multiple sclerosis

  • Cerebral palsy

  • Mental health or behavior issues

 You can also schedule a consultation with me to see if Occupational Therapy is right for you.

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