Welcome to the sensory needs workshop.
My name is Lauren, an occupational therapist in the social communication team. Together we are going to look at sensory needs, what this means, and how the needs may be affecting your child.
Sensory processing is the way our bodies take sensory information from the environment and from our bodies and sends this information to our brain (which is like a computer). It makes sense of the information, processes it and reacts to the stimuli. The reaction can either be a thought or an action.
For example, if I was sitting at work and heard an alarm, I would recognise the sound from previous experiences, and know what it was. I would also know that it doesn’t usually ring. I would realise that I need to react, and the reaction would be an action. I would need to get up and walk out the building. I wouldn’t be smelling smoke, so I would not feel threatened. I would therefore react appropriately, by walking calmly.
If, however, I heard the fire alarm and started to panic and ran down the stairs screaming I would be overreacting. And if I didn’t react at all, and carried on working, I would be under reacting.
We all know the 5 common senses, which are sight, touch, hearing, smell and taste, but we have 3 other senses, which are important for sensory integration. They are body awareness, which tells the brain where our bodies are in space; the sense of movement, which is the awareness of balance and movement; and the internal sense, which is interoception. It tells us how we are feeling internally, inside our bodies.
Body awareness is the ability to understand where our bodies are in space and how our bodies move. It is made up of our proprioceptive system (which are our muscles and joints) and our touch systems which work together. It is our unconscious awareness of our body parts and their relationship to each other, and to other people and objects. It tells us how much force is necessary for muscles to exert and allows us to grade our movements (to use less force or more force); like how loosely or tightly to grasp things, how much force to use to open or close a door and how close or far away to position ourselves to other people.
Children with body awareness difficulties may be clumsy, uncoordinated, like moving too quickly or crashing into things.
The sense of balance, or vestibular sense, is the sensation of any change in position, direction or movement of the head and is located in our inner ears. Every single time we move our heads, stand up, sit down, walk, or run we use our sense of balance.
The greater the movement, the more balance input we receive. So, if you do a handstand or run really fast, this requires more vestibular input than if you watch a tennis game and keep turning your head from side to side to see the ball or if you walk slowly.
This system is so important because it links our vision, auditory and body awareness systems. Because of that connection, it affects eye-hand coordination, which are visual motor skills (like riding a bike, hitting a ball with a racket) and how we move our bodies.
Children with balance difficulties may find these things hard: sitting crossed legged, poor balance, difficulty moving their bodies in new ways and difficulty organising skills or being clumsy.
If your child seeks vestibular input, they may:
- Climb dangerously high
- Spin frequently
- Seek out swinging and never seem to get dizzy
- Or always be running or moving.
Remember, if your child seeks out balance input, they will usually also seek out body awareness activities as these two systems work so closely together.
This is why the playground is so important for our children: it is designed to combine these 2 senses of balance and movement so that your child can practice and combine these senses to improve their balance, strength and coordination and therefore improve their body awareness.
Finally, we also have the internal sense. This gives us a sense of how we feel inside our bodies and gives us information about things like when we are hungry, thirsty, if we need to use the toilet, if we are hot or cold or if we feel any pain.
Functionally, interoception impacts on our sleep and eating, and toileting.
It also has an emotional aspect to it. For example, when we start becoming angry, we often have an internal feeling which signals to us that we need to stop and do something about it. Or having butterflies in our tummies helps to signal to us, perhaps, that we need to talk to someone about our worries. When we are sad, we might feel it physically around our heart or our tummies. There are individual differences between all of us in terms of how we experience these sensations, but there is some suggestion that autistic children tend to have less awareness of these internal feelings. This might mean it’s harder for them to spot what they are feeling, and they may miss the opportunity to share their worries or anger before reaching the stage of a meltdown.
Imagine everyone carrying a cup around with them. If your child has sensory processing difficulties their cup may be small and fill up quickly with sensory drops.
A scenario - your child wakes up with their cup empty from having a good night’s sleep, but by the time they get ready and are at school for the start of the day their cup is already filling up from not being able to find their clothes, maybe not wanting to brush their teeth and a really busy journey. Then at break time the playground is too noisy, and they find it difficult to stay regulated and their cup fills up with more sensory drops.
By the time home time comes and they can’t find their coat, they are so overwhelmed with sensory drops that their cup overflows and they have a meltdown. This is what teachers and parents can’t understand.
Sensory activities throughout the day will prevent the children’s cups from overflowing.
But remember that our children are having difficulties with sensory processing which also involves their internal emotions, so sometimes they just need space, time and our love and support and other times they might need sensory activities.
Co-regulation is a tool to use with your child together to calm and connect with them during times of distress. Each time you help your child to go from a dysregulated back to a regulated state, you are wiring their brains and nervous system for regulation, creating the neural pathways for them to be able to self-regulate in the future: a skill they will use throughout their lives.
This is helping your child to get to a positive emotional state. Examples are:
- Lowering your voice;
- Getting down to your child’s level;
- Labelling their emotions and;
- Helping them to express them in a safe way, or even;
- Breathing together.
We want to help our children when we feel that their sensory processing difficulties are getting in the way of them attending to their play and others and getting in the way of their learning and stopping them from doing all the things that they want to do.
It’s fair to say that we are all sometimes too high or over excited, like the red car on the right; sometimes we have low energy and need to switch off, like the turtle on the left, and sometimes, we are just right (we are not too high and we’re not too low). If we need to get to the right level. If we are tired but are about to go into an important meeting, we can either chew gum, drink coffee or move around before the meeting to feel energised. Or, if we are really excited about something, we can use calming strategies, like deep breathing, to calm ourselves down. This is called self-regulating, and we do this naturally, by ourselves.
Children with sensory processing difficulties may be unable to get from low to just right or from high to just right.
Therefore, they are not able to self-regulate.
We therefore need to use strategies to help our children to regulate.
Your child may present as over responsive to some stimuli. This means that a little bit affects them too much and they try to avoid it. Common examples can include:
- Disliking loud noises and having to cover their ears;
- Disliking touch, like hugs;
- Disliking washing or brushing their hair, cutting their nails, or having their hair cut.
- Avoiding activities;
- Avoiding mess and if they get wet or dirty, wanting to change their clothes or wash their hands immediately after;
- Disliking busy environments like supermarkets, shopping centres, and parties that are too overwhelming. They try to avoid these.
If they are under sensitive to sensory stimuli, they will need a lot of it to feel it so they will seek it out. These children might:
- Seek out loud noises;
- Bump into things and crash into things purposefully;
- They may be constantly on the go and move excessively;
- They may not notice when they have mess on their face and hands;
- Sensory seeking behaviours like spinning and jumping which they might do a lot;
- And they might not realise how much food they have put in their mouths.
If your child has low arousal levels like the slow turtle on the car and are more passive, then you will need to use alerting strategies to wake them up and to get them energised, so that they can concentrate. Try them jumping, running, climbing, and giving them crunchy snacks, fast movement and use a loud, excited voice.
But if your child has high arousal levels and is constantly on the go and it’s hard to get them to concentrate, you will need to calm them down by giving them firm hugs or a firm massage. They may like slow backwards and forwards rocking, and a low, gentle voice.
Heavy work activities combine body awareness and movement and are good for alerting and calming and are also similar to activities in the park.
You could try one of these activities before sitting to read with your child or to play a game, or before eating a meal.
Here are 2 examples of alerting activities: bouncing on a gym or therapy ball, by holding your child at the hips, or placing them in a duvet cover or sheet and having an adult at either end, holding onto the corners, and swinging them gently. These are fun, and easy to do activities at home. They are very engaging for your child and can get their best attention, just before you want them to concentrate.
These are examples of calming activities which are also easy to do at home. Try them. Your child will let you know if they like or dislike them by either relaxing into it and wanting more of it, or by trying to get away and disliking it. Don’t force your child but try to find the one that works best for them.
Children can be over or under responsive to different senses depending on their mood and their anxiety levels. Especially going out and about in London, it is good to think about having a sensory bag of quick fixes to support them, like:
- Ear defenders to block out loud sounds;
- Squeezy toys to help reduce their anxiety and calm them;
- Chew tubes to bite on to release stress and give feedback to their jaws.
- Try getting them to wear a backpack weighed down by 5% of their body weight when out. This will help them to feel a sense of where they are in space, and get them to walk better.
- But again, also remember about co-regulating when out. Sometimes you may need to stop and breathe with them or just give them a hug.
- At home you could use a pop up tent, to help them unwind when they are feeling overwhelmed from being out;
- Or a gym ball to bounce on, to lie over or to use to give them firm pressure.
Attention or concentration is a skill that children practice develop over time, and they need to expand this.
Attention is essential in order for children to observe others, to copy, to learn, they need it for playing, for any sitting to do a game, for any period of time when they are trying to concentrate, even for mealtimes. And therefore, sensory integration plays a massive role in their ability to do this.
Think of quick movements just before concentrating, like a star jump, or jumping up and down, or doing an animal walk across the floor. Do this just before you’re about to concentrate.
Think of how your child plays at home on the floor. Are they able to sit cross-legged or do they need to lean on something and relax in order to concentrate?
Think of how they sit for mealtimes. Are they able to sit upright with their feet touching the floor, or do they need a chair that has a footrest. Trip trap chairs are really good because your child sit with their hips, knees and feet at a 90-degree angle.
Once your child is comfortable, they can relax and then they can engage and concentrate better.
Thank you so much for taking the time to watch this video. We hope that you have found it useful.
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