Therapy Tips

Top 5 Questions Asked About Sensory Processing Disorder

As a pediatric occupational therapist specializing in sensory integration, I spend a lot of time answering parents’ questions.  The following are a few I hear most often:

1. How do you use sensory strategies to help a child attend at the table?

The vestibular (our sense of movement derived from receptors in the inner ear), auditory and visual systems strongly influence attention and affect our ability to attend to tasks. Giving a child opportunities to move can be helpful. The key is to get the child’s head moving in different planes of movement (up and down, back and forth, round and round). Activities such as bouncing on, rolling over and completing sit-ups on a therapy ball can achieve this. Swinging both back and forth and in circles will provide input. A Sit ‘n Spin and the IKEA egg chair are great options for rotary movement. Alternating sitting on balls, a one-legged stool, and a Disc O’ Sit Junior (a bumpy inflatable rubber seating cushion) can also help give a child some movement, which will help them to sit still. Deep tactile (touch) pressure from weighted items like lap pads, neck wraps and vests is also proven to calm and help a child attend. Specialized compression garments can also be helpful. When using a weighted item, the weight should be about 10% of the child’s body weight, and the child should wear it for about 20 minutes on and two hours off.

2. What are your suggestions for a child that cannot sit still or is always sliding in the chair?

One of the most important things for any type of activity is for a child to maintain proper posture. Ideally we want hips at 90 degrees, knees at 90 degrees and ankles at 90 degrees. When a child is properly supported in their seat, this will increase stability and improve the quality of movement in fine motor muscles.

3. Why do kids cover their ears?

Often this is a sign of auditory overload and/or spatial difficulties. Children can often become defensive when they can’t understand where a sound is coming from. It also can be due to sensory overload. Fidgets (small manipulatives that provide sensory input, such as squeeze balls, pencil tops, and small toys) can be used to help keep hands busy, and cushions or padding under the chair can be used to decrease sound feedback. Using headphones that are “open” and decrease noise but do not completely block out sound may also help.

4. My child has been diagnosed as having “low tone.”  What can I do to help him?

Low tone (hypotonicity) means a child has a low resting tension in the muscles. Strength is the ability of the muscle fiber to exert force. This is harder when you have low resting tension; it takes more work for the body to activate if the muscle fibers are like loose rubber bands. Keeping the vestibular system regulated and/or stimulated helps a child to regulate their tone. Positioning, positioning, positioning is the key. Use supported seating with sides to help increase proprioceptive feedback. Quick, fast movements and stretching as well as cold input and vibration help to stimulate tone.

5. Why use vestibular stimulation?

At our center, vestibular input is typically provided by way of a variety of suspended equipment or swings.  The vestibular system helps regulate attention, and increasing input also increases the ability to attend; it increases perceptual and acoustic processing of words, which aids in speech and language production. Vestibular input increases eye contact, eye movements, and social interaction. Movement stimulates the vagus nerve, which controls our ability to maintain a calm or alert state of arousal. It helps to engage the whole body and to stimulate core muscles (the deep layers of muscle in the trunk and torso that provide structural support to the spine, which keeps the body stable, upright, and balanced, providing a stable foundation for movements of the arms and legs).