Children’s Occupational Therapy: Sensory Advice

Following referral to our Occupational Therapy service please find attached general sensory activity ideas which you could try with your child that may help them to cope better within their environment. Unfortunately our service is not commissioned to provide sensory integration therapy or provide a sensory diagnosis.

This list of recommendations is not exhaustive and it is important to bear in mind that the strategies are not specific to your child. Some activities may not be suitable for all children, strategies can be tried and adapted to suit their needs, abilities and preferences. Adult support and/or supervision will be required.

If you require a paper copy of this booklet or in any other format, please contact the department on 01302 642636.

On this page:

  • Understanding sensory Processing
  • Visual (sight)
  • Auditory (hearing)
  • Olfactory (smell)
  • Oral
  • Touch
  • Movement

Understanding Sensory Processing

Sensory processing is the way our body receives and makes sense of stimuli through our senses. There are several sensory systems, these being:

  • Vision
  • Hearing
  • Smell
  • Taste
  • Touch

And the lesser known ones:

  • Vestibular (balance and knowing when the body is upright),
  • Proprioception (awareness of where our body is in space)
  • Interoception (awareness of our internal body conditions – hunger, thirst, temperature etc).

Some people can have increased sensitivity to stimulus. This means that they may be easily bothered by external stimuli such as lights being too bright or noises being too loud. This in turn can affect the person’s engagement and/or concentration and may appear as agitated, adverse, withdrawn or disengaged.

Examples of hypersensitivity may include:

  • Covering ears around loud noises.
  • Not liking touch from others.
  • Not liking certain food textures or mixing of foods.
  • Dislike and reaction to smells.

Other people may have reduced sensitivity to stimulus and crave more feedback from the stimulus. The person may appear as hyperactive, however in reality they are seeking more opportunities to gain sensory feedback.

Examples of hyposensitivity may include:

  • Touching objects/people more than expected.
  • Putting things in their mouth or licking items.
  • Constantly being on the move or struggling to sit for a seated activity.
  • Smelling people/objects.

The sensory strategies overleaf are general advice, which may provide ideas on how to support the individual to cope and engage better within their environment. It is important to remember that the strategies are general advice and not specific to the individual and need adapting to meet their needs, abilities and preferences.


Visual (sight)

My child can become distracted by lots of visual input

As they can become overwhelmed by a lot of visual input, keep the amount of visual stimuli to a minimum, especially the visual information on worksheets or handouts.

  • Keep the amount of items on the desk and the visually stimulating items around them whilst they are working to a minimum.
  • Keep the use of fluorescent lighting to a minimum.
  • Consider where the child is positioned in the classroom. Where appropriate, they may benefit from sitting towards the front of the class to minimise visual distractions from peers and away from the window to reduce the chance of outdoor visual distractions.

My child struggles to find things within a busy background

The use of a clear pencil case may be of benefit to your child as they experience difficulty finding things and therefore, with minimal items stored in a clear pencil case, this should enable them to find things with less difficulty.

My child stares at light, objects and/or people

Your child may benefit from being provided with regular strong bursts of visual sensory input in a sensory diet approach, which could be achieved by playing with:

  • Flashing toys

  • Kaleidoscopes

  • Clear rainmakers

  • Spinning tops

  • Lava lamp / bubble tubes

  • Blowing bubbles

  • Glitter sticks

  • Mirrored / reflective items

  • Glitter paints

  • Maze activities

  • Dot-to-dot activities

  • Picture books

  • Holographic picture books

In school, they also may benefit from visually stimulating work areas, with bright colours, reflective materials, etc.

My child struggles to understand written instructions

As your child does not always register visual sensory input, they may benefit from verbal direction in addition to visual directions for a task/activity.


Auditory (hearing)

My child doesn’t like loud noises

Your child may benefit from being warned prior to activities that are likely to be noisy.

They may benefit from engaging in some calming proprioceptive activities such as wall push-ups, chair push-ups and pushing palms together with interlocking fingers so their state of arousal is lowered and they therefore may be able to tolerate auditory input.

Wearing headphones with preferred music and giving your child control of the choice and volume when going somewhere noisy.

Visit noisy places at quieter times of the day.

When going to busy/noisy events, such as a birthday party, be there first and let the noise build up around your child as they may cope better than arriving and joining a busy party.

My child is easily distracted

Minimise the background noise.

Sit close to the front of class away from noise distractions.

My child struggles to understand long instructions

They may benefit from the directions for a task being broken down into stages and presented visually as well as orally, either in bullet points or picture form. A visual demonstration is also likely to be beneficial.

My child doesn’t respond when their name is called

Use a visual method to attract their attention, for instance waving or a touch on their shoulder in addition to calling their name.

My child makes noises

They may benefit from a ‘sensory diet’ approach being adopted whereby they are provided with opportunities to engage in activities providing strong auditory feedback at regular intervals throughout the day. Such activities could include:

  • Use of musical instruments
  • Listen to music through headphones (consider whether to use calming or alerting music)
  • Humming
  • Singing
  • Guess the sound games

My child doesn’t realise how loud they are speaking

Use visual cues, such as a volume control dial, to enable them to have increased awareness of their own volume.


Olfactory (smell)

My child dislikes smells

Your child may be able to tolerate unscented shampoos and conditioners more easily.

Consider smells when using cleaning products around the home.

Prepare your child for situations in which they are likely to encounter the smells they find it difficult to tolerate.

Have a scented tissue available with a favourable smell so your child has easy access to cover smells they dislike.

My child does not appear to notice smells

They may need attention to be brought to important smells such as burning etc.

My child smells objects and people

Your child may benefit from a ‘sensory diet’ approach being adopted whereby they are provided with opportunities to engage in activities providing strong smell feedback at regular intervals throughout the day. Such activities could include:

  • smelly pots
  • guess the smell games
  • smell playdough (use calming smells like almond and vanilla and alerting smells such as peppermint and lemon. Use of lavender smells and essential oils should be avoided with teenage boys ad this can have an adverse effects on hormones.

They may benefit from the use of a social story to teach which items it is appropriate to smell and which should not be smelt.

Distract your child from smelling inappropriate things.


Oral

My child mouths / chews / eats inappropriate things

Your child may benefit from opportunities to engage in activities providing strong oral feedback at regular intervals throughout the day. Such activities could include:

  • Blowing bubbles
  • Crunchy snacks (may include fruit, cereal or cereal bars)
  • Chewellery or other chew toys

Your child may benefit from the use of a social story to teach them which items it is appropriate to eat/put in the mouth/chew and which should be avoided.

Distract your child from mouthing/chewing on/eating inappropriate things.

Keep inappropriate foods out of reach from your child.

My child doesn’t realise when food is too hot

Your child may need prompting to let food cool to avoid the risk of burning their mouth as they may not register the temperature of food or drink in their mouth.

My child is a fussy eater

Your child may benefit from engaging in games with food where they are involved in food preparation and can present the food on their plate in a manner which is appetising to them.

When trying food which your child is avoiding, a graded approach should be adopted where they are encouraged to firstly touch the food with their hands, then smell it, lick it, and then hold it in their mouth before they are finally able to tolerate chewing and swallowing this food. Such activities could be made into a game. A graded approach must be taken towards these activities and persistence will be required.

At meal times, a self-service system could be adopted whereby each different food type is in a separate bowl on the table (i.e. meal on one plate, potato in one bowl, broccoli in one bowl, carrots in one bowl) and therefore visible and accessible to your child. This way they may decide to try the food of their own accord without having to be asked to try it.

When practicing the above-recommended strategies, ensure that force-feeding or starvation programmes are avoided.

Try food games:

  • Food painting – using sauces and runny foods for paint and celery sticks / bread sticks etc. for brushes

  • Food modelling – hold together with cocktail sticks (under supervision)

  • Food mosaic – cut up small bits of fruit / veg etc. and press into marzipan, bread, made play dough etc.

  • Potato printing – can also print with other foods e.g. lemons, apples, tomatoes

  • Pasta pictures

  • Hiding items in dried rice to find


Touch

My child touches things

Your child may benefit from the use of a fidget item during working periods as this may help them to focus. Items such as fidget on the end of pencils, a ‘tangle’, or any other small item which they can manipulate without becoming too visually distracted may be beneficial. They may need to try a range of different fidget items before they find an item which is the most suitable for them.

Your child may benefit from a ‘sensory diet’ approach being adopted whereby they are provided with opportunities to engage in activities providing strong tactile feedback at regular intervals throughout the day. For example:

  • Fidgets
  • Playdoh
  • Vibrating toys
  • Finger painting
  • Collage and other hands-on craft activities

My child won’t wear certain clothes

Having duplicates of clothing which they can tolerate is likely to be beneficial and comforting to them.

My child doesn’t like being touched

Avoid touching them unexpectedly and always approach from the front so that they can see you and be more prepared.

They may benefit from being warned prior to engaging in activities that involve touch from others so they are able to prepare themselves.

My child doesn’t like messy play

Your child may benefit from engaging in activities such as making shapes in shaving foam, hands on baking activities, modelling using play-doh or modelling clay and playing with cooked and cooled spaghetti making letters or shapes.

My child doesn’t register hot and cold

For bath time, your child may benefit from the use of a colour change plug so that there is a visual warning when the water increases in temperature. Use of such an item will increase their independence with personal hygiene. Schools should be aware of their lack of temperature awareness and consider this in the risk assessment of engagement in related activities in school and on residential trips as adult guidance/supervision may be required.

Your child may need prompting as to when they need to put on additional layers of clothing such as socks or a jumper when it is cold or when to take off their coat or jumper to avoid overheating.

My child doesn’t like brushing their teeth

Your child may benefit from wiping around their mouth with their fingers or a flannel prior to tooth brushing and rubbing the gums with a finger or rinsing their mouth vigorously prior to teeth brushing as this will prepare the area for the tactile input.

My child doesn’t like nail cutting, hair cutting or hair washing

Your child may benefit from providing themselves with deep proprioceptive touch (firm touch) before a problematic personal grooming activity. For instance, they could be encouraged to press their palms together or squeeze on a stress ball prior to activities such as nail cutting or a firm scalp massage prior to hair cutting/washing. Your child should be encouraged to be as independent as possible in personal grooming activities and this way they can determine the pressure used.


Movement

My child is always on the move

They would benefit from regular movement breaks throughout the day to provide them with the movement input they are seeking. They could therefore be encouraged to engage in activities or movement breaks such as; jumping, running, hopping, spinning games, action songs, shaking arms in the air, out to the side and down to the ground etc.

Incorporate purposeful tasks which also provide movement into the child’s day where possible. This could be introduced by allowing the child to become a teacher’s assistant, assisting the teacher by handing out books, handouts, taking the register to the offices etc.

The child may benefit from the use of a ‘Move and Sit’ cushion. This is an air filled cushion which due to its texture and consistency provides the child with constant sensory feedback. This may enable the child to maintain focus on activities completed whilst sitting down.

They could play on toys such as a bopper hopper, a trampoline or ‘sit and spin’ at home prior to activities where they will be required to sit down for a period of time such as mealtimes.

My child struggles to complete complex tasks/activities

Break movement activities down into smaller parts to facilitate their successful completion of these.

My child can become anxious when participating in certain activities

They may benefit from receiving a firm touch at the hips. This will provide your child with deep tactile feedback which may help them to feel more secure whilst engaging in the activity. They should be warned prior to this touch input and they should determine how firm the touch is. If any signs of resistance are shown by your child this must be stopped.

Make movement activities predictable and talk your child through these movements so they know what the activity will entail and when it will be finished.

It may be necessary to break movement activities down into component stages.

Your child may benefit from a graded approach to movement, whereby they are first encouraged to produce forward and backward movements, this could then be progressed on to up and down movements, then side-to-side movements before finally progressing to spinning movements. Persistence will be required in gradually increasing the child’s tolerance of movement input. If any signs of resistance are shown by the child, this activity must be stopped.

Avoid sudden changes to your child’s sense of gravity.


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