Staying Regulated amidst an uncertain world. Tools for regulation. Post by Irene Lestari, MS, OTR/L5/14/2020 Sensory tools for kids
Amidst the COVID-19 outbreak, our lives have been altered in many different ways. Disruptions of daily life and routines can cause our body undue stress. Stressful experiences or the presence of sustained stresses, such as during these unprecedented times, can wreak havoc on the nervous system. Amid school and extracurricular activities closure, children are deprived of their needs for sensory input. Rather, they are stuck at home, with less than optimal sensory stimulation they were used to prior to this pandemic. Children react to stress differently than adults. They tend to somatocize their stress within their body and give meaning to emotions and feelings through their bodily sensations. It makes sense then to utilize their body and senses as vessels to alleviate any accumulating stress or discord in their body. As such, their bodies and senses can be utilized to mitigate the effect of stress which subsequently fine-tune and regulate the nervous system. Engaging in sensory experiences can also activate and strengthen the vagal nerve by calming the autonomic nervous system through stimulation of the parasympathetic (calming) nervous system. To glean upon the intricate interplay between sensory input and our capacity to regulate stress, it is useful to have some understanding of what sensory processing is and how our senses function. Sensory processing is the ability to take in sensory information, process that information, and then produce an output response to function efficiently and effectively in the environment. Efficient sensory processing allows the central nervous system to regulate such things as attention and activity level by enabling one to attend to salient stimuli, filter out irrelevant stimuli, and modify the amount of stimulation one is exposed to. Stress can have a direct impact on sensory processing capacity. During stressful situations, your child’s ability to process sensory input can be different from when they are in a calm/restful state. Deep tactile input, deep pressures as well as proprioceptive input are especially pivotal to restore balance to the nervous system. Deep breaths, humming, and singing is known to stimulate the vagus system, which can improve arousal state. We all know the five basic senses: sight, smell, hearing, touch, and taste. These five systems are important to everyday well-being in everyone, two other senses that are less talked about, but are just as important. These are the vestibular and proprioceptive systems. The tactile or touch (skin) sensory system has many vital functions, including providing us with the ability to know what an object is without looking (tactile discrimination) and identifying temperature and pain. Deep tactile input is calming and organizing for the body. It releases dopamine, which combats the effect of adrenaline and cortisol that is released when the child is in a high stress/fight or flight state. Movement or the vestibular system consists of parts of the inner ear and related central nervous system structures that perceive and interpret changes in head position. It automatically coordinates movements of one's eyes, head, and body. Activities that provide vestibular input are activities that changes the position of the head in relationship to gravity. The vestibular system is the first sensory system to develop and is therefore the foundation for all other sensory systems. For children that are over-reactive to vestibular input, linear vestibular activation is the first type of movement provided as it is the least intense type of movement. It is important to follow all vestibular input with heavy work as this can help reduce any dysregulation that may occur as a result of vestibular input. The proprioceptive system provides information related to the muscular and skeletal systems and, therefore, the position of one's body. Proprioceptive input, or "heavy work" activities, are activities that challenge a child to move against resistance. These include pushing, pulling, climbing, carrying, log rolling, etc. Proprioceptive input provides organizing stimuli to the nervous system which can help with motor planning and body awareness, improve attention, and increase muscle tone. This calming and organizing input can also combat an aroused state. The regulating effects of 15 minutes of proprioceptive input can lasts 2- 4 hours depending on the child and the intensity of the input. Vision consists of both the motor function of the eye as well as perception of visual information. It is also a protective sense which offers information about what is happening around us. The auditory system consists of hearing, speech, and language, the child's response to sound, and their ability to perceive the spoken word and follow directions. Included in this blog are some simple sensory tools you can try to help regulate and decrease stress to the child’s nervous system. It is crucial to engage in multiple sensory systems' activities every 3 hours to notice their positive effects on the child's nervous system. Finding the most appropriate sensory experience at the right amount is the key. Examples of selected daily activities are included at the end of this blog. Sensory regulation tools Tactile/Touch
Visual schedule as organization · Have a visual schedule. Visual schedules are an effective way to help children manage challenges with focus, task execution and transitions. A visual schedule would be helpful for the child to outline daily events and also to break down daily routines such as the morning and bedtime routines. A visual schedule can be an important component in regulation so the child can know what is expected and when, it brings a sense of order and predictability into the home. A good companion to a visual schedule is a tool to track time. · Provides a daily schedule to organize the child’s day. Start with one part of the day and make a list of 3-5 tasks that the child is required to do. · Adding pictures to be more specific about the task can improve accuracy and follow through. · Different tools for executive function tasks can be found here: http://efpractice.com/shop Other strategies for the home · Try to schedule calming activities in between more demanding activities to maintain the nervous system at a calm state. · Prepare auditory and visual materials ahead of time to assist in transitions. Timers, clocks with alarms, watches with a timer and concrete transitional objects may be helpful during transitions. · Modeling self-care and attunement to your own needs for sensory activities. · Keep a “sensory backpack” to use during “sensory emergency”. Fill the backpack with items such as massagers, different essential oils, headphones and regulating music, a soft weighted toy animal with different textures, a book with different textures, play dough, pipe cleaners, chewy toys, and pop beads. · Have an area in a house designated for a calming, quiet sensory oasis. Have it be a darker corner in the house filled with tactile activities (such as water beads, kinetic sand, theraputty, and weighted blanket). · Provide daily access to dry sensory play materials (make a bin filled with different tactile items). In cooperating sensory tools into self-care routine Eating:
· Listen to calm music (ex: light classical music, piano covers of Disney songs) · Play with a fidget · Eat crunchy snacks · Sit with weighted blanket and/or weighted toy · Carry a Sensory backpack during trips: massager, a soft toy animal with different textures, balloon, scratchy stickers, lavender, lemon and minty smell, silly putty or play dough, headphone and music, fidget stuffs: rubber coiled key chains, pipe cleaners, wiki sticks, chewy toys, stretchy band, coil shoe string, plastic pop bead, and koosh ball) Example of daily sensory activities Monday
- Animal walks
Tuesday
Wednesday
Thursday
Friday
- A magic carpet ride - Push something heavy - Play in the water or swimming or extended bath
Saturday
Sunday Outdoor play! References Moore, K.M (2008). The Sensory Connection. Self-regulation workbook. Learning to use sensory activities to manage stress, anxiety and emotional crisis. Franconia, NH: The Sensory Connection Program. Yack, E., Aquilla, P., Sutton, S (2015). Building bridges through sensory integration (3rd edition). Arlington, TX: Sensory world.
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 Everything is different now. The way we work, the way we interact, the way we school our children, the way we deliver and receive health care services…it’s all changing. And these changes are not easy. So much on the internet is telling us, it’s a blessing! Slow down and enjoy! But what about our responsibilities? We can’t just drop those because the world told us we can’t go outside. We still need to pay our mortgages, we still need to buy groceries, our children still need to learn, and some children still have therapy goals. I’ve talked to many parents right now who are trying not to panic, but are worried about progress. You’ve been working so hard for so many years, spent so much time and money, and now it all comes to a screeching halt.
But did it? Yes, clinics and schools are closed. Therapy services are delivered through video instead of hands-on treatment. But really, what are our therapy goals? Sure, some children have postural goals, some children have handwriting goals, some children have social-emotional goals, some children have sensory integration goals. However, when we zoom out and look at all those goals, they have one major thing in common. It’s “allow my child to participate in their roles in a way that is joyful and engaging.” And what is a child’s role? It’s the role of a son or daughter, the role of a brother or sister, the role of a student, the role of a friend. So maybe, this time gives us a chance to support our child’s roles in a way that we didn’t have before. Talk to your child’s OT to make sure you understand the underlying foundational skills that your child struggles with, so you can allow your child to participate in your family life in a way that supports their goals and gives them a purposeful role. Keep those telehealth appointments, and use that time to really feel empowered. Does that sound overwhelming? It might, but it should also feel freeing. Take a deep breath and know you can do this. Set yourself up for success. Be well fed and hydrated yourself, and expect that things will be different. But with no extra-curricular activities to get to, does it really matter if something takes a little longer? I’m going to say no. Use Everyday Activities We can use everyday activities to support their goals. When the main goal for therapy is participation in life, then why wouldn’t we use everyday activities? We can use these activities to target underlying skill deficits. But we need to be mindful about how hard some of these tasks can be! If you know what’s hard for your child, you can help support your child in doing them. If your child has trouble with visual scanning, guide them to look across the entire room when cleaning her toys. If your child has postural instability, get on the floor with them and help them shift their weight while he’s Swiffering. If your child has sequencing challenges, break down a cooking task to two or three steps at a time. If your child struggles with fine motor skills, let her peel her own banana or orange. This is where a conversation with your OT comes in. We can help guide you in how to help your child so that they can participate. Use telehealth sessions to learn how to support your child. Let’s break down a few common household activities that can’t be put on hold just because everything else in the world stopped. Speaking as a parent, the hardest part about this is recognizing that things will be a little different. It will take longer. It will make a bigger mess. It will not be the way we usually do it. But take a deep breath in, and a long exhale out. Realize that the end goal of each activity is not to complete the activity perfectly. The goal is to allow your child to participate in the family in a way that is meaningful to them.
Now is the time to really think about your child within the context of the family. It’s time to slow down, and participate in daily life with them. It’s time to observe them without being dictated by busy schedules. Allow them to participate, and be mindful about how they participate. Know their struggles, but identify their strengths. Recognize and verbalize their value within your family dynamic. And let’s use this time to support their goal: the bigger, overarching goal of creating meaning in everyday life, so that when this is all over, they can go out into the world and flourish. Hello Child’s Play Families,
We are working on compiling a place for resources to help support you and your families through these unprecedented times which we will attempt to update periodically. However, these are merely just suggestions. We in no way want this to overwhelm. At a time like this the most important thing is to practice self-care, hugs, connect with your kids, play, go outside, and remember to breathe!
A. Examples of Daily Schedules: 1. OT Specific Activities: https://creativehealthllc.com/wp-content/uploads/2020/03/COVID-Calendar-OT-Activities.pdf?fbclid=IwAR0BGngvdLXuTvWsfUYagbZejLpIZB89BpCItUgQHCJC339CherCc6eoBI 2. https://mommyhood101.com/daily-schedule-for-kids B. Sensory Strategies 1. https://www.spdstar.org/node/1485 C. Gross Motor/Play Ideas: 1. Movement break for Kids https://family.gonoodle.com/ 2. Cosmic Kids Yoga https://www.youtube.com/user/CosmicKidsYoga 3. 87 Energy Busting Games and Activities for Kids (Because Cabin Fever is No Joke) https://whatmomslove.com/kids/active-indoor-games-activities-for-kids-to-burn-energy/
D. Calming/ Stress Relief for the Caregiver: 1. https://www.cdc.gov/coronavirus/2019-ncov/prepare/managing-stress-anxiety.html 2. https://www.nytimes.com/2020/03/18/parenting/parents-need-stress-relief-too.html E. Academic or Other Resources:
Credit: 1. Brij, Maliya OTD, OT From Sarah Guy, COTA!!
Here are two great little routines that I found from Raising an Extraordinary Person. Roxy who is 8) and I had so much fun doing them today! For some kids 45 seconds might be a bit long for some of the activities so you can adjust accordingly. It’s a good idea to do movement activities such as these at least twice a day, once in the morning and once in the afternoon. https://hes-extraordinary.com/morning-workout-for-kids Here is another good one. https://hes-extraordinary.com/improve-emotional-regulation-just-7-minutes-per-day For kids who are sensory seekers (kids who are on the move all the time) intuitively we typically try to calm them down. However, it’s important to remember that these kids need more activity, not less, to satisfy their sensory needs. Activities should include a lot of vestibular and proprioceptive input. Here are some ideas: *Note: it is a good idea to include ways to engage their brain while doing these activities below and provide lots of changes to head position and stops and starts. Simply jumping on a trampoline may actually wind them up rather than regulate them. So for example, you could have your kiddo jump on the trampoline while counting by 2s until 30, then crash onto couch cushions or a mattress on the floor, then bear walk to grab a stuffed animal, and then back to the trampoline for more jumping (this time counting by 5s). Vestibular input for fast, intense, arrhythmic swinging, jumping, bouncing, or rolling such as: Swinging on a swing from a single point Log rolling Forward rolls Trampoline jumps Bouncing on a therapy ball Upside down bowling (with head down and rolling ball between legs to target) Sliding down the slide head first Scooter rides Yoga moves that get the head upside down. Proprioceptive input of pushing, pulling, climbing etc. Get and give blanket rides pulling each other around the room on a blanket Carry books, groceries, or the like Climb up the slide Tug of war Wall pushes Yoga Push ups Sit ups Jumping Jacks Crawl or run over couch cushions on the the ground Jump and crash onto the couch cushions Jumping on a trampoline Mopping the floor Washing windows Scrubbing...well anything! Dusting The chores idea is limitless! After doing some of the above then you can give your kiddo some calming deep pressure input such as: A massage Rolling a therapy ball over them Squish them between couch cushions Pillow fight Brushing with joint compressions For kiddos that are more on the over-responsive type or anxious about movement activities it is best to start with deep pressure input such as mentioned above. Also it is important to keep vestibular activity slower, linear (back and forth), rhythmic, and predictable such as swinging on a swing from 2 points or rocking on a rocking chair. After that some proprioceptive activity is a good idea. |
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