Tag: regulation

Heavy Work and Movement Activities for Sensory Regulation

By: Anna Bieschke Midwestern University Occupational Therapy Doctoral student and Linda Merry, OTR/L

Being stuck inside for this long of a time is certainly not fun, especially for little ones who are used to spending their day going to school, seeing their friends, playing at the park, or venturing out into the community with their families. When your child is cooped up indoors, they may not get as many opportunities to climb, jump, lift, pull, or move as much as they typically would. For many children, especially those with sensory processing difficulties, this heavy work and movement helps them to remain calm and alert throughout the day.

Your child’s ability to remain calm and focused during their daily activities is known as sensory regulation. This occurs when your child can respond appropriately to the information they take in from the environment through their senses (tasting, smelling, hearing, seeing, etc.). When a child is presented with too much or too little sensory input (like in the case of being stuck indoors with little exercise and movement), they may have a difficult time managing their emotions and behaviors.  This is called sensory dysregulation.

Some Signs Your Child is Dysregulated

  • Becomes distressed when required to sit still
  • Is easily distracted by objects or people in the environment
  • Reacts defensively to certain textures, smells, sounds, or foods in their mouth
  • Repeatedly and vigorously shakes their head, rocks back and forth, or jumps up and down
  • Becomes frightened when they are in close contact with other children
  • Runs away or becomes aggressive towards sensory input that makes them uncomfortable
  • Hides or retreats to a quiet spot
  • Appears extremely wild and/or engages in dangerous behavior

Why is Sensory Regulation so Important?

Helping your child stay regulated is important because it lays the foundation for the child to grow and develop new skills. As seen in the house diagram below, all the senses make up the base of the house. Without a stable base, your child’s coordination, language, attention, engagement in daily activities, and academic learning, among other skills, can be impacted. Just think how difficult it would be to sit and pay attention to an at-home school lesson if your distracted by the need to move around or are visually distracted by objects in the room.

Image Retrieved from: https://www.pinterest.com.mx/pin/75294624990224433/

Sensory Breaks with Heavy Work and Movement

One way to support your child’s sensory regulation while limited to being inside is to provide your child with sensory breaks, particularly with heavy work and movement. Heavy work is a form of proprioceptive input. Your proprioceptive sense lets you know where your body is in space and involves any activity that requires pushing, pulling, lifting, or squeezing. Proprioceptive and heavy work activities help ground the child and slow their bodies down to make them feel organized and calm. Movement activities can also be incorporated to help break up seated activities to support your child’s alertness and attention. Here are some fun ideas for heavy work and movement activities:

  1. Indoor Obstacle Course
    • This activity is great because it allows you and your child to get creative. Use everyday items throughout your house to build an obstacle course that allows your child to jump on, climb over, crawl through and crash down. Pots and pans can serve as cones, pillows can be crash pads, and chairs can serve as tunnels or hurdles. Get your child more involved by having them help you choose objects and set it up. Remember, any lifting or pushing of objects can add an extra heavy work component to this activity.
  1. Build a Fort
    • Take whatever theme your child loves and run with it! Whether it’s a princess castle or a lion’s cage, have the child use their imagination to make a playful space. Help your child push furniture together, grab heavy blankets or pillows, and lift boxes or baskets to really provide them with that organizing and calming input. When the fort is made, it can also serve as a quiet and secluded place for your child to take a break if needed.
  1. Catch Bubbles
  • It’s pretty safe to say that many kids love bubbles. For this activity, blow bubbles towards the child and have them pop them by clapping both their hands together. Encourage the child to press their hands firmly together when clapping to increase the proprioceptive input to their joints. Blow the bubbles high to encourage your child to jump or low to encourage your child to squat down. Try to provide as many opportunities for different movements as possible.
  1. Play a Movement Video
    • YouTube has many great movement videos for yoga, dancing, and animal walks that can engage your child in movement form the confines of your home. Clear some place in the living room and use your electronic devices to stream the videos. With this activity, it’s more about getting your child moving instead of making sure they are doing the movements perfectly.
      • Cosmic Kids Yoga (https://www.youtube.com/user/CosmicKidsYoga): This is a YouTube channel that provides yoga and mindfulness activities specifically designed for kids. This one is especially fun because many of the yoga themes follow along to your child’s favorite movies.
  1. Putty Play
    • Whether it’s play-doh, resistive putty, or thick cookie dough, have your child smash, pound, pull, and press the putty into various shapes. Use cookie cutters or other tools that encourage your child to press firmly down to make different shapes and cuts. To add an extra movement component, have them form the putty into balls and roll the putty to others at the table or toss it into a wide container. You can also hide small objects (beads, marbles, coins, etc.) into the putty for the child to pull out. All this pulling, pressing, and pounding will provide some heavy work to the arms and hands.
  1. Push-O-War
    • This game follows the same concept of tug-o-war except now the children will be pushing objects instead of pulling. To play, place a piece of masking tape or painter’s tape in the middle between your child and another child to create the center line on the floor. Put an object in between the two children (could be a garbage can on its side, a large pillow, big ball, etc.) and have them both push the object at the same time to see who can push it over the center line first.
  1. Wagon Rides
    • Have the child pull their smaller sibling or favorite toys in a makeshift wagon. Place a laundry basket or larger bin on a blanket and have the child fill the basket with their favorite toys (large stuffed animals, dolls, action fingers, etc.). The child can pull onto one side the blanket to slide the basket across the floor. A smaller sibling or friend can also sit in the basket to add some extra fun for all the kiddos in the house.
  1. Involve the Child in Household Chores
    • What’s better than getting some household chores done while also providing your child with heavy work? Even though you’re cooped up inside, there is still work to be done. Have your child help carry and fill laundry baskets, bring the garbage down to the street, vacuum, sweep, or carry in bags from the grocery store. Cooking activities like stirring batter, tearing lettuce, and kneading dough can also be great options for heavy work and movement.
  1. Other Movement Games
    • Other games including Simon Says, Ring Around the Rosie, Red Light Green Light, and Freeze Dance are also some games that can be played to promote movement when stuck at home. On nice days, take the child out onto the driveway or backyard to give them more space to run around and move.

For more information about occupational therapy at Easterseals DuPage & Fox Valley, visit: https://www.easterseals.com/dfv/our-programs/medical-rehabilitation/occupational-therapy.html.

References:

Bazyk, S. (2020). Sensory and self-regulation strategies. Every Moment Counts. https://everymomentcounts.org/view.php?nav_id=204

Pfeiffer, B., Frolek Clark, G., & Arbesman, M. (2018). Effectiveness of cognitive and occupation-based interventions for children with challenges in sensory processing and integration: A systematic review. American Journal of Occupational Therapy, 72, 7201190020. https://doi.org/10.5014/ajot.2018.028233

How Speech-Language and Occupational Therapies Work Together

By: Danielle Maglinte, MAT, MS, CCC-SLP

Ryan - webYoung children go through many developmental stages before they begin talking. One of the first stages of development is shared attention. In a baby, shared attention looks like the baby turning her head toward mom when she hears mom’s voice or a baby looking into dad’s eyes when dad talks to the baby. As children get a little older, shared attention looks like mom holding up a toy, the child looking at the toy, then looking back at mom and smiling. The next step in developing shared attention is dad looking at or pointing to a toy, the child looks where dad looks or points, then he looks back to dad. These steps towards developing shared attention typically happen within the first 12 months of a child’s life.

When a young child reaches a stage of shared attention where they can follow a caregiver’s point and they can shift their gaze between the caregiver and the object, they start to develop back-and-forth communication. At first, this looks like a child reaching for an object to tell the caregiver “I want that.”

As back-and-forth communication with gestures continues to develop, the child starts to vocalize. In the beginning, these vocalizations are mostly babbling. As parents talk back when the child babbles, these vocalizations turn into jargon where a child sounds like they are speaking in sentences but not actually saying words. Some parents comment that it sounds like the child is speaking in another language. Over time, the child’s vocalizations are shaped into short, simple words, such as mama, dada, and baba for bottle. Children with speech delays often demonstrate limited shared attention. Working to develop strong shared attention will help a child learning to communicate.

One challenge for some children with speech delays is that they need to maintain a calm, regulated state so that they are available for interactions and can share attention with another person. Read more about self-regulation from OT Maureen here.

15_JJAzariahIf a child is focused on seeking sensory input, they may not have the ability to focus on social interactions, developing shared attention and speech with caregivers. Occupational therapy can help figure out activities and ways we can include these activities in everyday life so that a child can remain in a calm, regulated state so that she is available for social interactions. This may look like a child with limited eye contact running away and looking back to see if you are chasing him or a child who is quiet asking for “more” when you stop pushing the swing.

When a child stays regulated for longer periods of time, she will be available for interactions so that she can continue to develop strong shared attention, and move on to using gestures and speech to communicate. By working together, speech-language therapists and occupational therapists can help a family find activities, such as climbing, playing chase, swinging, and swimming  or others that help a child with speech delays stay regulated and available to develop shared attention and communication skills.

To learn more about speech-language and multi-discipline therapy at Easterseals DuPage & Fox Valley visit: http://www.easterseals.com/dfv/our-programs/medical-rehabilitation/speech-language-therapy.html. 

Sensory Regulation, What Is It?

By Maureen Karwowski, OT

As I sit at my desk typing this blog on my laptop, I am regulated enough to focus on this task.  I am able to filter out the sounds of the lights buzzing, my coworkers typing, the feeling of my clothing, and the light coming in from the window beside me.  I will admit that some times I am able to do this, and not others.  For a child with sensory processing challenges, the interpretation and responses to the  sensory experiences I described can be ineffective.  These ineffective responses can impact a child’s overall regulation and can affect many areas of development.  It is estimated 01_Mason Esquivelthat 1 of 20 children are impacted by a sensory processing deficit (Ahn, Miller, Milberger, McIntosh, 2004).

I have worked with many children with sensory processing challenges as a pediatric occupational therapist.  I know from my work that every person presents with their own unique sensory profile.  Since every child is so unique, I am required to closely assess each client to be sure that I understand where their challenges are and what I can do to assist them.  A skilled occupational therapist will use a variety of assessments, some are standardized evaluations, and others are from observations of the child.  A thorough assessment will address three areas of sensory processing: sensory regulation, sensory modulation, and sensory discrimination.  Today’s topic is sensory regulation.

Sensory regulation refers to a person’s ability to keep their arousal at the right level for the situation.  Adequate self-regulation is essential to the development of attention, regulation of sleep/wake cycles, control of emotions, as well as the daily transitions that make up a child’s routine.  Sensory regulation is necessary for social interactions and learning.

One of my clients, who has significant challenges with this skill described a story about how at school, he loves to run around on the playground at recess.  He told me that the problem is that all of the other kids can slow down after recess, line up and then go back into school.

“I get so revved up that I can’t control myself anymore.”10_Logan

His teachers stated that he ran into the building, bumping into other kids at times, and did not respond to verbal directions.  This is a great example of how regulation issues can impact transitions and school.  This story ends well for this little boy.  His mother and I worked together and identified what were the factors that were impacting his regulation challenges.  For this boy, he was sensitive to movement and visual input.  He was correct in his statement that running around on the playground “revved” him up.  In occupational therapy sessions, and at home with his parents, we worked to address his challenges with movement and with visual input.  This in turn assisted him with his transition from running around to lining up to go back inside the school much easier.  We also worked on using some “tools” to help him with this transition, such as being given an earlier warning than the other kids from the teacher, he blew the whistle which gave him a chance to take a deep breath, and was in charge of carrying the bin of recess equipment into school which gave him some heavy work.

We all have strategies that assist us in keeping our arousal level where they need to be.  People chew gum, drink coffee, fiddle with objects, all in an effort to keep alert.  We also have strategies to calm ourselves down such as deep breaths, working out, knitting, herbal tea.  It is very important for children with sensory regulation challenges that we identify what are the regulating strategies that they can use to assist them.  Something as simple as chair pushups, sucking on a piece of candy, squeezing a stress ball, or rocking in a rocking chair can be useful.  It is important to customize these strategies to your child, as everyone responds differently.

I find that my occupational therapy sessions are the most effective when the parents and I are working together to identify the child’s sensory processing challenges and how those challenges are impacting daily life.

Stay tuned, as my next blog post will discuss sensory modulation.  Sensory modulation is the amount of sensitivity a person experiences towards a sensory experience.

For more information about Easter Seals DuPage & Fox Valley please visit EasterSealsDFVR.org.

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