Sensory 101: Part 2

Click here for part 1.

This is more a list of situations and solutions of how to deal with solutions depending on if the child is hypersensitive or hypo-sensitive. These situations may also apply to power struggles with terrible 2's/ 3's.











SITUATION:
Waking up/ Rise & Shine
Over-Reactive child: Wakes up already overloaded. Family feels like they are walking on egg shells. Easily startles & wakes irritable, especially when startled by loud noises. May have difficulty transitioning out of bed to avoid "starting the day." Helpful equipment: gradual alarm clock rug placed on floor by bed; sun blocking blinds; time timer; visual schedule; calming background music. Helpful Strategies: Joint compressions; wall pushes; firm hug; brushing program; allow time to complete morning routine; use visual timer; quiet voice limit.
Under-Reactive child (which is part of hypo-sensitive): This child refuses to get out of bed or is extremely challenging to wake up & motivate in the morning. They are hard to wake up, often hit the snooze button several times, and can sleep through alarm. Helpful equipment: traditional alarm clock with bell or buzzer [not music]; dizzy disc/ sit & spin; therapy ball; trampoline. Helpful strategies: Alerting activities like jumping on trampoline; shower int he morning to "wake up"; leave blinds open so room is brightly lit; regulate sleep cycle; use loud upbeat music to wake up during morning routine; implement morning exercise routine.
Sensory Seeker (which is also part of hypo-sensitive): This is the family alarm clock. Helpful equipment: weighted hat; visual schedule/ chore/ activities child is allowed to do in morning. Helpful strategies: heavy work activities; chore list; joint compressions/ brushing program.

SITUATION:
Getting dressed
Over-reactive child: Refuses to get dressed and can have adverse response to getting dressed. Can go through many outfits in the morning. No clothes "feel right." Tantrums over getting dressed. Helpful Equipment: calming music CD; environmental adaptations. Helpful Strategies: let child pick out clothes; put on clear undies and socks night before so body is already used to these; may need to accept changing outfits; use bear hug vest/ lycra clothing; take them shopping with you; pick your battles.
Under-reactive child: Decreased initiation to get dressed & will often lose focus. Clothes & appearance are disheveled. Helpful Equipment: upbeat music; therapy ball/ trampoline/ sit-n-spin. Helpful strategies: Shower with towel rub to alert & get ready for dressing; dressing schedule with timer; lay out clothes night before; use massager prior to getting dressed or rub lotion on skin.
Sensory Seeker: These kids are in constant motion, making dressing a challenge as they don't stay still. May have difficulty fastening clothes because don't have precise control to manage fasteners. Disheveled appearance. Helpful Equipment: time timer; visual supports. Helpful strategies: child needs to engage in movement activity prior to getting dressed; clothes picked out night before & let them help pick out outfit.

SITUATION:
Grooming
Over-reactive child: Adverse reactions; refuses to participate; fight/ flight response; anxiety. Helpful equipment: Soft terry face towel; natural flavored toothpaste. Helpful strategies: Use firm pressure with warm water; use toothbrush with soft bristles, no flavored toothpaste, warm water to brush teeth; wet brush with warm water and comb through hair apply pressure to head & body
Under-reactive child: Unaware of messy appearance; doesn't do thorough job of completing grooming activities. Helpful equipment: cinnamon or mint flavored toothpaste; battery operated toothbrush. Helpful Strategies: Wash face using cold water to alert/ wake up; battery powered toothbrush with mint/ cinnamon toothpaste.
Sensory seeker: Makes a mess- toothpaste/ water everywhere; distracted by moving water. Helpful equipment: time timer; grooming schedule; therapist ball. Helpful strategies: set timer and have child brush til timer sounds; use schedule to stay on task.

SITUATION:
Breakfast
Over-reactive child: refuses to eat; has meltdown over eating. Helpful equipment: weighted lap pad; chair hug; proper positioning in chair. Helpful strategies: avoid smells or place calming scent in environment; may need to eat later; eat in alternative environment away from smells of morning.
Under-reactive: may take long time to complete meal. may exhibit disinterest in breakfast, prefer same foods every day, or have trouble finishing meal. may overstuff self or not eat due to difficulty discriminating feelings of fullness or hunger. Helpful equipment: spices; therapy ball; chair hug. Helpful strategies: spice up food and use strong flavors; drink through straw.
Sensory seeker: Easily distracted by themselves, environment, and their need to move. Have difficulty staying seated during meal. Their busy is so busy that they may not even stop & realize they're hungry. Rush through a meal. Helpful Equipment: intense flavors; spices; provide crunchy & chewy food for breakfast. Helpful strategies: Sit on therapy ball; weighted utensils; weighted lap pad; bungee cord on chair; tennis balls on bottom of 2 legs of chair allow for movement during eating; quiet environment to eat to avoid distraction stimuli such as TV.

SITUATION
Car or bus ride
Over-reactive child: May get car sick; can become irritable, overloaded, hyperactive. Helpful equipment: weighted animal/ lap pad; weighted hat; fidgets; sun glasses; ear phones; doodle pro/ coloring book. Helpful strategies: sit at front of bus; car pool so there are less kids; listen to music through head phones.
Under-reactive: difficult to transition into vehicle. Helpful strategy: sit at back of bus.
Sensory seeker: gets out of seat belt & moves around; bouncing up & down; makes loud noises; touchy hands; feet up on seat or kick back of seat. Helpful equipment: weighted animal/ lap pad; weighted hat. Helpful strategies: use lap belt; keep child occupied in vehicle.

SITUATION
Bath
* Contrary to popular opinion, it's not necessary to bathe kids everyday unless there are medical or sanitary reasons to do so. Rather than bathe, use a washcloth or wet wipes (which can be kept warm in a warmer) to zap any dirty areas daily, and schedule unavoidable bath time for one or more days each week consistently.
* Use large sponge or loofah sponge and rub firmly to decrease defensiveness.
* Before bath, do resistive exercises or activities that provide deep proprioceptive input.
* Have bath water drawn before having child undress. Make transition from undressing to getting into tub as quick & smooth as possible. Keep bath temp warm & have them dress while still in bathroom.
* If child dislikes having his/her face or body washed, encourage them to do it themselves. Self-imposed touch produces less defensive reaction.
* Use fragrance-free soap, as well as sensitive skin brands.
* Use tub toys, soap paints, and bubble baths for them to play with & keep occupied.
* For showers, use a hand-held nozzle. Let child control direction & force of water. This can be especially helpful washing for kids who are afraid of a big shower.
* Use a large towel & quickly & firmly wrap child in it. Avoid exposure of wet skin to air.
* Provide deep-touch toweling to extremities, hands and feet to decrease defensiveness. If child will tolerate, provide firm massage, using lotion to avoid skin irritation.
* Some kids who dislike the bath, will go into the shower with no/ less problems.

SITUATION
Bedtime
Establish a consistent routine- I've heard suggested no tv/ computer time for 60 mins prior to bedtime. Suggested calming activities:
* Rocking/ swinging
* Dim lights, use small space. Use only for quiet time like reading or regaining composure when upset. Not for punishment or it will lose its effectiveness.
* Relaxing scents such as lavender or vanilla.
* Oral input- try fruit or jello. Or drinking something through a straw.
* Wrap snugly in blanket or towel. Ask child if they want you to press more or less firmly.
* When reading to your child, give him bear hugs.
* Warm pajamas in dryer before going to bed. This may provide neutral warmth to help body calm for sleep.
* Tell your child you'll stay with him for 10 mins and once time is up, leave room. Set a timer if it's helpful.
* Turn on calming music for child.

SITUATION
Dining out
* Choose 1 or 2 familiar restaurants to master before attempting new places
* Call ahead & order food to avoid a wait if you like
* Make sure child has something of his/ her own.
* Ask for drinks right away. Ask waiter to bring out kids' food first if it's ready before adults'.
* Ask server to bring extra napkins
* Bring objects to keep waiting kid occupied. (koosh balls, cars, etc)
* Bring weighted lap pad if helpful

SITUATION
Doctor/ Dentist visit- trip to doctor/ dentist can be stressful & traumatic experience for some kids. Here's some suggestions to decrease anxiety:
* Let your kids wear sunglasses
* Bring fidget toys to keep hands busy & entertained
* Use deep pressure or massage to calm child before appointment. Allow them to wear weighted lap pad or x-ray apron while sitting in dentist chair.
* Ask if child can bring own toothpaste from home to dentist if they're sensitive to tastes & smells.
* Create social story with child so they know what to expect or read them book about trips to doctor/ dentist.
* If orally defensive, do oral motor stimulation to "wake up" their mouth muscles & decrease sensitivity before visit.
* To diminish amount of time spent in waiting room, call ahead to see if office is on schedule or arrange to be first visit of the day.
* Warn child before any procedure. Choose words carefully to not frighten them. Like we say that shots will sting instead of hurt. We explain shots are medicine to keep them healthy.
* It may help to bring along your kid to one of your other kids' or your own doctor visits so they can see observe the environment/ equipment. We used the same tactic for blood draws too. I have to get blood draws frequently for anemia tests, so I've taken my kids in with me so they can see it's no big deal.