Sensory based strategies to support participation in activities

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Touch (tactile) Distressed/avoids areas with people (supermarket/playground) o Upset when others brush past them). o Push/shove others, fearful of them getting close. Avoid/distressed during play activities involving touch (i.e. messy play, painting). Distressed when their hands/face are messy (i.e. mealtimes/baking). Distracted and fidgety. Dressing difficulties: poor tolerance certain fabrics/clothing/labels. Avoid/Distressed during self-care activities (washing/hair-brushing). Allow child to stand at end of queuing line (supermarket/school). Child to push trolley/carry shopping in supermarket. Allow child to sit on a small table at front or back of class. "Deep pressure/heavy work prior to, during and after exposure to sensation (i.e. washing/grooming activities/busy places). Allow child to have their own space (at home & school). Seamless clothes/lycra garments. Consider type of clothing (fabric and length of sleeves, cut out labels). Use pressure when shampooing/ drying with a towel. Encourage child to wash/dry self. Vibrating toothbrush Under-sensitive: Stand/sit too close to others. May be heavy handed. Appears to have high pain threshold. Difficulty sitting still. Touches items more than peers. Not notice having messy hands and face/twisted clothing. Difficulty with fine motor tasks. Difficulty manipulating pencils/scissors Difficulty cleaning themselves after using the toilet. Encourage tactile experiences: Messy play (sand, water, paint, lentils/rice, foam, play-dough, powder, jelly, slime). Hide & Seek - find objects of hidden in bowls of rice/pasta etc. "Deep pressure/heavy work" Dress in front of mirror (visual cue for motor planning & body awareness. Hand warm up before fine motor tasks. Pencil grips. Use moist toilet roll.

Taste & Smell Vomit/Gag at smells that may not bother others. Mealtime difficulties: o Get upset by certain tastes and/or smells and may not appear to get used to the smell. o Has a bland diet. o Appears anxious at mealtimes Become distracted by a smell in the room and have difficulty focusing. Won t use toilet at School. Avoid/Distressed during self-care activities (washing/grooming). Allow child carry out some Deep pressure/heavy work activities to distract and calm them from the smell/taste (prior to, during & after exposure). Allow them to have their favourite scent or an object that they like the smell of to block out smells they don t like. Consider food textures. Food textures that encourage biting & chewing (deep pressure). Encourage breathing through mouth instead of nose. Wash and dry clothes in unscented products Use non-perfumed soaps/sprays. Cold food (ice pops/ice) prior to eating foods child dislikes. Involve child in food preparation, and give them choices on what to make. Under-sensitive: Crave certain tastes and/or smells. Under reacts to bad/strong or good/nice smells. Scratch and sniff stickers. Scented perfumes. Scented pens. Cooking with strong smells. Play near freshly cut grass. Play with strong playdough Food textures that encourage biting & chewing (deep pressure). Strong tasting food (sweet/sour/ spicy) prior to trying new foods.

Visual Distracted by pictures or people in the room, affecting engagement in school, mealtimes, dressing. Difficulty engaging in conversations/learning. o Distracted by clutter, board displays, bright colours. May dislike or cover their eyes when the lights switched on. May complain of a headache, rub their eyes, have watery eyes or squint. Dislikes lighted environment, prefers darker environments. Ensure child has had an eye test with an optician. School: o Build privacy boards with cardboard around desk. o Minimise wall & ceiling displays. o Sit the child at front of class to block out visual stimuli. o Give regular breaks. o Only get out what they need for that task. Keep Home & classroom clutter free. "Deep pressure/heavy work" prior to, during and after exposure to sensation. Timeout space at home and in school with dimmed lighting. Use natural light where possible. Keep visual distractions to a minimum when participating in tasks. Be colour sensitive when choosing toys, towels, wall colours etc. Undersensitive: Difficulty concentrating at school: Takes more visual information to respond. Likes different types of lighting (reflective, fluorescent, spinning). Use bright lights, lots of colour and movement. Use different coloured papers. Use lots of hand gestures. Increase visual stimulation when teaching/playing with the child. Use visual cues when completing activities.

Auditory Avoids or becomes distressed in noisy places (playground, shopping centres, swimming pool. Easily startled by noise. Dislikes loud noises. May cover ears. Appears anxious before expected noise (i.e. fireworks, school bell). Over react to sounds that others barely notice. Difficulty concentrating, distracted by noise such as a fan, or ticking clock and be unable to focus on another task. Hums to self. Audiologist hearing test. Forewarn child of any loud noise (i.e. bell/fire alarm). Rugs/carpet in house/school. Headphones/ear plugs when noisy. Don t sit child near to school bell or speakers. Consider tone of voice and use of language. Allow time out to a quiet space (pop up tent/other room). Encourage participation in "deep pressure/heavy work" prior to, during and after exposure to sensation. Be aware of other visual or auditory noises in the room which may affect participation in self-care/leisure/ productivity activities. Carry a heavy back pack in noisy environments. Plan for special events (football games, firework displays). Under sensitive: Difficult learning new skills, participating in activities of daily living: appears not to hear information. Enjoys loud noises. Hum to self Speaks loudly. Audiologist hearing test. Alter tone and pitch of voice. Only speak to the child when they are facing you and looking at you. Give simple instructions. Don t use too many words. Speak loudly and clearly to these children at all times. Find out what activities are alerting.

Vestibular Avoids activities where feet may be off ground (gymnastics, swings, toilet). May become dizzy/sick easily. Difficulty engaging in play: avoid apparatus or fast-moving playground equipment Hesitate or avoid walking downstairs Be fearful of heights even on slightly raised surfaces Avoid tilting the head from midline e.g. dislikes doing forward rolls, becomes distressed/avoids having hair washed/brushed. Appear cautious, move slowly, and unlikely to take risks Supportive seat, feet firmly on ground. Ensure child always has feet grounded, use a stool/step if required (toilet, classroom seat). Use your hands to help child develop his awareness of his body position. Always use firm grounding touch and concentrate on the joints of the body. This will also help to focus the child s attention on an activity. Deep pressure/proprioceptive/ heavy work prior to, during and after exposure to sensation. Under sensitive: Need to keep moving as much as possible to function. Have difficulty staying or sitting still in their seat. Repeatedly jump up and down, rock back and forth, and shake their heads. Crave intense movement experiences, going upside down jumping off furniture etc. Regular change in position (laying on tummy, cross legged, standing) Obstacle courses where child must go over/under/through obstacles. Move in sit cushion. Fidget toy Active work. Deep pressure/proprioceptive/ heavy work throughout the day. Sports: swimming/running/cycling. Go to the playpark before School. Regular short movement breaks. o Jumping Jacks. o Circular moves/spinning. o Forward/backward & up/down movements.

Proprioception Climbs & hides in small spaces. Difficulty sitting still, and concentrating. Poor fine and gross motor coordination. Difficulty washing & dressing. Difficulty using cutlery. Poor handwriting. Uses too much or too little force on objects (pencils, scissors, buttons, zips) and people. Difficulty throwing and catching. Poor balance. Seek out rough and tumble play. Bump into or push objects or people. Appear to uncoordinated or clumsy. Play games with large cardboard boxes allow child to climb/hide/squeeze into then rip apart/jump on it etc. Regular deep pressure/heavy work proprioceptive activities through day. Frequent movement breaks. Fidgets. Supportive seat, feet on floor with arm rests. Allow various sitting positions (laying on tummy, against a wall). Air cushion/move & sit cushion for activities that require concentration (school work, mealtimes etc). Try obstacle courses where child has to go over, under, between obstacles. Hand warm up exercises prior to completing fine motor tasks. Make a burrito or sandwich : Firmly press on your child s arms legs and back with pillows or make a burrito by rolling them up in a blanket.