Sensory & Daily Routines

Sensory Seeking

• This child seeks out sensory stimuli in order to make sense of the world around them, including auditory (noises and voices), tastes, touch, smells, and movement. 
• This child's nervous system has a high threshold, and they need a high level of input to stay regulated during their day. This child may be described by caregivers as always "on the go", "overly active", or is a "risk-taker" in dangerous situations involving climbing or swinging.

Sensory Over-Responsive

• This child actively avoids or is sensitive to a variety of sensory stimuli, including auditory (noises or voices), tastes, touch, smells, and movement. 
• This child's nervous system's "fight or flight" response is over-reactive, and this child may feel "overloaded" with certain sensory stimuli or in busy environments.

Sensory Under-Responsive

• This child is unaware of or does not notice sensory stimuli in their environment, including auditory (noises or voices), tastes, touch, smells, and movement
• This child's nervous system needs additional input to "wake-up" those senses and help to make them aware of what is going on in their surroundings.

It is important to note that we all have sensory preferences. When a child is unable to self-regulate or these sensory preferences interrupt their ability to participate in daily activities like play and hanging out with others, then there are strategies available to improve their ability to participate. Please see the "Sensory Strategies for Daily Routines" page on this website for more ideas and consult the Occupational Therapist on your child's team. 

Sensory Processing Disorder - YouTube video that can help to explain Sensory Processing Disorder (SPD) and other sensory issues.

• STAR Institute: Experts in Sensory Processing and Sensory Processing Disorder
• American Occupational Therapy Association: Resources to learn more about how an occupational therapist can help improve your child's participation in their daily routines through sensory strategies and modifications.

Successful Sleep

• Create a consistent naptime/bedtime routine that works for you and your child. Most children will do well with more calming activities before bedtime, such as reading a book, listening to or singing soothing music, getting wrapped up in a blanket and snuggled, and turning down the lights. 
• Be SAFE! Click on this link (Mayo Clinic - Sudden Infant Death Syndrome) to learn more about how best to keep your infant and toddler safe while sleeping. 

Infants

• Create a calm environment. Your child may prefer slow rocking or back-and-forth motions while being snuggled. The temperature of the room should be just right to allow your child to be comfortable. Reduce noise as much as you can, but be aware that your child may prefer silence when trying to self-soothe to sleep. 

References: 

Henry, D. A., Kane-Wineland, M., & Swindeman, S. (2015). Tools for Infants: Sensory-Based Strategies for Parents, Caregivers, and Early Intervention Providers. Glendale, AZ: Henry OT

Infants and Toddlers

Breast or Bottle-Feeding: 

• It is important to maintain a proper alignment when breast and bottle-feeding. There are a variety of different positions to try, such as the cradle hold. Research what works best for you and your infant. 
• Hold your infant close to your body, using as much skin-to-skin contact as possible and holding eye contact. A calm environment is best if possible. 
• Once your child is able to hold their own bottle, they should be in a semi-reclined or upright position, with or without support (based on their developmental skill level). One way to determine this is by checking to see if the child's ear is more elevated than their mouth.  This is to ensure proper alignment for safe swallowing, as well as to avoid illnesses, such as ear infections. 

Starting Solids:  

• Once your infant is approved for solids by your pediatrician, gradually begin to introduce foods in the order suggested by your pediatrician. This is typically around 4-6 months of age and may also depend on if your child is able to sit upright and alone on a stable surface. 
• Allow your child to get the food on their hands and bring to their mouths themselves, so they can prepare for its smell and taste. 
• Ensure proper alignment with head support, good head/trunk control, with their hips and knees at right angles. 
• Encourage your child to mouth a variety of infant-safe objects to prepare their mouths for chewing. 
• Provide your child with 2 or 3 spoons or toys at a time to scoop food and play/eat with to make mealtime exciting! You can use one and they can try to self-feed or play with the others. 
• Some children prefer to have small portion sizes on their tray or table in front of them at one time. They can always have more! 
• Expose your child to a variety of smells. If your child is already sensitive to smells, learn what they prefer/avoid, and help them cope with that smell by introducing it slowly. 
• Watch this short video for more tips on starting solids! 
  • Kaiser Permanente: Starting Solids Video

References: 

Henry, D. A., Kane-Wineland, M., & Swindeman, S. (2015). Tools for Infants: Sensory-Based Strategies for Parents, Caregivers, and Early Intervention Providers. Glendale, AZ: Henry OT.

Dressing is an important part of an infant and toddler's day. Over time, your child will begin to cooperate with dressing, put in arm or leg in, begin to take off simple clothing items, and eventually, dress themselves. Try these strategies to make dressing enjoyable and individualized for your child's preferences. 

• Before dressing, encourage muscle work activities such as propping self on forearms, taking weight on feet, and pushing with hands or feet. 
• As he begins to use his hands, let him tug on a blanket, your clothes, or his socks while dressing him. 
• Before, during, and after dressing, massage and touch with deep pressure (more soothing than fast, light touch). 
• Allow her to gain more experience with a variety of textures, both clothed and unclothed (think laying on different textured towels, blankets, etc.), especially during tummy time! 
• Discover his clothing preferences such as loose or tight, silky or cotton, fleece or flannel. Wash new clothing or use fabric softener prior to putting it on her. 
• Offer different or favorite toys during dressing to play with in hands or to put in mouth. 
• Sing his favorite songs or make a soothing “shush” sound. Make eye contact and smile often.
• Dress in front of a mirror to allow her to see what is happening.

References: 

Crawford, M. J., & Weber, B. (2014). Early Intervention Every Day!: embedding activities in daily routines for young children and their families. Baltimore, MD: Paul H. Brookes Publishing Co.

Henry, D. A., Kane-Wineland, M., & Swindeman, S. (2015). Tools for Infants: Sensory-Based Strategies for Parents, Caregivers, and Early Intervention Providers. Glendale, AZ: Henry OT.

Make Bath Time Fun for All!

• Prepare your child ahead of time for bath time. Use a timer or sing a song to transition into the bathtime routine. 
• Show your child a picture of the bathtub and let them know that is the next activity for their day. 
• If your child is old enough, have them help to gather everything needed for bath time. This can help develop decision-making and independent self-care skills. 
• Let child play with/in warm water in the sink to understand that water play can be fun!
• Household items make good bath toys, e.g. measuring cups for scooping, whisk to make bubbles, bowls, and other child-safe toys like rings or rattles.
• Bring in a doll or plastic toy to introduce how to use a washcloth, learning/naming body parts, and beginning self-bathing.
• Never leave your child alone. Always stay within arm's length.
• Calming music can be played to soothe your child. 
• Before and after bathtime, wrap your child in their towel or blanket and provide gentle massage/rubbing body to help calm and prepare their body for the water. 

References: 

Crawford, M. J., & Weber, B. (2014). Early Intervention Every Day!: embedding activities in daily routines for young children and their families. Baltimore, MD: Paul H. Brookes Publishing Co.

Henry, D. A., Kane-Wineland, M., & Swindeman, S. (2015). Tools for Infants: Sensory-Based Strategies for Parents, Caregivers, and Early Intervention Providers. Glendale, AZ: Henry OT.

Outside

• Let your child know in advance that they will be playing outside. Show them a picture of the door or your yard to help them transition to that activity. Use a timer or sing a song to move to getting ready for outside play. 
• Prepare your child for outside activity by checking the weather and determining appropriate clothing needs for that day. Bring extra clothing in case your child gets dirty or is too cold. 
• Based on your child's abilities, let them decide what to do when outside. If going for a walk with a stroller, allow your child to walk while pushing stroller for a little while, or holding onto an adult's hands. 
• If your child is not yet walking, allow them to see the outdoor world through the stroller in an upright, supported position. Point out and talk about what you are seeing, even if your child cannot yet talk back. This is great opportunity for bonding and learning about the environment. 
• Set up a safe place to put down a blanket and bring some easily cleaned toys outdoors to play outside. Allow your child to play in the grass or dirt, picking up leaves or pine cones. Although it can be frustrating for some caregivers to see their child getting dirty, this can help a child learn through feeling what is around them. View this as a learning activity and talk about what they are feeling or seeing. 

Indoor 

• Create a safe space for your child to play. 
• Use a variety of home objects to promote learning and development: cups, measuring cups, bowls, spatulas, tongs, balls, paper, crayons or markers, laundry baskets, etc. Adult supervision recommended. Know your child's developmental play level for appropriate play activities. 
• Play or sing music and have a dance party. 
• Infants and toddlers are often content in playing with someone side-by-side or having an adult play with them. If you are feeling prepared for it that day, try to be interactive and silly! 
• Pay attention to what interests your child and follow their lead. 
• Messy play is a great way to help your child learn about different textures, which will prepare them for more difficult eye, hand, and finger tasks. Scroll below for a list of "edible sensory play ideas" 
• As your toddler ages, provide them with more opportunities for "role-playing" or "pretend-play" by giving them old clothes for dress-up or creating a space for them in the kitchen to "help" prepare dinner. 
• Praise your child for playing appropriately and show interest and affection for what they have created. Re-direct your child from unsafe situations and explain why they are not safe.

Sensory Seeking

• Incorporate "heavy work" activities to release energy and to calm down sensory seeking behaviors (see list below) 
• Embrace your child's active movements and allow them to self-regulate by recognizing when your child may need to "let loose" and get out some energy. Recommend adult supervision for safety! 
• Change the child's environment by incorporating bright colors, sounds, tastes, and safe places to explore.

Sensory Over-Responsive

• Examine which sensory preferences cause your child to become upset. 
• Acknowledge which are under your control to change. For example, you may be able to cut the tags from your child's clothing, but you may not be able to change when the garbage trucks does its pick-up. Be aware of what your child's needs are, and problem-solve ways to help them adapt. 
• Gradually introduce your child to new sounds, tastes, textures, etc. Your child may need a warning to prepare for a sound or smell.  

Sensory Under-Responsive

• Examine which sensory preferences go unnoticed in your child. 
• You may need to combine multiple sensory stimuli to encourage your child to take notice. For example, if your child does not respond to name by sound alone, you may need to step into their sight, touch their arm, and say their name at the same time. 
• Incorporate a variety of stimuli into your child's routine. Strong smells, crunchy foods, louder noises or voices, and brighter colors can improve attention to a task or person.

"Heavy Work" activities build up the major muscle groups, joints, and ligaments in your child’s body to provide information to their proprioceptive sense (one of our “extra” body senses) to allow your child to know where their body is in their environment (body awareness), which helps with coordination and strengthening. 

Most Importantly, it provides deep pressure to the muscles, joints, and ligaments, which has a calming and organizing effect on the nervous system and brain. 

Many children need additional “heavy” work activities to help regulate their body and brain, improve concentration, and prepare to do the tasks that they need to do everyday (dressing, eating, transitions, sleep, etc.), also known as childhood occupations. 

Here are some examples of "Heavy Work" activities that can be done with supervision from a responsible adult: 

• Try different animal walks: Bear walks, crab walks, snake crawls (on belly), frog jumps
• Do turtle walks: Place a large pillow on the child’s back and see how long they can crawl around with a “heavy shell” on their back
• Wheelbarrow walks: Child places hands on floor, grown-up holds child’s legs off floor and helps them walk with only their hands on the floor. Child should keep fingers facing forward as much as possible. Easier = hold child’s legs at knees or hips, harder = hold child’s legs at the ankles
• Jump and crash into a bed mattress, large beanbag pillows, or couch cushions
• Tug-of-war: Can be done in a variety of positions such as standing, sitting, kneeling, or laying on tummy
• Pour items such as sand, dry beans, dry rice, or water back and forth between containers (larger containers = more heavy work)
• Squeeze, squish, and smash play dough 
• Play catch with a big pillow or ball
• Complete an obstacle course or relay race
• Build a fort (include chairs and large pillows for extra heavy work while constructing)
• Blow bubbles, kazoo, harmonica, whistle, pinwheel, or similar items (provides proprioceptive input orally)
• Carry laundry or bags of groceries into the house (make sure child is given bags of items that will not break)
• Help with “pushing” and “pulling” activities around the house: “Heavy work” chores such as vacuuming, sweeping, mopping, wiping down tables or countertops, wiping/washing mirrors or windows, scrubbing floor, scrubbing bathtub or shower, transferring wet laundry from washer to dryer (avoid exposing to chemicals unnecessarily)
• Help push the stroller when on a walk
• Provide chewy or crunchy food at snack or meal time: Celery, carrots, apples, fruit leather, jerky, pita chips
• Drink thick liquids through a thick straw: milkshakes, smoothies, yogurt, applesauce
• Drink from a suction water bottle
• Rearrange small furniture with your child, encouraging her to push or pull
• Give your tot ‘bear hugs.’ Child faces away from you and you hug from behind
• Give deep pressure squeezes down arms and legs
• Have your child fill a laundry basket and let him push or pull it around the room and then let him dump it all out, repeat 

Please note that this list contains suggestions. For more individualized information for your child, please consult an occupational therapist. 

Reference:

Kiley, C. (2015, April 7). 40 Heavy Work Activities for Kids. Mama OT.