Do you remember the last time you were walking through town and were suddenly alarmed by the warning whistle of a train passing through the railroad crossing? What about the embracing sensation of a bear hug from the Uncle you haven’t seen in 2 years? Or the sweet taste of your grandma’s banana cream pudding in the summertime? These are all examples of sensory engagement. Your body is reacting to some sort of sensory experience and the brain processes that experience so you can react accordingly.
When your ears sense the loud train whistle, your body quickly makes the decision to either flinch at the sound, cover your ears, or acknowledge it without any reaction at all. Some may react to the train whistle in a complete state of shock or panic. They hear the whistle and know a train is close by, but they aren’t quite sure if they are in the way, if the noise is going to get louder, or if it will sound off again. The train whistle could even momentarily paralyze the person and lead to a panic attack or anxious episode. Everyone reacts differently to what we hear, see, touch, taste, and smell.
This is an example of a sensory processing issue that’s typically experienced by those that have sensory processing disorder or SPD. SPD’s can occur in people of all ages but is most commonly seen during the developmental years in a child’s youth. As a child grows older and starts to explore their surroundings, their senses develop and they start to recognize textures, sounds, smells, tastes, and lights. When there is a disconnect or delayed reaction in this sensory development stage, the children are often put on a sensory diet by a doctor or therapist.
A sensory diet is a growth and learning tool that exposes children or adults to a variety of sensations that they may react positively or negatively to. Occupational therapists are the primary creators of a sensory diet for an individual. Therapists work with the child or adolescent over a series of visits, interviews, and assessments to determine the following:
- What are the stimuli that positively/negatively impact the patient?
- What is their current sensory range or ability?
- Establish short-term and long-term sensory integration goals
- Perform trial and error integration with sensory toys and activities
- Document data and monitor results so that the diet can evolve
How long does a sensory diet last?
The lifetime of a sensory diet differs with each person. Sometimes it can last for as little as several weeks for those that don’t have a diagnosis of Autism, ADD, or ADHD. In these cases, the diet is more of a sensory learning experience for the child and teaching experience for the parent.
In the case of a child with an SPD like Autism or ADD, sensory diets can last months, years, and even long-term throughout their adult life. There is a bit of trial and error that takes place early on in the diet by the therapist because they need time to evaluate the sensory experiences that can cause traumatic episodes.
Once certain disruptive stimuli are eliminated from the diet, the therapist can focus on building on other positive sensory experiences before transitioning some of the disruptive stimuli back into the diet. With some children, but usually adults, certain sensory activities are completely eliminated altogether and do not get integrated into the diet again. For example, if an adult veteran with severe PTSD from war is on a sensory diet, the therapist may choose to completely avoid loud, impulsive sounds during their visits. The sounds could remind them of an explosion or negative scenario from their time serving in a war that triggers them to become anxious or fearful.
The therapist may choose to gradually integrate quiet or medium sounding noises into the diet in an attempt to ease the anxiety caused by a very loud noise. However, if there are no signs of improvement with this method, sound integration may be eliminated from the diet.
What’s in the Sensory Diet
The diet is a selected group of activities determined by the occupational therapist that allows the adult or child to explore their senses. The activities focus on the variations of input our brain receives via our senses.
Proprioceptive input refers to the sensation we feel from within our muscles and joints. It stems from our sense of touch but is a deeper feeling that you experience when you do a pull-up or lift a heavy bag of groceries. Activities using this input may include lifting heavy bean bags or using the monkey bars throughout the sensory diet.
A vestibular input may be included in the sensory diet if the child easily gets motion sickness, has poor balance, is constantly bumping into things, or is out of sync with their range of motion.
Types of vestibular input that might be introduced during the diet may include swinging, speed and motion activities, hanging upside down, or performing hand and leg movements and stretches.
Children and teens often experience auditory anxiety if they have a sensory processing disorder. Loud, quick onset and disruptive noises can stress and frighten them easily. Auditory input is commonly introduced in the sensory diet early on and may involve listening activities that involve the outdoors – listening to water in a stream, or the sound of birds in the trees. There are a variety of toys like piano keyboards or building blocks that also provide auditory input that does not come off as overly loud or intimidating.
Most sensory diets include many forms of tactile objects which target the tactile sense or sense of touch. Simple exposure to objects with interesting surfaces or textures is a common activity. Bowls of hard macaroni pasta, bins of soapy foam, workspaces with Play Dough, or even water tables are all examples of introducing the sense of touch into a sensory diet.
Olfactory input is the sense of smell. This can be a challenging integration sense as many children with sensory issues strongly dislike certain scents, especially overpowering ones. Scent games can be gradually introduced in a sensory diet that is not so overbearing at first. Some therapists start with smelling mild herbs, spices, or flowers and then gradually introduce citrus fruit or foods being baked or cooked.
Visual input refers to what is being seen. Different forms of light are introduced like lava lamps,
strands of Christmas lights, slow-moving LED light shows, or glow in the dark stars on a ceiling. Strobe lights and impulsive light shows are typically avoided during a sensory diet.
The sense of taste can also be a tricky input to incorporate. Not only is the actual taste of something perceived as good or bad, but the consistency in which it is delivered may also be an agitator. Some children have strong dislikes in food consistencies so this type of input is based on trial or error. If the child has a favorite flavor, the flavor may be consistent in a tasting activity but in different forms. For example, say the child loves bananas. The activity could involve tasting banana ice cream, banana pudding, banana jello, banana juice, and a slice of banana. Even though the flavor of the banana may be appealing and is consistent with all the food samples, the jello or pudding texture could be a turnoff and should be avoided until later in a sensory diet.
A sensory diet is just one type of therapy that promotes sensory integration. The Occupational Therapy Division at the University of Southern California refers to sensory integration as,
“… A model for understanding the way in which sensation affects development… and a series of intervention strategies that enhance information processing, praxis, and engagement in daily life for individuals, populations and organizations.”
Sensory diets are not for everyone and depending on your insurance provider, may be costly or unavailable to you. Luckily there are a few other alternatives that have similar positive effects. Other sensory integration alternatives include attending a sensory gym or creating a sensory room in your home that only has objects, sounds, or lighting that is positively stimulating to the child.
Sensory gyms have been popping up across the U.S. due to the nation’s rise in Autism and other developmental disorders. Vanderbilt University in Tennessee partnered with the CDC and released a report in April of 2018 that estimated that Autism is now seen in 1 in 59 children and teens in the United States. With nearly 1 million children impacted by this increase, a new demand for sensory gyms, playgrounds, and activities are being seen nationwide.
If a family cannot work with an OT on a sensory diet for whatever reason, the family can still integrate a sensory experience into the child’s life by searching for a local sensory gym. Private recreational gyms and fitness centers have started to cater to this new demographic that is trending to reach into the millions over the next decade.
Gyms may have a dedicated space at their facility that include swings, balancing bars and platforms, and other sensory engaging tactile objects. Other recreation centers may just offer specific classes or monthly parties that are for special needs children only. Such parties or classes may have a sensory theme like a superhero party or involve a hiking outing where children can touch rocks, sand, or animals.
If you find that there isn’t a recreation center nearby that fits your family’s sensory needs, you can create your own sensory room at home. Ever wondered what to do with that extra bedroom or bonus room above the garage? Some families convert unused spaces into sensory rooms that engage the whole family. Sensory rooms can be as simple as being filled with toys and objects that stimulate the nerves through the senses. Other rooms are perfectly designed and planned to create a stimulating, peaceful, and safe place for the child. Some of the best engaging sensory rooms typically have the following:
- Plastic ball pits
- LED Bubble Tubes
- Strands of fiber-optic lights
- Swings or Hammocks
- Barrel Roll toys
- Mini trampoline
- Exercise Ball
- Beanbag chairs
- Lava lamps
- Calming music playing in the background
- Elevated climbing surfaces
- Plush stuffed animals
- Crisis deescalating solutions like a weighted vest or blanket
It’s possible that you can’t dedicate an entire room as a sensory room, but do you have a small wall to spare? Possibly even in the child’s bedroom?
Sensory walls are also commonly seen in schools and recreation centers that want to incorporate sensory integration into their offerings but don’t have the space or budget to create an entire room.
You can do the same at home. Sensory walls come in a variety of shapes and sizes. Often times they are referred to as busy boards or fidget boards. Some are attached to a wall and others are adhered to the floor for children and teens to walk on with their bare feet.
Sensory walls and boards are usually targeting the senses of touch and hearing. A variety of tactile fabrics, gadgets, and motion-engaging objects are used to create the wall. Some common sensory wall components include:
- Doorknobs and sliding handles
- Phone dials
- Swatches of soft or interesting fabrics
- Rocks or irregularly shaped natural elements
- Aluminum foil frames
- Letters or tiles with numbers that can be spun or arranged
- Plastic lids or containers that can be opened or closed
Sensory Processing Symptoms in Adults
Sensory processing issues occur in both children and adults. A sensory diet is not right for everyone, and a treatment method should be determined by an OT or doctor. Here are some common symptoms of adults that do have sensory issues and may want to learn more about sensory diets and sensory integration.
- Overstimulation of the senses
- Senses are perceived as being more subtle than what they really are; or the opposite
- Fabrics or stitching can be distracting or aggravating
- Being dirty or sticky is intolerable
- Discomfort while being hugged
- Wearing socks or shoes
- Picky when it comes to food textures or strong scents
- Fear, anxiety, or nausea is triggered during lighting or thunderstorms
- Strange social interaction at home or work
Sensory Processing Symptoms in Children
It may be unrecognizable to parents at first that their child has a sensory processing issue, especially when they approach age 2 or 3. Here are a few sensory processing red flags:
- Refusing to or annoyed while getting dressed or brushing their hair
- Constantly touching something or someone
- Doesn’t understand personal space
- Unaware of their body or motion range – making them clumsy
- Afraid of being in large groups or crowds
- Fearless and/or constantly gets injured
- Difficulty being potty trained
- Picky about food textures
Sensory diets have come a long way in recent years and are trending upward with the rise in Autism and developmental inabilities. They may not be a cure-all approach for some, but they are successful at familiarizing the individual with their senses and they learn from their experiences and reactions. Great alternatives to clinical sensory diets include exposure to a sensory gym, creating a sensory room, or designing a sensory wall or bin that has a wide variety of textures and objects that will stimulate the senses.