If your child is in Occupational Therapy and has sensory concerns you may have heard the term “sensory diet.” A sensory diet is a treatment that can help kids with sensory processing issues. It includes a series of physical activities your child can do at home, school, daycare, etc. to help them get into that “just right” spot which allows them to attend, learn, and behave to the best of their ability. It has nothing to do with food. An occupational therapist can design a sensory diet routine tailored to meet your child’s needs.
More specifically, it is an individually tailored home and/or school, preschool or childcare program of sensory and physical (‘motor’ or muscle) based activities. It is used to help manage a child’s sensory-motor needs and reduce the impact any such dysfunction may be having upon the child’s attention and activity levels, behavior and/or learning and skill development. A sensory diet is used both as a treatment strategy when attention or behavior is problematic as well as a preventative tool in advance of known behavior challenges (exposure to known triggers, certain times of day or specific environments).
WHY IS A SENSORY DIET IMPORTANT?
Just like we try to eat a balanced food diet (of more fruit and vegetables and less chocolate) to keep fit and healthy, we also need a balanced amount of sensory information in our bodies each day to allow them to work well. A “sensory diet” provides regular opportunities for a child to ‘keep in check’ the imbalance in the sensory stimulation they are lacking, seeking or avoiding, to ensure that the amount received meet the body’s required levels to function well.
A specifically tailored sensory diet is established then modified over time to meet the individual child’s needs as their sensory processing changes or the environmental demands shift. Thus a “sensory diet” consists of sensory activities that help children to feel calm and organized, which then helps them to obtain an optimal state for learning, attention and behaving appropriately.
As a child learns to self-regulate (their energy level, behavior, emotion and attention) through the use of a sensory diet, skills such as concentrating, sharing and taking turns also become more mature more quickly. This enables a child to move from depending on others to beginning to manage tasks or situations by themselves.
WHAT ARE THE BUILDING BLOCKS NECESSARY TO HAVE SUCCESS WITH A SENSORY DIET?
Sensory processing (emerging): accurate processing of sensory stimulation in the environment as well as in one’s own body.
Planning and sequencing: The sequential multi-step task/activity performance to achieve a well-defined result such as following a sensory based obstacle course.
Attention and Concentration (emerging): sustained effort, doing activities without distraction and being able to holding that effort long enough to get the task done.
Receptive (understanding) Language: Comprehension of spoken language.
Executive Functioning: Higher order reasoning and thinking skills to create a sensory obstacle course or change the sensory game from on format to another.
Compliance: The ability of the child to follow through with commands and requests.
HOW CAN YOU TELL IF A CHILD WOULD BENEFIT FROM A SENSORY DIET?
If child has sensory processing dysfunction which requires management by a sensory diet this might be demonstrated by the child:
- Being very physically active (to the point they can not settle to a task) or
- Looking tired and lethargic, or vague and day-dreamy
- Becoming ‘wound up’ with physical activity
- Being unable to settle after being in busy environments
- Having difficulty controlling impulses
- Has trouble modulating the tone of voice used
- Being restless at group time or in crowds
- Being too rough in play
- Failing to understand personal space (invading others inappropriately)
- Having difficulty sleeping
WHAT OTHER PROBLEMS CAN OCCUR WHEN A CHILD HAS SENSORY PROCESSING DIFFICULTIES THAT REQUIRE MANAGEMENT WITH A SENSORY DIET?
When a child has sensory processing dysfunction that requires management with a sensory diet, they might also have difficulties with:
- Following instructions
- Understanding instructions
- Working memory (retaining learnt skills)
- Getting to sleep and staying asleep
- Taking risks in play (either excessive risk taking or being overly cautious)
- Accessing the preschool or school curriculum (due to inattention, poor behavior)
- Academic performance (could be fine motor, literacy and numbers, peer interaction, organization)
HOW CAN A SENSORY DIET BE MODIFIED TO BE MOST EFFECTIVE?
Frequency of input: The frequency of need varies for each child, and will be guided by observations of the child both before and after the activities. It is often a case of ‘the more often, the better’ to ensure that once a child obtains a “just right” state of organization and attention, sensory diet activities help to maintain this state longer over the course of the day.
Intensity and duration of input: The effectiveness of the sensory diet will be influenced by not only the frequency of the activities but also the intensity and duration of the activities as well as the ‘goodness of fit’ of the activities to the child’s actual sensory needs.
Timing of activities: The sensory strategies are best used before, as well as during, activities that are known to be challenging for the child. For activities, such as sitting and listening in class, attending assemblies or playing in a settled manner, the child’s nervous system needs to be calm. To achieve this state before the task, it is helpful to use the strategies in preparation for the activity, particularly in the 10 minutes leading up to the task.
Incorporate play and daily tasks: For sensory diet recommendations to be effective, it is important to incorporate them into play and daily life, preferably making them part of every day. It often helps to encourage the child to choose activities they enjoy from the list of known effective strategies. Where possible, keep the items used in these strategies, or pictures of these items, in a clear box and refer to it as the child’s “tool box”.
Record behavior changes: Effective use of the sensory diet is a trial and error process. So, wherever possible record the behavior changes noted following engagement in a sensory activity and the intensity, frequency, and duration with which it was provided.
Alert program is the use of sensory motor strategies in combination with a child’s greater cognitive awareness of their state of sensory organization to achieve self-regulation.
M.O.R.E program uses motor (muscle) components, oral organization, respiratory demands, and eye contact to assist with sensory regulation.
The Wilbarger Protocol (Deep Pressure Proprioceptive Technique), more commonly known as the ‘Brushing’ program, is a therapeutic program designed to reduce sensory or tactile defensiveness or discomfort and to assist with sensory regulation.
All of these programs have to be recommended by a therapist before completing. They have specific protocols and trainings in order for them to be completed the correct way.
WHAT ACTIVITIES CAN BE USED IN A SENSORY DIET?
A sensory diet consists of a range of activities that target the different sensory systems and must be specifically tailored to the child’s needs. In order to work out what kind of sensory input is required, the Occupational Therapist and parent collaborate to determine the types of sensory input the child requires based upon formal assessment as well as observations of the child’s responses to a variety of environments and trialed sensory activities. The sensory diet activities that may best suit one child, may not necessarily work for another, which is why a sensory diet must be developed in conjunction with parents and therapists. Different times of the day and different environments may be more conducive to one type of sensory diet activity more than another and it is often a matter of trial and error to determine what will work best for the child (and their caregivers).
Not all strategies work all the time. The efficiency depends upon the child’s sensory processing on the day or at that moment, the environment and the demands on the child. You may find that strategies that worked really well yesterday do not work today. You may also find that the specific strategies used in the moment are not a good fit that day, but another from the list will be. The activities used in a sensory diet need to be fluid and changeable but provide a consistent kind of input in a different form.
COMMONLY USED SENSORY DIET ACTIVITIES CAN INCLUDE:
Physical activities are the easiest to start with, as most children tolerate movement better than any other type of sensory input. Physical activities, which use the large core muscles, result in a greater amount of sensory stimulation and might include:
- Wheelbarrow walking
- Animal walks (bear walks, crab walking, frog jumps)
- Jumping on a trampoline
- Riding a bicycle or scooter
- Swings (forward and back, side to side, rotary)
- Rough and tumble play
- Deep pressure squishing or sandwiching with pillows or balls
- Wearing a heavy backpack for movement (e.g. to carry heavy water bottle when scooting)
- Playing with weighted items (lap pad while sitting or weighted blanket for sleep)
Tactile: Play with play-doh, slime, kinetic sand, shaving cream, bird seed, rice or any other tactile products. You can just play, draw or hide objects to retrieve in these tactile products.
Visual: looking at books, using dot-to-dots or mazes to narrow visual attention.
Oral: Chew toys or specifically chewy foods.
Auditory: ‘white noise’ or favored music on an iPod, noise reduction headphones.
Visual cues can often be very useful to help your child to follow longer instructions as it provides them with something to refer back to if they are having difficulty remembering what they need to do. It also highlights the order in which they need to complete the instruction.
WHY SHOULD I SEEK THERAPY TO DEVELOP A SENSORY DIET FOR MY CHILD?
Therapeutic intervention to help a child with sensory processing difficulties that would benefit from a sensory diet is important to:
Prevent adults encouraging the child to engage in unhelpful activities or unhelpful amounts of sensory input, resulting in typical behavior strategies not working as well as they should.
Ensure attention, behavior and learning benefits are seen across all environments.
Help the child self regulate in order to be able to perform in academic and social environments.
A sensory diet is a tailored program to address the sensory needs of children that helps them to attend, learn and behave better. These are the skills that form the foundation of preschool and school readiness.
The sensory system continues to develop up until the approximate age of 7. It is for this reason that it is most beneficial to access therapy early. This is not to say that therapy is pointless after this age, but it just becomes more important to know the specifics of what the child’s sensory system requires.
IF LEFT UNTREATED WHAT CAN DIFFICULTIES WITH AN INADEQUATE SENSORY DIET LEAD TO?
When child has an inadequate sensory diet they might also have difficulties with:
- Learning and demonstrating learning in an academic environment
- Poor self-regulation of physical activity, attention, emotion, or thought
- Ongoing sleep difficulties that can impact their ability to learn in general
- Difficulties coping in busy social settings, thus affecting social interactions
- Anxiety and poor self-esteem issues
- Social isolation because they find it hard to cope in group situations
A sensory diet helps kids get in a “just right” state so they can pay attention and learn. Activities in a sensory diet can help kids who are over-reactive feel calmer, and under-reactive kids feel more alert. You can talk with the school about working sensory diet activities into your child’s school day and IEP. It’s always best to consult with an Occupational Therapist if you have concerns.