On a previous post about sensory therapies (http://wp.me/p2OomI-AQ), I promised to write about our sensory life, so here it is. To sum up our current approach, first I observe Beth closely and try my best to understand her sensory needs and challenges. Then I give her time throughout the day to self-regulate with her preferred sensory activities, while providing her opportunities to move up the developmental ladder when the time is right. Here are the “sensory rules” we live by:
1. Home is the Sanctuary
My rule now is no therapists in our home. I want home to be a place of relaxation for Beth. Yes I do “therapy” play activities and teaching with Beth, but it is done in a way that is not stressful to her (based on her interests, short sessions, many sensory breaks). We have speech therapy, but it is outside our home.
Anything goes at home, as long as it is not dangerous. Beth relaxes with mint floss, Altoids, bubble baths, chomping on ice, watching and feeling Seltzer water bubbles in a container on a light table, and chewing edible toothpaste on a toothbrush. Beth wants the blinds closed all the time, loud noises to a minimum, and even light distribution in a room. Jumping on the couch is permitted, because it helps her self-regulate. I let Beth develop her own routines, which have sensory experiences interwoven within the steps. For example, her bedtime routine is currently this: play with iPad close to bedtime, eat a crunchy snack, lie in the master bedroom bed under the soft blanket, go lie in her bed under her heavy and soft blanket and look at the stars on the ceiling (1), listen to song-type books I read to her, kiss daddy goodnight and rubs his “scratchy face,” then off to sleep.
2. Development is Based on My Child’s Timeline, So I Let Her Be the Guide
I try to figure out where Beth is developmentally and work at that level, introducing very small challenges when the time is right (also known as Floortime, but I use this concept in every aspect of our life, not just play). Trying something before she is ready is pointless. For example, I spent a lot of time trying to get her to tolerate spinning around while I am holding her, in an effort to help mature her vestibular system. Eventually I stopped pushing my agenda, and when she was ready, she started spinning on her own and requesting that I spin “faster” while I am holding her.
3. Roll with It (Some Days are Good, Some Days are Challenging)
I remember being so upset at a blow-up jump center when Beth seemed to regress and refused to go on the slides. Over time I realized a pattern. When Beth is starting to get sick, needs to have a bowel movement, or hasn’t had enough sleep, she gets absolutely terrified of vestibular (movement) challenges. I roll with it now, and let her be the guide.
Some places on certain days absolutely terrify Beth. I just cut the visit short now if possible, because I realize I haven’t figured out everything yet. There are a few stores that bother Beth more frequently, and I think it may be the visual clutter and/or lighting. I trust that time will reveal the answer.
4. Observe Reactions to Sensory Input, Respect the Need, and Think of Ways to Help
When Beth was younger, it was nearly impossible for me to figure out her sensory needs. Now she is starting to let me know when and how things bother her, either verbally or non-verbally, so it is getting easier.
Clothing really irritates Beth. Beth’s clothing is always cotton, no tags, no gathering or decals that are rough inside, not tight, no gloves (we use a big coat to cover the hands), the coat has smooth/soft material inside, and socks are stretchy.
I can tell when something is bothering Beth when she flaps her hands rapidly at eye level (this happens when she is getting sick, needs to have a bowel movement, is extremely tired, or is very stressed by the environment). I reduce demands and try to change the environment to help her calm herself down.
5. Provide Opportunities for Input Cravings, and Use it My Child’s Advantage
All sensory activities are spread throughout the day and upon request. Child-driven works better than any “sensory diet” I have come up with.
Beth likes edible toothpaste (there are plenty of homemade recipes if you Google “recipes for edible toothpaste” and a commercial glycerin-based option called toddler toothpaste). So, we use it throughout the day in very small doses and she chews on her toothbrush. She will try new things or work extra hard for a dose of it, so we use that to help her progress (for example, we have an edible toothpaste motor-planning game, which I will write about in a later post).
6. Outings Are Very Challenging, So Adjust Accordingly
Our outings include inflatable jump centers, quick trips to stores, eating at restaurants with TVs and/or her favorite foods, drum shopping, visiting parks and gardens, pet stores and zoos, play dates, and a story time that I run (so I can prep Beth for it). I find that she is calming down over time with outings in general, but her ability to cope is still highly variable.
I am working on understanding why outings are so difficult for Beth and expanding her willingness to go on outings. We try to balance respecting her desire to leave a place with helping her learn to cope with the environment and stay a little longer. Peppermints, lollypops, stickers (she likes to feel the stickiness on her hands and lips), chewing on ice, and crunchy snacks all help her cope on outings. If it is a very challenging outing (like an indoor party), I bring the iPad.
7. Encourage Play Equipment, Don’t Require It
Sometimes she likes outdoor play equipment, sometimes she doesn’t. After considering several theories (fear of heights, motor planning confusion, fear of kids, equipment not exciting enough due to Beth being under reactive, bad past experiences, etc.), all of which sometimes fit her behavior, but often did not, I have decided just to let her lead until I figure out what the issue is. My newest theory is the light bothers her, so we are working on wearing sunglasses. Of course it could simply be she is just not that into it!
We do active things that don’t involve outdoor play equipment. Beth loves indoor bounce places and indoor places with trampolines better than outdoor play equipment, so we frequent these places. When we go to a park we let her run or throw rocks in the creek.
8. Try a Place More Than Once to Discover Sensory Challenges and Ways to Work Around Them
Some days Beth is fine at a certain place, others it is a disaster. Why have to go several times over a long time period to truly understand her sensory challenges. This is getting a little easier now that she has more expressive language and can hint at what is bothering her.
9. Self-Stim Serves a Purpose
Beth can get stuck in stim (2) sometimes, but usually her stims mean something. If I figure out what a stim means I can help her (if it is stressed related), or let it go (if it is a happy stim).
I mentioned above that flapping rapidly at eye level is an indicator for needing to have a bowel movement. It is a VERY strong indicator. I also noticed that Beth plays with certain iPad apps when she needs to have a bowel movement and it seems to relax her. So if I notice the rapid hand flap at eye level, I let her play with the iPad standing up and leave her alone. If she seems to be stuck, I tell her every once in awhile to try to go potty. Eventually, either on her own or after I tell her, she usually walks into the bathroom and has a bowl movement. Then, the flapping at eye level disappears entirely or goes to a hand flap near her chest.
10. Child-Led External Pressure
Per therapist suggestions, when Beth was 3-4 years old and very dysregulated with daily meltdowns, I tried joint compression massage, face pressure, a brushing protocol, weighted blanket, and squishing Beth between pillows. I feel like many of the things the therapists suggested were along the right path, but Beth was just too dysregulated and over-reactive for the ideas to work. With time and by letting Beth indicate what she needed, we have made some progress. For example, I wait for her to put my arms around her to ask for squeezes or sometimes she will press her head against mine for pressure. Also, Beth found a blanket (my synthetic down comforter) with the weight and texture she liked this past winter and I believe it is one factor that has helped her sleep better.
11. Warn of Sudden Noises, Label and Show the Origin of Noises
From the ages of 3-4.5, Beth spent a lot of time zoning out listening to noises, even inside the house. One day I took her hand walked her to the noises, gave them a label, and tried to show her where the noise was coming from. Examples include noise from the freezer motor, my husband taking a shower upstairs, a plane flying over the house, and the heater fan. Now if she starts to zone out due to a noise, I label the noise and I can get her attention back to a teaching or play task fairly easily.
If I am going to make a loud noise, like the coffee grinder, I warn her. All she has to do is see the vacuum and she trembles, so I vacuum when she is away from the house.
12. Point Out Things in New Environments
I learned the “look, it’s a…” game from a former therapist. I just label meaningful and favorite things on an outing at first, because Beth is usually overwhelmed in new places. I say, “look, it’s a…” or “I see a …” or “Wow, that’s a ….,” etc. It helps her get a hold of where she is and helps her focus on things important to her in the environment, which helps avoid sensory overload. Later, when she is more comfortable in location, I let her fill in the blank herself, which makes it a combo exercise in awareness of surroundings and language practice. As stated above, it is important to label noises and show where they are coming from, and warn of sudden noises.