Holidays are often super fun and a joyous time to gather with family 👨👩👧👦🏡 But, with them comes biiiig changes in routines. From the food, to being with people you might not see often, travel and unfamiliar places. …it’s a lot of “different” shoved into an often short period of time. Lots of kids are impacted by these changes, but especially sensory kids and kids with anxiety 😬 🧠
So how can you help to make this as smooth as possible for your little one?
Check out my tips below to make sure your little one is well supported. Meltdowns may still happen, but these tips will hopefully give you a little buffer.
Don’t make this the time to push trying new foods/have safe foods. You can offer your child the chance to help with preparing the dish you’re bringing or talk about your favorite memories surrounding your family food traditions for the sake of sharing your family culture, but not pressuring to try something. Having a food you know they like available can make them feel more comfortable and secure. You can choose whether to serve other foods on their plate or have a “learning plate” where you put unfamiliar foods. Just because your relatives think your child needs to try Thanksgiving dinner foods, doesn’t mean it’s true.
Have a plan ready for when they need a break. If your sensory kid feels they have permission to take a break and know how to advocate for that, you’re less likely to run into meltdowns and tantrums when they’re overwhelmed but don’t know how to tell you. Talk about where/what room they can go to to take a break. Bring things from home they know help them to feel calm (lovey, fidget toy, music, etc.) Talk about where they can go if they need quiet vs. if they need to move around.
3. Be flexible about what you “require” them to wear. Obviously it’s a special day and you usually want them to look a little fancier…but think about what’s most important and if you and your child can compromise with some outfits that are comfy but appropriate.
4. Make sure their blood sugar is balanced! Might seem funny because Thanksgiving is full of food…but if your child isn’t going to eat the appetizers or is going to eat very little of Thanksgiving dinner, make sure you have foods they’ll eat so a drop in blood sugar isn’t the culprit for a meltdown.
5. Involve them in food prep. Whether it’s in the garden or in the kitchen, being around food for a looong time before it hits your sensory kid’s plate helps them. They get lots of time to “get to know” foods. To see that mashed potatoes are mushy, hot and white. Instead of seeing if for the first time on their plate. When they get to participate in making things, kids are often more excited and proud to try it.
6. Let them make their own dish to serve! This will work best if you have supportive family members. And I know adding something to your to do list sounds like “No thanks.” But within your emotional capacity, consider if you can help your child make something simple. I’m thinking Charlie Brown snack mix vibes. This shows your sensory kids that there is room for their preferences in a holiday meal. That it’s more about being together, sharing & being thankful. Maybe someday they’ll like Thanksgiving food, but let’s not wait until that day for them to feel included. I think a lot of sensory kids might feel really happy & proud if they saw their preferred food on the dinner table.
8. Talk about greetings/physical touch before hand. Unsolicited touch can make (anyone) but especially sensory kids uncomfortable. Talk about boundaries and give your child options before you see family. “If you don’t want to give a hug, you could smile, wave or say hi.”
9. Be prepared to advocate for them. I don’t think kids should be rude or mean, nor do I excuse truly bad behavior. But…a lot of things your child struggles with aren’t behaviors. So remember that you don’t have to justify your parenting to your family members or random guests.
10. Give your child and yourself loooots of grace. The holidays are often dysregulating for the reasons I mentioned above. Please be kind to yourself. You are juggling making sure that the kids are dressed, getting to the party, bringing the dish you promised you would make, and maybe worrying that they’ll get sick in this crazy intense flu/RSV/cold season. Please remember you love your children well, and what counts is that. It doesn’t matter how fancy everything looks. Your child’s behavior isn’t a reflection of your parenting, it’s insight to what your child is working through right now.
What would be on the menu if your sensory kid’s favorite food was what’s for dinner?
Sensory travel tools are worth a shot, because I feel like the challenge of traveling with kids is one of those life experiences that you don’t understand until you do it for yourself. I can at least speak for myself and say that a 9 hour car ride in the backseat with my 4 month old baby changed me 😅
Depending on your personality type, the actual act of traveling itself might feel like no big deal, or it might get you stressed just thinking about it 😳 There’s figuring out what clothes you need (or might possibly need. #chronicoverpackersunite), making sure you have enough snacks to manage your blood sugar levels and prevent hangry episodes, things to entertain yourself with on the trip…
But traveling with kids. That’s next level. Because now you have to use your fortune telling skills to try to anticipate someone *elses’s* needs on a trip. What snacks will they want, what activities will keep them entertained [I, for example, never expected a 1 L water bottle to be the MVP of road trips, but I periodically remind my husband to not throw it out because it has proved its worth in gold multiple times no2w], what clothes will be comfy for them to travel in. So let me first give some general sensory tips to consider for traveling, and then I’ll share some sensory tools that can be useful for family trips.
Structure The Trip to Meet Sensory Needs
Let your child decide what clothes to wear. Obviously if you are dressing all your kids in a certain color so you can easily identify them, stick with the plan. But make sure it’s something they’re comfy in.
Make sure to have good meals and have plenty of snacks! I think this is something that most parents know, but I think we can sometimes get so stressed by trying to get all of our stuff and all of the people through security/in the car/on the train etc etc in time and your child starts having a meltdown when you realize, “Oooh. We haven’t eaten since breakfast 4 hours ago.” 😳
Speaking of snacks…Especially if your child likes crunchy or chewy snacks, make sure to pack some for some good, calming oral motor input. Just be mindful of snacks that could be a choking hazard while they’re eating in the car. Another great way to fit in some oral motor input while traveling is using water bottles with straws.
Consider playing music with a heavy beat for kids who get carsick/motion sickness. Music is a very powerful sensory tool. And if your little one (or big one) gets motion sickness? Often times music with a very grounding, heavy beat (like reggae, reggaeton, rap, country) can be very calming and help them to feel more connected to their body (when they feel disconnected is part of how motion sickness happens).
Be prepared to take breaks where they can move around. As best as you’re able, allowing your child to climb around for 10 minutes at a rest stop, get some spins in or walk or crawl up or down the aisle on a plane…little kids’ (particularly sensory kids’) brains are wired for movement so they crave it, and get a little more grouchy, hyper, emotional, etc. when they don’t get it.
Now onto the tools…some are very simple and very old school (which I’m a fan of.) I very much subscribe to the idea that you don’t need to spend a bunch of money to meet a child’s sensory needs. *However* I’m also going to include some fun/nifty/unique items that I think are worth getting if you are interested in them.
Pom poms. I said old school, right? These little guys are great because they’re quite portable (can stick them in a pocket, purse, backpack…) and they’re a great physical/tangible tool if you want to get some breaths in. Taking calming breaths rarely works for many of the sensory kids I know. A lot of sensory kids really require hands on tools for learning, and trying to breathe requires a lot of body awareness that many just don’t have. But if you add a pom pom to the mix, you might get some breaths! Blow them across the tray on an airplane for self regulation, or just some fun 🙂
Bubbles: For the same reasons as pom poms…you can get some breaths in using a prop if your child can blow from the bubble wand. Alternatively, these are great for kids who like visually interesting things. Speaking of which…
Sand or gel timers: These are great for kids who love visually captivating things. They can be used to actually track time or to just watch the sand or gel trickle down. They’re nice and portable also, which makes them a great sensory travel tool.
Wacky Track Fidgets: These are a nice, travel-sized heavy work activity for your child’s hands. Heavy work is generally calming for everyone. Using your hands to work against resistance can fit in some nice heavy work, and these links that click when you snap and manipulate them can work that in to your child’s travel time.
Floam: Obviously most textured sensory mediums are way too messy to take on trips, but I think Floam is worth a shot for a sensory travel item. The texture is kind of like a non-edible version of rice crispy treats. It pulls and pushes apart and has a slightly sticky aspect to it. You can squish it up and easily form it into shapes for sculpting etc, or just use it like a stress ball and squish to your heart’s desire. It’s not crumbly like kinetic sand and it shouldn’t squish into things like carpets etc.
Squigz: What’s a sensory toys/tools list without Squigz? Just kidding–kind of. These are just fun and intriguing. They also provide some of that heavy work for your hands I mentioned with the Wacky Track Fidgets. They stick onto basically anything, and the hard work of pulling them apart is fun and can use up some energy. The standard size ones are kind of big to take many of on a plane, but they also have mini ones available. These might be best suited for slightly older kids (manufacturer info says 5 years old) because they could be too hard for little hands to pull.
Noise cancelling earbuds/headphones: These are a great tool to have on hand for kids who get easily overstimulated by noises. The noise deafening are great for children [or parents] who want to still participate in convos but just need things to be toned down a bit.
Headphones for music: Alternatively, you might have a child who really is soothed by music, so having their own set of headphones to listen to music while traveling can be supremely helpful. Work with your child to decide if ear buds or over ear headphones are best.
Eye mask: this may be my personal bias, because I am *very* sensitive to light. But if you’re traveling (particularly on a plane or train) during times when your child might need to sleep and they’re sensitive to light, an eye mask might help them a bit. It is also useful to have in the event that wherever you’re staying is brighter than home and your child struggles to fall asleep that way.
Snack box: This is part sensory but also part fun and motor. This is just a fun way to expand the time your child takes to work through all those yummy snacks you packed.
There you have it! My top 10 sensory recommendations for sensory travel. I hope something strikes you as helpful for your child and that you can feel a bit more empowered as you prepare to travel with your littles in tow!
By the time your child is 5 years old (if they’re pretty typically developing) I will give the overall advice that you should follow their lead/interests in developing hobbies and activities that meet their sensory and motor needs.
For instance, riding bikes, cooking, doing crafts, playing sports, exploring outdoors, [and doing chores 😉 ]etc. are all chock full of natural sensory and motor development. You don’t have to try very hard to curate a sensory or motor experience.
That being said, this lists has some activities that fit the bill of being everyday activities that could be matched to your child’s interests.
5-8 Years Old
Mini Toys/Games: I promise you there is nothing more inviting to a child than mini games and toys. (Maybe that’s a big promise. lol) But they are so, so enticing!! This is a great way to work on fine motor skills and muscle grading (how much force do I need to use to manipulate this item). As your child stabilizes their arm and hand, they work on focus and the muscles of the hand and arm.
Jenga: This is a classic, but for good reason. This game also requires focus, self control and muscle grading. Your child will strengthen up the muscles they need for writing, buttoning, tying shoes, etc. while having fun with the family. Nice thing is you could also use these blocks for building and more open ended play. Some people will even write questions, sight words etc. on the blocks. You could maybe even write words in another language if you’re trying to incorporate bilingual learning.
Small Pop Beads: These small beads are great for strengthening the arches of your hand as you have to push with a good amount of force to get them together. Bonus is as you clean up, pulling apart the beads can get a second round of strengthening in. Another highlight of this toy is the two hand coordination required for stabilizing and pushing the beads together.
Twister: This game targets so many good things sensory and motor. Listening skills, motor planning (how can I make a plan and move my body), problem solving, core strength, shoulder stability, and provides lots of movement sensory input that is often needed. A great option to keep around for cold weather and days when you need to stay inside.
Bean Bag Chair: Bean bag chairs give the comforting deep pressure input many kids crave. It’s kind of like a little hug. It will help your child to get the squish they’re seeking if they’re one who likes to roughhouse, seems clumsy, asks for big hugs, breaks crayons when coloring, etc. Nice feature is that they’re mobile. You can also use them for heavy work by tossing them or giving someone squishes.
Velcro Mitt & Ball: I love this toy. Aside from the obvious hand eye coordination benefit from a motor perspective, it’s great sensory input. Your child has to pull hard everytime they toss the ball back to you, getting some of that calming heavy work.
7. Magnatiles: I’ve seen these become super popular, and I think with great reason. This is an open ended toy (one that allows your child’s imagination to make the fun) and it provides more of that calming heavy work as your child pulls magnets apart while building. This also provides an opportunity for strengthening hands.
8. Beados: I loved discovering this toy as an OT. Especially if you have a kiddo who struggles to hold a pencil, this toy is great for practicing that. Lots of fine motor practice to push the tiny beads into the bulb, release one bead at a time using the pen, squirt water to make them stick together. Your child also develops visual scanning, visual perceptual and discrimination skills as they use their eyes to discern how many beads of each color they need and where they go.
9. Bop it: The package says 8 and up, so maybe reserve this for 7-8 year olds. If you have a child who doesn’t get frustrated easily and likes a challenge, I’d say this could still be fun for them. I had this growing up, and I did seriously love it. Writing about it makes me want to play again, haha. It’s a really fun motor challenge. Bop it is another awesome way to get your child moving and working on lots of the same skills I mentioned above for Twister.
10. Card Games: Card games are a great activity to play with your whole family, and manipulating the cards strengthens your child’s grasp as well as midline crossing skills, which are important for higher level problem solving and motor planning. Spot it is particular favorite of mine because kids enjoy it but it’s also actually fun and challenging for adults too. Another classic is Uno and Go Fish for the kids on the younger end of this range.
11. Lite Brite: Lastly, another nostalgia provoking classic. Lite Brites are an excellent way to continue to strengthen the arch of the hand. They also provide lots of practice for developing some of the visual skills similar to those I mentioned for Beados. The bright colors and lights can also be very satisfying visual sensory input for some kids.
There you have it!
A full list loaded with toys that will not only (and most importantly) fill your house with more fun and joy, but also strengthen your child’s sensory and motor skills. These toys are mostly classics, and that’s with good reason. Multiple generations have realized how fun they are, and so worth having in your home.
Have Other Kids?
Don’t forget to check out my guide for your other little ones too! I have toys to foster sensory and motor development for kids ages birth through 8 years old. You can find the main post with the separate posts broken down into age groups here.
Your baby may be feeling much less like the snuggly newborn from days of yore and looking much more like a little “big kid.” As baby continues to grow, he or she will love to explore and maybe sometimes get into trouble with all of the new motor skills they’re learning.
The toys I included for your 12-24 month old focus on the fact that baby is learning to refine the control and coordination of his or her limbs and body. These toys offer opportunities for important developmental skills such as using two hands together, learning how much force to use to maneuver items and using their joints and muscles to push, pull and smoosh as they develop their body awareness (aka where is my body is space).
12-18 Months
Knob puzzles: These are a great starting point for your baby who is learning how to use more and more precise movements with their arm and wrist. Also develops sensory skills as baby learns how much force to use to place pieces inside the frame.
Finger paints: I know mess can be triggering…but letting kids get messy really is great for them!! And painting is a fun way for them to start to express themselves. If your child is hesitant, you can start by rolling a toy car or a ball through the paint and always having a cloth nearby to wipe hands when they feel overstimulated. This also helps your little one develop the muscles or their hands and using two hands together.
Poke a Dot Book: These books by Melissa & Doug are a great way to get that pointer finger poking. They also provide some satisfactory sound input as well as heavy work for fingers for your little ones who are getting used to being gentle with how much force they use.
Musical Instruments: This age is an awesome time to encourage your little one to make some music. Instruments help to develop and strengthen shoulder, arm and wrist muscles as well as provide opportunities for two hands working together. Obviously sensory input is sound, but it’s also good for them to use their muscles and joints to get some input there as they shake, rattle and bang away.
Wooden Blocks: Simple cube wooden blocks are a classic for a reason. Your little one will continue to strengthen shoulder, arm, and hands with picking up, dropping and stacking. This also helps develop muscle grading, which is our ability to know how much force to use to maneuver items. This particular set is dyed using vegetable and spice food dyes!! Super cool.
18-24 Months
Height Adjustable Easel: An easel is an awesome way to increase your child’s shoulder and wrist stability. Scribbling and painting on a slanted surface encourages lots of strengthening that will come in handy when it’s time for drawing and writing down the road. I picked this one because it looks like the height can be adjusted for little ones.
Bingo Dot Markers: These are great first tools for drawing and “writing” for your little guy or gal. Your child will have fun learning the cause and effect of making dots and drawing. These also provide some satisfying heavy work feed back as you have to push a little harder to get the ink moving.
Velcro Fruits & Veggies: This is a toy that packs a punch because you get hand strengthening, two hand coordination, imaginative play and some heavy work as your kiddo has to pull velcro fruit apart.
Suiggs: Have you seen these guys yet? I feel like they’ve gotten fairly mainstream. But, they are super awesome. Pulling and pushing these whimsical looking suction cup/alien antennae looking suction cups works on hand and arm strength, two hand coordination and gives lots of heavy work for your little one who likes to roughhouse, asks for tight hugs or has lots of energy.
Shopping Cart: I was between this and a ride on toy. Both are great for getting big movement (especially when you need to move play indoors.) Your child gets heavy work as they get lots of input to their joints and muscles with pushing, pulling and loading up the cart. For some extra oomph add some bags of rice, beans, ankle weights etc. to the lower compartment to really tire them out 😉
So now you’re ready to select the toys that you think look the most fun for your baby, knowing what sensory and motor benefits they’ll be getting as a bonus as they play.
Which toy do you think your baby will be most excited to break in?
Got big kids too? Check out the main page of the gift guide for my recommendations for kids 0-12 months and 2-8 years old!
For young babies, their whole life is an abundant sensory and motor experience! They’ve exited the womb and entered the world, and often times they’re super excited for all of things that have become mundane to us.
So as far as toys go, I keep it very simple. I look for toys that are not over-stimulating, and that promote babies’ interest in moving, cause and effect, engagement, joy and exploration.
0-4 Months
Yoga ball: When babies are not so mobile on their own, a yoga ball is a great way to introduce them to movement. You can sit and bounce while holding your baby, you can lay baby on his or her back and belly and do gentle rocking movements in all directions. Best part is this item can grow with your child. You can roll it, bounce it, etc. as they get older and bigger.
Tiny Love Black and White Activity Mat: I thought I didn’t want an activity mat, but I’m super grateful we have this one. The black and white is great for when that’s about all baby notices. This mat comes with a nice little accordion set of black and white pictures which was great for our early tummy time days. The items that hang off of the hooks are simple and not overstimulating, and most importantly, I enjoy the little songs the hedgehog plays. That’s important for a toy that makes noise.
Usborne Tummy Time Book: I am VERY excited for my mom and dad to bring this for my baby! I love it because it has a mirror, which is an awesome and perfect tummy time tool. It “grows” with your child as there are multiple sides to the book, which evolve into a cloth book with pages to flip, etc.
Wooden Rattle with Bell: A friend bought this for my baby and it’s awesome. I like using wood/more natural and simple toys when possible. I like this one because baby can grasp it in the holes of the rattle, which encourages development of the muscles of the arch of the hand. And the bell is a more charming noise than plastic beads. Though, we have one of those rattles too. 😉
4-6 months
Colorful scarves: I was with a mom friend the other day, and she brought these out for her 4 month old son, and I thought–brilliant. Colorful so baby’s interested, and scarves are a lovely form/texture for babies who are just learning how to grasp things. Basically they are pretty likely to be successful as opposed to when they are trying to grasp a more formed toy. Bonus is you can throw these in the dress up bin someday.
O-ball teether: If you don’t know by now, OT’s love the O-ball. 2 for one. Teether and a ball. Also, the open web-like design allows for a little bit of help for little hands that are learning to grasp and use their fingers.
Suction Cup Zebra Activity Toy: This guy is awesome. It’s one part teether, one part rattle, one part something to swat at. Bonus is that it has a suction cup, so you can attach it to a high chair, grandma’s table, the table at the restaurant etc. And there is a little rotating compartment with mini plastic beads that gives lots of cool visual sensory input.
Touch and Feel & Crinkle Books: These books are lovely. I always have to touch every texture myself, lol. As baby starts swatting at things, they’ll be (hopefully) delightfully surprised to explore interesting textures. Bonus is that baby can help turn the pages with chunky board books.
6-9 Months
Roly Poly Musical Toy: This toy is great to encourage more controlled/directed swatting from baby during tummy time as well as crawling. Light bells or chimes is the old school way to teach baby cause and effect with auditory sensory input (pre push a button, toy plays music)
Melissa & Dough Stackable Animal Wooden Cars: Someone gifted us these, and I already use them with baby during tummy time. They’re fun because you can stack them. So I often will roll it across the mat to work on his visual tracking and then stack them up and knock them down to address his attention and cause/effect play. As he gets older, he’ll be able to roll them, knock down other things with them, etc.
Hand Drum: Another great way to introduce music for natural sensory input along with an opportunity for baby to play at midline while using both hands together to bang away as they improve their aim with their hands.
Activity Cube: I like this for (at least) two fold reasons. One is that as your baby is getting more sturdy during tummy time, they can use a cube like this to challenge their shoulder stability as they reach up off the floor. It’s also a great toy for your baby as they look for something to play with while sitting up. This particular cube allows you to take off the twisty-twirly maze, which makes this a great activity to practice dropping items into a container.
9-12 Months
Large Pop Beads: Being that baby is sitting or on their way to being a more sturdy sitter, using two hands to do something a little more challenging will work on their core, shoulder and hand strength.
Fisher Price Stack & Roll: This is seriously one of my all time favorite toys as a pediatric therapist. I use it with kids of so many different ages. It’s awesome because the “cups” that nest together also push together to form balls of varying sizes. So you can work on rolling the ball to each other, rolling to knock things over, etc. The stacking is nice because they “click” so they’re more sturdy than other stacking toys. They are a little challenging to push and pull apart to make the balls, so mom or dad will have to help with that for now.
Fisher Price Gumball Drop Toy: Dang, I really like Fisher Price’s toys for 9-12 month olds, lol. This one (though it has lights and music…you could choose to not put in batteries. Baby won’t know the difference) is super fun because baby will work on refining their ability to release items into a large opening as well as pushing down a lever to release the ball down the ramp. The balls are all very cute with captivating sound or visual input.
Phew!
There you have it. Those are my recommendations for toys that are unique/worth keeping around the house that will also bring baby joy as they develop their sensory and motor skills. Share this post with a new mama who is also looking for toys she won’t regret buying!
If you have other big kids (12 months to 8 years old!) don’t forget to check out my suggestions for them too! You can find each post broken down by age here.
If you want ideas for toys that will support your child’s sensory and motor development and like to be intentional with your purchases, this guide is for you.
By and large I am ever striving for a minimalist lifestyle. I have anxiety and lots of extra stuff makes that worse. However, I also am a sucker for a great toy that I think will get a lot of mileage and/or uniquely suites a child’s needs or interests.
Overall, I stay far away from toys with lights and music because I truly believe kids need opportunities to create their own magic in play. (I have exceptions. Such as for kids with significant motor delays I think technology, lights and music [barring those susceptible to seizures!] give kids lots of bang for their buck when they have to work so hard to get their bodies moving!
Benefits to Being Intentional with Toys
Play is slowly making a comeback, and everyone will benefit from that! In play, children develop….
Attention skills
Self regulation and emotional regulation
Executive functioning
Language
Relationships
Imagination
Problem solving
You get it. Play is awesome. But being intentional about which toys you select helps you set the stage to promote your child’s sensory and motor development and lots of fun without tons of unused things gathering dust.
Below you’ll find my recommendations by age. For ease I created separate links for 0-12 months, 12 months through 2 years, 2-4 years old and 5-8 year olds. Click on the image for the list you want to be brought to that post. When possible, I included links for items that I recommended that I found on Etsy, in an effort to support small businesses. I cannot attest to the experience you’ll have with sellers or stores. I’m just showing you what toys I think will be awesome for your kids! There are also affiliate links from which I will receive a portion of sales.
Mindfulness has been a buzz word for I would say the past four years or so in education. Maybe in society at large also, but it seems it’s really made itself known in how it might help the young minds we help to educate. Kids have always needed adults to model and teach how to process the sometimes overwhelming world. However, in today’s society where technology is king, one has to be more and more intentional to be truly connected to what is going on in your life.
I really loved this article because I think it highlights the importance and connection of mindfulness on self-regulation. As an OT I often approach self-regulation by addressing sensory processing deficits with sensory input or modifications to the environment. However, I also love bringing children’s awareness to situations, triggers and reactions and teaching them tools they can use to help in those situations.
Also…I’m really interested in one of the assessment measures they used. It’s called the Head-Toes-Knees-Shoulders and is used to assess controlling and directing actions, inhibitory control, paying attention and remembering instructions! If I were working right now, especially in the schools, I would definitely be looking into this.
Journal Journal of Child and Family Studies (SNIP 1.061)
Article Title Effects of a Mindfulness-Based Program on Young Children’s Self-Regulation, Prosocial Behavior and Hyperactivity
4 Case series (and low-quality cohort and case control study) [This study was a cross-sectional study]
5 Expert opinion without explicit critical appraisal
MethodsInvestigators assigned 127 children aged 4-6 in eight kindergarten classrooms from Toronto public schools to either a control or intervention group. The primary researcher implemented the training program for all classrooms as she was trained in the specific program used in this study. It is the Mindful Schools program.
Intervention
Children in the intervention group participated three times a week in twenty minute lessons for a period of six weeks. Some components of this particular mindfulness program included children practicing external and internal mindful awareness practices and lessons in “heartfulness”(Viglas, M. & Perlman, M. p. 1153, 2018). To conclude the session, children wrote or drew about the new practice they learned in their “Mindfulness Journal.” In addition, investigators encouraged children to practice these skills and teach them to their family. Children were invited to share about those experiences at the start of the subsequent session.
Measures To measure controlling and directing actions, inhibitory control, paying attention and remembering instructions, researchers assessed children with the Head-Toes-Knees-Shoulders (HTKS).
Teachers filled out the Strengths and Difficulties Questionnaire as a means to assess children’s prosocial and hyperactive behaviors. The five subscales are Prosocial Behavior, Hyperactivity, Conduct Problems, Emotional Symptoms and Peer Problems.
These items were measured before the intervention began and once the six week program had finished.
Findings
After the intervention was complete, students who participated in the Mindful Schools program showed better self-regulation skills than those in the control group per results of the HTKS.
Children in the mindfulness group also demonstrated significantly better scores in the Prosocial and Hyperactivity subcales on the Strengths and Difficulties Questionnaire when compared to peers in the control group. Researchers detected no significant difference between groups for the subscales for Conduct Problems, Emotional Symptoms and Peer Problems.
When researchers compared children’s scores from the first to second assessment using the HTKS, they found those who had lower self-regulation at the start had significantly more gains and benefited to a higher degree from the mindfulness interventions than those with higher scores on the HTKS during the first data collection.
Similarly, change in scores from before to after intervention of the teacher completed questionnaire indicated that those with higher scores for hyperactivity and lower scores for prosocial subscales before treatment benefited significantly more from mindfulness training than peers with opposite scores (higher prosocial and lower hyperactivity) before the program began.
Things to Consider
When I select articles, I make an effort to look into interventions that are relevant to OT practice. A limitation as an OT in applying this research is that this study assessed a specific program. In order to be truly confident of generalizing the findings here, you would have to use this same program.
Also, the program is structured in a way that seems to provide treatment on a group level. In this study, the same interventionist visited classrooms three times a week. I know that isn’t possible for you and your school caseload.
However, I’m taking this information as evidence that a structured program/curriculum on mindfulness can demonstrate significant and positive results for self-regulation. I’ll continue to research into mindfulness programs and will definitely share if I find one geared more toward a one on one approach to increase its generalizability to OT sessions.
Reference
Viglas, M. & Perlman, M. (2018). Effects of a Mindfulness-Based Program on Young Children’s Self-Regulation, Prosocial Behavior and Hyperactivity. Journal of Child and Family Studies (27)1150–1161. https://doi.org/10.1007/s10826-017-0971-6
We’re all overly familiar with the phrase, “sensory or behavior,” but I think we may leave important factors out when we pit the two as an “or” situation as well as the connotation of what “behavior” means to us. Behavior, while simplified by an Antecedent, Behavior, Consequence model can seem straightforward, is often just the opposite.
What impacts a child’s behavior? So. many. things. We know that physiological factors like blood sugar and being tired impact it. We also know that emotional processing and patterns shaped by dynamics at home and with caregivers impacts it. Communication skills, especially an impairment of, guide behavior.
Today’s review explores a study that investigated the relationship between sensory processing and anxiety. A CuriosOT follower on Facebook requested that I explore this topic, and I was happy to do so as this is a topic I’ve wondered about myself in recent years.
In our busy society, I think we can see that more adults and children alike are presenting with mental health concerns. As an OT I know that I have seen kids who may have sensory issues, but definitely have anxiety. Other times I’ve seen children who seem to me that they obviously have anxiety, and I’m not sure if sensory processing is contributing to their challenges in occupational performance.
So, are sensory processing and anxiety related? Either way, what is OT’s role in treatment when we receive a child who has one or both of these diagnoses? Today’s post will cover the relationship between sensory processing and anxiety, and my next post will cover what is OT’s role.
Journal Journal of Abnormal Child Psychology (SNIP score 1.759)
Article Title Sensory Over-Responsivity: An Early Risk Factor for Anxiety and Behavioral Challenges in Young Children
4 Case series (and low-quality cohort and case control study)
5 Expert opinion without explicit critical appraisal
Methods
The study authors obtained their baseline sample from the larger sample of the Duke Preschool Anxiety Study. That study had three parts: screening, in-home assessment and a laboratory phase (Carpenter et al., 2018, p. 4). The sample from the Duke Anxiety studied was obtained by screening children between 2-5 years old during visits to their primary care clinics. The sample was found to be representative of the general population.
Authors of the Duke Anxiety study invited the children who met criteria for generalized anxiety disorder (GAD), separation anxiety disorder (SAD) and/or social phobia to participate in the Phase 3 laboratory assessment (Carpenter et al., 2018, p. 4). Authors of the current study recruited children from this phase 3 to participate in the Learning About the Developing Brain (LABD) study. This was a five year study in which researchers followed a group of 191 children to assess relationships between sensory processing during preschool years and anxiety during school-age years.
Assessments
Study authors used the Preschool Age Psychiatric Assessment to assess anxiety and sensory over responsivity characteristics. Parents completed interviews to assess for symptoms of a variety of psychiatric disorders for children of preschool age. Parents of 191 children completed this assessment when their child was in preschool and age at school-age.
Anxiety
Researchers classified children as either meeting impairment and symptom criteria for the included anxiety disorders (GAD, SAD and/or social phobia) or not meeting those criteria. Children were identified as positive on the anxiety screening if their parent included at least 4 of 10 items on the screening tool.
Sensory Over-Responsivity
Researchers used the PAPA at baseline and follow-up to assess sensory over-responsivity. Responses to the following sensory experiences were accounted for: 1. physical contact with other people 2. Contact with fabrics, clothes tags, etc. 3. Contact with food textures 3. Visual experiences 5. Auditory experiences, including loud or high-pitched noises 7. Olfactory experiences 7. Tastes 8. Sensations of motion 9. Any other sensory experiences.
Behavioral Challenges
This study highlighted sleep problems, GI problems, food selectivity and irritability as related behavioral challenges.
Findings
Sensory Over-responsivity is not Uncommon for Preschool Children
Twenty percent of parents reported at least one sensory domain as over-responsive from the pre-school sample (Carpenter et al., 2018, p. 8). The most commonly rated areas were tactile (18%) and auditory (4%). Children with sensory over-responsivity at preschool who remained rated as such by school-age was 56%.Sixteen percent of children whose parents did not rate them as sensory over-responsive in preschool were rated as having sensory over-responsivity by school-age.
The proportion of females who parents described as sensory over-responsive was higher than the proportion of males who parents ranked as so (Carpenter et al., 2018, p. 8). Parents of children whose children were categorized as below the federal poverty line also were significantly ranked more often as sensory over-responsive.
Relationship Between Sensory Over-responsivity and Anxiety Disorders in the Preschool Sample
Researchers found a significant relationship between sensory over-responsivity and anxiety diagnoses in preschool, as 43% of children who were categorized as sensory over-responsive also demonstrated criteria of anxiety disorder. Researchers found that there was also a significant relationship between sensory over-responsivity and other disorders (i.e. ADHD) from the preschool sample (Carpenter et al., 2018, p. 9).
Did Sensory Over-responsivity in Preschool Predict Anxiety Symptoms by School-age?
The authors found that sensory over-responsivity in preschool significantly predicted anxiety symptoms by six years old. This stayed true when other potentially confounding variables (including sex, age, race, poverty status) were accounted for. This also remained true when the factors of a child having sensory over-responsivity by school age, anxiety symptoms when in preschool and a diagnosis of other disorders in preschool were accounted for. All this to say that potentially confounding factors assessed for in preschool did not otherwise explain the development of anxiety by school-age.
What Type of Anxiety Disorder Does Sensory Over-responsivity Predict?
The authors found sensory over-responsivity as a significant predictor only for generalized anxiety disorder, not separation anxiety disorder or social phobias.
Could Preschool Anxiety Cause School-age Sensory Over-responsivity?
A child having anxiety symptoms in preschool did not significantly predict a presence of sensory over-responsivity in school age children. When researchers assessed if preschool sensory over-responsivity predicted non-anxiety disorders for school age children, they found it did not. This indicates that preschool sensory over-responsivity is a significant predictor specifically of anxiety for school age children as opposed to a wide variety of non-anxiety disorders.
So What’s the Link Between Preschool Sensory Over-responsivity, School-age Anxiety and the Behavioral Challenges We See by School-age?
Researchers found a significant relationship between preschool children with higher levels of sensory over-responsivity showing higher levels of anxiety by school-age. They also noted that school-age children with higher levels of anxiety have higher incidences of irritability and sleep problems. Researchers did not find a significant relationship between the sensory and anxiety measures as they impacted GI symptoms or food selectivity by school age.
Things to Consider
The authors mention that they only collected data for two periods of time which is insufficient to completely achieve the ideal statistical criteria to state the impact sensory over-responsivity has on how anxiety and behavioral challenges manifest.
The authors also mentioned that to measure sensory over-responsivity they used an interview that was comprehensive and not specific to sensory over-responsivity. They feel it may be best to use a tool that specifically measures that.
Also of note is that the measures for anxiety and over-responsivity came exclusively from parent-report. It would be beneficial to have a second rater to corroborate these levels. They also mentioned that research has shown that sometimes a mother’s emotional symptoms impacts her rating of her child’s symptoms of mental health conditions.
The researchers would also like to assess how sensory under-responsivity and sensory seeking relate to anxiety.
What Do You Think?
How do you decide if a child presents with anxiety or sensory processing disorder? How would you use this information to guide your treatment?
References
Carpenter, K. L., Baranek, G. T., Copeland, W. E., Compton, S., Zucker, N., Dawson, G., & Egger, H. L. (2018). Sensory Over-Responsivity: An Early Risk Factor for Anxiety and Behavioral Challenges in Young Children. Journal of Abnormal Child Psychology,47(6), 1075-1088. doi:10.1007/s10802-018-0502-y
