Tag Archives: sensory play

Is It Sensory Treatment…Or Sensory Stimulation? How To Know The Difference

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I have spent the first part of my career in pediatrics convincing parents, teachers, and other therapists that sensory processing is important for development, and that sensory processing disorders are a real “thing”.  I am spending the latter part of my career trying to explain to the same groups that using a sensory-based activity does not constitute sensory treatment.

Why?

Results.  You will not get good results to any treatment if the underlying principles aren’t understood and used correctly.  This requires more than a therapy ball and a brush.  A local school district uses general sensory activities for the whole class, rather than sensory-based treatment for kids with sensory processing disorders.  I get a lot of private practice referrals from this neighborhood.  The district’s refusal to address children’s needs in the classroom, while telling parents that they are “sensory-aware”, is frustrating to everyone, including the therapists in the district.  They don’t seem to stick around…..

Therapy for sensory processing disorders requires an evaluation.  Assessing the problem and identifying a rationale for the related behaviors or functional deficits is essential.  Tossing out a sensory-based activity because it is fun, easy, or has worked for another child is the hallmark of a well-meaning provider that wants to help a child but doesn’t have the training of a licensed therapist.

A good example would be to offer teething toys to a child that chews their shirt.  Sounds like a solid plan:  oral seeking equals oral stimulation.  But wait! What if the child is using oral seeking to address severe sound sensitivity?  Isn’t it better to deal with the cause of the problem rather than the end-point behavior?  You would need an evaluation to know that their greater problem is poor modulation and sensitivity.

Treatment techniques follow a pattern that is based on the brain’s neurological response to sensory input.  I didn’t take courses in neuroscience because I liked looking at brain sections.  I took those courses so that I could understand the structure and function of the brain!

The right intervention (movement, pressure, etc.) uses intensity, duration, specificity of sensory input, location of contact/input, frequency, and timing to achieve results.  This sounds like a lot to consider, and….it is!  The way OTs create a sensory diet isn’t by looking at what worked for another child.  We look at what we observe, what we assess, and what the child’s performance demands are.  Only then can we identify what should be used, how and when it should be used, and how to determine our next steps in treatment. 

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A great treatment that isn’t used at the correct level of frequency or used when it is most needed is going to fail.  So will the right frequency of treatment used vigorously rather than with skilled observation.  Non-therapists can be taught a treatment intervention, but it takes training and experience to create a treatment program.  This is no different from any other type of therapy.  Psychotherapists aren’t just talking to you. Speech therapists aren’t simply teaching you how to pronounce the “r” sound.  If it was that easy, we wouldn’t need licensure or even a degree.   

It would be a lot more fun.  We make it look easy, and that is the art of OT.

 I have just explained (some of) the science.

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Sensory Stimulation is not Sensory Treatment

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I thought that I might never hear it again, but there it was.  Another parent telling me that a member of her child’s treatment team had placed her hands in a rice-and-bean bin.  “Why?” I asked.  “She said it was sensory.” was the response.  This particular child has no aversions to touch, and no sensory-seeking behaviors either.  Her aversion to movement out of a vertical head position keeps her in my sessions, and her postural instability and hypermobility will keep her in PT for a while. But unless she is swishing around in that box while on a balance board or while she is sitting on a therapy ball (BTW…not) it isn’t therapy.   I struggle to see the therapeutic benefit for her specifically.  It is sensory play, but it isn’t therapy.

It seems that OTs got so good at being known for sensory-based interventions and fun activities, that it appears that engaging in sensory play is therapy.

Let me be clear:  if your child is demonstrating sensory processing issues, random sensory input will not help them any more than random vitamin use will address scurvy or random exercises will tone your belly.

Sensory processing treatment is based on assessment.  Real assessment.  A treatment plan is developed using an understanding of the way individual sensory modalities and combinations of modalities are neurologically and psychologically interpreted (remember, mind-body connection!)  It is delivered in a specific intensity, duration, location and/or position, and in a particular sequence.  I know it LOOKS like I am playing, and the child is playing, but this is therapy.  In the same way that a PT creates an exercise program or a psychotherapist guides a patient through recalling and processing trauma, I have a plan, know my tools, and I adjust activities on the fly to help a child build skills.

I never want to make other professionals look bad in front of a parent.  That’s not right.  I ended up making a suggestion that the therapist could use that would be actually therapeutic.  Some day I hope to finish my next e-book, the one on hypermobility, and hope that the information will expand the understanding of what OT is and is not.  It is absolutely not playing in sensory bins….

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Best Preemie Toy? Try An O-Ball Toy For Easy Grasping And Playing

 

Preemies often wait a long time to start playing.  NICU life isn’t about fun, it is about survival.  Once your preemie is home, you will want to get the party started.  If she has a weak grasp or isn’t coordinated enough to easily hold every rattle and toy that you got for your shower, you might want to consider the O-ball to develop visual-motor skills.

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The Original O-Ball!

This is the basic O-Ball, a great toy that I recommend for my 1-4 month clients.  I also recommend the next generation O-ball toys, such as the O-ball car, for equally easy grasp with my slightly older preemie or developmentally delayed kids.

Why do I like this ball over cloth balls or those bumpy sensory balls?  

  • The web-like design allows a child to hold it with almost any type of grasp.  Low muscle tone, spasticity, or weakness reduce a baby’s ability to grasp and retain a toy.  It just isn’t fun if your toy keeps falling out of your hand.
  • Texture, but not too much texture.  The plastic is a little bit grippy, so it doesn’t fall out of her hand like a smooth plastic ball, but not so textured that a sensitive infant would find it overstimulating.  Preemies sometimes leave the NICU a little overwhelmed by sensation, and yet many need the extra touch input to really feel what is in their hands. This ball is a good balance of tactile inputs.
  • Fun at a fraction of the weight.  A baby that has strength or tone issues needs lightweight toys to pick it up easily and continue to hold it as gravity pulls the ball down and out of his hand.
  • The O-ball is large enough and light enough for 2-handed grasp, an important developmental milestone.  As an OT, we know that using two hands at midline (the center of your body) supports all the other movements that require a sense of moving around a center…rolling, crawling and walking!  Start now to develop awareness of midline and two-handed activity.
  • Second and third generation O-balls have built-in rattles and are more colorful than this one.  None have sharp edges or pieces that can fall out.  Safety first.
  • Did you say “Spit up”?  Wipes clean in an instant.
  • It is a bit squishy, which means it will bend, not break.  If your child drops it on her face or on the floor, she might cry from surprise but not from injury.
  • It will still be fun to play with next year.  This ball will still be fun to roll and throw later on in life, unlike those rattles that will be tossed out in a few months.

Here is another great post for parents of NICU graduates: Baby Wearing for Premature Babies

Is your preemie hypermobile?  I wrote an e-book just for you!

The JointSmart Child:  Living and Thriving With Hypermobility Volume One:  The Early Years is finally out!  I include techniques to hold and carry your child, how to use infant exercisers and how to do “tummy time”  with a hypermobile baby.  There are chapters on how to talk with your family, babysitter, and even how to talk to your pediatrician about your child’s needs.  You can buy it on Amazon.com today!  Don’t have a Kindle?  NP!  You can read it on any screen or desktop.  Want a printable copy?  Buy it on Your Therapy Source today!

Live in the NYC area and want to learn infant massage for your preemie?

Visit my website tranquil babies and make an appointment for an in-home lesson designed just for preemies today!