The Out-of-Sync Child

by Carol Kranowitz

  The sensory diet concept was developed by occupational therapists Patricia and Julia Wilbarger in the 1990s. One of the best books on the subject is Building Bridges through Sensory Integration, by OTs Paula Aquilla, Ellen Yack, and Shirley Sutton (Sensory World, 2003).

  Just as the main food groups provide daily nutritional requirements, a daily sensory diet fulfills physical and emotional needs. The out-of-sync child needs an individualized diet of tactile, vestibular, and proprioceptive nourishment more than most but doesn’t know how to get it. So, we must and can help.

  A sensory diet includes a combination of alerting, organizing, and calming activities. An alerting or calming activity may come first, depending on your child’s needs.

  Alerting activities benefit the underresponsive child, who needs a boost to become effectively aroused. These include:

  • Crunching dry cereal, popcorn, chips, crackers, nuts, pretzels, carrots, celery, apples, or ice cubes,

  • Taking a shower,

  • Bouncing on a therapy ball or beach ball, or

  • Jumping up and down on a mattress or trampoline.

  Organizing activities help regulate the child’s responses. They include:

  • Chewing granola bars, fruit bars, licorice, dried apricots, cheese, gum, bagels, or bread crusts,

  • Hanging by the hands from a chinning bar,

  • Pushing or pulling heavy loads, or

  • Getting into an upside-down position.

  Calming activities help the child decrease sensory overresponsivity or overstimulation. They include:

  • Sucking a pacifier, hard candy, frozen fruit bar, or spoonful of peanut butter,

  • Pushing against walls with the hands, shoulders, back, buttocks, and head,

  • Rocking, swaying, or swinging slowly to and fro,

  • Cuddling or back rubbing, or

  • Taking a bath.

  When you initiate your own home program for a sensory diet, it is always best to consult a therapist about your child’s requirements. What are appropriate activities? Where should your child do them? When? How often? For how long?

  Here are some guidelines:

  • Set up specific times during the day for a structured sequence (after breakfast, after school, and before bedtime).

  • If possible, supply the activity that your child wants. Often, the child will tell you. Even if he can’t say, “My nervous system desperately requires an intense movement experience,” you may be able to read his mind as he prepares to leap from the playhouse roof. Find another way to let him jump!

  • Let the child direct the play. While “more!” may mean more, do supervise so the child doesn’t become overaroused. “Stop!” means stop at once. During the activity, watch and listen for nonverbal signals: Relaxation and pleased facial expressions suggest that the activity feels good; whimpers or raucous laughter suggest that it is time to cool down.

  • For variety, change the routine and environment.

  • Check periodically with the therapist to ensure your home diet is “nutritious” and is meeting your child’s varying needs.

  A balanced sensory diet is like a fitness plan. It will enhance every child’s functioning, whether the child is in or out of sync.

  PROMOTING HEALTHY SENSORY PROCESSING AT HOME

  Many children seek more touch and movement than others. They are Touchers-and-Feelers, Bumpers-and-Crashers. Their high activity level tells us that if they can play “bumpety bump” on the tire swing, or soar into a leaf pile, or wallow in mud puddles, they will “get it all together.” They are right.

  Other children avoid touch and movement experiences, which make them uncomfortable. These children need guidance to explore their environment and to feel safe. Once they learn how to play actively, they, too, begin to get it all together.

  Following are some ideas for multisensory activities that parents and caregivers can provide for young children at home. Every little body can benefit from these suggestions—not only the children who seek such activities, but also the children who are more tentative about exploring their environment.

  Want more? For hundreds of detailed activities for children of all ages, see The Out-of-Sync Child Has Fun (Perigee, 2006), The Goodenoughs Get in Sync (Sensory World, 2010), Growing an In-Sync Child (Perigee, 2010), and In-Sync Activity Cards (Sensory World, 2012).

  Activities to Develop the Tactile Sense

  Rub-a-Dub-Dub—Encourage the child to rub a variety of textures against her skin. Offer different kinds of soap (oatmeal soap, shaving cream, lotion soap) and scrubbers (loofah sponges, thick washcloths, foam pot-scrubbers, plastic brushes).

  Water Play—Fill the kitchen sink with sudsy water and unbreakable pitchers and bottles, turkey basters, sponges, eggbeaters, and toy water pumps. Or, fill a washtub with water and toys and set it on the grass. Pouring and measuring are educational and therapeutic, as well as high forms of entertainment.

  Water Painting—Give the child a bucket of water and paintbrush to paint the porch steps, the sidewalk, the fence, or her own body. Or, provide a squirt bottle filled with clean water (because the squirts often go in the child’s mouth).

  Finger Painting—Let the sensory craver wallow in this literally “sensational” activity. Encourage (but don’t force) the sensory avoider to stick a finger into the goop. For different tactile experiences, mix sand into the paint, or place a blob of shaving cream, peanut butter, or pudding on a plastic tray. Encourage him to draw shapes, letters, and numbers. If he “messes up,” he can erase the error with his hand and begin again.

  Finger Drawing—With your finger, “draw” a shape, letter, number, or design on the child’s back or hand. Ask the child to guess what it is and then to pass the design on to another person.

  Sand Play—In a sandbox, add small toys (cars, trucks, people, and dinosaurs), which the child can rearrange, bury, and rediscover. Instead of sand, use dried beans, rice, pasta, cornmeal, popcorn, and mud. Making mud pies and getting messy are therapeutic, too.

  Feelie Box—Cut a hole in a shoebox lid. Place spools, buttons, blocks, coins, marbles, animals, and cars in the box. The child inserts a hand through the hole and tells you what toy she is touching. Or, ask her to reach in and feel for a button or car. Or, show her a toy and ask her to find one in the box that matches. These activities improve the child’s ability to discriminate objects without the use of vision.

  “Can You Describe It?”—Provide objects with different textures, temperatures, and weights. Ask her to tell you about an object she is touching. (If you can persuade her not to look at it, the game is more challenging.) Is the object round? Cool? Smooth? Soft? Heavy?

  Oral-Motor Activities—Licking stickers and pasting them down, blowing whistles and kazoos, blowing bubbles, drinking through straws or sports bottles, and chewing gum or rubber tubing may provide oral satisfaction.

  Hands-on Cooking—Have the child mix cookie dough, bread dough, or meat loaf in a shallow roasting pan (not a high-sided bowl).

  Science Activities—Touching worms and egg yolks, catching fireflies, collecting acorns and chestnuts, planting seeds, and digging in the garden provide interesting tactile experiences.

  Handling Pets—What could be more satisfying than stroking a cat, dog or rabbit?

  People Sandwich—Have the “salami” or “cheese” (your child) lie facedown on the “bread” (gym mat or couch cushion) with her head extended beyond the edge. With a “spreader” (sponge, pot scrubber, basting or vegetable brush, paintbrush, or washcloth) smear her arms, legs, and torso with pretend mustard, mayonnaise, relish, ketchup, etc. Use firm, downward strokes. Cover the child, from neck to toe, with another piece of “bread” (folded mat or second cushion). Now press firmly on the mat to squish out the excess mustard, so the child feels the deep, soothing pressure. You can even roll or crawl across your child; the mat will distribute your weight. Your child will be in heaven.

  Activities to Develop the Vestibular System
>
  Rolling—Encourage your child to roll across the floor and down a grassy hill.

  Swinging—Encourage (but never force) the child to swing. Gentle, linear movement is calming. Fast, high swinging in an arc is more stimulating. If the child has gravitational insecurity, start him on a low swing so his feet can touch the ground, or hold him on your lap. Two adults can swing him in a blanket, too.

  Spinning—At the playground, let the child spin on the tire swing or merry-go-round. Indoors, offer a swivel chair or Sit ’n Spin. Monitor the spinning, as the child may become easily overstimulated. Don’t spin her without her permission!

  Sliding—How many ways can a child swoosh down a slide? Sitting up, lying down, frontwards, backwards, holding on to the sides, not holding on, with legs straddling the sides, etc.

  Riding Vehicles—Trikes, bikes, and scooters help children improve their balance, motor planning, and motor coordination.

  Walking on Unstable Surfaces—A sandy beach, a playground “clatter bridge,” a grassy meadow, and a waterbed are examples of shaky ground that require children to adjust their bodies as they move.

  Rocking—Provide a rocking chair for your child to get energized, organized, or tranquilized.

  Riding, balancing, and walking on a seesaw.

  Balancing on a Teeter-Totter—Center a board over a railroad timber. (See The Out-of-Sync Child Has Fun for ideas.)

  Sitting on a T-stool—A T-stool helps improve balance, posture, and attention. (See The Out-of-Sync Child Has Fun for ideas.)

  Balancing on a Large Therapy Ball—Your child can lie on her stomach, on her back, or sit and bounce. Some balls have handles for bouncing up and lower (hippity-hopping).

  Tummy Down, Head Up—Have the child lie on her stomach. On the floor, she can rock to and fro to “Row, Row, Row Your Boat”; draw on paper while listening to music, using crayons, which require her to bear down to make a mark; and play with small toys. On a swing or therapy ball, she can “draw” on the ground or carpet with a stick; throw sponges into a basket; and bat a suspended ball with a cardboard tube.

  Jogging—Run around the block together!

  Activities to Develop the Proprioceptive System

  Lifting and Carrying Heavy Loads—Have the child pick up and carry soft-drink bottles to the picnic; laundry baskets upstairs; or grocery bags, filled with nonbreakables, into the house. He can also lug a box of books, a bucket of blocks, or a pail of water from one spot to another.

  Pushing and Pulling—Have the child push or drag grocery bags from door to kitchen. Let him push the stroller, vacuum, rake, shove heavy boxes, tow a friend on a sled, or pull a loaded wagon. Hard muscular work jazzes up the muscles.

  Hanging by the Arms—Mount a chinning bar in a doorway, or take your child to the park to hang from the monkey bars. When she suspends her weight from her hands, her stretching muscles send sensory messages to her brain. When she shifts from hand to hand as she travels underneath the monkey bars, she is developing upper-body strength.

  Hermit Crab—Place a large bag of rice or beans on the child’s back and let her move around with a heavy “shell” on her back.

  Joint Squeeze—Put one hand on the child’s forearm and the other on his upper arm; slowly press toward and away from his elbow. Repeat at his knee and shoulder. Press down on his head. Straighten and bend his fingers, wrists, elbows, knees, ankles, and toes. These extension and flexion techniques provide traction and compression to his joints and are effective when he’s stuck in tight spaces, such as church pews, movie theaters, cars, trains, and especially airplanes where the air pressure changes.

  Body Squeeze—Sit on the floor behind your child, straddling him with your legs. Put your arms around his knees, draw them toward his chest, and squeeze hard. Holding tight, rock him forward and back.

  Bear Hugs—Everyone needs twelve hugs a day.

  Pouring—Let the child pour sand, beans, or water from one container to another.

  Opening Doors—Is this hard? Then your child needs practice! Take the time to let her do it all by herself.

  Back-to-Back Standing Up—Position two children on the floor, back to back. Ask them to “dig their feet into the floor” and to stand up together by pressing against each other’s back.

  Bulldozer—One child sits in a large cardboard box or on a folded gym mat, and another child pushes the load across the floor, using his head, shoulders, back, or feet to make it move.

  Arm Wrestling—If you are stronger than your child, please let him win once in a while.

  Activities to Develop the Auditory System

  Simplify your language. Speak slowly, shorten your comments, abbreviate instructions, and repeat what you have said. Reinforce verbal messages with gestural communication: facial expressions, hand movements, and body language.

  Talk to your child while she dresses, eats, or bathes, to teach her words and concepts, such as nouns (sunglasses, casserole), body parts (thumb, buttocks), prepositions (around, through), adjectives (juicy, soapy), time (yesterday, later), categories (vegetables/fruits), actions (zip, scrub), and emotions (pleased, sorry).

  Share your own thoughts. Model good speech and communication skills. Even if the child has trouble responding verbally, she may understand what you say.

  Take the time to let your child respond to your words and express his thoughts. Don’t interrupt, rush, or pressure him to talk.

  Be an active listener. Pay attention. Look your child in the eye when she speaks. Show her that her thoughts interest you.

  Help your child communicate more clearly. If you catch one word, say, “Tell me more about the truck.” If you can’t catch his meaning, have him show you by gesturing.

  Reward her comments with smiles, hugs, and verbal praise, such as, “That’s a great idea!” Your positive feedback will encourage her to strive to communicate. (Don’t say, “Good talking,” which means little to the child and implies that all you care about is words, rather than the message the child is trying to get across.)

  Use rhythm and beat to improve the child’s memory. Give directions or teach facts with a “piggyback song,” substituting your words to a familiar tune. Example: To the tune of “Mary Had a Little Lamb,” sing, “Now it’s time to wash your face, Brush your teeth, comb your hair, Now it’s time to put on clothes, So start with underwear!”

  Encourage your child to pantomime while listening to stories and poems, or to music without words.

  Read to your child every day!

  Activities to Develop the Visual System

  Making Shapes—Let your child draw or form shapes, letters, and numbers in different materials, such as playdough, finger paint, shaving cream, soap foam, sand, clay, string, pudding, or pizza dough.

  Mazes and Dot-to-Dot Activities—Draw mazes on paper, the sidewalk, or the beach. Have the child follow the mazes with his finger, a toy car, a crayon, a marker, or chalk. On graph paper, make dot-to-dot patterns for the child to follow.

  Peg Board—Have the child reproduce your design or make his own.

  Cutting Activities—Provide paper and scissors and have your child cut fringe and strips. Draw curved lines on the paper for her to cut. Cutting playdough is fun, too.

  Tracking Activities—Lie on your backs outside and watch birds or airplanes, just moving your eyes while keeping your heads still.

  Jigsaw Puzzles!

  Block Building!!

  More Activities to Develop Sensory-Motor Skills

  Sensory processing is the foundation for fine-motor skills, motor planning, and bilateral coordination. All these skills improve as the child tries the following activities that integrate the sensations.

  FINE-MOTOR SKILLS

  Flour Sifting—Spread newspaper on the kitchen floor and provide flour, scoop, and sifter. (A turn handle is easier to manipulate than a squeeze handle, but both develop fine-motor muscles in the hands.) Let the child scoop and sift.

  Stringing and Lacing—Provide shoelaces, lengths of yarn on pla
stic needles, or pipe cleaners, and buttons, macaroni, cereal “Os,” beads, spools, paper clips, and jingle bells. Making bracelets and necklaces develops eye-hand coordination, tactile discrimination, and bilateral coordination.

  Egg Carton Collections—The child may enjoy sorting shells, pinecones, pebbles, nuts, beans, beads, buttons, bottle caps, and other found objects and organizing them in the individual egg compartments.

  Household Tools—Picking up cereal pieces with tweezers; stretching rubber bands over a box to make a “guitar”; hanging napkins, doll clothes, and paper towels with clothespins; and smashing egg cartons with a mallet are activities that strengthen many skills.

  Office and Classroom Tools—Have the child cut with scissors; use a stapler and hole puncher; draw with crayons and chalk; paint with brushes, feathers, sticks, and eyedroppers; squeeze glue onto paper in letters or designs, sprinkle sparkles on the glue, and shake off the excess; and wrap boxes with brown paper, tape, and string.

  MOTOR PLANNING

  Jumping from a Table—Place a gym mat beside a low table and encourage the child to jump. After each landing, stick tape on the mat to mark the spot. Encourage the child to jump farther each time.

  Walking Like Animals—Encourage the child to lumber like a bear, on all fours; a crab, from side to side on all fours; a turtle, creeping; a snake, crawling; an inchworm, by stretching flat and pulling her knees toward her chest; an ostrich, while grasping her ankles; a duck, squatting; a frog, squatting and jumping; a kangaroo or bunny, jumping; a lame dog, with an “injured” leg; a gorilla, bending her knees; a horse, galloping.

  Playground Games—Remember Simon Says, Ring-Around-the-Rosy, The Hokey-Pokey, London Bridge, Shoo Fly, and Mother, May I?

  Insy-Outsy—Teach the child to get in and out of clothes, the front door, and the car. With a little help, the child may become able to perform these tasks independently, even if it takes a long time!

  BILATERAL COORDINATION