A Therapists Guide to Fix the Developmental Delay of Baby Milestones

Sensory Integration Tips

Saturday, July 17, 2010@ 7:13 PM

child with sensory integration problemsI promised that I would provide some useful information to parents/caregivers of preemies who noticed potential sensory integration problems. The tips and activities I’m going to describe can also be used on any child you suspect may have some sensory issues. By the way, all of us have sensory issues to some extent. How many people cringe at the sound of either fingernails or chalk on a blackboard? Even thinking about it raises the hair on my arms! It took me years to be able to tolerate cottage cheese (my desire to diet finally exceeded my dislike for the texture). We all have decidedly personal reactions to sight, sounds, tastes and textures. What might be okay for one might be intolerable for another. However, when the avoidance or intolerance for a certain sensory stimuli creates a problem with activities of daily living, it needs to be addressed.

Babies with sensory integration problems often do not like to be cuddled and tend to arch away from their caregiver. Their muscles may feel stiff and they do not relax against the person who is holding them. They tend to develop too much extension (using muscles of back) and not enough flexion (using the abdominal muscles and legs to assume the fetal position). What you can do is hold the baby so that one leg is straight and one leg is bent at the knee. Your arm goes between the legs and supports the bent leg while letting the other leg dangle free. The baby’s upper body should end up nestled in the crook of your arm. The benefit of this position is two-fold. You are giving firm input and a secure feeling to the baby by tucking them into your arm and holding them against your body, and the one straight leg/one bent leg helps your child learn to tuck and helps break up the pattern of extension. The pattern of extension is with back arched and both legs stiff and straight.

You can also do some calming exercises on the ball. One of the best activities to calm a fussy baby is to place her on her tummy on top of the ball, place your hand gently but firmly on her back, and then slowly rock the ball back and forth. You can also try this with the baby on her back if she resists being put on her tummy. If you take a look at the video section of my blog, you will see a demonstration of this activity. If the baby does not calm with just your hand pressing on her back, you can add more sensory input by resting your upper body gently but firmly on the baby’s back, and rocking in unison. Please make sure that the baby’s nose and mouth are clear of the surface of the ball. You can do this by turning her head to the side so that only her cheek is resting on the ball. Make sure that she can breathe freely at all times.

For bedtime or naptime, you want to reduce stimulation. Make sure that the room is dark enough and quiet enough for the baby to sleep. You can use a night light if the baby gets distressed in the dark. What I like and what my clients like are those musical fish tanks. Those are the lights that have fake fish moving inside a solution or that have fish scrolling across a screen. Fiber optic lights are also good, as well as lava lamps. These things are mesmerizing and calming for adults, so they do the same for infants.

Clothing is another possible problem for babies and children with sensory issues. A lot of companies are now making label-less clothing which is much better for sensory kids. A lot of children, even those without obvious sensory problems, don’t like the feel of labels and tags. Wools and other fibers can be itchy and irritating. Usually the best clothing is those with a softer feel and less noticeable nap.

Sensitivity around the mouth and aversion to food textures is also very common. I previously mentioned using a vibrator around the mouth and in the mouth. Some companies make vibrators specifically to address sensory problems. Z Vibe has a sensory integration kit which has a variety of tools. Nuk brand has an introductory toothbrush which has little “nubs” on it. Rubbing the head of this brush around the gums and letting your baby teeth on it helps de-sensitize the mouth. If your baby is very young, you can use your finger to rub her gums, or use the tip of a clean wash cloth to rub the gums.

For toddlers and young children, certain activities help organize the sensory system. I used to use a sit-n-spin, which the children loved. There are several companies which make a similar product, but you can use any one that lets your child sit and rotate. This particular toy has the added benefit of improving upper extremity and hand skills. Swinging is also very helpful. There are a few swings available that are small enough to set up in an apartment. Get a small trampoline and let your child jump. Again, there are a few that are made for very young children and have a bar to hold on to. If your child needs constant input to stay organized, you can try a weighted vest. Usually they have small pockets to insert the cylindrical weights, and you can experiment with the amount of weight that works best.

I am going to touch briefly on the subject of toilet training. This can be an issue regardless of whether or not the child has sensory issues. For many children, physical security is a necessity. Remember how you used to wrap your legs around a chair when sitting. Well, you did that to stabilize and feel secure. A small bottom seated over a big space can be unnerving. Make sure that you use a toilet seat that fits your child. Also, the noise of a flushing toilet can be upsetting to a sensory child. If you flush after they leave the bathroom, they will develop a habit of not flushing. Find a strategy that prepares your child for the flush, whether it is singing to themself, focusing on something else in the bathroom or counting down the flush. Bowel movements are often problematic. I’m not going to say a lot right now. I will mention one trick that is very good. Many children, especially those who fall in the spectrum disorder category, are scared to let go of their bowel movement. For those who will poop in their pull-ups but not in the toilet, here’s a little trick. Start by sitting your child on the toilet while wearing the pull-up. Get them used to being on the toilet. Once they tolerate sitting, the next step is to cut a hole in the back of the pull-up. Make it big enough so that your child can poop and it will all go into the toilet. After they are successful, show them their accomplishment and praise them. Having them go while wearing the pull-up gives them the security they need.

I have covered just a few techniques and activities that are helpful and that are easy to do. There are many more that I have not discussed. If you think your baby or child needs expert help, you should seek a consultation with a developmental specialist. There are centers and programs which specifically treat sensory integration problems.

6 Responses to “Sensory Integration Tips”

  1. Alysia says:

    Thank you for all of your advice! My 4 yr old has SPD and is also on the spectrum, so I look forward to reading all your posts and advice. He’s currently working with an OT at school for his handwriting, but also creating a sensory diet for him at school. We’re working to implement it at home as well. I’ve been writing about our adventures on my blog. Looking forward to following you!

    Alysia
    http://trydefyinggravity.wordpress.com

  2. Nancy Konigsberg MA OTR/L says:

    Hi Alysia,
    I realized after I answered the w-sit question that you also have a 4 y/o with SPD. I don’t know if your 4 year old also had issues with postural positions and would w-sit, but I want to give you something to think about. Often times, children with low tone and joint laxity, like those who tend to w-sit, have an internal radar that tells them that positons aren’t safe. They will present like children with gravitational insecurity. They often dislike movement and avoid going against gravity. But they don’t have SPD. Once they develop age appropriate postural stability and strength, the movement and fearfulness issues go away. It is often hard to distinguish one issue from the other. The only reason I mention this is because the treatment is very different, depending on the cause of the gravitational insecurity.

  3. Body Core Strength says:

    Building up your core muscles is very important for strength, posture, and overall health. I have back issues and I focus a lot on core exercises to help take care of my back now…and proper stretching of course.

  4. It is an incredible post, but I was wondering how do I suscribe on the RSS feed?

  5. Nancy Konigsberg MA OTR/L says:

    HI,
    Thanks for the nice comment. Just click on subscribe by the rss feed link on the home page.

  6. Great articles on your site!
    Please add precautions for parents to watch for such as delayed responses following SI treatment. Some children will have melt downs or withdrawals hours after intense SI treatment or become dizzy or nauseous while participating in an SI activity especially with spinning.
    Keep up the great educational artilces!

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