Tag Archives: sensory processing disorder

What is Therapeutic Listening ®?

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This weekend I had the opportunity to further my professional development by obtaining training in a therapeutic program I’ve been wanting to use since before I was a therapist: THERAPEUTIC LISTENING ®.

Answers to basic questions about the Therapeutic Listening program for children who struggle with sensory, attention, social, emotional, or basic regulation issues.

What is Therapeutic Listening ®?
Therapeutic Listening ® is an “evidence-based auditory intervention intended to support individuals who experience challenges with sensory processing dysfunction, listening, attention, and communication.” It’s not a stand-alone program. Therapeutic Listening® (“TL” for short) is one tool that can be used as part of a bigger-picture therapy program based in sensory integration, along with the use of a daily sensory diet (but I like to refer to it as a “sensory lifestyle”).

Basically, kids (or even adults) wear special headphones that play special music which has been “filtered” or modified in order to expose the nervous system to “low sounds” (below 1,000Hz, related to vestibular and postural functions), “mid range sounds” (1,000-4,000Hz, related to key speech sounds), and “high sounds” (›4,000Hz, related to attention, discrimination, and emotional subtleties) at various times throughout the music track. In addition to filtering, the music has also been specially crafted or selected based on the type and number of instruments used (percussion, bass, stringed instruments all affect the nervous system differently) as well as the rhythm (beat, pattern, repetition, tempo), melody, and even the physical space in which the recording was made. Music selections range from nursery songs to nature sounds to classical music to upbeat/pop songs and more.

What does Therapeutic Listening ® do?
Though Therapeutic Listening ® impacts kids’ nervous systems in MANY ways, here are five main highlights of what it does:
1. Influences kids’ extreme patterns of seeking or avoiding movement
2. Influences kids’ understanding and use of their body in space (including motor skills, timing, planning, and coordination)
3. Influences kids’ arousal and activity level so their “Engine” can be “Just Right”
4. Influences kids’ biological rhythms that they may struggle with such as sleep/wake cycles, hunger/fullness, bowel/bladder control, respiration, etc.
5. Influences kids’ ability to use and control their eyes in relation to their head and body

This program uses sound to address functional goals such as improved engagement, social participation, ability to tolerate transitions, communication, learning/academic performance, attention, self-help skills, tolerance for new foods and clothing textures, and even improved handwriting performance. According to the course instructor, most parents report their child’s first responses to TL include changes related to engagement and movement (vestibular: balance, spatial orientation, postural control).

How is the Therapeutic Listening ® Program structured?
In general, children listen to a particular therapist-selected CD for two weeks, at a rate of twice per day for 30 minutes each, with at least three hours in between each listening session. Because Therapeutic Listening ® is a HIGHLY individualized program, it does not follow a cookie-cutter approach. Every child’s plan will be different. Trained therapists use their clinical reasoning to choose and adjust music selections based on the child’s needs/history, the parent’s concerns, and the child’s response to each CD. It is highly dependent on clinical observation and open communication between parents and therapist. Music selections are divided into three categories (Engagement, Interaction, Discrimination) and children are assigned one of three “profiles” in order to guide the therapist in choosing music selections that will best address the child’s needs as they move through one or all three of the categories. Children typically spend a minimum of 12-16 weeks engaging in their individualized program; most will spend even longer depending on their needs and response to each phase of the program.

Who can benefit from doing the Therapeutic Listening ® program?
Everyone! Well…almost. Therapeutic Listening ® should NOT be used with individuals with schizophrenia, auditory-evoked seizures (which are rare), or during active ear infections (prior to 24 hours of antibiotics). It can be used (some with special considerations) for individuals with hearing aides, cochlear implants, Traumatic Brain Injury, Fetal Alcohol Syndrome, children under two, and even premature infants in the NICU (so cool!). As mentioned above, this program is meant to be used as part of a therapy program that utilizes additional sensory integration techniques to address bigger picture needs that influence a child’s ability to function in his or her daily life.

So, yes, kiddos and teens with SPD, Autism/Asperger’s, developmental delays, Down Syndrome, Cerebral Palsy, visual motor/handwriting difficulties, ADD/ADHD, generalized anxiety, social anxiety disorder, difficulties with executive function, and even/especially those with no diagnosis or who don’t qualify for school-based services but clearly have needs affecting their learning or function in their school or everyday environment…all will benefit! After taking this training, I’m even thinking I need a bit of Therapeutic Listening ® intervention for myself! We all have our own issues, right?

What programs can be used in conjunction with Therapeutic Listening ®?
For those of you therapists who are reading this, you can certainly use TL in conjunction with interventions such as the Astronaut Training Program, Core Concepts in Action, Rhythmic Movement Training, Interactive Metronome, The Alert Program/How Does Your Engine Run, ZONES of Regulation, R.O.P.E.S. Program for improved executive function, and even Handwriting Without Tears. Any others I didn’t list that you would recommend?

How do I get started with the Therapeutic Listening ® program?
First you or your child must be under the supervision of a therapist trained in the use of the Therapeutic Listening ® program. Ask your child’s therapy provider about this or find a certified provider on the Therapeutic Listening ®  website by visiting www.vitallinks.net and then clicking Find a Practitioner (or just click here). Once you find a TL provider, discuss whether it would be a good fit for your child and your family. I’ll be honest — it’s a commitment. Two 30-minute sessions a day, seven days a week for at least three to four months? That kind of schedule is not for everyone, and there may be other ways to address your child’s needs and functional goals. Plus, just because it’s not right for you right now doesn’t mean it may not be great at some point in the future.

If you and your child’s therapist decide to begin Therapeutic Listening ®, you may have to purchase some equipment designed specifically to access the therapeutic benefits of the program. As mentioned before, the headphones are specifically designed for use with TL (find online here) and the music selections are customized for the program as well. Music can be played from CDs using a regular portable CD player (secured in a backpack or hip pack), or it can be accessed in the form of a Sansa clip that attaches directly onto the special headphones so you don’t have to worry about dealing with discs. Music should not be burned onto other CDs or compressed into separate MP3 files because it will affect the range of sounds transmitted in music and will compromise the music’s therapeutic effects. Many clinics or therapists may be able to work with families in terms of lending out parts of the program (such as the music) while expecting them to fund some of it themselves (such as buying their own set of headphones and CD player/Sansa clip). Talk with your therapy provider to find out more about their policies regarding this program.

Where can I find more information about Therapeutic Listening ®?
Visit the Vital Links website at www.vitallinks.net. Equipment ordering information can be obtained at www.vitalsounds.com.

If you have any further questions about how the Therapeutic Listening ® program works please leave a comment below, or contact a certified provider in your area (click here) and discuss your specific questions or concerns with him or her.

Happy listening!

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Intro to Messy Play: Painting with Shaving Cream

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If you have a kiddo who is hesitant to dip their little fingers into messy sensory materials, or even outright HATES it, try giving them a tool such as a paintbrush or spoon. This will allow them to engage with the tactile media without actually having to touch it. It also serves as a nice introduction to messy play! Then as the child becomes more comfortable engaging in sensory play with the tool, she can gradually begin to explore the messy stuff on her own terms, when she feels ready.

When it comes to messy play, shaving cream is perhaps the most classic medium used by pediatric occupational therapists. Some kids LOVE the stuff and could bathe in it from head to toe every day if their mommies let them (like the kids in this picture). Others, like those mentioned above, probably wish it was buried in a deep dark cave far, far away.

So what do we do? Give ‘em a tool!

Introduce kids to messy play by painting with shaving cream. Especially good for those with tactile defensiveness who don't like to get messy.

My toddler son got to try this activity last week since he’s still not so sure about things that are goopy or foamy. All we needed was a baking sheet, some old paintbrushes, a big piece of paper (bought a whole pad from the dollar store for future projects!), and three drops of food coloring.

I squirted the cream onto the pan, showed him how I swirled in the food coloring, and then demonstrated how to brush, brush, brush! on the paper since he was a little nervous about it at first. But once he saw that it was okay and we could sing fun songs while we brushed, he reached for a brush and joined right in! He remained engaged in this process for about five minutes before he decided he was all done. It was a good start!

Introduce kids to messy play by painting with shaving cream. Especially good for those with tactile defensiveness who don't like to get messy. As mentioned previously, if you have a child who is nervous about or avoidant of tactile sensory experiences like this one, don’t force them to touch it or “just be fine” with it. Gauge their comfort level, offer demonstration and gentle encouragement, allow them to watch peers or siblings engage with it while positively reinforcing them for doing so (but DON’T punish or shame the one who doesn’t engage), sing songs or count or rhyme while doing it, make shapes and faces and sound effects as appropriate, and provide plenty of opportunities for exposure over time. Make it fun! Praise them when they try it and allow them to wipe their hands or take a break when they need to in order to keep it as positive an experience as possible.

Introduce kids to messy play by painting with shaving cream. Especially good for those with tactile defensiveness who don't like to get messy.  Have fun!

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Holiday Survival Tips for Families of Children with Special Needs

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The holiday season is often filled with shopping, unique food, and special time spent with distant loved ones. For many families, this is no big deal — chaotic, but manageable. But for families of children with autism and/or special sensory needs (especially sensory sensitivities), these events may often be met with dread, stress, and major meltdowns.

children with special needs

Here are some tips for helping children with special needs survive the holidays:

1. Minimize kids’ time spent in stores and malls. It’s a jungle out there right now — stressed out crowds, lots of overwhelming sounds, weird smells, long lines, and more kid-tempting merchandise than any other time of year. If at all possible, avoid sensory overload and leave the kids at home or with a sitter while you do your shopping. You could devote one entire day to getting all your in-store stuff done. Or, better yet, do your shopping online. There’s still time to ship before the holiday and you can avoid the madness. If you’re looking for kiddie gift ideas, check out MamaOT’s list of Holiday Gift Ideas for babies, toddlers, and preschoolers. And if you’re not sure what to get for the child with special sensory needs, check out this great list of holiday gift ideas from AbbyPediatricOT.

2. Prep your kids. All the people and events involved in holiday festivities can be overwhelming for kids in general, but this is especially true for kids with autism/sensory difficulties. One of the best things you can do is prep them for what to expect. You can familiarize them with who they will see by going through photos with them online (yay, Facebook) or creating a special photo book (nothing fancy) so they can look through it with you in prep for the big day. You can make your own version of a Social Story by helping your child put together a basic book (pieces of paper stapled together) with stick figures and descriptions of what will or may happen in different aspects of the upcoming festivities. If you’ll be traveling a long distance, you can prep them for what will be involved with transportation and include that in your social story (going to the gas station, standing in line, security checks, special seat belts, cabin pressure, loud railroad noises, etc.). The more you can prep them for what’s to come, the better.

3. Prep your family. If you’ll be spending time with family and loved ones who may not be in the loop with your child’s needs, you may want to fill them in a bit so they know what to expect and won’t be offended if little Johnny cries when Aunt Marge tries to give him a big hug and kiss or sweet Susie won’t eat Grandma’s homemade ham. This can be a touchy subject for some families, especially if they don’t feel comfortable letting others know their young child has a diagnosis yet (such as autism). Only share as much as you are comfortable. All you need to say is that Johnny is more comfortable with high fives than hugs and kisses (which you know is due to tactile sensitivities), or Susie is still learning how to try new foods (which you know is due to oral sensitivities), and leave it at that. But please make sure you communicate something so your sweet family gathering doesn’t turn into a day of raised eyebrows and hurt feelings.

4. Maintain routines. Many children with autism/sensory challenges have major difficulties when it comes to change, especially changes in routine, diet, or sleep schedule. Their bodies and brains often don’t adapt as well, and this may result in over-arousal, disorganized behavior, increased sensory seeking/avoiding behaviors, and/or meltdowns. If your child is one who heavily relies on routines to maintain their sense of organization and emotional regulation, then you know what I mean. So amidst all the school plays, errands, and travels, try your very best to keep your most critical routines as much the same as possible. If your child follows a special sensory diet created by an occupational therapist, then make sure he or she is engaging in those special sensory activities as regularly as possible in order to maintain their level of physical and emotional regulation.

5. Maintain diet. I mentioned diet in the previous point, but it’s so important that I’m giving it its own section. Food fuels our bodies and our brains. Some bodies and brains can continue to function in an optimal (if not slightly hyper or lethargic) level despite temporary changes in diet such as increased sugar, fat, red food dyes, wheat, or carbonation. Other bodies, however, get totally thrown off kilter when holiday foods are introduced, and it can put kids with sensory challenges into a whole new level of struggle. You know your child and what his or her tolerance is to changes in diet, so it’s ultimately up to you on how to navigate the holiday offerings of cookies, fudge, marshmallows, candy canes, etc. But just be aware that holiday foods have the potential to greatly influence and alter a child’s ability to function in their day-to-day, especially if they have special sensory or dietary needs.

6. Bring your own food. If you know food will be an issue for your child, consider providing food you know he or she will eat. Loud, stressful holiday family gatherings are NOT the time to try and introduce new foods to your selective eater. This is why it’s important to at least minimally prep your family in advance of mealtime, so they won’t make a big fuss about why your child isn’t eating what everyone else is eating. If they’re eating chicken nuggets while everyone else is enjoying prime rib and mashed potatoes with gravy, that’s fine! Again, you know your child best, so do what you think will work. But please don’t stress about how they will respond to all those new foods. They don’t have to eat them.

7. Make a plan for “escape”. What are you going to do if and when your child has had enough sensory input for one day and is teetering on the point of meltdown (or has already zoomed past that point into total meltdown)? If you know where you will be on the big day, try to create a “safe space” where your child can retreat before he or she gets to the point of explosion. It could be a spare bedroom with video games/movies, a small tent or fort with pillows/blankets/preferred toys, or even the car or garage. Or on the opposite end of the spectrum, what are you going to do if your sensory seeker has been cooped up in a car or airplane and is now expected to sit still as a guest in someone’s house all day. Not gonna happen! Try to find ways to give your seeker opportunities for vestibular input (spinning, swinging), proprioception/heavy work (running, crashing, carrying heavy things), and/or tactile experiences (play dough, fidget toys) before they end up in trouble. Like I said, the more communication you can have with family in advance, the better chance you have at successfully navigating your time together.

8. Have a support team. Enlist at least one other person or family to be on your “team” during your gathering. This could simply be someone who makes sure the “safe space” is all ready to go, or it could be an adult or older kid whom your child trusts and is able to hang out with while you try to eat and socialize. Whatever you do, don’t do it alone!

There are so many aspects of the holiday season that can be difficult for families of children with special needs that I couldn’t possibly cover all of them in one post. So please visit these other helpful links on similar topics if you are looking for more information:

Happy holidays to you and your family!

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Get Ready for Info on Sensory Processing Disorder (SPD)

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This weekend I had the distinct privilege of attending the 15th annual international symposium on Sensory Processing Disorder (SPD). It was held in my hometown of Sacramento, CA, and I was honored to be in the presence of some of the greatest leaders in the field of SPD research and intervention.

In a nutshell, Sensory Processing Disorder (SPD) occurs when the brain misinterprets sensory information (like touch, sound, smell, movement) and either over-responds, under-responds, or excessively craves it to the extent that it interferes with a person’s ability to function in his or her daily life. These difficulties with sensory processing also frequently contribute to motor-based problems that end up delaying the development of age-appropriate fine motor skills (small muscle groups: hands/fingers) and gross motor skills (large muscle groups: legs, shoulders, trunk).

sensory processing disorderThe most well-known speaker at this weekend’s conference was Dr. Lucy Jane Miller, an amazing woman who has devoted her life to helping children with issues related to sensory processing. She is the author of Sensational Kids: Hope and help for children with sensory processing disorder and No Longer A SECRET: Unique common sense strategies for children with sensory or motor challenges, and she has co-authored many other books and prestigious research articles on the topic of SPD. Dr. Miller is also the leader of the STAR (Sensory Therapy and Research) Center in Denver, Colorado, which is a unique place for children and their families to engage in intensive sensory-based treatment and education in order to help them more successfully participate in daily activities (such as self-care, eating, playing, and participating socially) and increase their quality of life.

As anticipated, this conference built upon my current knowledge about and experience with sensory processing disorder. Ten lectures over the course of two eight-hour days? Yeah, I learned A LOT!

And I bet you’d like to know some of what I learned?

Well, you’re in luck.

This conference, of course, has reinvigorated my passion for everything sensory, and over the course of the next several weeks, I will be sharing some juicy tidbits that I hope you will find helpful for yourself, your own children, or other children you work with. While I won’t be able to write blog posts about every single thing I learned, I will be sharing many helpful sound bytes throughout the weeks via Twitter and Facebook. So make sure you’re following me on Twitter (@mamaotblog) and you’ve become a fan of MamaOT on Facebook (http://facebook.com/mamaotblog) so you don’t miss out on some really great info.

Topics I look forward to sharing with you are (in no particular order): 
• Basics of sensory processing and SPD
• ”Sensory Diet” vs. “Sensory Lifestyle”
• SPD and Autism
• What happens in the brains of kids with SPD as it relates to sensory processing, why this causes them to behave the way they do, and what we can do about it
• Sensory-inclusive playgrounds for kids with SPD and autism
• Emotional regulation as it relates to sensory processing
• ”Picky eating” and sensory sensitivity in kids with SPD

I hope you’re as excited as I am. And, hey, if you’re not interested in reading about SPD stuff, don’t worry, I’ll still be blogging about other topics over the next several weeks as well. I just wanted to give you a heads up so could prepare yourself (because that’s what we pediatric OTs do, right?).

Looking forward to sharing with you!

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Foods to help kids focus in school

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It’s that time of year again. School is about to begin (or already has for some of you) and the kids are (about to be) out of the house for much of the day…Yippee! said all the parents. This means it’s time to get back into the habit of packing lunches (Boo!) and sending kids off to school with a load of goodies to fill their bellies. But did you know you’re not just feeding kids’ tummies when you give them food? You’re feeding their brains and nervous systems too, and there are actually some types of foods that can be used to help increase kids’ attention and focus during the school day.

Vegetable Medley: 26/09/06

As you pack your child’s lunch, just remember to F.O.C.U.S.

F: Fiber and whole grains both help slow down the speed at which sugar enters the bloodstream. So when kids eat fiber and whole grains as part of a healthy snack and/or lunch, they are less likely to experience a spike in blood sugar levels, and this helps them avoid a “crash” in energy later on. More stable energy levels equal better potential for focus. Some kid-friendly foods filled with fiber and/or whole grains include plain popcorn, beans, avocado, hummus, almonds, bananas, whole wheat pasta, quinoa, brown rice, edamame, whole wheat bread (different than “multi-grain”, which is not whole grain), fruit with skin (like pears and apples), berries (especially blackberries), and oatmeal-based products (but watch out for the added sugar in things like oatmeal cookies that will cause that crash later on!)

O: Omega-3 fatty acids contribute to brain function and cognitive behavior and can be found in kid-friendly foods such as avocado, tuna, tilapia fish sticks, salmon, extra virgin olive oil, almonds, walnuts, pumpkin seeds, and macadamia nuts.

C: Crunchy and chewy foods are one of the best kept secrets when it comes to foods that help kids focus. Though it’s common knowledge among pediatric occupational therapists, not a lot of people know about it for some reason, so I’m telling you now! Foods that are crunchy or chewy can provide a lot of “heavy” input to the jaw because the muscles really have to work to break them down, and this particular type of sensory input helps increase focus and attention. Obviously you don’t want to go overboard and send your child to school with a jawbreaker candy or tootsie pop everyday, so try foods like crackers, pretzels/pretzel rods, peanut butter, cheese, nuts, granola bars, corn nuts, carrots, celery, broccoli, sliced bell peppers, snap peas, apples, fruit leather, or dry cereal (such as granola, Cheerios, or Chex/Chex Mix).

U: Giving kids unprocessed foods will help reduce the amount of trans fats and high fructose corn syrup they eat during the day, which means they will be more likely to eat fresh foods that will keep their energy at a balanced level and help them maintain their focus. Remember, “processed foods” are foods that have been altered from their original state, and they are EVERYWHERE. They often contain ingredients such as white flour, added sugar, added salt, partially hydrogenated oils (the trans fats), and high fructose corn syrup. Think of it this way: if a food can sit on a shelf for weeks or months on end without going bad, then it’s most likely processed. Conversely, unprocessed foods will “go bad” more quickly but will provide your child with healthier fuel to help their body and brain stay energized and focused during the school day. I know it seems impossible to feed a child food that isn’t processed (hello, mac ‘n cheese!), so be realistic with what you know your child will eat and go from there. Every little bit counts.

S: Food and drinks that require sucking can really help kids get focused and increase their attention. This is another trick pediatric occupational therapists keep in their back pocket that not too many people know about. Sucking through a straw or straw-like container can be a very “focusing” activity, so if you send kids to school with suckable fruit pouches and a pop-top water bottle or straw for their milk (how about a fun crazy straw?), you will be setting them up for school success!

BONUS FOOD: Protein. I couldn’t figure out how to fit protein into my tidy little acronym, so it’s just gonna have to hang out here by itself. But just because it didn’t make it into the top five doesn’t mean it’s not important! Protein contributes to stable energy levels (which contributes to focus and attention), so be sure to include kid-friendly protein in your child’s lunch with foods like hard boiled eggs, beans, nuts, quinoa, meat (the less processed the better), hummus, cheese, milk, yogurt (easy on the sugar!), or avocado/guacamole.

So there you have it. Don’t feel like you have to try all these foods at once or that you have to strictly follow these ideas. Find what works for your child and allow him or her to help you come up with ideas for new combinations of “focus foods” (like apples and cheese or peanut butter-filled pretzels). When you pack your child’s lunch in the morning (or the night before, if you’re really ambitious), do a quick scan of their lunchbox and ask yourself: 

Am I helping my child F.O.C.U.S.?

. . . . .

If you feel your child has significant difficulties focusing in school or you have specific nutritional questions about any of the above-listed foods, be sure to bring it up to your child’s pediatrician. He or she will (hopefully) be your best resource for addressing your child’s specific needs and pointing you in the right direction. And if your child already sees an occupational therapist, check with her or him for specific recommendations regarding your child’s particular sensory needs. This post is not an exhaustive list of foods because there are even more food- and drink-related ways to help kids stay alert and attentive during class, if you can believe it! Another post for another day, I suppose. But I hope this is a good start.

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