We pediatric OTs sure love big words and jargon. Hey, you can’t blame us. We need to sound fancy every once and awhile, especially since we are typically covered in shaving cream and glitter for the majority of our work day. One of our favorite phrases has to be “sensory diet,” a term created by Patricia Wilbarger, an OT who has made significant contributions to the field of sensory integration.
What is a sensory diet?
My husband has been married into the peds OT life for the better part of a decade. At this point, he pretty much gets it. But when I asked him what came to mind when I said “sensory diet,” he shrugged and said, “An apple wearing headphones?” Sigh… (But also, thanks to him for the title image for this post.)
A sensory diet is a set of activities tailored to meet the specific sensory processing needs of your child throughout their day. Or, even more simply – it’s a home exercise program for children with sensory processing difficulties.
Using the term “diet” in the phrase makes it sound a little more complicated than it actually is, but I think it allows for a good analogy to a food diet. I mean, you can’t avoid eating food; you need it to live. However, some foods are better for your well-being than others. Maybe you avoid dairy for the sake of your gut, or eat sugar in moderation so you won’t crash a few hours later.
Using that same frame of reference, if you live in the world with the rest of us, you likely can’t avoid sensory input (touch, smell, taste, etc…). However, some types of input might be better for your well-being than others. For example, unexpected touch might cause you to become over-stimulated or jumpy, while repetitive movement or sound may cause you to become under-stimulated or zoned out.
Therefore, just like a nutritionist might assist someone in choosing the right foods for their body, an occupational therapist can assist a parent in choosing the right sensory activities for their child.
How exactly does a sensory diet help?
It is important to note that a lot of children with sensory processing difficulties have huge peaks and valleys in their arousal levels on any given day. Over-excited and over-tired are not favorable places for their nervous systems to hang out. By engaging in regulating sensory activities throughout their day, or avoiding activities which send them into a dysregulated state, the child is better able to adapt to challenges and be more successful in their daily occupations.
Think about your own life – do you sit completely still in a meeting that has gone way too long? Or do you swing back in forth in your chair, bounce your leg up and down, or click your pen incessantly? Whatever you choose to keep yourself from dozing off in that super important meeting is your attempt at regulating your arousal level. Children simply don’t have as many choices or control in their little worlds as we adults do.
So instead of pen clicking, little Johnny might be climbing to the top of his bunk bed and free falling into a laundry pile. He needs a sensory diet of activities that provide the type of input his nervous system is seeking to become regulated, but in a much safer and structured way. That way, you might not have to discover a daredevil show staged in your child’s bedroom on a regular basis.
So what does it look like?
The interesting thing is that a sensory diet looks different to every therapist. It’s the beautiful and sometimes frustrating part of sensory integration theory in practice – everyone seems to have a slightly different interpretation.
I’ve seen detailed, hour by hour directions that look something like this:
8AM – 3 somersaults, 10 jumping jacks, 10 wall push-ups
9AM – Spin 10 times, crab walk, etc…
I’ve also seen general themes to guide the day, which may be as simple as a conversation with your therapist:
“He seems to do much better if you can do heavy work activities before you leave the house, and maybe incorporate messy play whenever you can…”
I dare say that one isn’t necessarily better than the other; more than anything, it has to do with what works for the family and parenting style. Some people are intimidated by long laundry lists of “things to do,” while others thrive on the structure. OTs should always be tailoring our treatment to the family we are working with.
There are programs such as The Alert Program: How Does Your Engine Run and Zones of Regulation which are designed to develop sensory diets and promote self-regulation in a progressive, structured way. My favorite part of programs like these is the fact that they give children and parents mutual vocabulary to talk about how a child is feeling in a given situation. Having a line of communication with your child about their sensory processing can be life changing.
Some therapists will also use specific protocols to develop sensory diet programs for children, using things like (get ready for some serious jargon right here…): Astronaut Training, Therapeutic Listening, Wilbarger brushing protocols, reflex integration, Bal-A-Vis-X, Brain Gym activities, I could go on… It depends on their training, their experiences, and their assessment of your child.
If you feel like you aren’t getting enough direction in your sensory diet, just straight up ask your therapist what you should be doing at home. Even if no one uses the term “sensory diet,” you can be collaborating on home program ideas which will assist your child in maintaining their optimal state of arousal.
What’s the end result?
Having a sensory diet allows you to better understand what your child needs in order to stay regulated throughout their day. It might even change your entire perspective on why your child is acting the way they are in certain difficult moments- Do they need more movement? Less auditory input? When you are able to become their sensory “detective,” life becomes much easier for everyone.
A rewarding scenario can be when a parent comes to a session and says something like, “I noticed he was getting restless in the grocery checkout line, and I did some joint compressions/offered him a fidget/let him push the cart, and he calmed right down.” This is such a better outcome than missing the signs, having the child become overstimulated, and going into total meltdown mode. That’s no fun for anyone.
Also, as your child engages in appropriate activities through their sensory diets, their bodies learn what “regulated” feels like, and hopefully they can gain a little more control over how they feel, and ultimately more independence in self-regulation.