#165 - A Deeper Look at Sensory Milestones & Red Flags to Note

by Jessica Hill, COTA/L & Rachel Harrington, COTA/L, AC August 11, 2021

#165 - A Deeper Look at Sensory Milestones & Red Flags to Note

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A Deeper Look at Sensory Milestones & Red Flags to Note 

The developmental milestones in the first 12 months of life are widely spoken about, but there are equally important, yet often overlooked sensory milestones to be aware of.

In today's informative episode, Jessica and Rachel explore the different sensory systems; auditory, visual, tactile, vestibular, and oral. We hear about the key developmental markers of each of these systems, along with some red flags to look out for. Jessica and Rachel also share some easy-to-implement activities for each of the sensory systems so that you can expose your baby to as much as possible early in life.

It can seem like there is an overwhelming amount to do and look out for, but these are all simple things which you can incorporate into your daily routine. Sensory processing and integration is such a critical part of daily functioning and overall well-being, which is why it is vital to ensure that you integrate a range of activities into your baby's life as early on as possible.  

Key Points From This Episode:

  • Developmental milestones are not the only important milestones.
  • What a sensory system is and how it impacts all aspects of our lives.
  • Why it is important to start sensory integration activities early on.
  • What the auditory system is and a look at how it develops over the first year of a baby's life.
  • Red flags when it comes to auditory system functioning.
  • Some auditory sensory integration activities to do in the first 12 months of a baby's life.
  • How the visual system develops over the first year and related red flags.
  • Activities to stimulate your baby's visual system.
  • The importance of exposing your baby to a variety of places.
  • What the tactile system is and the different milestones over the first 12 months.
  • Important tactile-related red flags to look out for.
  • Key activities you can do with your baby to help their tactile sensory system.
  • Insights into what the vestibular system is and the key milestones.
  • Vestibular system development red flags.
  • How to activate your baby's vestibular system.
  • A look at the oral system and the crucial developmental milestones.
  • Some activities you can incorporate into your baby's routine to help their oral system.
  • It is so beneficial to expose your baby to as many sensory activities as early on as possible.


“Developmental milestones are important, like rolling, crawling, walking, clapping, pointing, all those things, they’re all very important. But there’s more than just those motor milestones that are important to development.” — Jessica Hill[0:01:10]

“Kiddos will not tolerate new textures in their mouth unless they can tolerate it on their skin, on their hands. If we’ve got picky eaters, family is dealing with that, then take it back to messy play and help them process that input on their hands, and then work on the tactile processing in their mouth.” — Rachel Harrington[0:02:03

“Babies are designed to explore, and move, and to have those new experiences.” — Rachel Harrington[0:35:50]

“Being able to give your baby as much sensory experiences as possible is just going to be so beneficial as they grow older. Because they think, new sensory experiences can be scary at first. The older you get, the more likely you are to be afraid.” — Jessica Hill[0:43:26]

Links Mentioned in Today’s Episode:

STAR Institute

Advanced Brain Technologies



All Things Sensory on Instagram

All Things Sensory on Facebook


Full Show Transcript

[00:00:02] RH: Hey, there. I’m Rachel.


[00:00:03] JH: And I’m Jessica and this is All Things Sensory by Harkla. Together, we’re on a mission to help children, families, therapists, and educators live happy, healthy lives.


[00:00:13] RH: We dive into all things sensory, special needs, occupational therapy, parenting, self-care and so much more. In each episode, we share raw, honest, fun ideas and strategies for everyone to implement into daily life.


[00:00:26] JH: Thank you so much for joining us.




[00:00:31] RH: Hello, everyone. Welcome back to another episode of All Things Sensory by Harkla. This is Episode 165. You’re listening to Rachel and —


[00:00:42] JH: Jessica. We’re so happy that you’re here and we’re really excited to talk about this topic that we’re about to talk about.


[00:00:52] RH: Yes. It’s a little bit different. We are going to talk about sensory milestones and expectations based on ages. Most of you are familiar with developmental milestones, but not a lot of people talk about what to expect sensory wise at different ages and milestones. 


[00:01:10] JH: Right. Because developmental milestones are important like rolling, crawling, walking, clapping, pointing, all those things, they’re all very important. But there’s more than just those motor milestones that are important to development.


[00:01:28] RH: Yeah. If parents were aware of these sensory milestones and expectations to look for in the first year of life, what would happen?


[00:01:39] JH: I mean, everyone would just be probably, I don’t know.


[00:01:43] RH: I think people will just be more aware that they sensory systems.


[00:01:47] JH: Yes, there we go. Okay. Good call.


[00:01:50] RH: I think it would be so cool if people knew just how impactful the sensory system was. More than just playing in a ball pit, or getting messy or, I don’t know. What else is do people normally think of when they think of like sensory for babies?


[00:02:07] JH: I don’t know, because we do get a lot of questions about, “Oh! I love your page on Instagram, but what do I do with my baby, my infant?” We always say, “Do all of the same things. You just modify them, and down, and make sure they’re safe and they’re not eating all the little things.” But we all have sensory systems so it is a lot simpler to give babies sensory input than we think. We make it pretty complicated, but it’s actually pretty simple.


[00:02:34] RH: Yeah. Last month, we actually put in the Harkla Sensory Club, a sensory diet for babies. It was just six different simple activities to go through to give your baby sensory input throughout the day. It wasn’t specified to anyone specific. It was just if you have a baby, these are some activities, some general activities that you can try and that will be beneficial.


[00:02:58] JH: Yeah. Okay. Let’s talk a little bit more about the sensory system and what that is, what it means. We really like to STAR Institute. If you haven’t checked them out, get on line and just Google STAR Institute. But they talk about sensory processing and how we feel. It’s how we use what we sense to make sense of the world around us. Everyone has a sensory system. Everyone processes a sensory input. The sensory messages that we receive from our bodies and the world around us, we respond to those messages every single second that we’re alive.


[00:03:35] RH: Yeah. I just think it’s so interesting that people don’t realize that sensory processing and integration is foundational to development daily functioning skills, participation and activities, learning academics and just overall psychological well-being. I mean, that’s a lot. If we don’t have a functioning sensory system that is modulated, things are going to be wonky for us.


[00:04:04] JH: They’re going to be super wonky, which is what we see in our kids with sensory processing challenges. Their sensory systems are super wonky.


[00:04:13] RH: They’re wonky, yeah. That’s how we’re going to describe it today for layman’s terms.


[00:04:17] JH: Please don’t cancel us for using the word wonky. Thank you. Okay. Moving on.


[00:04:24] RH: Okay. Now that we kind of understand what exactly sensory processing is, what it looks like, let’s chat about why it’s important to start these sensory integration activities from the very start. 


[00:04:38] JH: Well, first, neurosensory development occurs while the baby is still in the womb. As they’re growing in the womb, they’re starting to hear sounds, they’re starting to move around, they’re experiencing a lot of vestibular input when their mom who’s carrying them is walking, and sitting and laying down. They’re already developing their sensory systems in the womb.


[00:05:06] RH: Yeah. Going along with that. They’re hearing noises and they’re feeling — you tap against your belly or someone else tap against your belly and they’re hearing fireworks going off and they are working on almost understanding the world from the inside out.


[00:05:23] JH: For sure. Then when a baby is born, they’re exposed to all this new sensory information, they’re exposed to gravity for the first time, to visual input, new tactile sensations, definitely new auditory sensations, because I’m sure that it sounds a lot different than in the womb. 


[00:05:41] RH: Yeah. New smells, new tastes, new reflexes. We’ve talked about reflexes a lot. But all of those experiences begin in utero. I think it’s important to realize that babies come from being upside down in the womb most of the time. When they come out and when they’re born, when they’re just placed on their back, when they’re just carried in one position, we’re not stimulating that vestibular system, for one, like they were in the womb. I think that’s one of the things we need to keep in mind is that, babies are getting sensory input within the womb so we need to continue with that once they’re born.


[00:06:26] JH: Yeah. When I think about it, I think about the first year of life and how much that first — how much is involved in that first year of life. Think of a baby who can’t even lift its head up when it’s born to by the first year of life, they’re probably walking, they’re probably starting to make a lot of noises, and babbling, and laughing and they’re coordinating their hands together, and potentially self-feeding. There is a lot that a baby learns how to do in those first 12 months. We have to think about their sensory system and how much their sensory development happens in that first year as well.


[00:07:06] RH: Absolutely. We did find an article that says how well documented that early childhood experiences for just crucial determinant of health, like Jessica said and identifying these sensory processing challenges as early as possible. And providing those appropriate interventions that influence the nature of the early childhood experiences can improve the developmental outcomes. We need to be targeting the sensory system in order to facilitate development, not just working on the physical milestones or cognitive milestones for that as well.


[00:07:48] JH: Well, I think when we target the sensory system, we’re inadvertently also going to target the motor system and the cognitive system, like it’s all connected. If we can just look at the sensory system, it’s going to expand and open up from there.


[00:08:02] RH: Absolutely!


[00:08:03] JH: All right.


[00:08:04] RH: Okay. Let’s break down each sensory system and chat about what you can see, what you can expect and then some — maybe just some red flags to look for.


[00:08:15] JH: And what you’re here for are the activities to do.


[00:08:21] RH: Bada bing bada boom.


[00:08:23] JH: Okay. The first one is going to be auditory, the auditory system. From birth to three months, a baby is going to prefer the sound of human voice. Their hearing is about the same as an adult, unless there’s an underlying medical, physical hearing condition. They’re going to recognize the voice of their primary caregiver and they’re going to start making cooing noise, maybe some other little baby, those cute little baby noises.


[00:08:53] RH: Grunts and silly things like that.


[00:08:55] JH: Yep. Then they’re also going to be startled by loud unexpected noises, which is related to the moro reflex.


[00:09:03] RH: So then, from three to six months, typically, we’ll see an understanding of tone of voice. They may start imitating sounds and noises they hear. They’re probably going to start understanding the words you say and they’re going to watch your mouth move as you talk.


[00:09:19] JH: Then those last six months from six to twelve months, they’re going to start understanding specific language and especially the word, “No.” They’re going to respond and turn their head to the sound of their name. They’re going to start their first word like mama, dada, baba, like those repetitive consonant vowel sounds. Then they might even start dancing to music.


[00:09:44] RH: I know Trip loves to dance right now.


[00:09:45] JH: As he should.


[00:09:47] RH: He’s so cute.


[00:09:48] JH: As he should. That’s all within the auditory system.


[00:09:52] RH: All right. So some red flags that we might want to keep an eye out for is, if your baby does not start turning their head when they hear noises. 


[00:10:01] JH: Another big one is that maybe they don’t seem to notice loud or unexpected noises. Maybe they don’t — maybe their moro reflex doesn’t kick in with a loud noise and they don’t startle to a loud noise.


[00:10:14] RH: Then if they can’t imitate noises, and watch your mouth, and try to move their mouth, and make noises and imitate your noises, that can also be something that we want to look.


[00:10:25] JH: Now, I think it’s important to remember that if you don’t see some of these things happening with your infant, that it’s a really good idea to get their hearing checked because that can identify any underlying cause. If their hearing test comes out that their hearing is normal or typical, there could be some sensory processing challenges related to the auditory system.


[00:10:48] RH: Maybe they hear a sound, but they have delayed response to turning their heads or it takes them a while to really imitate those noises, and maybe they struggle with processing what they’re hearing and then making an appropriate response.


[00:11:05] JH: Yeah, exactly. Some of our favorite activities to do with infants of all ages is going to be music. Listen to some music. Those can be your favorite rap songs. Those could be —


[00:11:19] RH: I like big butts and again out loud.


[00:11:22] JH: You know, I mean, babies love that song, okay. There’s proof on TV that babies love that song. If you don’t know what we’re talking about, I’m very sorry.


[00:11:30] RH: Oh, no!


[00:11:32] JH: But yeah, just music in general and dance to music, sing to music. Music is just such a great emotional connection activity, I feel like.


[00:11:42] RH: Going along with that, we love interactive songs. Any time that you can do hand motions, or finger motions or move their whole body, like going on a Bear Hunt or Itsy Bitsy Spider.


[00:12:01] JH: Wheels on the Bus.


[00:12:02] RH: All of those are fantastic so they can not only see you, but they can hear you and they can watch those movements and kind of recognize what’s expected and what’s coming.


[00:12:13] JH: Yeah. If you’ve been with us for a while, you know that we love the listening program by Advanced Brain Technologies. They do have a program for babies, so that can be something to check out as well.


[00:12:25] RH: Yep. We also love doing the metronome with babies. We’ll set this to the beat of mom’s heartbeat when they’re first born. Because if you think about it, and we just had George on the podcast talking about rhythms.


[00:12:39] JH: Which if you haven’t listened to that episode, you really should.


[00:12:42] RH: Yeah. And a while ago, we talked with April who shared about the interactive metronome and those benefits from the metronome as well. But we are all based on rhythm, and time and if the baby —


[00:12:54] JH: Yeah. Our heartbeat has a rhythm to it.


[00:12:55] RH: Yes. Babies in the womb can hear and feel that heartbeat and the blood whooshing around, and tapping and moving. That rhythm is just an innate part of babies, of development.


[00:13:11] JH: Of life even.


[00:13:11] RH: Survival, yeah. Setting the metronome either to 60 beats per minute or find out what your heart rate, moms, dads and turn it on to match the heartbeat as well.


[00:13:23] JH: Yeah. You don’t actually have to do like anything specific with the metronome. As the baby gets older and starts learning how to clap, you can start practicing clapping with the metronome. But just having that metronome on like Rachel said to the same rhythm as the heartbeat of the caregiver is just going to be really calling to that baby.


[00:13:40] RH: Yep.


[00:13:42] JH: All right.


[00:13:42] RH: The next thing you’re going to do is make noises around babe, like vacuuming, using the blender, sneezing.


[00:13:51] JH: We get a lot of people asking us how to help their children who have auditory sensitivities and who have meltdowns with these loud noises. They do think that these this starts in infancy of exposing your infant to these loud noises. 


[00:14:08] RH: Yes. I like to let baby know that it’s going to happen before it’s going to happen. They understand more than they can express. If I let them know, “Hey! I’m going to turn the vacuum on, it’s going to be loud.” Then, have them help, have them push the buttons with you, have them vacuum their legs up so they can have a funny reaction, and laugh, and smile and they can sense if you are uncomfortable or if you are afraid that they’re going to cry. They can sense that. Then you’re almost teaching them that —


[00:14:38] JH: It is scary.


[00:14:39] RH: Yeah. That they should be scared and it’s not a good noise.


[00:14:43] JH: I think also that you can expect a reaction, especially the first couple of times with these loud noises. Expect a negative reaction, but your response to that reaction is really going to help your child to provide an adaptive response the next time. “Oh! That was loud. Yeah, that scared you a little bit. Sometimes it scares me too. “But we need to blend our food. We need to vacuum and pick up the crumbs on the ground.” 


[00:15:09] RH: Yep. Then you move on.


[00:15:12] JH: All right. should we jump to the visual system?


[00:15:15] RH: Yes.


[00:15:16] JH: All right, let’s do it. 


[00:15:17] RH: Okay. Around one month, they can see about 12 inches in front of them. They enjoy looking at faces and they love those high contrast images, black and white pictures, things with a lot of contrast. They can see those the best.


[00:15:32] JH: By about two months, your baby can visually follow a toy when it’s moved slowly in front of their face. Now, I’m not saying like right, right in front of their face, but within 12 inches of their face.


[00:15:44] RH: By about three to four months, they are going to be able to focus on an object or on your face when you’re smiling, like one to two yards away. They can see a full range of colors at three to four months as well.


[00:15:58] JH: By seven to twelve months, their vision has pretty much fully developed. They’re making eye contact, they’re looking around their environment, especially looking at people, looking at moving objects, looking at things that make noise. 


[00:16:13] RH: Maybe they’re starting to point at objects that they see in their environment. Some red flags to be cautious of is when they are young, they’re not able to track objects or their eyes aren’t working together while you’re moving an object for them to track or they aren’t converging or bringing their eyes almost like cross eyed, when you’re bringing object closer to them.


[00:16:37] JH: One thing to really keep an eye on is the lazy eye, because this can be a sign of poor muscles in the eyes.


[00:16:46] RH: They might prefer fast motion or colorful TV shows, rather than just playing with blocks on the floor.


[00:16:55] JH: They might prefer looking at spinning items like fan, or wheels or they might intentionally spin things and just get like hyper focused on those spinning moving objects.


[00:17:08] RH:Now, keep in mind that it’s normal for babies to check these out and learn how things spin, how they move, and watch them and play with them. We’re saying a red flag could be when that’s all the child does. They don’t make eye contact, they don’t engage with you, they are just so focused on those fast motion TV shows, the sensory TV which is terrible.


[00:17:33] JH: Wait! What’s the sensory TV.


[00:17:35] RH: Oh! You don’t have a baby right now.


[00:17:36] JH: I don’t. What’s the sensory TV?


[00:17:38] RH: It’s like a black screen with like these vegetable characters that just like bounce and dance and move to music.


[00:17:46] JH: Why?


[00:17:46] RH: I don’t know. I don’t know who started it or why they started it. But they’re obviously marketing really well because people think that is beneficial for their babies and it’s not.


[00:17:57] JH: We do not recommend that, no.


[00:18:01] RH: Anyways, just note that if your child — like Trip right now, he’ll spin the wheels on this truck, he’ll watch the fan, but it’s not all the time. He can pull his attention away from it. He makes eye contact. I think it’s important to know that just because they’re learning about these things and engaging with them, it doesn’t necessarily mean that it’s a red flag, if it’s all-consuming.


[00:18:22] JH: Yes, that’s a really good point. I’m glad you brought that up.


[00:18:25] RH: Thanks. It helps having a kid right now in doing this episode.


[00:18:27] JH: Oh, for sure. For sure. Some of our favorite activities to stimulate and develop the visual system are those high contrast, black-and-white cards or books for the babies, I think Lovevery has a some really good ones.


[00:18:44] RH: Mirror play is great, grabbing a full-length mirror or just like a little baby mirror and putting those up, putting mirrors in the car. Mirrors are just great for everything, not just that visual system.


[00:18:55] JH: For sure. Reading books and specifically pointing and touching the items in the book while you’re reading. So, if it’s like a little farm animal book, you’re naming the cow while you point and touch to the cow. You do this enough times, baby is going to imitate you and also point and touch.


[00:19:14] RH: It’s almost like the normal things that you do as a parent, just modifying them and making a couple of changes to really target those sensory systems.


[00:19:22] JH: Yeah.


[00:19:22] RH: That’s what we’re teaching.


[00:19:23] JH: Yeah, that’s all we want.


[00:19:26] RH: Stacking blocks, doing puzzles, doing peg puzzles, whatever age your child is, modifying that, but modeling how to play with those activities will be really helpful.


[00:19:37] JH: This is probably I think one of the — this is what I think is one of the most important things for baby development, is going through your environment, going outside the grocery store, at home, in the car and pointing and naming objects in the environment. So that baby is learning about all the different things that are around them and they can also point and name objects in their environment to learn about them.


[00:20:06] RH: Yeah. Going along with that. The heck with the toys. We should just tell people, take your kids to the grocery store, to the hardware store, restaurants, just take your babies out so they can see everything. The world is a little over stimulating.


[00:20:23] JH: There’s a lot out there.


[00:20:24] RH: Yeah. Having them check the scene, and look at everything while they’re young, they’re going to learn to process and filter out unnecessary visual input that maybe isn’t important as they grow up.


[00:20:36] JH: Really quick before we move onto the next one. I just have to say, Rachel and Daniel did this so good and this is a great example. When we were in McCall a while back, and we went to a restaurant, we went to a brewery and we’re sitting there. Trip was kind of like in and out of his stroller while we were eating. You guys put him in his stroller for a couple of minutes while you’re eating, and he kind of starting to get upset. I don’t remember if it was your idea or Daniel’s idea. I’d be really proud of Daniel if that’s his idea. But I don’t remember. But you guys turned his stroller around so he was actually facing the restaurant, so that he could see the whole restaurant. He like calmed down and just like watched everything around him.


[00:21:14] RH: Yeah. I remember that.


[00:21:14] JH: It’s like just a simple trick, like you can go ahead and eat your dinner while baby is turned around watching the restaurant and everyone’s happy.


[00:21:24] RH: Yeah, I forgot about that. I’m glad you brought that up.


[00:21:25] JH: I don’t know why I remember that. I just remember it and I was like, “Dang! That was a great idea.”


[00:21:31] RH: Yeah. Thank you.


[00:21:33] JH: Will give Daniel credit for that one.


[00:21:34] RH: Okay. We could do it. He’s learning. He’s a sensory dad.


[00:21:38] JH: Yeah. He better be.



[00:21:39] RH: We just want to take a minute and talk to you about our company, Harkla. Our mission at Harkla is to help those with special needs special needs live happy healthy lives. Not only do we accomplish this through the podcast, but we also have therapy products, easy to follow digital courses and the Harkla Sensory Club to try to bring holistic care to you and your family.


[00:21:57] JH:Listeners of the All Things Sensory podcast get 10% off their first purchase at Harkla with a discount code, “Sensory.” We’d recommend checking out some of our best-sellers, like the compression sensory swing, weighted blankets or our course on sensory diets. 


[00:22:13] RH: Here’s the best part, 1% of each sale gets donated to the University of Washington Autism Center to support autism research and fund scholarships to families in need to receive in-clinic therapy for their child.


[00:22:24] JH: Learn more about Harkla and all we have to offer at harkla.co. Don’t forget to use the discount code “sensory” to get 10% off your first purchase. That’s S-E-N-S-O-R-Y for 10% off.


[00:22:46] RH: The best part is, all Harkla orders come with a lifetime guarantee and free shipping.


[00:22:53] JH: You really can’t beat that.


[00:22:54] RH: No.


[00:22:55] JH: No, you can’t. Okay. Let’s go back to the show.




[00:22:59] RH: All right. Let’s talk about the tactile system now. This is your sense of touch. You have tactile receptors all over your body, your skin, fingers, in your mouth, your head, your ears, your elbows, everywhere.


[00:23:11] JH: Everywhere. Babies are typically born with a pretty well developed tactile system already. Being able to tolerate touching things, tolerating different textures of clothing, different textures on the floor, people touching them, being held, being rocked, being squeezed and hugged. Yeah, I mean, we live in a very tactile world, because yeah, we’re always touching something and so babies are always, whether they have clothing on them, whether it’s just a diaper, whether they’re totally naked but they’re lying on the floor. Whether they’re in the water, always touching something.


[00:23:50] RH: I think that’s important to recognize, is that wearing clothes is a tactile activity in and of itself, because our bodies are made to be able to tune out that unnecessary input. Our body can say, “I’m wearing clothes. I’m safe. I don’t need to have a fight or flight reaction.”


[00:24:08] JH: So, I can focus on what else I need to focus on.


[00:24:10] RH: Exactly. But for kiddos who maybe struggle or adults who struggle with this tactile sense, making sure that they can tolerate clothing without having that adverse reaction. Some people, you put them in a shirt that has a tag on it and they can’t tune out the fact that tag is itching their back, and they can’t focus, they can’t learn, they can’t move, they can’t play. That’s like where tactile system came from. That’s what it was designed to do. When we have these red flags, that’s so important to keep in mind.


[00:24:42] JH: Yeah. That first red flag is going to be not being able to tolerate clothing.


[00:24:47] RH: Going along with that, avoidance of messy play. Whether they don’t like to get messy or whether they don’t have the opportunity to get messy. Two things to keep in mind. It is just so important to be able to tolerate getting messy. We’ve said this before, but kiddos will not tolerate new textures in their mouth unless they can tolerate on their skin, on their hands. If we’ve got picky eaters, family is dealing with that, then take it back to messy play and help them process that input on their hands, and then work on the tactile processing in their mouth.


[00:25:23] JH: Yeah, mic drop. Some other red flags for the tactile system might be, either your baby resists being held or they are only calm when they are being held. Those are both signs that there might be some tactile dysfunction.


[00:25:41] RH: These kiddos might be anxious or avoidant of crawling, or walking on different surfaces, different textures like grass and sand, concrete, hard floor, carpet. But again, I have to throw in my two sons, because I have a kid doing this right now. My little boy who’s ten months today actually.


[00:26:03] JH: Oh my gosh!


[00:26:04] RH: I know. He’s a crawling camp, but he will start to bear crawl, like Mowgli crawl as Samantha says.


[00:26:13] JH: Yeah, that monkey. Mowgli crawl.


[00:26:16] RH: If he’s on like a hard surface, or grass or sand. But eventually, once he modulates that input, he’ll go down onto his knees and he’ll crawl with hands and knees like we want.


[00:26:26] JH: Intent exposure, but we’re still talking about red flag.


[00:26:29] RH: Yes, okay.


[00:26:29] JH: The last one is going to be stress during bath time or significant adverse reactions with water splashing, water on their face. Those are also signs of tactile dysfunction.


[00:26:43] RH: Okay. Let’s do some activities.


[00:26:44] JH: The first one was exposure. Exposure, exposure, exposure.


[00:26:47] RH: All the textures you can and to their entire body, not just their hands.


[00:26:52] JH: Okay. Sensory bins, messy play. Do messy play with good items, like yogurt, apple sauce, that kind of stuff. Then also, do it with other items like shaving cream.


[00:27:03] RH: Easter grass.


[00:27:05] JH: Easter grass. Mud.


[00:27:07] RH: Water, ice cubes, grass.


[00:27:09] JH: Anything you can think of can be turned into messy play and a sensory bin.


[00:27:13] RH: Yep. Just go to the bulk section at a store like WinCo and grab some random things in bulk and make it into a sensory bin.


[00:27:22] JH: Yeah.


[00:27:23] RH: Okay. Deep touch massage. Babies love and are so calmed by massage. It’s not the type of input that is usually noxious to a sensory system for anyone.


[00:27:37] JH: Also doing play activities with light touch, so this is going to be like tickling with feathers, or light touch with different types of cloths, that kind of thing. This light touch activities really stimulate the tactile system.


[00:27:54] RH: But if your child is getting overstimulated by that light touch, which they probably will, follow that deep touch pressure, massage, those heavy work activities to help regulate their nervous system.


[00:28:05] JH: Yep. You mentioned this a little bit already, but messy play during feeding, don’t be afraid to let your baby get messy while they’re learning how to self-feed. That’s going to just help them have a better food rapport overall. 


[00:28:19] RH: During bath time or water play, if you go to the swimming pool, really work on improving tolerance of water being poured down over there head, or splashing, let them splash. We don’t want them to have an adverse reaction when water hits them in the face or when we’re washing their hair and water gets poured over their face. Which they will have a reaction, I mean, it’s kind of an uncomfortable thing, but just making sure that your reaction is calm and positive so they realize that it’s okay.


[00:28:52] JH: I mean, I do think, if your child is having a really significant reaction to this, you can try some strategies of like at least in the bath washing with a cloth, instead of splashing water. Or get like a bath visor that they can wear to keep the water out of their eyes.


[00:29:09] RH: Do they make bath visors?


[00:29:10] JH: Totally. Like the little plastic ones.


[00:29:13] RH: Oh!


[00:29:13] JH: Logan never liked taking a shower for a long time because he didn’t like the water in his face. We kept trying it and I helped him a lot. Now, he tolerates it. A big thing is just that consistent exposure.


[00:29:28] RH: Love that. Should we move on to the vestibular system.


[00:29:33] JH: I think this is my favorite system I have to say.


[00:29:34] RH: Yeah. All right. Zero to six months, let’s talk about how baby can sleep without being rocked, swung, bounce or just, they don’t require movement to be able to go to sleep.


[00:29:49] JH: Yep. They can tolerate car rides. They can tolerate you putting them in a baby carrier and walking around, so they can tolerate that movement.


[00:29:58] RH: They can also tolerate stroller rides. That’s a big one too and so good to get out for everyone’s sanity.


[00:30:06] JH: Yeah, that’s true. Also, between birth and six months, your baby is going to start rolling in both directions.


[00:30:15] RH: Yep. Not only from tummy to back and back to tummy, but rolling to their left and rolling to their right. Make sure you’re keeping track of as well. They’re going to tolerate being placed on their tummy, on their sides and on their back during play and during ADLs, like diaper changes, or getting dressed, or eating. You have to be tilted back to nurse or drink a bottle.


[00:30:41] JH: So then, between six and twelve months, your baby is going to start pushing up onto their arms while they’re on their tummy, as well as, will begin rocking in quad so that is on their hands and knees and kind of rocking back and forth. 


[00:30:57] RH: From there, they’ll begin crawling, army crawling, then they’re going to really perfect that crawling pattern with that asymmetrical left, right movement —


[00:31:07] JH: On their hands and knees.


[00:31:09] RH: Yes. It is not that perfect crawling pattern if they’ve got one leg up, if they keep their fingers flexed, curled. If they are externally rotating or internally rotating their wrists. If anything just doesn’t look right, then that is something to be aware of, which we’ll talk about.


[00:31:32] JH: Yeah. Between six to twelve months, they’re going to start tall kneeling, pulling to stand, cruising along furniture and then potentially walking. Some babies don’t walk by 12 months, but they should show these other signs of pre-walking.


[00:31:47] RH: Kind of going along with the tactile system, but babies will be able to tolerate tipping their head back in the bath tub. As they get a little bit older, they can tip their head back and they’re in control of their body. But with the vestibular system, it’s really just all about movements, and balance and visuals. Like it kind of brings everything together. What’s the word that I’m thinking of? Muscles tone, postural control. We want to see all of those skills start to develop.


[00:32:17] JH: Yeah. Kind of going along with that, we just listed off a whole bunch of typical developmental milestones, but we’re talking about the vestibular system and that’s because that vestibular system is related to movement and milestones. I mean, it’s all related. That’s why we mentioned those, because they’re part of the vestibular system.


[00:32:39] RH: Yep. All right. Some red flags for the vestibular system. We might see motion sickness, car sickness, severe adverse reactions during car rides. Cars are hard because there’s a lot going on, but if you can rule out some of the other challenges and recognize that it really is the movement from the car, then that could be related to the vestibular system.


[00:32:59] JH: Also, if your baby is unable to fall asleep and stay asleep without constant movement. 


[00:33:06] RH: If the child dislikes swings, so when they’re sitting up and you put them in the park swing, six to seven months and they are extremely uncomfortable. Not only the first time, because the first time, they might be a little bit uncomfortable and that’s expected. But if you continue to practice, and practice, and practice and they’re screaming and uncomfortable, clenching, that’s more of a red flag.


[00:33:28] JH:Yeah, for sure. If baby is not rolling by six to seven months.


[00:33:34] RH: Yep. If they are struggling to visually track items because that visual system is directly connected to the vestibular system.


[00:33:44] JH: And if there’s no eye contact, because again, like Rachel just said, vision is directly related to the vestibular system. 


[00:33:51] RH: Yeah. You can even see connections too with, if they’re not turning their head to a sound that they hear because they have to rotate, and move and follow that with the vestibular system with what they hear.


[00:34:04] JH: I’m just about to take a side note and say, if you’re a new listener and you’re, “What the heck is the vestibular system? I don’t understand.” The vestibular system is located in our inner ear canals, which is why it’s related to that head movement. But also, we do have a podcast on the vestibular system to explain it more, so go check that out.


[00:34:25] RH: We actually have a podcast on all of these sensory systems separated out. You can scroll back a few and find those and that will be helpful for you.


[00:34:34] JH: Okay. For your babies, what do you want to do to activate and help that vestibular system?


[00:34:42] RH: Play, move. 


[00:34:45] JH: Less container time and more floor play during waking hours.


[00:34:51] RH: Can we take a little side note and share the conversation that we had the other day about sensory seekers and babies and how we can see those sensory seeking behaviors in kiddos who aren’t in containers?


[00:35:03] JH: We can, but I don’t remember that conversation.


[00:35:05] RH: Really?


[00:35:06] JH: So, you have to just start.


[00:35:06] RH: I made it because I had it with my mom the other day too. Because she’s like, “Oh man! Trip is so busy.” I’m like, “Well, yeah. He’s never been contained. He’s never been in like a place structure where he can’t move and play. He’s always been on the floor. That’s where he’s happiest and he seeks that movement and that play because that’s what he knows.”


[00:35:25] JH: I think Logan is the same way, because we really didn’t have containers. We also didn’t have like — we have like a little play pen, but mostly, we just like — once he started crawling, we would like block off the living room with furniture and that was his play area.


[00:35:38] RH: Yeah, exactly.


[00:35:41] JH: Yeah, you’re right though. It does make it seem like he’s a sensory seeker, which maybe he is in a sense, but he’s very self-regulated.


[00:35:50] RH: Yeah. Babies are designed to explore, and move, and to have those knew experiences. If that means new movement experiences, new climbing, new jumping, new crawling, I think that — I just think that’s interesting.


[00:36:07] JH: I just had a thought too. When you’re sitting down whether it’s on the couch, or sitting at a desk for a long period of time and then you stand up and you have to like stretch. Think about a baby who’s in a container for hours at a time, and then you try to put them on the floor and their body is stiff and cold and they don’t know how to move because they haven’t had enough experience yet. It’s the same thing. We need to give them that movements.


[00:36:33] RH: Absolutely.


[00:36:36] JH: [Inaudible 00:36:36].


[00:36:36] RH: Yep. Some more activities. Movement that is outside of like a baby swing, like that continuous linear swinging from baby swings. Things like rocking, and bouncing and using a baby carrier, like a baby wearing device versus like putting them in a container to provide more natural vestibular input.


[00:36:59] JH: Swings are great, but you do want to make sure that your baby has a full head control before you swing them. Always start slow with swings first.


[00:37:09] RH: Yes. I even like to wait to do swings until the child is sitting up on their own unassisted for a few seconds at a time.


[00:37:19] JH: Yeah, totally. But you can always swing with your baby. You can put your baby in your lap while you swing and give them that same movement.


[00:37:26] RH: Totally.


[00:37:29] JH: Okay.


[00:37:29] RH: Tummy time, on the therapy ball, laying over the therapy on their back, getting their head into those different positions is going to be fantastic to not only help with things like the diaper change, and car rides, but just working on integrating that vestibular system.


[00:37:43] JH: Then, you know, kind of the same thing with the swing. Once the baby has head control and is able to sit upright, you can position your baby on sitting on the ball and do some bouncing.


[00:37:56] RH: All right. Oh! One more.


[00:37:58] JH: I mean, that goes along with all the other things you said, I suppose.


[00:38:01] RH: All right. That is all for the vestibular system. Let’s do the last one that we have here today, which is the oral system or the gustatory system.


[00:38:12] JH: This is going to go along with oral motor and taste I feel like.


[00:38:17] RH: Even olfactory, sense of smell. I mean, they’re all super connected. You can’t eat a good without smelling it.


[00:38:23] JH: That’s so true. From birth to three months, oral motor input is calming to a baby. You think about the sucking that they do to feed, and that sucking is very calming.


[00:38:36] RH: Baby has reflexes to protect their airway. They also have a rooting reflex, which is stimulation to the side of their cheek. They’re going to turn their head and they’re going to try to eat. 


[00:38:49] JH: That’s a great example. I was picturing my head while you’re doing it.


[00:38:51] RH: Great. 


[00:38:51] JH: Then at this age, they also have the suck, swallow, breathe reflex which aids them in feeding.


[00:38:59] RH: Yep. From three to six months, baby will bring their hands and objects to their mouth to chew on them, teeth, suck on them, whatever they want to do.


[00:39:08] JH: Now, this is really important because this is a big developmental milestone of how babies learn about objects in their environment. I mean, this is a premature red flag, but if your baby is not mouthing objects, that’s a sign that there could be some sensory challenges.


[00:39:25] RH: They might become more interested in food that others are eating around this age as well.


[00:39:33] JH: Then they might start eating purées. We always want to make sure that your baby has full head control, full trunk control. They’re able to sit up on their own before we start giving them solids. But some babies are ready by six months. 


[00:39:48] RH: From six to twelve months, we’re going to see the baby eating a variety of flavors and textures and they should gag to protect their airway when they have new flavors and new textures in their mouth. 


[00:39:59] JH: This is huge. Gagging is a normal part of baby development. 


[00:40:03] RH: Even though it’s scary as shit.


[00:40:06] JH: Yeah. I think — I remember with Logan, we had to really differentiate gagging from chocking, because there is a big difference. When a child gags, you don’t want to have a big reaction versus if they’re actually choking. Go ahead and have a big reaction. You know what I mean? 


[00:40:23] RH: Yeah.


[00:40:23] JH: It is important to maybe do a little research to understand the differences.


[00:40:27] RH: Yeah. Also, at six to twelve months, they’re going to be drinking from an open cup, then transitioning to a straw cup and working on both of those skills.


[00:40:37] JH: Red flags like I said a little bit ago. They’re not mouthing items. They’re not mouthing their hands.


[00:40:46] RH: They continue to gag or vomit with solids after continuous trials. The gagging is expected with novel taste and textures, but they should get used to it with more trials and more practice.


[00:40:59] JH: I think also, some more red flags from this area is going to be, not wanting to get messy, not wanting to try new foods, goes right along with the tactile system.


[00:41:09] RH: This age, this six to twelve-month age, baby should be trying everything. They should be open to trying everything. It isn’t until after that that we start to see some like — I don’t’ want to say picking. I don’t think we need to define our kids as picky eaters. I think we need to realize that they’re changing and they’re learning what they enjoy and what they don’t.


[00:41:30] JH: Yeah. I don’t know if we talked about this in a previous episode. We might have, but there is pretty normal typical response with young children, with toddlers, where they may seem picky and it really is just related to the fact that they’re asserting their independence. It’s normal for that age. Anyways.


[00:41:51] RH: Okay. Let’s talk about some activities from the time you bring baby home, get inside of their mouth with your fingers as they get a little bit older, using vibration like the Z vibe. Just work on letting them realize that it’s okay to have these novel textures and things in their mouth and kind of help prepare them for the next sensory milestones to come.


[00:42:14] JH: Yeah. You can make popsicles out of formula or breast milk, whatever they’re eating and that can be a new oral motor experience.


[00:42:23] RH: Yeah. Long teethers that they can nod own and practice chewing are really helpful.


[00:42:29] JH: Blowing bubbles and blowing through straws is a great game for those older babies as they’re getting closer to that 12-month age. 


[00:42:37] RH: Imitating silly faces and exaggerating those mouth movements while talking, and singing, and making faces. That’s super fun and helpful for oral motor development, like sticking out your tongue, or pushing your tongue to your cheek, or flowing raspberries, some things like that.


[00:42:53] JH: Yeah, just as much as movement with your mouth as you can that they’re going to be able to imitate and make it into a game. 


[00:43:01] RH: Yep. Of course, if you have concerns about any of these things that we talked about, anything else that you have, always talk with your pediatrician, ask for an OT referral if you really feel the need, if you want to rule it out. We always say, early intervention is key. The research says that’s not just us.


[00:43:25] JH: That’s so true. I think, being able to give your baby as much sensory experiences as possible is just going to be so beneficial as they grow older. Because they think, new sensory experiences can be scary at first. The older you get, the more likely you are to be afraid. When you think about us as adults, we know the consequences that could happen from like jumping out of a plane, so we’re probably less likely to do it in someone who’s younger, that maybe can’t visualize the potential consequences. But that’s a really weird example.


[00:44:03] RH: I was thinking of like a roller coaster.


[00:44:04] JH: Yeah, that too. Sure.


[00:44:07] RH: Anyways —


[00:44:09] JH: Anyways, this is kind of a longer episode.


[00:44:13] RH: It was. If you have questions, don’t hesitate to reach out. If you love this episode and it was helpful for you, then take a screenshot and share it on social media at All Things Sensory podcast. We’d love to know your thoughts and if you have questions, we’re here for you.


[00:44:29] JH:All right you guys, we will talk to you next week.


[00:44:31] RH: Okay. Bye. 


[00:44:32] RH: Thank you so much for listening to All Thing Sensory by Harka. If you want more information on anything we mentioned in the show, head over to harkla.co/podcast to get all of the show notes. 


[00:44:44] JH:We always have the show notes and links, plus full transcripts to make following along as easy as possible for everyone. If you have followed up questions, the best place to ask those is in the comments on the show notes or message us on our Instagram account, which is at @harkla_family. If you just search Harkla, you’ll find us.


[00:45:03] RH:Like we mentioned before, our podcast listeners get 10% off their first order at Harkla, whether it’s for one of our digital courses, one of our sensory swings, the discount code SENSORY will save you 10%. That code is S-E-N-S-O-R-Y. Head over to harkla.co/sensory to use that code right now so you don’t forget.


[00:45:26] JH:We’re so excited to work together to help create confident kids all over the world and work towards a happier healthier life.


[00:45:33] RH: All right. We’ll talk to you guys next week.


Just a friendly reminder, this is general information related to occupational therapy, pediatrics and sensory integration. We do not know you or your child, therefore, we do not know any specific needs. Therefore, you should always refer back to your pediatrician and occupational therapist for mor information.




While we make every effort to share correct information, we are still learning. We will double check all of our facts but realize that medicine is a constantly changing science and art. One doctor / therapist may have a different way of doing things from another. We are simply presenting our views and opinions on how to address common sensory challenges, health related difficulties and what we have found to be beneficial that will be as evidenced based as possible. By listening to this podcast, you agree not to use this podcast as medical advice to treat any medical condition in either yourself or your children. Consult your child’s pediatrician/ therapist for any medical issues that he or she may be having. This entire disclaimer also applies to any guests or contributors to the podcast. Under no circumstances shall Rachel Harrington, Harkla, Jessica Hill, or any guests or contributors to the podcast, as well as any employees, associates, or affiliates of Harkla, be responsible for damages arising from use of the podcast.

Keep in mind that we may receive commissions when you click our links and make purchases. However, this does not impact our reviews and comparisons. We try our best to keep things fair and balanced, in order to help you make the best choice for you.

This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing “standard of care” in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast.

Jessica Hill, COTA/L & Rachel Harrington, COTA/L, AC
Jessica Hill, COTA/L & Rachel Harrington, COTA/L, AC

Rachel Harrington, COTA/l, AC, CPRCS, and Jessica Hill, COTA/L, CPRCS are Harkla's in-house Certified Occupational Therapy Assistants (COTA) and Certified Primitive Reflex Clinical Specialists. They have been working with children for over 6 years in outpatient settings. They specialize in creating easy-to-digest, actionable content that families can use to help their child's progress at home. Jessica and Rachel are the in-house experts, content creators, and podcast hosts at Harkla! To learn more about Jessica and Rachel, visit the Harkla About Us Page. Make sure to listen to their weekly podcast, All Things Sensory by Harkla for actionable, fun advice on child development.

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