#173 - What is Overflow and Why is it Important to Know About?

by Jessica Hill, COTA/L & Rachel Harrington, COTA/L, AC October 06, 2021 1 Comment

#173 - What is Overflow and Why is it Important to Know About?

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What is Overflow and Why is it Important to Know About? 

Have you ever found yourself sticking your tongue out while concentrating on an activity, like cutting something out or backing up your car? That’s called overflow, or overflow-associated movements. Although many of us do it, sometimes overflow can be a cause for concern. In today’s episode, Jessica and Rachel define what overflow is and give some examples of how it can present itself. We hear about when this would be visible during an OT session, along with what some red flags would be. Overflow itself isn’t an issue, but it can be, depending on the underlying cause. We also discuss how to help children with overflow. Wrapping up, we begin the new Q&A segment of our show, where we answer two listener questions. Tune in to hear it all!

Key Points From This Episode:

  • Defining overflow and examples of how this can manifest itself.

  • Overflow is normal and it is a part of the development process.

  • If you don’t see some overflow during infancy, that might also be cause for concern.

  • Some of what we might see during an OT session during fine and gross motor activities.

  • Who struggles with overflow and the reasons they have difficulties.

  • What you can do to help children who display overflow when they shouldn’t be.

  • Tricks for children who hate having their faces wiped. 

  • How to help children who have meltdowns when they get home after school.


“Motor overflow refers to the involuntary movements which may accompany the production of voluntary movements.” — Jessica Hill[0:02:03]

“I love it when the research backs what we see.” — Rachel Harrington[0:11:59]

“The more the child exerts to complete a task, the more overflow associated movements will be present.” — Rachel Harrington[0:14:18]

Links Mentioned in Today’s Episode:


All Things Sensory on Instagram

All Things Sensory on Facebook

Primitive Reflex Integration Training

Check out our video about Motor Overflow! 

Full Show Transcript 

[00:00:01] RH: Hey, there. I’m Rachel.


[00:00:02] JH: I’m Jessica. This is All Things Sensory by Harkla. Together, we’re on a mission to help children, families, therapists and educators live happy, healthy lives.


[00:00:11] RH: We dive into All Things Sensory special needs, occupational therapy, parenting, self-care much more. In each episode, we share raw, honest, fun ideas and strategies for everyone to implement into daily life.


[00:00:25] JH: Thank you so much for joining us.




[00:00:31] RH: Hey, hey, hey, everyone. We are back. We are excited to talk about a very unique topic today. I'm Rachel.


[00:00:42] JH: I'm Jessica. Yeah, we're talking about something that I feel there's not a lot of good information about this topic out there.


[00:00:51] RH: No, but it's something that we see clinically a lot.


[00:00:56] JH: We've talked about it on previous podcast. Just mentioned it. Then, we've also mentioned it on our Instagram before as well. If you're a therapist, this is going to be really great. If you're a parent, I mean, it's really great for everyone.


[00:01:11] RH: It’s great for everyone. Yes.


[00:01:14] JH: It's good to hear here. Today, we are talking about overflow, or overflow associated movements. We're going to break down what exactly it is, why it's important to recognize it, when it's normal, when it's a red flag, when we need to look into it, when it could be dysfunction. Then we're going to give you some strategies, of course, to work through overflow if it is a challenge. Stay with us, because we're going to give it all to you today.


[00:01:45] RH: Yeah. We'll start with defining what overflow is. We'll also link all of our resources in the show notes, so that you can read the full articles where we got a lot of this information.


[00:01:57] JH: Yeah. We found some great research articles, too.


[00:02:00] RH: All the good ones. Motor overflow refers to the involuntary movements, which may accompany their production of voluntary movements. While overflow is not usually seen in the normal population, it does present in children and the elderly, as well as those suffering certain neurological dysfunctions.


[00:02:21] JH: Age inappropriate overflow movements, for example, near movements. If you move one hand in a certain way, your opposite hand is going to mirror that movement. These are motor signs, thought to reflect immaturity in cortical systems involved in automatically inhibiting extraneous movement. That's very scientific, but we’re going to break it down.


[00:02:45] RH: So technical. Basically, going with those two definitions that we just talked about, I think you mentioned, if you're moving one hand and doing something on purpose with one hand, and you see overflow associated movements with the other hand that are not on purpose, that's what we're talking about.


[00:03:04] JH: Do you guys remember when we talked about the Chinese Baoding balls in your hands –


[00:03:09] RH: I love those.


[00:03:10] JH: - where you’re doing the in-hand manipulation. You're making those two balls go in a circle in your hand?


[00:03:16] RH: We did that. We talked about that on our palmar grasp reflex episode.


[00:03:20] JH: Yup. We have an Instagram video, so you can see that. That is what we're talking about. That's just a quick example of overflow, when, I think, you were doing in the video, but you're trying to move those balls in a circle. Then, your other hand is moving in the same pattern, because you're concentrating so hard on those movements in your right hand, that it's overflowing into that left hand as well. Maybe the mouth as well.


[00:03:44] RH: Yeah, that's the other part of it, is we see a lot of overflow into the oral structures, the lips, the jaw, the tongue, and even the eyes, you'll see, it sometimes too. Hopefully, that all makes sense.


[00:04:00] JH: I think, it's important to note that overflow is normal and it's a natural part of the developmental process. In infants and babies, we see overflow into the hands and mouth during feeding, sucking, which is a good sign that their brain and body are working together.


[00:04:15] RH: Yeah. Those are actually related to primitive reflexes. That's related to the Palmer grasp reflex, and then the sucking and rooting reflex as well. If you don't see that overflow in infants during feeding, that can actually be a sign of dysfunction as well, if you don't see the overflow that's normal at that time.


[00:04:37] JH: That overflow in infants and toddlers is normal and a natural part of that developmental process. Like we said, it helps these children learn how to meet those developmental milestones, like rolling side to side, front to back, crawling in a good crawling pattern, walking, manipulating objects with their hands. I mean, right now, Trip is a year old when we’re recording this.


[00:05:00] RH: Oh, my gosh. She's a year old.


[00:05:01] JH: I know.


[00:05:02] RH: I can't even handle it. If you've been here for a while. Do you remember when we would record episodes before Trip?


[00:05:09] JH: Yeah, it was crazy.


[00:05:10] RH: Oh, my gosh.


[00:05:12] JH: Anyways, he will shake a toy and make noise and his other hand is shaking, too. He can't disassociate his left from his right yet to be able to shake an object, or pick up a bean off the floor, because his other hand mimics that. It mirrors that same pattern, which is normal.


[00:05:35] RH: For this age. Yeah. What happens if these overflow associated movements continue as the child ages? It can be a sign of dysfunction.


[00:05:48] JH: Yes. Let's talk a little bit about what we see during an OT session, if we were working with a kiddo during let's say, a fine motor task. Let's say, the child is completing something like, writing, or cutting, or stringing beads, and we'll see them pushing their tongue into their cheek, moving their lips, sticking their tongue out, sometimes, cutting. Oftentimes, we'll see the mouth open and shut with the scissors opening and shutting. That's a big one.


[00:06:20] RH: A lot of times, too, with these fine motor tasks, if the child is so focused with using their dominant hand, then their non-dominant hand might also have some movement associated there.


[00:06:32] JH: That's why we like to make sure the opposite hand is stabilizing whatever they're working on. We like to make sure that the opposite hand has a functional task, which we will talk about in our strategy section later on.


[00:06:46] RH: Then, we're also going to see some overflow during certain gross motor activities. If a child is completing a balance beam, or trying to coordinate their upper body, or lower body movements, we might see that similar overflow into their mouth, like we just talked about with fine motor tasks. Then, we might see overflow into other parts of the body. That's just their brain and body's inability to separate those movements apart.


[00:07:18] JH: You know what, what I'm thinking of right now?


[00:07:20] RH: Which one?


[00:07:21] JH: You know the snowball maker, the open and shut.


[00:07:23] RH: I love the snowball maker.


[00:07:25] JH: Yes. That is a little handheld device that you grab the handles. You can get them in the grocery store during the winter seasons, but you open it, and it closes to make the snowball. We would to transfer objects. I remember so many kiddos opening that and trying to work so hard to open and close to pick up objects that their mouths would just be opening and closing and opening and closing. It took so much effort, and so much concentration that almost every kiddo had some overflow.


[00:07:57] RH: Another time we're going to see these overflow movements is during primitive reflex activities. We might see it during duck, or pigeon walking. That's where you're going to walk with either your toes pointed out, or your toes pointed in. You're going to see associated movements in the hands, arms and typically, the mouth.


[00:08:20] JH: You'll also see some overflow with the Superman banana exercises for the tonic Labyrinth dye and reflex, as well as lizard crawls, which we like to do for the ATNR, the Asymmetric Tonic Neck Reflex. Those ones, you can help work through and we'll talk about our strategies. We just want to bring that awareness of those permanent reflexes, those exercises take a ton of concentration and a lot of work to do, especially for those who have severely retained reflexes. We want to be cautious of that.


[00:08:54] RH: One other time that we'll see these overflow movements in, say an OT session are during any activity that requires a significant amount of focus, or skills that are beyond the child's current level. Now, that's not to say that an eight-year-old, who should be able to cut, it's more like, an eight-year-old who developmentally is at a four-year-old level and is just learning to cut. That's what I mean by that.


[00:09:24] JH: Yeah. Some games like suspend, which is a balancing game. Dribbling a ball is a big one. Stacking blocks, if it's a really challenging activity for a young kiddo. Swinging on a platform swing, while you're trying to clip a toy onto a rope. Those types of activities that require the multi-sensory processing aspect as well. We can see a lot of overflow there.


[00:09:46] RH: Yup. I think, the one that comes to mind the most for me is the tongue sticking out, or the tongue in the cheek during a really, really focused activity.


[00:09:59] JH: Let's talk about who struggles with associated movements and why. This is where we found some research to back this and explain it a little bit more, because sometimes it's unclear. We're going to break it down, explain this a little bit more in detail to help you understand why and who are struggling with these overflow movements.


[00:10:24] RH: Okay, so the first one, overflow is observed in people with neurological impairments, and in healthy children and adults during strenuous and attention demanding tasks. In this particular study, they found that young infants produce vast amounts of motor overflow, which we talked about, that's normal. Then, while manipulating an object with one hand, all of these typically developing for seven-and-a-half-month-old infants were observed to display these overflow movements with their free hand. Just like we just talked about, it's normal. It's a part of the developmental process for these infants and young children, these toddlers to have a lot of overflow when they're doing these activities.


[00:11:12] JH: It should go away.


[00:11:13] RH: Exactly.


[00:11:15] JH: Another research article that we found shows that children with ADHD showed significantly more overflow movements. ADHD is –


[00:11:24] RH: A neurological condition.


[00:11:28] JH: Yeah, absolutely.


[00:11:28] RH: Okay. This next one that talks about theories on overflow movements consistently implicate impairments in the white matter tracks, including the corpus callosum. The white matter connections in the brain might be altered, and thus, influence motor behaviors. Again, it's such a neurological connection, when we're talking about these overflow movements.


[00:11:57] JH: So interesting. I love it when the research backs what we see. It's just so cool. Thank, goodness. That's the beauty of OT.


[00:12:06] RH: Quick side note, all of our fellow OTs and OTAs are going to love this, because what we do needs to have that research behind it, that evidence-based practice. Here we are.


[00:12:17] JH: Here we are. Yes.


[00:12:19] RH: Okay. Moving on.


[00:12:19] JH: Another one said, the frequency of associated movements has been reported to decrease with age, but can be seen in adults under stress, extreme force and fatigue.


[00:12:31] RH: I will say that I noticed myself having a little bit of overflow sometimes if I'm really, really focused.


[00:12:37] JH: Me too. I'm aware of it, so I will consciously try to not have the overflow.


[00:12:45] RH: At least not so much.


[00:12:47] JH: Yes. Yes. It's so funny, because people who aren't aware of overflow will say, “Oh, it's so funny. I stuck my tongue out as a kid when I was doing this, this and this.” Us, we're like, “Oh, we got some overflow going on.”


[00:13:04] RH: Let's give you some ideas.


[00:13:05] JH: Let’s dive deeper into that. To the typical population, you're not going to realize that it could be a negative thing. You just think it's funny.


[00:13:14] RH: Yeah, for sure. Okay, got a little bit more here. In another study, they found that in the elderly and the neurologically impaired, changes in brain function produce these overflow movements. Inhibitory signals in the motor cortical are reduced and ineffective in controlling the specificity of commands going to each limb, and then deficits in the corpus callosum. Other parts of the brain tracks have been implicated in motor overflow. It's just backing up the other research articles saying that, if you're seeing these overflow movements in older children and adults, there's something going on in the brain, for those listening.


[00:14:01] JH: Yes. I will say, I thought it was interesting that in ages three to six, the overflow was noted more in the extensor muscles. From ages seven to 11, the overflow was more pronounced in the flexors.


[00:14:14] RH: That's weird.


[00:14:17] JH: Yeah. The more the child exerts to complete a task, the more overflow associated movements that will be present. Crazy.


[00:14:25] RH: So interesting. If your child is exhibiting these overflow movements, and they're at an age where they shouldn't be, where those associated movements should be gone, and they should be able to control those movements. Or if you're a therapist, and you're working with these kids, you have tons of overflow. Let's talk about what you can do.


[00:14:49] JH: That's why you’re all here.


[00:14:51] RH: Favorite part of the episode.




[00:14:53] RH: Okay. We just want to take a minute and talk to you about our company, Harkla.


[00:14:57] JH: Our mission at Harkla is to help those with special needs live happy, healthy lives. Not only do we accomplish this through the podcast, but we also have therapy products, digital courses and a ton of free resources on YouTube and our website to try to bring holistic care to you and your family.


[00:15:14] RH: Listeners of the All Things Sensory Podcast get 10% off their first purchase at Harkla, with the discount code Sensory.


[00:15:22] JH: We would highly recommend checking out some of our bestsellers, like the compression sensory swing, the weighted blankets, and of course, our course on sensory diets and primitive reflexes.


[00:15:32] RH: The cool thing is that 1% of each sale gets donated to the University of Washington Autism Center to support autism research and fund scholarships for families in need to receive in-clinic therapy for their child.


[00:15:45] JH: Learn more about Harkla, and all we have to offer at harkla.co. That's H-A-R-K-L-A.C-O. Use the code Sensory to get 10% off your first purchase. That's S-E-N-S-O-R-Y for 10% off. Don’t forget that our Harkla orders come with a lifetime guarantee and free shipping.


[00:16:09] RH: All right. Let's get back to the show.




[00:16:12] RH: Let's discuss what you're going to do if your kiddo is above the average age where they shouldn't be presenting with overflow associated movements, what should you do?


[00:16:22] JH: First, you want to do these activities more often. One of the reasons they're exhibiting this overflow is because their brain is not processing the information. You need to do these challenging activities, or exercises on a more regular basis.


[00:16:39] RH: Another trick we like to do is to provide video feedback. It's simply just taking a video of the kiddos, while they're doing these activities. I personally don't like to bring it to their attention. I like to take a video and then have the kiddo watch the video back with me. I like to see if they can identify what's going on. I'm not necessarily pointing out, “Look at your other hand, look at your tongue. You have overflow.” It's more like, “What do you notice? Why do you feel like you're doing that? Why is your tongue sticking out? Shall we try pushing your tongue to the roof of your mouth next time? Is that an expected behavior to have your tongue sticking out in the middle of class?” Things like that, we all play detective and let them help work through it after they watch their video.


[00:17:28] JH: Another trick is if you're noticing overflow in the opposite hand during the functional fine motor task, give that other hand something to do. That could be squeezing a stress ball, or putting your hands on your hips, if you're doing a duck or pigeon walk. If you give that body part something else to do, it will decrease that overflow and help dissociate those movements.


[00:17:57] RH: Like we were talking about earlier with cutting, stabilizing the paper with the opposite hand, well, throwing, holding that paper so it's not moving and chewing gum, or pushing your tongue to the roof of the mouth. Those proprioceptive-based activities are really helpful as well.


[00:18:15] JH: Yeah. A big one is integrating those primitive reflexes. If the primitive reflexes are retained, or still in the body, then the body is not going to dissociate certain movement patterns in certain sides of the body. We need to get those primitive reflexes integrated, so that new neural pathways are created and the body can move freely with more control.


[00:18:42] RH: Yoga moves are great. Rock climbing is great. Those types of activities that really work on disassociating, left and right, top and bottom, they take a lot of strength and control and balance. Those activities are going to be great to practice.


[00:18:59] JH: As always, we recommend working with an occupational therapist, or occupational therapy assistant, who is trained in sensory integration and primitive reflex integration, because they are going to have some great strategies for overflow and some good ideas for parents to take home, or for educators to use in the schools.


[00:19:18] RH: Absolutely. Make sure you check out our primitive reflex digital course. We do have a course that goes into detail testing primitive reflexes, five of the most common ones, as well as activities, functional activities and exercises to work towards integration.


[00:19:35] JH: Yeah, and then listen to some of our previous podcast episodes on primitive reflexes. We mentioned the Palmer grasp reflex episode, where we talked about overflow when we're doing fine motor activities and how it's related to that primitive reflex.


[00:19:50] RH: Okay. That wraps up our episode on overflow associated movement.


[00:19:54] JH: But don't leave yet.


[00:19:55] RH: Because we are doing something new. We are opening up a Q&A session at the end of every podcast episode now. That means that you can send us your questions via DM on Instagram, voice message on Instagram, email, Facebook, however you want to contact us. Send us your questions and we are going to do just a quick Q&A at the end of our episodes.


[00:20:23] JH: Okay, so let's do it. We're going to answer two questions today. The first question is, what are some tricks for a child who hates having their face white? Now, let me tell you what Rachel's response was read this question and put it in this episode. Her response was all kids hate having their face wiped.


[00:20:46] RH: Yeah. I will say, I was literally wiping Trip’s face this morning, or trying to wipe his nose this morning. He hates it.


[00:20:54] JH: He's, what? 12 months?


[00:20:55] RH: Yeah.


[00:20:56] JH: I think that's a good point is that infants and especially as they're starting to assert independence at this 12, between, basically, one and four years.


[00:21:09] RH: I have long ways to go.


[00:21:10] JH: As we grow. They're probably not going to having their face wiped, because one, it's not their choice. Two, it probably stops them from doing whatever it is they were doing before. If we're talking about from a sensory perspective, a child who struggles with tactile processing, and hates the texture, and the feel of their face being wiped, that's a different story.


[00:21:30] RH: Here's my thoughts. First of all, how would you like it, if someone came at you with a wipe and pulled on your nose and wiped on your face and you don't know how hard it is that how hard they're pushing? I never want to – I just think, just empathize. Think about how uncomfortable that is. Maybe we should try it and see how we like. Okay, it's terrible.


Number two, have the kiddo practice wiping their own face. Teach them to do it themselves. I will hand Trip a wet wipe and have him practice. Why, because he imitates me. He practices. He does it himself. Is it great? No. Do they try? Yes. That's fine.


[00:22:13] JH: Use a mirror.


[00:22:14] RH: Throw a mirror in front of the kiddos they can see.


[00:22:17] JH: Give them some warning. Let them know, “Hey, you have jelly on your face. Let's clean it off,” and give them the opportunity, like Rachel said, to wipe it themselves. Then maybe you help.


[00:22:32] RH: Go to the sink and have them – get their hands wet and then wash their face, or wash their nose, and then dry it with a towel.


[00:22:41] JH: Try maybe some different types of material for wiping. Instead of a washcloth, use a wet wipe, or use a wet paper towel, or something that's really, really soft.


[00:22:54] RH: Or maybe dry.


[00:22:54] JH: Or something dry.


[00:22:55] RH: A tissue. A dry tissue, a dry towel. Try those different textures.


[00:23:00] JH: I think the biggest thing here is to empathize and try a new way of approaching it. Make it positive, make it fun. I think using a mirror is going to be really, really beneficial in this case.


[00:23:10] RH: Then, let them wipe your nose and wipe your face to reverse the roles. Or let them wipe your face first, then you say, “All right, my turn to wipe yours.”


[00:23:20] JH: Especially if this is during mealtime, chances are you're probably wiping your face during mealtime, so take turns.


[00:23:25] RH: Yeah. All right. There you go. Lots of ideas for that one. Question number two, sensory seeking kid melts after school. They seem to be overstimulated and dysregulated. Please help. Okay. I feel this is 99.9% of not only sensory kiddos, but all kiddos.


[00:23:44] JH: Oh, for sure. This kiddo holds it together all day long at school. Hold it together through all of the different sensory input, all the cognitive tasks that are pushed on them, all of the things and then they get home and they're in a safe space where they can just let it all go.


[00:24:03] RH: Yeah. First thing I would do is offer a snack, as soon as they get home. Talk less to them, instead of immediately pounding them with questions and things that they're going to do and just talking to them non-stop.


[00:24:20] JH: Side note really quick. Don't lose your train of thought. That's what I've had to do with my kid. He's in second grade. I pick him up from school and I ask him one question. I just say, “How are you?” I don't ask any more questions until either he initiates conversation, or we're home eating a snack, taking a break. I probably, most the time, I wait until dinner to ask him about his day. I think that's a huge point.


[00:24:48] RH: I'm glad you do that.


[00:24:49] JH: If a kid was holding it together at school all day, they don't need to talk about it as soon as they're done. Let them chill for –


[00:24:55] RH: Let them chill. Okay, so after you stop talking to them, you give them a snack.


[00:25:02] JH: Please stop talking to them.


[00:25:04] RH: Give them a sensory-based activity to do. I would highly recommend kicking them outside, have them play with chalk, jump on the trampoline, ride their bike, play in the dirt, swing, some sort of outdoor sensory-based, nature-based activity after school.


[00:25:20] JH: Yeah, definitely, if possible, for sure. If for some reason you can't get outside –


[00:25:26] RH: Get outside.


[00:25:28] JH: Have a sensory corner, or a sensory space in your house, where they can go and just decompress with some favorite toys, or fidgets made of blanket.


[00:25:40] RH: A sensory bin.


[00:25:41] JH: A sensory bin. Maybe like a lava lamps and quiet music, or headphones.


[00:25:46] RH: Or the body sock.


[00:25:47] JH: Body sock. Swing. Just allow them some free time to get the sensory input that their body needs.


[00:25:55] RH: Because it wasn't getting that input at school all day. Because chances are, that wasn't part of the curriculum.


[00:26:02] JH: Nope. Probably not. If you have a chance on the weekend, and if your child's able, see if they can help you create a plan for after school. I say on the weekend, because on the weekend, it's probably more relaxed, and they're better able to think and process and plan. Make a list. Use pictures of ideas for your child, of things they can do after school that they're going to enjoy, and that's going to help them feel good. If they're able to participate in the process of planning this out, that's even better.


[00:26:33] RH: I love that. All right, cool. Those are fun. I like these.


[00:26:37] JH: Yeah. If people want –


[00:26:38] RH: Rapid fire.


[00:26:39] JH: Yeah. If you want us to answer a question on the podcast, send us a DM on Instagram, All Things Sensory Podcast, or even at Harkla_Family, we’re there too. Thanks for listening.


[00:26:50] RH: Thank you. If you have questions, don't hesitate to reach out. Please leave us a review on iTunes. Those help us reach more families, more therapists, more educators. We appreciate your feedback.


[00:27:01] JH: We're going to link everything in the show notes, so you can check out all the research, all the different ideas that we mentioned. Is there anything else?


[00:27:10] RH: That's it. We'll chat with you next week.


[00:27:11] JH: Okay. Bye.




[00:27:13] RH: Thank you so much for listening to All Things Sensory by Harkla. 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.


[00:27:24] 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 follow-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 @harkla_family. If you just search Harkla, you'll find us.


[00:27:44] 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.


[00:28:07] JH: We're so excited to work together to help create confident kids all over the world and work towards a happier, healthier life.


[00:28:13] RH: All right. We'll talk to you guys next week.




[00:28:17] RH: 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 more 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.

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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.

1 Response


June 16, 2022

Are your references listed somewhere? I would love to review them. Thanks

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