#310 - Answering Your Sensory and OT Questions

by Jessica Hill, COTA/L & Rachel Harrington, COTA/L, AC May 28, 2024

#310 - Answering Your Sensory and OT Questions

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Answering Your Sensory and OT Questions

In this episode, we are answering your questions. We talk about strategies for helping an 8 year old with toileting skills, toddler sleep challenges, games that help with teaching the Zones of Regulation, how to help a 4 year old wake up easier, tips for parents who are ‘touched out’ with their sensory seeking child, and ideas for a toddler who seems extra clumsy.

We’d love to answer your questions on the podcast! Fill out this form -> https://harkla.typeform.com/to/ItWxQNP3


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Skill Breakdown for Toileting

Toilet Training Tips for Everyone

All Things Poo

Demystifying Sleep Training

Sensory Strategies for Better Sleep Quality

Sleep Genius - Advanced Brain Technologies

The Zones of Regulation - Shop

Vital Neuro

Interview with the Co-Founder of Vital Neuro

Infant and Toddler Webinar 


Check out our video! Q&A - Your Sensory Activity and Strategy Questions Answered by Pediatric Therapy Experts


Answering Your Sensory And OT Questions

We frequently encounter numerous inquiries regarding sensory needs in occupational therapy. Today, our goal is to address some of these questions.

Achieving Independence In Toileting

Q: An eight-year-old child with autism is working to enhance their toileting skills, striving for sustained independence. Our primary goal is to support this child in developing better toileting habits. What are some effective strategies?

Our approach starts by meeting the child where they are in terms of comprehension and establishing attainable objectives to enhance their awareness of bathroom cues progressively. To achieve this, we plan to integrate vestibular activities into their sensory schedule, fostering a connection between the interoceptive and vestibular systems.

Moving forward, we aim to enhance bathroom use efforts, possibly with:

  • Visual aids, such as a daily schedule, are customized to match the child's communication skills.
  • Make sure the child drinks enough water.  
  • Assessing the child's nutrition to ensure it does not adversely affect their toileting habits.

Sensory And Sleep

Q: Toddlers with sensory issues often struggle to sleep through the night. Any suggestions?

Identifying the root cause is crucial. Once pinpointed, modifying the environment or the bed may be necessary—consider experimenting with Lycra sheets, a weighted blanket, or a weighted stuffed animal.

Engaging with auditory programs such as Advanced Brain Technologies or Sleep Genius is advantageous. These programs have the potential to positively rewire the brain, enhancing sleep quality and addressing underlying issues.

Seeking a professional evaluation from an orofacial myofunctional therapist could be beneficial. Additionally, exploring the potential of sleep apnea is crucial, as disruptions in breathing—often due to enlarged tonsils or adenoids—commonly result in children's difficulty in sleeping soundly through the night.

Finally, addressing a child's sensory needs throughout the day, especially in the toddler years, is vital to promoting active engagement in various physical activities and providing rich sensory experiences. Extended periods of inactivity and excessive screen exposure can detrimentally impact their sleep quality.

Tools For Managing Emotions

Q: What engaging games effectively teach the Zones of Regulation?

The Zones of Regulation is our foremost method for imparting emotional intelligence. Its website features carefully designed games specifically aimed at educating users on the nuances of the zones.

Simulating real-life situations that the child encounters.

    To enhance interactivity, consider creating a game featuring six-sided dice, each symbolizing a distinct scenario the child might encounter. This approach facilitates discussions about emotions, guiding the child to identify when they are in the "red zone" of anger or distress.

    Next, we delve into strategies that facilitate their return to a calm state, such as retreating to a sensory corner or selecting an alternative toy. This method not only enhances the engagement of the learning process but also imparts crucial emotional regulation skills.

    Tailor the visual elements for each regulating activity chosen by the child within their respective zones.

      Engaging with personalized visuals turns learning into an enjoyable activity. It boosts a child's comprehension and application of the zones of regulation, especially when they explain the concept to others—whether siblings, parents, or teachers.

      Behavior And Sleep

      Q: How should one respond when a four-year-old suddenly awakens in aggressive dysregulation?

      The initial step in addressing irritability or unhappiness is to evaluate sleep quality and quantity. Insufficient or poor-quality sleep can leave you feeling on edge and less content.

      Should a child wake up feeling aggressive and dysregulated, consider implementing these strategies:

      • Positively redirect their focus by engaging in co-regulation.
      • Experimenting with various lighting and sound options for their bedroom.
      • Think about adopting a more gentle wake-up routine and crafting a few deliberate strategies to implement right when they wake up.
      • Refrain from abruptly switching on the lights in your child's bedroom, as this can be startling and may potentially trigger a fight-or-flight reaction.

      Addressing The Sensory Needs Of Parents

      Q: Advice for parents feeling overwhelmed by physical touch on how to meet a toddler's need for closeness.

      Begin by introducing engaging heavy work activities for your toddler to enjoy throughout the day.

        Channel their energy into entertaining activities, like transforming couch cushions spread on the floor into a makeshift game or imagining the floor as molten lava. Stimulate their senses with a variety of engaging activities throughout the day.

        Express your needs clearly and straightforwardly.

          If you're feeling overwhelmed and require a brief pause, it's important to communicate this without making your child feel embarrassed about their sensory needs. Consider establishing a cue, such as a safe word or a visual signal that both understand.

          Provide ample opportunities for connecting throughout the day.

            Ensuring your toddler feels a solid connection to you is paramount. Infants and toddlers especially need close contact with their caregivers, seeking comfort and security.

            Hence, it's crucial to deliberately carve out times throughout the day for the affection and support your toddler seeks, which, in return, profoundly enhances your own life. This might mean setting aside specific cuddle times on your visual planner or designating movie time as a special opportunity for closeness, enabling them to snuggle, touch, and clamber over you.

            Remember, it's sometimes necessary to gently convey that it's not the right time for cuddles. Suggesting a jump on the bean bag can be a great alternative.

            Unexpected Shifts In Your Child's Development

            Q: My three-and-a-half-year-old has recently begun to fall frequently, a new development that wasn't a concern. Could you share any insights?

            Discover insights into your child's developmental path. Several factors that may contribute to falls include: 

            • A growth spurt may be making them somewhat uncoordinated.
            • Ill-fitting shoes.
            • Internal rotation.
            • Delays in ocular motor skills.

            Discuss your worries with your pediatrician. 

            Falls could signal a neurological condition, so discussing a referral to a neurologist during your child's pediatric appointment is important. If a healthcare provider overlooks your concerns, it's vital to seek someone who will listen attentively and investigate potential underlying causes.

            Get a referral to an occupational or physical therapist. 

              It is advisable to discuss potential solutions to your concerns and identify the most effective strategy for addressing them. Although it might seem premature, exploring the integration of primitive reflexes in infants can prove advantageous.

              In times of uncertainty, it is wise to explore every possible avenue. The primary objective is to identify and eliminate potential causes, methodically working towards a solution.




              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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