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sensory processing

Vestibular Self-Assessments

Sarah Norris

If you have sensory processing differences, your vestibular system (both the sensory organs in your inner ear responsible for your sense of equilibrium and balance, and the complex brain connections associated with them) might need a little extra attention and care.

Here are some symptoms of vestibular issues (from the Vestibular Disorders Association):

  • Dizziness: A sensation of lightheadedness, faintness, or unsteadiness.
  • Imbalance: Unsteadiness or loss of equilibrium that is often accompanied by spatial disorientation.
  • Vertigo: A rotational, spinning component, and is the perception of movement, either of the self or surrounding objects.
  • Brain fog: When the brain is dedicating a great deal of energy to maintain equilibrium and stay steady, activities such as recalling details or short-term memory may become more difficult, and thinking might seem “slow”.
  • Tinnitus: Abnormal noise perceived in one or both ears or in the head. May be intermittent or continuous and can be experienced as a ringing, hissing, whistling, buzzing, or clicking sound and can vary in pitch from a low roar to a high squeal.
  • Hearing loss: Reduction in the ability to hear sounds is a common symptom of many vestibular disorders. When VeDA conducted a patient poll, over two thirds reported that they had hearing loss in one or both ears.
  • Vision impairment: The link between the vestibular system and vision, vestibulo-ocular reflex (VOR), is described in detail with information on evaluation, treatment, coping strategies, and potential solutions for vision correction, including glasses and contact lenses.
  • Nausea: The feeling of being nauseated.
  • Cognitive changes: Difficulty thinking, paying attention/concentrating, recalling basic facts (such as your own phone number), short-term memory loss, etc.
  • Psychological changes: Due to the unpredictable nature of symptoms and the chronic nature of most disorders, vestibular patients tend to suffer from anxiety and/or depression.
  • Motion sickness: Symptoms appear when the central nervous system receives conflicting messages from the visual system and the vestibular system in the inner ears.

One way to figure out if/how much you may need to target your vestibular system, is to start with one or more of these self-assessments:

  1. The Dizziness Symptom Profile
  2. Situational Vertigo Questionnaire
  3. Vestibular Activities and Participation (VAP) Questionnaire
  4. Activities-Specific Balance Confidence (ABC) Scale
  5. Visual Vertigo Analogue Scale

Another way is to give yourself a little physical test. Please use extreme caution when attempting these activities. They may bring on or intensify symptoms of dizziness, unsteadiness, and/or nausea. Be sure you are near a wall, countertop, or chair so you can easily catch yourself if you lose your balance. And if in doubt, make sure you consult a doctor or other medical professional before attempting any of the following. If you feel comfortable to attempt some physical tests, here are some ideas to get you started:

  • Stand on one foot (eyes opened and eyes closed)
  • Stand heel to toe (eyes opened and eyes closed)
  • Walk heel-to-toe along a line
  • Walk backward along a line
  • Step over and around low-lying obstacles (such as large sponges, beanbags, or balled-up pairs of socks)
  • Tilt and turn your head in various directions while in different positions (sitting, standing, lying down, kneeling, etc.) – be careful or skip this one entirely if you have neck problems
  • Attempt to keep your balance on a moving or uneven surface, such as a large exercise ball or fitness balance pad
regulation, sensory processing, strategies, support

Weighted Products

Sarah Norris

Important Disclaimer: This post is not a substitute for medical advice. Please consult with your medical provider(s) for specific recommendations based on your individual needs.

Weighted products promote calm for those with autism, anxiety, sensory processing disorder, PTSD, and any condition that disrupts regulation or a sense of safety. They can be incorporated into virtually every aspect of daily life. There are many wonderful weighted products on the market and there are also some easy, low-cost do-it-yourself (DIY) solutions. Here’s a sampling of different kinds of weighted products that are available and/or craftable:

  • Blankets – provide the ultimate calming experience and can help improve sleep, reduce anxiety, improve sensory processing, boost attention and improve body awareness
  • Clothing – wearable jackets and vests can provide weight and/or compression that can ease the stress of travel or boost focus when completing tasks that require concentration
  • Accessories – things like weighted belts, ties, scarves, suspenders, and caps offer fun and discreet options
  • Lap pads – a portable sensory solution that helps kids, teens and adults feel grounded
  • Stuffed animals – an adorable and portable sensory solution that can provide soothing proprioceptive input in stressful situations
  • Objects – toys, exercise equipment, fidgets, pens, pencil toppers
A sampling of weighted objects

From the author’s personal collection:

  1. Custom weighted blanket (from Etsy)
  2. Mermaid heart pillow (from Amazon) with DIY weighted pillow
  3. Faux fur throw pillow (from Target) with DIY added weight
  4. Weighted ball (like these from Amazon)
  5. Meditation cushion (from Amazon)
  6. Handmade weighted lizard (from Maura Mooneyham at STAR Institute, similar to these from Future Horizons)
  7. Neoprene coated hand weights (like these from Amazon)
  8. Craft rocks (from Michaels)
  9. Assorted fidgets – Buckyballs, PBLZ, IsoFlex ball, heart-shaped rocks (like these from Amazon)
  10. DIY weighted beanbags (made with upcycled Lycra and polished pea gravel)
  11. DIY weighted tube socks (made with tall tube socks and rice)
  12. Weighted eye mask (from Amazon)

Guidelines

Frequency and length of use – weighted objects can be used throughout the day but are not intended for sustained use. The general guideline for weighted objects (such as lap pads, blankets, clothing, and accessories) is 1 hour on, 1 hour off.

Amount of weight – all objects should be easily manipulated by the user. If an object is too heavy or used improperly, it could lead to injury or even death. This is especially true for weighted blankets. The general guideline for an appropriately heavy weighted blanket is 10% of the user’s body weight (in pounds) plus 1 pound.

Added features

Tactile features – some weighted products, like lap pads, offer extra tactile input, such as built-in fidgets, interesting textures, or vibration. Some double as an activity pad, and others are easily wiped-down for sanitation and cleaning (which is good for shared objects and those used during meals). Keep in mind that less is sometimes more, especially if the user is someone who gets easily overwhelmed or distracted.

Visual features – some weighted products, like toys or lap pads, have special features like interesting patterns, lights, moveable parts, or other eye-catching qualities. This is best for when the user needs to stay in one place but being distracted is not a problem (like waiting at a doctor’s office).

Resistance – some products (both weighted and non-weighted), like fidgets, can be squished, pulled, or otherwise manipulated in a way that offers a massage-like variation of deep pressure input. This can be especially helpful for individuals who need a lot of movement input to soothe and calm. Just be sure the object(s) selected are durable enough to withstand heavy use!

Compression – some wearable products (both weighted and non-weighted) provide deep touch pressure through compression. Some products are designed specifically to address the sensory need for deep touch pressure, like weighted compression vests, compression bedsheets, sensory sleeves, and compression undergarments (Fun and Function has a wide selection). There are also several high-quality medical-grade products on the market, such as those used for surgical recovery, splinting, and bandaging. There are several commercially available products as well, usually marketed as shapewear and activewear.

Want some DIY inspiration?

There are lots of great ideas out there. We have a Pinterest board full of DIY sensory tools you can check out, or you can do an internet search for whatever you want to try making + “DIY”.

evaluation, lifespan, occupational therapy, occupations, therapy

What is Occupational Therapy?

Sarah Norris

The simplest way to explain OT is this: therapy that targets ‘participation in everyday living’ (AOTA). The ‘occupation’ in occupational therapy refers to a wide variety of life activities, including:

  • Activities of daily living (ADLs) – taking care of one’s own body in ways that enable basic survival and well-being (e.g., bathing, showering, toileting, dressing, eating, functional mobility, hygiene, and sexual activity)
  • Instrumental activities of daily living (IADLs) – more complex home and community activities (e.g., care of others, care of pets, communication management, driving, financial management, health management, clothing and home management, cooking and cleaning, shopping, spiritual activities, and home safety and maintenance)
  • Rest and sleep
  • Education
  • Work and volunteering
  • Play and leisure
  • Social participation

From an OT perspective, functional engagement, participation and health can be impacted by many factors. For example, the environment and social supports are just as impactful as a client’s individual factors. OTs look at the big picture surrounding a client’s limitations and use meaningful occupations (things the client enjoys and/or wants to be able to do) as both a means and an end to improve function. Depending on the client, the therapeutic process might include coaching, skill development, environmental adaptations, task accommodations, and collaboration with other professionals to maximize a client’s development, recovery from an injury or illness, or ability to age in place.

When a client is referred for occupational therapy, regardless of the setting, the basic process will include an evaluation, intervention (treatment), and targeted outcomes (goals). Sometimes this process is brief, while other times therapy may need to continue for a longer period of time. The end goals are always the same, however: maximal independence and fulfillment in daily life, whatever that may look like for a client.

For more information, download this brochure, visit AOTA’s website, or watch this video that highlights the broad scope of OT:

sensory processing

Self-Care for Couch Potatoes

Sarah Norris

Just about everyone is doing more sitting than ever during the Covid-19 pandemic. Between working from home and staying inside more due to curfews and exposure risks, and the easy access to technology, it’s not uncommon to spend most of your day in pretty much one place.

I am willing to bet you know an overly sedentary lifestyle is not good for your health. But did you know that taking care of your body when you are sedentary is also important? For example, if you have back or neck problems, you know how much trouble ignoring your posture can be.

Oww…

So, how can you take care of your body when you’re staying in one place most of the day? Well, there are lots of ways. Here are some ideas:

Movement breaks — ideally every 45 minutes to one hour, but at least every two to three hours. Stand, stretch, walk around, and change positions.

Bio breaks — you need to eat, stay hydrated, use the bathroom, and take rest breaks. Pushing through your body’s needs will only destroy your health and mood.

Get outside — the change in scenery and fresh air will do you good, promise.

Rest your eyes — Your eyes are designed for both near and far vision use. When you are inside, your eyes probably stay focused almost exclusively on things near your face. You need to look at least 20 feet away for 20 seconds every 20 minutes to maintain healthy vision.

Ergonomics — Your body is designed to be changing positions frequently. Your anatomy is not suited for long periods of inactivity. So when you need to stay in one place for an extended period of time, it’s vital to ensure your body is in the best position possible to avoid repetitive use injuries, muscle imbalances, and slumped posture.

Two things to keep in mind for seated work:

  1. Stability before mobility
  2. Moving is alerting

Stretch — Oft neglected but critical to long-term health and mobility, you need to bend, twist, and stretch. It helps relieve tension, lubricate joints, and remind you that you have a body. Depending on your body and your lifestyle, you will need to find stretches that work for your body. If you’re not sure where to start, a massage therapist, yoga instructor, or physical therapist (among other body workers) would be able to help you. Two general tips:

  1. Go to the end range of your movements (where you start to feel resistance but before you feel any pain) and hold for several breaths
  2. Target any area of your body that you bend or extend for long periods of time and stretch it in the opposite direction (open your chest and arms up and out if you tend to hunch forward, and open and extend your hips if you sit a lot)

Need more inspiration? You can check out our Product Recommendations for all sorts of self-care goodies. And, coming soon, be sure to check out our simple self-care videos with tips and tricks for how to actually take care of yourself a little better.

evaluation, lifespan, sensory processing

The Sensory Processing Three Dimensions Scale (SP3D)

Sarah Norris

Why is getting an accurate and thorough sensory processing disorder (SPD) diagnosis so hard? There are a few major factors, but here’s a big one:

There are virtually no quality clinical tests to assess for it.

Right now, the only clinical tests for SPD are old and outdated and are only for children 8 years old and younger.

Clinicians who have specialized training can use their judgment and reasoning to document signs and symptoms of SPD that are apparent when using other, primarily motor-based assessments or by testing for “soft” signs of neurological impairments. This isn’t always a very accurate method and does not always convince physicians and insurance companies of the validity of an SPD diagnosis.

The only other way of assessing for SPD are questionnaires that have been standardized* (like the Sensory Profile and Sensory Processing Measure), but these are limited by how aware of symptoms the person filling out the questionnaire is (usually a parent, teacher, and/or the person being tested). These questionnaires are also limited in the scope of symptoms assessed and may not provide a complete or accurate picture of symptoms. (*Standardized means the assessment tool has been researched on a sample of people of varying abilities and statistically analyzed to determine what is “typical” and “atypical”.)

Now, here’s the good news: There is a new test in development for clinical assessment of SPD!

The test was developed by clinicians and researchers at the STAR Institute for SPD and the University of New Hampshire and is being published by Western Psychological Services.

The test is called The Sensory Processing Three Dimensions Scale (SP3D) and is the first assessment for SPD with a version for teens and adults. It consists of seven subtests and assesses symptoms of SPD across all three subtypes (sensory modulation disorder, sensory discrimination disorder, and sensory-based motor disorder).

You can help by volunteering to participate in research.

There are several trained clinicians across the United States who are collecting data by giving the assessment to a wide variety of people. You can apply here to see if you qualify to participate!