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regulation, sensory processing, strategies, support

Weighted Products

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?

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

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)

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!

sensory processing

Sensory-Based Motor Disorder

According to a leading paper on the topic, Sensory Processing Disorder can be categorized into three basic patterns or subtypes:

  1. Sensory Modulation Disorder, including sensory over-responsivity, sensory under-responsivity, and sensory seeking/craving.
  2. Sensory Discrimination Disorder
  3. Sensory-Based Motor Disorder

My post entitled What is Sensory Processing? defines Sensory Modulation Disorder and Sensory Discrimination Disorder. This is a follow-up post about the third subtype: Sensory-Based Motor Disorder.

Simply put, some motor coordination difficulties are due, at least in part, to faulty sensory processing. There are two sub-types of Sensory-Based Motor Disorder: Postural Disorder and Dyspraxia.

If things like this happen to you often, you may have Sensory-Based Motor Disorder.

Postural Disorder

To understand Postural Disorder, it’s important to first understand postural control. The terms for postural function vary somewhat among professionals and in the literature. Most experts agree, though, that there are two main functions of the postural control system:

  1. To keep you upright against gravity and help you maintain your balance, for which I prefer the term postural stability. This can be further broken down into static and dynamic functions. Static posture (meaning still, unchanging) is when you are holding a position against gravity without moving, and dynamic posture (meaning ever-changing) is how you keep your balance while moving.
  2. To keep the rest of your body still so you can use a part of the body to push, pull, reach and/or use force to complete a task. For this function, I like the term postural regulation. To conserve energy and increase the accuracy and precision of your movements, you must stabilize parts of your body and use isolated movements to carry out actions.
Keeping the pinky finger side of your hand stable while moving your thumb and forefinger to write and draw is an example of postural regulation.

Postural control is a lot more complex than just standing and sitting up straight, which is what many equate with “good” posture. In addition to keeping us in good alignment, research has shown postural control actually prepares the body to move, which is referred to as anticipatory or feedforward postural adjustments. Postural control also contributes to your body schema or internal map of where you and all your body parts are in relationship to gravity. This is crucial for maintaining joint and muscle alignment as well as determining your center of gravity. Additionally, reflexive postural reactions help you recover when you are bumped, jostled, or otherwise knocked off balance. And, perhaps most complex of all, motor coordination relies on the combination of good posture and movement.

Postural skills are largely subconscious, meaning you probably do not pay much attention to them. However, you rely heavily on your posture to complete every day tasks such as brushing your teeth or typing at a computer. Holding yourself up against gravity and coordinating your movements actually requires integration of multiple sensory systems. The sensory systems that contribute most to posture include your: proprioceptive (muscles and joints), vestibular (equilibrium and balance), tactile (touch), and visual (sight) systems.

So, what qualifies a posture problem as a Sensory-Based Motor Disorder? Just like all sensory disorders, a sensory-based posture disorder is caused by brain wiring differences that are developmental (present from birth). Therefore, poor posture due to injury, disease, poor physical fitness, or health problems would not be considered a sensory-based condition.

Symptoms of a postural disorder may include:

  • Chronic muscle tension in the neck, shoulders, and back
  • Unusually loose or tight muscles at rest
  • Poor control of movements (i.e., clumsiness, poor body awareness)
  • Core muscle imbalance, resulting in rounded or slouched posture
  • Slow reflexes/reactions when knocked off balance (for example, you may not be able to catch yourself when tripping or falling)
  • Inefficient or excessive/extraneous movements (such as motor overflow) resulting in fatigue
Chronic poor posture can lead to chronic pain and inflammation.

Dyspraxia

Motor praxis is perhaps even more complex than postural control. In sensory integration theory, the term “praxis” encompasses all of the processes involved in performing skilled movements. Briefly stated, praxis includes:

  • Ideation–coming up with ideas; problem-solving; using the imagination to “mime” actions without objects (for example, pretending to brush your teeth without an actual toothbrush)
  • Planning–deciding what to do
  • Sequencing–logically ordering actions from “Where should I start?” to “How I know I’m finished”
  • Execution–carrying out your plan of action
  • Feedback–reflecting on how well a plan of action worked (as well as feedforward, which is how well a plan of action is working in the moment)

When a professional is assessing praxis abilities, some of the areas that may be examined are:

  • Constructional praxis–building or copying configurations of materials or shapes from a model or instructions
  • Oral motor praxis–coordinating the muscles of the mouth and jaw for speech production and facial expressions
  • Imitation of movements–watching a demonstration of a complex movement or a series of motions before doing the same movement/motions
  • Motor patterns–sustaining repetitive movement patterns (such as a rhythmic clapping pattern)
How many times can you repeat a clapping pattern before messing up?

When praxis is optimal, it has three main functions:

  1. Coming up with ideas, making plans, thinking of ways to get organized, and problem-solving for actions you will take in the future. This includes reflecting on recent experiences and processing what you thought went well (and what you wish had happened differently). These processes happen in the top and front area of the brain, primarily in the frontal lobe of the cerebral cortex.
  2. Monitoring your performance in the moment to sustain actions, or make adjustments to improve your accuracy or speed. This process combines cortical functions throughout the cerebral cortex as well as more automatic or reflexive functions that occur in the subcortical region of the brain.
  3. Completing motor tasks automatically, often using the same pattern of movements without much thought. For example, you may shower or fix breakfast the same way every day without making any decisions about what action to take next. You just “go through the motions.” This automaticity of movements saves a lot of mental energy, which frees up energy for your brain to use on newer, more interesting functions. This process occurs at the base of the brain in the subcortical region and is more a result of good praxis than an actual function of praxis.

When praxis skills are not fully functional, one or more of the above processes are impaired. This impairment is called dyspraxia. The literal definition of dyspraxia is “bad” or “difficult” action. Some people use the term dyspraxia interchangeably with, or prefer other terms, such as apraxia (which is literally defined as “without” action), developmental coordination disorder, or motor planning problems. In the United States, occupational therapists commonly use the term dyspraxia as an umbrella term for developmental praxis problems and apraxia is reserved for praxis challenges brought on by illness or injury.

Praxis abilities are based on the sensory processing functions of modulation and discrimination of inputs, the cortical functions of planning and sequencing, as well as the cerebellar functions of sequencing and rhythmicity. Dyspraxia, as categorized under Sensory-Based Motor Disorder, is developmental in nature (as in developmental coordination disorder), and not caused by illness or injury (such as a head injury or stroke). Again, in the United States, rehabilitation professionals tend to prefer the term apraxia for praxis challenges brought on by illness or injury.

Some symptoms of dyspraxia are:

  • Poor coordination, especially for complex tasks involving multiple body parts
  • Difficulty learning complex motor skills, such as driving a car
  • Struggling to come up with ideas or becoming distressed when answering simple open-ended questions, like, “What do you want to eat tonight?”
  • Difficulty with multi-tasking
  • Having trouble following multi-step instructions
  • Always doing things “the hard way” or in an illogical or inefficient way
  • Having trouble planning ahead
  • Difficulty managing time
  • Poor organization
  • Being overly rigid with plans and routines

As you can see, Sensory-Based Motor Disorder can be quite complex and affect many different aspects of daily life. Currently, best practice for addressing posture and praxis challenges is to work on bottom-up (body- and sensory-based) strategies in combination with top-down (cognitive) strategies to manage symptoms and improve quality of life.