Rachel Harrington, COTA/L, AC & Jessica Hill, COTA/L
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.
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.
Make it really fun and silly and engaging, like, okay, let's play floor is lava. Let's jump on the pillows on the floor. How many can you jump to? Let's do a log roll. So I would try to redirect their energy and those sensory needs to something more expected and more appropriate. And then I would also communicate those needs to them in an easy to understand way. Like Mom's feeling a little overwhelmed right now. I'm going to take a little break and just making it simple. I don't want kids to feel shame for having certain sensory needs. Maybe you guys can have a cue or like a safe word or like a visual that you can wrestle together and it's okay. I'm Rachel.
jessica:
And I'm Jessica. And this is All Things Sensory by Harkla.
rachel:
We are both certified occupational therapy assistants and together with Harkla, we are on a mission to empower parents, therapists, and educators to help raise confident and strong children of all abilities.
jessica:
On this podcast, we chat about all things sensory, diving into special needs, occupational therapy, parenting, self care, overall health and wellness, and so much more.
rachel:
We are here to provide raw, honest, and fun strategies, ideas, and information for parents, therapists, and educators, as well as other professionals to implement into daily life.
jessica:
Thank you so much for joining us.
rachel:
Hey, everyone. Welcome back to all things sensory by Harkla. We are so happy to have you here today. It's a great day for a podcast. It's a great day to be here. It's a great day to be alive and we are going to answer your questions today.
jessica:
All right, let's just jump right in. First question. It's not really a question. It's kind of listing, but it's like listing the challenges. So it's a question. All right, an eight year old autistic child with a goal to enhance toileting skills challenges going for a long period independently. I'm not 100 percent sure about the second part of that, but an eight year old autistic child who needs to enhance their toileting skills. What tips do we have?
rachel:
The challenge is I don't know where the child is already, and I would start by meeting them where they're at. Like, let's, let's get on the same page. Let's figure out where we're at. Are we struggling with the clothing management? Are we struggling with the interception to identify that they have to go to the bathroom. Are we struggling with holding? Are we struggling with the sequencing of, first we do this, then we do that, and then we wash our hands, yada, yada. So really honing in on where the child's at and then setting those realistic goals of, okay, we're going to work towards increasing awareness that we need to go to the bathroom. So we're going to incorporate some vestibular activities into the sensory diet, really connect the interoceptive and vestibular system together, and then, you know, go and try to go to the bathroom and maybe set up a visual aid as well depending on the child's ability to communicate. Meeting them where they're at again from a communication standpoint. So there's a lot of variables on this question, but I would really like to find the root. Like, just the root, like, where are we, where can we be, what internally do we need to work on?
jessica:
My go to is always like the vestibular, maybe some vibration, and then using visuals to show these are the steps for using the bathroom. Maybe you set up a visual daily schedule and they're using the bathroom at the same time every day. That can kind of be helpful sometimes. Making sure the child is drinking enough water so they actually have to go to the bathroom.
rachel:
What's their diet like?
jessica:
Yes, yeah. There's definitely a lot here. Like Rachel said, identify where they're at and meet them where they're at. We do have other episodes on toileting and bathroom skills and all of that. We'll leave those in the show notes.
rachel:
Okay, the next question. Toddlers sleep with sensory issues. The toddler is not sleeping through the night. My heart goes out to you. I know how exhausting this can be. So, again, we're really going to try to find that root cause. Is it, is the bedtime routine winding them up? Are they not meeting their sensory needs throughout the day? Are they over responsive to sensory input? Are the sheets bothering them? Are their pajamas bothering them? Is it too dark? Is it too light? You know, really try to hone in on the underlying issue if possible and then I would try modifying the environment, modifying the bed, try the lycra sheets, try a weighted item if they're capable of getting out from underneath it. Try a weighted stuffed animal. I would also maybe look into a program like Advanced Brain Technologies or the Sleep Genius. There's some auditory programs that can potentially help kind of rewire the brain in a positive way to help them sleep through the night and to work on some of those underlying causes. Make sure that the tongue is suctioning to the roof of the mouth. They don't have any airway disorders. Maybe you can chat with an orofacial malfunctional therapist to have them assessed. Make sure there's no sleep apnea. Sometimes when kids are having a hard time sleeping through the night it's because they're waking up because maybe they're not breathing or whatnot, their tonsils or adenoids. So there's, there's just so much that goes into it.
jessica:
Yeah, there's a lot that goes into sleep and I think my go to is like meeting their sensory needs throughout the day. Rachel already mentioned this. Meeting their sensory needs, making sure, especially in toddlerhood that they're getting a lot of movement, a lot of input throughout the day. If they're sedentary and on the screens a lot, that is going to negatively impact their sleep. People don't want to hear it. Sorry to break it to you. The research shows that screens impact sleep. So see what you can do about it. Get a sleep study if needed. Work with a professional to look at any potential underlying causes.
rachel:
Okay, this next question. Jess, I don't know, I've been chit chatting my little brain off here. Do you want to answer this question, fun games to teach Zones of Regulation?
jessica:
So the Zones of Regulation is kind of our go to emotional intelligence learning program and they actually have games that you can purchase on their website. We will link them in the show notes. We have them at the clinic. We use them with our clients and that's my initial answer is use the games that are designed for zones of regulation because they're created to teach the zones. So I think that's my initial response.
rachel:
I like to role play situations that are going on with the child as is, and create my own game or make a dice, like a six sided dice that has different situations and if the child is verbal and they can communicate, you know, Oh, my brother stole a toy from me. That makes me feel like I'm in what zone they have to identify, Oh, the red zone and then the activity that I can do to feel calm, to calm myself down. I can go to my sensory corner. I can go find a different toy. So like role playing through those different situations is kind of what I always go to and it's fun and you can make it silly and engaging and then connecting the sensory activities to the emotional state. So like these are, you know, and you can make your own visuals too. You can print off some pictures of activities that the kid chooses that they can do when they're in the red zone and then they can pick the activities that they can put in the yellow zone and the green zone and they can just create their own visual and you can play. And then anytime they can teach someone else. about the zones of regulation, a sibling, a parent, another teacher, that's always really helpful for kiddos too.
jessica:
Okay, next question. What to do when a four year old instantly wakes up in an aggressive dysregulated state? My first thought is look and see if they're actually getting enough sleep because I know at least for me if I wake up and I haven't gotten enough sleep or I didn't sleep well, I'm definitely more on edge, not as happy, I'm more dysregulated. So I think the first step is identifying if they're actually getting enough sleep and if they're not getting enough sleep, then change the routine so that they can get enough sleep.
rachel:
Yeah. And, you know, assess the quality of sleep. This goes back to our, our second question. I'm really into the oral facial malfunctional therapy. Making sure that they are actually getting that good quality of sleep and their mouth. Is in a good position. Their tongue is in a good position. All of that. But I think meet them where they're at and really try to focus on co regulating when a child wakes up really aggressive and dysregulated. Try to distract them in a positive way just speaking from experience here. My three and a half year old will wake up dysregulated and like, where's daddy? I need daddy and I'm like, well, daddy. So this can go one direction or the other and we'll look out the window together, we'll identify some things outside, we'll talk about what the weather is going to be, we'll talk about opening the blinds, and what clothes we're going to pick today, what games we're going to play. So just like, in a positive way, try to distract them, but also co regulate and don't be upset with them for waking up dysregulated. Like, it's normal, it happens. We're all human.
jessica:
Yeah, I think, too, like, once you've identified if it's sleep or not, like, they're not getting enough sleep, they don't have good quality sleep, and you're starting to address that, maybe you change the way you're waking them up. Maybe you're waking them up in a way, and to no fault of your own, you only know what you know, but maybe the way you're waking them up is not working for them and you need to change how you're waking them up in the morning. Maybe you need to use different lighting, different sounds to wake them up. Maybe you need to wake them up a little bit slower, have a couple of specific strategies, like Rachel mentioned, ready to go when they do wake up. So they know what's going to happen. They're going to wake up and get to listen to music and look outside, and, It's a little more maybe calm and expected. They know what's going to happen. Maybe
rachel:
On some sound machines now they have like different colors that you can change and they have different sounds. So if you can turn on the birds, like we'll turn on the birds in the morning and change the input. And I also will see this is so bad, but I'll see people on social media doing like day in the life videos, which I love so much. But they'll flip the lights on and it's completely dark in their kid's room. Anytime the lights get flipped on and I'm like still waking up, that like triggers my fight or flight response. So if you're walking into a completely dark room and you're flipping the lights on, let's not do that.
jessica:
Yeah. Change how you wake them up.
rachel:
I'm glad you brought that up. That was a good, it was a good thought. Okay, next one.
jessica:
Next question, tips for a contact craving toddler for parents who don't like the contact because they're touched out. Rachel, what you got?
rachel:
This is my season of life. I feel like, wow, where do we even start with this one? I would start by setting up some different heavy work activities for the toddler to do throughout the day. So try to redirect them to jumping on the couch, put pillows on the floor and make it really fun and silly and engaging. Like, okay, let's play floor is lava. Let's jump on the pillows on the floor. How many can you jump to? Let's do a log roll. So I would try to redirect their energy and those sensory needs to something more expected or more appropriate. And then I would also communicate those needs to them in an easy to understand way. Like mom's feeling a little overwhelmed right now. I'm going to take a little break and, and just making it simple and we're not, I don't want kids to feel shame for having certain sensory needs. Maybe you guys can have a cue or like a safe word or like a visual that you can wrestle together and it's okay. But I would just try to redirect giving them more input and then I would also try to work on your underlying sensory needs by doing something like advanced brain technology or the vital neuro and deep pressure brushing. Get your get your dry brush and brush your body first thing in the morning before you go to bed at night to try to meet your own sensory needs.
jessica:
I also think that it's important to make sure you are providing your toddler with that connection because infants and toddlers especially crave and need that contact with their caregiver for security purposes. So make sure you're having a couple of times throughout the day where you do give your toddler that contact that they are craving. But in a very supportive way for both of you. So maybe it's on the visual schedule for snuggle time. Or maybe they know that when you sit down to watch a movie together, that's when they get to snuggle with you and touch you and climb on you. And then other times of the day where it's, you know, actually, it's not time to snuggle with me right now right now it's time for us to go jump on the bean bag and just making sure that you're not taking away that contact. Because even if you are touched out, your child still needs that for that connection, that safety, that security. So do the things you need for yourself, the Vital Neuro, regulate your own nervous system, however you need to do, so that you can still give that to your child.
rachel:
Love that. We have one more. Three and a half year old recently started falling frequently. It wasn't an issue before. Do you have any thoughts?
jessica:
My first thought is to talk to a neurologist. Just because.
rachel:
Start with your pediatrician, bring that up, ask for a referral.
jessica:
Yes, get a referral. Because if your three and a half year old has mastered walking and climbing and they're navigating and then all of a sudden they just start falling, it could be a sign that something's going on neurologically. That, that was my first thought.
rachel:
I just feel like when in doubt, rule it out. Like, you're not going to be in trouble for being overprotective or like overly concerned. Like, what if there was something?
jessica:
But also don't let your pediatrician tell you that it's no big deal. It's probably not a problem. I did just have this conversation with somebody that I went to high school with where she's having some challenges and concerns with her children and the doctor said, nope, it's fine, they'll grow out of it, or we'll put them on medication and I just want parents to know that, yes, your pediatrician has a lot of great information and is very helpful. But they don't know everything.
rachel:
We do, no, I'm just kidding.
jessica:
No, we, we do. No, we don't. We don't.
rachel:
Kidding, kidding.
jessica:
But so if you think that there is something going on, if your gut is telling you that something is off, that something's not right, don't let that get pushed aside by one professional. Make sure that you find a professional who will listen to you and who will dig in to find out why.
rachel:
I agree. I think that advocating is so important. I would work on maybe incorporating more vibration, maybe a vibrating plate, work on some maybe deep pressure brushing, more joint compressions. Get a referral to OT and talk to a therapist about this.
jessica:
OT or PT?
rachel:
Mm hmm. Yeah. And just maybe work on primitive reflex integration. I know it's a young age to work on primitive reflex integration, but our infant course really goes into some functional activities that you can do with this age group in order to help integrate primitive reflexes. There's so many things that could be, and like, It's like, there's no way that we could even tell you what it is. Maybe they're just going through a growth spurt and they are a little clumsy. Maybe their shoes don't fit right. Maybe check their shoes. Maybe there's some internal rotation. Maybe there's something wrong with their eyes. Maybe you should go to a developmental optometrist. and assess their ocular motor skills, not just their regular vision, like really how their eyes are working together. At least maybe you can start to get an idea of where you want to go first. When in doubt, rule it out. That's, that's the end. That's the end all theme here.
jessica:
Hopefully that was helpful for all of the people who asked these questions.
rachel:
Love answering your questions though. It's so helpful and especially like the fun games to teach zones of regulation. That's such a different question than we get and it's a good one. I like, I like that challenge.
jessica:
Yeah, definitely. If you have questions that you want us to answer on the podcast, there is a form that you can fill out. It's linked in the show notes, or you can send us a message on Instagram.
rachel:
Okay. With that, we'll chat with you next week.
jessica:
Goodbye.
rachel:
Thank you so much for listening to all things sensory by Harkla.
jessica:
If you want more information on anything mentioned in the show, head over to Harkla.co/ podcast to get the show notes.
rachel:
If you have any followup 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 or at All things sensory podcast. If you just search Harkla, you'll find us there.
jessica:
Like we mentioned before, our podcast listeners get 10 percent off their first order at Harkla. Whether it's for one of our digital courses or one of our sensory swings, the discount code sensory will get you 10 percent off. That's S E N S O R Y.
rachel:
Head to Harkla.co/sensory to use that discount code right now.
jessica:
We are so excited to work together to help create confident kids all over the world. While we make every effort to share correct information, we're still learning.
rachel:
We will double check all of our facts, but realize that medicine is a constantly changing science and art.
jessica:
One doctor or therapist may have a different way of doing things from another.
rachel:
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 evidence based as possible.
jessica:
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 child.
rachel:
Consult your child's pediatrician or therapist for any medical issues that he or she may be having.
jessica:
This entire disclaimer also applies to any guests or contributors to the podcast.