Re-Thinking (and Re-naming) Sensory Diets: Two Types
This blogpost is written by Kelly Beins who was a guest on my podcast and has offered to write a blog for us about Re-thinking (and Re-naming) Sensory Diets.
Learn from our Mistakes
In my prior blog post on “Re-Thinking Sensory Diets with a Polyvagal Lens”, I shared mistakes that I’ve made when working with children who have sensory processing disorder. These mistakes led me to reflect on 3 more effective ways we can present sensory strategies:
1) Connect & Join,
2) Embed Strategies into Daily Routines, and
3) Make Supports Sustainable and Feasible.
Re-Thinking Sensory Diets with a Polyvagal Lens
Learn from our Mistakes
I also shared that, “additional research is needed to provide evidence of best practice when it comes to use of sensory support plans, but until such evidence exists, incorporating frameworks such as polyvagal theory, that are based in brain science, is an evidence informed approach to refining our practice.”
Making Support Plans Easier for Caregivers to Implement
Today I’d like to explain how I think we can refine use of sensory (diets) support plans to make them easier for caregivers to implement and thus more effective for clients. For the duration of this post, I will boldly (and unashamedly) be changing the terminology i.e. sensory “diet” will now in my world (and I hope yours) be referred to as sensory “support plan”…
Pinterest worthy Sensory Strategies
Traditionally, the practice of implementing a sensory support plan has entailed the therapist giving suggestions to a caregiver about sensory strategies she/he thinks might be helpful to a child at home or school and, sometimes demonstrating those strategies, sometimes monitoring implementation, and sometimes measuring outcomes. Most times, there is some kind of written plan but not always and I don’t know any OT that hasn’t tried (most times in vain) to provide pinterest-worthy visuals to accompany said sensory strategies, in hopes of making life easier for families, getting more consistent carryover and better outcomes. I also know that many times, even if the visuals work at the beginning, MOST sensory support plans don’t last. There are now online apps available for creating and implementing sensory support plans and there are multiple programs
available to help structure the process of how we approach this area of our practice (Zones of Regulation, The Alert Program, Brainworks). I have used many versions over the years and don’t have a strong love or dislike of any of them. I do know how helpful they can be.
Over the years I have also seen some common hurdles that don’t get consistently addressed and I believe NEED to be addressed when setting up and teaching parents to implement sensory support plans:
1) Parents have different learning styles
2) Parents are stressed when we are trying to teach them or get stressed at home when they need to implement them
3) Each client is at a unique point in their sensory journey and thus parents have differing amounts of knowledge and energy
4) Parents have mixed expectations and often misperceptions about sensory (diets) support plans
5) Parents have fears that they’ll do it wrong or mess it up and/or have forgotten how or haven’t learned to trust their instincts when it comes to their child
6) Parents are not therapists they are parents thus they have their own relationship (and history) with their child, which inherently changes the child’s experience of the sensory strategy
Two New ways to think about Sensory Support Plans
For these reasons above, I now think about teaching sensory support plans in one of two ways. I use a prescriptive approach or an intuitive approach and often, I will start with one and switch to the other, depending on the family’s needs. However, I think labelling and describing these two approaches for parents at the start of teaching, helps them to more easily understand what we are expecting or asking of them and it helps us to be more clear when establishing and communicating expectations for carryover.
A Prescriptive Approach
Examples: jump on a trampoline every day before homework, the Wilbarger Brushing Protocol, sitting on a therapy ball daily while watching tv before dinner, movement breaks every 15 min’s
• More structured & rigid
• Repetitive
• Concrete & predictable
• Minimal knowledge-base needed
• Helps with new learning
• schedule leads the way
An Intuitive Approach
Example: parents are taught to interpret sensory signals based on any given day/moment, parent takes a child to a birthday party and wants to “see how it goes” for when the child needs a break in the car, child takes a sensory backpack when they go in the car but may only use it some days and has it “so they are ready”, family goes on vacation and packs sensory items for the plane-ride
• Flexible
• Changes based on child & environment
• Unpredictable
• Relies on parent knowledge & skill level for interpreting sensory signals
• Parent leads the way
Some examples of when to use a prescriptive approach might be:
* Client D has had several years of prior OT and they have just moved to the area. Client is an only child with a stay-at-home mom who has family close by. Mom asked specifically about how to help her child get more proprioceptive play and is wondering about the connection between vestibular and auditory processing.
* Client E has been with you in OT for a few months now and both parents seem to understand sensory. Parents are asking more specific questions and are letting you know about ideas they came up with on their own to help with dressing.
* Client F has a different schedule every day due to other family members. Parents seem knowledgeable and/or ready and willing to learn.
Find the approach that works for the parent and the child
Regardless of the approach that you choose to use when setting up a sensory support plan, remember that it’s fine to switch, should the situation warrant it. I have a parent who is asking about ways to calm her child in preparation for sleep and I’ve offered prescriptive options because they are just beginning to understand sensory processing and I just started with them recently. That said, the child is already refusing the strategies I’ve recommended mom try on a daily basis. Therefore, I am shifting to offer additional parent education and we are setting up a separate parent meeting in hopes of me being able to help these parents get baseline knowledge so it’s easier for them to think on the spot and use their intuition about what their child needs. We are building common language and mom is learning to trust herself and her interpretation of the behaviors she sees.
Sensory support plans are intended to be just that, “a support” and there is no one right way. Yet, when we connect with and take the parent needs into consideration right from the start we are impacting the resources that parent has internally and externally, for helping their child.
Learn More about Kelly Beins:
If you are interested in learning more about my approach to sensory diets, you may purchase the replay of my webinar here. I will also be discussing them briefly during my upcoming webinar for OT’s, “OT & Polyvagal Theory: A Framework for Refining our Practice”.
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