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There are a wide range of resources and top tips for you to try.

We recommend that you avoid changing lots of things at once. Instead, choose what is most important to you and your family. Implement strategies and changes gradually. This will make it easier for you to work out what is going to be helpful for your child, as well as being more manageable for you as a family.

Not all of the resources may be relevant, depending on age or developmental stage. Some resources may be relevant now, but some may provide ideas that will be more helpful in the future.

Top Tips for Parents

Top Tips have been designed to support a range of daily activities such as dressing, teeth brushing and sleeping. These resources have been developed to help us consider how we can make small changes to the environment or the way an activity is carried out to have a positive impact on how we manage day-to-day.

To compliment the handouts, we have included some short video demonstrations showing what the strategies look like in practice.

These video resources have been produced by Sheffield Children’s NHS Foundation Trust Sensory Processing Service and, with their kind permission, we have been able to include these on our website to support families in Northumberland.

Sensory Processing and Sleep

Children who have challenges with their sensory processing frequently experience issues with sleeping. It is generally recognised that insufficient sleep can have a significant impact on learning and development. Without adequate sleep, children can become easily dysregulated and irritable.

When a child struggles with sensory processing, they can find it challenging to process the information coming in from their individual senses. For example, being unable to tolerate the feeling of nightwear material due to it being too scratchy, too silky, the fit is too tight or too loose or even the material makes them feel too hot.

Labels and bedding/blankets can be difficult to tolerate, the lighting in the bedroom is either too dark or too light or even smells or noise coming from outside the bedroom can cause difficulties with drifting off and staying asleep,

Some helpful strategies are listed below that can aid with achieving a healthy sleep routine (sometimes referred to as sleep hygiene).

Nightwear

  • Encourage your child to choose their nightwear
    garment.
  • Try to avoid synthetic materials and try using a
    very loose cotton t—shirt — this will also help with
    temperature regulation.
  • If unable to tolerate the movement of clothing on
    their skin, consider close fitting garments which can
    offer a slight calming compression element.
  • Remove tags and labels where possible from
    nightwear and bedding if they are causing distress.

Bedtime

Implementing a regular bedtime routine:

  • Begin the routine no less than 30 minutes up to one
    hour before bedtime.
  • Engaging in heavy work can have a calming effect.
    Activities such as wheelbarrow walks, yoga stretches
    and the Burrito activity (please refer to top tips video
    for demonstration) can be completed approximately
    one hour before initiating a bedtime routine.
  • Consider avoiding sugary foods and sugary drinks
    before bedtime.
  • It is recognised that blue light from computer screens,
    TVs, tablets and phones can be a cause of distraction
    and impact sleep. Consider reducing screen time one
    hour before bedtime if this is an area of concern for
    you. If screen time is required before bed, consider
    opting for a blue light filter. The filter can be
    downloaded from the app store on iOS or Android
    devices.
  • Consider using a visual timetable for bedtime. Use
    visual cues to help the child progress through the
    bedtime routine. For example, encourage them to
    choose a book, laying out their pyjamas or let them
    watch you run a bath.
  • Consider soothing activities like drawing, puzzles
    and reading.
  • Use gentle movements that are regular and
    predictable such as rocking or gentle swinging can
    help to calm.
  • Consider a hand massage or back rub.

Find a sleep routine that works best for you and your
child and keep it consistent – try:

  • Take a warm bath or shower at least one hour
    before bedtime
  • Put on pyjamas
  • Use the bathroom
  • Brush teeth
  • Read a book
  • Go to sleep

If your child frequently wakes through the night,
implement a consistent routine to assist them back to
bed. Make sure to keep lighting and noise levels to a
minimum and if they need to go to the bathroom keep
the routine simple.

Sleep Environment

Environmental considerations:

  • Dim lighting where possible. Consider using a red
    nightlight as this imitates natural lighting and
    promotes the production of sleep hormones.
  • Keep the bedroom cool as this helps to slightly
    lower the body temperature and helps the
    transition into sleep,
  • Tightly tuck the bedsheets in to provide a constant
    firm pressure which will help to calm your child but
    please make sure they are able to get out if they
    choose to.
  • Consider offering a body pillow to hug or a large
    soft toy.
  • Consider reducing visual distractions, for example
    having pastel coloured walls rather than heavily
    patterned wallpaper or plain, simple curtains. Use
    blinds and lined curtains to block out unwanted light.
    Try to eliminate excessive background noise
    where possible such as TVs, radios, and household
    appliances.
  • Encourage exposure to natural daylight around
    breakfast time to help regulate sleep wake cycles.
  • Allow your child to have regular opportunities during
    their day to incorporate heavy work activities which
    will help to regulate their sensory systems.

Top Tips for Dressing

Children who experience challenges with their sensory processing can often find dressing very difficult. They may struggle to tolerate different clothing materials or find the seams on the inside of clothing, such as socks and underwear, unmanageable.

Here are some helpful strategies to help support children with dressing:

Preparation

Preparing your child for dressing:

Before getting dressed, have your child engage in some heavy work activities.

For example, encourage pushing and pulling heavy objects, such as a laundry basket or toy box, back and forth across the floor. This will help to get their bodies ready and focused for dressing.

Deep—pressure activities can help calm their nervous system. Try activities such as:

  • A firm massage before getting dressed
  • A firm scalp massage can be helpful to help tolerate wearing a hat.
  • Bear hugs with firm pressure whilst rocking gently back and forth-
  • Sit facing one another with the soles of your feet touching and holding hands whilst gently pulling and pushing backwards and forwards and singing along to Row, Row, Row Your Boat.
  • Try sucking a thick liquid, such as a smoothie or yoghurt, through a straw.

Allow plenty of time to get ready in the mornings:

  • Pick out clothing ahead of time.
  • Encourage your child to be involved in the selection of clothing options.

Seasonal wear advice:

  • Transitions between seasons – consider using social stories to help ensure children pick appropriate clothes for the weather.

Consider reducing audio and visual distractions:

  • Turn off the TV or radio.

Some children with sensory processing challenges may struggle with their balance:

  • Encourage your child to sit during dressing so that they can concentrate on getting ready rather than trying to maintain their balance.

Consideration

Clothing consideration:

  • Try cutting out labels in clothing or buy clothing without tags.
  • Consider flipping undergarments and socks inside out to allow any uncomfortable seams to be worn on the outside of the body.
  • Consider purchasing seamless socks/underwear designed to reduce irritation.
  • Some synthetic fabrics can be difficult to tolerate try to buy softer fabrics like cotton, fleece, and flannel where possible.
  • Some children prefer wearing tighter fitting garments. Consider trying base layers underneath your child’s clothes this can provide a calming influence.
  • If tolerating stiff clothing is an issue, consider drying clothes in a tumble dryer.
  • Some children prefer well—worn clothes, try washing clothing multiple times to soften the material or use clothes that are second-hand or handed down.
  • If your child is sensitive to smell, consider using a washing powder and a fabric softener that is unscented.

Alternative consideration:

  • Please also remember a large percentage of dressing difficulties are related to our tactile system being hypersensitive to touch. Therefore, encouraging children to engage in a range of sensory-based play activities can be very helpful.

Top Tips for Bathing and Showering

Some children and young people may find it difficult to have a bath or shower due differences in their sensory processing, children may find the sensory experience of being in the bathroom difficult to cope with. This may be due to the noise of running water, the temperature of the water and or the feel of the water on their skin or even the smell from wash products.

Try the following strategies to help manage bath/shower time:

Before

Before bathing / showering:

  • Consider trying showering or bathing at different times of the day as your child may be calmer in the morning or at night.
  • Try to work out what routine works best for your child and maintain a regular time slot.
  • Encourage participation in heavy work activities half an hour before getting ready to have a bath or shower. Heavy muscle work activities, such as, pushing and pulling a toy box or laundry basket or doing wall push ups can help children to be calmer.
  • Where possible give your child a choice between bathing or showering. Generally showering is often an alerting experience and bathing can be more calming and relaxing especially before bedtime.
  • Consider giving a firm body massage before having a bath/shower. Providing firm pressure to the shoulders can be helpful.
  • If your child dislikes the noise of running water, run the bath water before the child or young person goes into the bathroom.
  • Agree with your child in advance the water temperature, they may prefer a cooler water temperature than you think! Let your child test the water temperature with their fingers.
  • Give your child more control in the selection of personal care products if they struggle to deal with certain smells or the feel of hygiene products.
  • If showering and the touch of water on the skin is difficult to tolerate consider adjusting the spray type on the shower head
  • Try using social stories to aid understanding of the importance of going in the bath/shower.

During

During bathing / showering:

  • Some children can become overwhelmed due to bright lights consider dimming the lights in the bathroom. Smart bulbs could be used to alter the lighting colour and to help create a relaxing environment.
  • Consider using ear plugs if your child struggles to tolerate noise levels.
  • It is helpful to place a bathmat on the bottom of the bath to help reduce the chances of slipping in the bath. Feeling secure when sitting may help to reduce their overall anxiety level.
  • It is not uncommon for children to dislike laying down in bath due to struggling with the change in head position. If this is the case, consider maintaining an upright position and use a handheld shower spray and if possible, encourage them to take control of it. If changes in head position is challenging for your child, they may prefer to shower.
  • To help with staying calm in the bath, try using toys that encourage heavy work with the hands such as squeezy and stretchy toys and pouring water from one container to another, Also try wetting a hand towel in the warm bath water and draping this over the shoulders to maintain a constant pressure.
  • Some children struggle with having water touch their face when washing their hair. Consider using a bath visor and use a cup or jug to use to pour water over their hair when rinsing.
  • Some children will struggle when getting water in their ears, try using ear plugs to reduce chances of getting water in their ears,
  • If your child is easily over stimulated, consider reducing clutter around the bathroom.
  • If your child struggles to tolerate shampoo and conditioner, consider using a dry shampoo and only use a conditioner when in the bath or shower.
  • When washing the hair use a firm touch and count down in time to give a definite end point,
  • It can be very distressing to get soapy water into your eyes. Consider using tear free soaps/products. Allow swim goggle or masks in the shower or bath if this helps to make the activity more tolerable.
  • Some children can find firm pressure calming, Try applying firm pressure with a face cloth and use slow downward strokes when washing the body,
  • Try using visual timers to show how long is left in the bath or shower.
  • If your child struggles with the temperature change from getting out of the bath, try placing a towel on a warmed radiator and use it to wrap them up in afterward bathing, drying off.
  • Some children prefer a soft towel others prefer a heavier towel try maintaining a firm pressure when

Top Tips for Going to the Dentist

Visiting the dentist can be an overwhelming experience for some children and young adults, especially for those who struggle to process sensory information.

Children may squirm in the dentist chair due to the bright lights located above the chair, or dislike being in a reclined position for a prolonged period of time, or they may struggle to deal with loud dentistry tools.

Included below are several strategies that can be tried. Consider talking with your dentist before the appointment on how best to implement them.

Before

Before the dental appointment:

  • To reduce anxiety: at home, role-play going to dentist. Also, ask if you can visit the dental practice with your child before the appointment.
  • Keep scheduled check-ups.
  • Consider telling your child about the appointment as early as you can and discuss any worries they may have.
  • Social stories can be helpful to explain what is going to happen at the appointment and why it is necessary.
  • Try a facial massage, applying firm pressure around the mouth to help desensitise the area.
  • Drinking thick fluids through a straw or eating a chewy snack on the way to the dentist can provide a calming and regulating input.
  • Heavy work activities or wearing a backpack filled with toys or books whilst walking to dentist can help to calm and regulate.
  • Also consider planning a lovely activity to do after the appointment.

During

During the dental appointment:

  • Encourage your dentist to explain each step of the process.
  • Allow your child to see tools the dentist may use if they are comfortable with this.
  • Consider using a visual timer to indicate how long the dentist visit will take.
  • If your child is sensitive to light, consider using protective sunglasses or a hat to reduce the intensity of the dentist light.
  • Consider turning off any unnecessary lights to reduce the overall lighting level.
  • If the dentist drill is required let the drill run for 30 seconds outside the mouth to allow the child to get used to the noise.
  • If your child is noise sensitive, try to reduce the overall noise level in the room, for example, turn off a radio. Also, consider using ear defenders or noise cancelling earbuds.
  • Consider bringing fidget toys or a comfort toy to help with distraction.
  • Consider using a weighted lap pad during the visit to provide a calming input.

Top Tips for Hair Cutting

Visiting the hairdressers can be demanding for a child who struggles to process sensory information. There are often loud noises, lots of smells, unavoidable physical contact, new faces, and having to sit still for a period of time.

Please see below some strategies to make the experience less stressful:

Before

Before the haircut:

  • Try to keep a consistent haircutting schedule, for example, on the same day. If possible, try to have the same professional each time.
  • Try to familiarise your child with the environment first and watch someone they know get a haircut before they get a haircut.
  • Massage the child’s scalp regularly to help reduce scalp sensitivity or encourage them to rub their own hair dry with a towel.
  • On the way to the appointment try wearing a weighted backpack to provide a calming and regulating influence.
  • Make appointments at the beginning or end of the day when the environment is calmer.
  • Consider washing their hair at home before the appointment to reduce appointment time and avoid unfamiliar scents.
  • Ensure your child knows how long the hair cut will take. Consider bringing a visual timer to the appointment.

During

During the haircut:

  • Always touch on the child’s terms. Firm touch is often preferred and should be used first to prepare for lighter touch.
  • Minimise the use of clippers or avoid them all together.
  • Try dimming the lights and minimise noise if your child can become easily overwhelmed. For older children consider trying noise cancelling earbuds.
  • Encourage sitting in front of a mirror so they can see what is happening.
  • Talk to your child throughout and describe what is happening and what will happen next.
  • Consider bringing fidget toys or stuffed animals to help the child feel comfortable and occupied.
  • Consider using a weighted lap pad for the child to use during the haircut.
  • Allow movement breaks as and when required.
  • When finished agree to do something enjoyable.

Top Tips for Nail Cutting

Some children can experience difficulties with being able to tolerate having their nails trimmed. It can be an activity that is equally distressing for parents/carers and children.

Here are some helpful strategies to help make the experience less stressful:

Before

Before nail cutting:

  • Encourage engaging in heavy work activities (activities that stretch the muscles), for example, animal walks, wall press ups or pushing and pulling toy boxes. This helps to calm the nervous system and aids self-regulation,
  • Playing with Thera-putty or play dough provides heavy work to the hand muscles to help reduce sensitivity to the hands.
  • Try giving a firm hand/foot massage to reduce tactile sensitivity,
  • Keep when and where you trim your child’s nails consistent and set up a routine, for example, Tuesday after bath time is nail cutting time.
  • Consider the use of child-friendly nail clippers that have softer, rounded edges and can be more visually appealing for children or try using a nail file instead.
  • Pay attention to the environment, for example, if noise is distracting or distressing, pick a quiet place to trim nails.

During

During nail cutting:

  • Try to trim a child’s nails after a bath or shower when the nail is softer.
  • Introduce the activity by only doing 1 or 2 nails at a time, and gradually build their tolerance.
  • Encourage your child to choose the order in which their nails are cut. If their fine motor ability allows, let them cut a nail on their own with supervision.
  • Consider using a weighted lap or shoulder pad to provide deep pressure during the activity to provide a calming influence.
  • Try using distraction during the activity, allowing the child to watch their favourite TV show, play relaxing music or encourage use of a fiddle toy,
  • Be mindful not to cut far into the nail bed — this can be painful.
  • Provide a visual timer so the child knows when the activity will end.

Teeth Brushing

For children who struggle to process sensory information, teeth brushing can be a very stressful and unpleasant experience

Please see below some strategies that can help with teeth brushing:


  • Ask your child to stand or sit in front of a mirror to brush their teeth so they can see what is happening.
  • Consider using a softer silicon bristle toothbrush initially to help tolerate the sensation on their teeth and gums before moving onto a normal toothbrush.
  • Consider using a flannel with toothpaste if the child does not tolerate a toothbrush.
  • Some children may prefer stronger-tasting toothpaste, so consider trying different flavours. If the taste from normal toothpaste is too strong consider using a fluoride non- flavoured toothpaste. Please see the link below to access a website with non-flavoured fluoride toothpaste: www.multi-sensoryworld.co.uk.
  • Create a consistent morning and evening routine with clear visual and verbal cues that lead to toothbrushing.
  • Consider using a chewable toy before teeth brushing to decrease the child’s sensitivities in the mouth and help build awareness of the mouth.
  • Try a face massage before teeth brushing.
  • Visual timers can help children gauge when the activity will finish. Consider singing or listening to a song during teeth brushing which can reduce anxiety and help your child’s understanding. Please see the resources below.
  • Include the child in the process and allow them to choose their own toothbrush and toothpaste. If the child is not fully independent with brushing their teeth encourage them to complete sections of their mouth and slowly work your way up to allow them to brush their teeth.
  • Some children may require increased sensation to be able to tolerate teeth brushing. Consider trying a vibrating toothbrush, encourage your child to handle the toothbrush first, then place it on the back of their hand, and allow them to put it on the outside of their cheek, and then finally into their mouth.

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Using the Toilet and Bottom Wiping

Some children may experience anxiety when having to go to the toilet or bathroom. They could be worried about their balance when sitting on the toilet or the motor skills required to perform the task.

Alternatively, they could be scared of sitting on the toilet as it might feel too cold or too hard. The lighting maybe too bright or too dark or the noise and smells may make them feel overwhelmed or they have difficulty in understanding the sensations of when they need to go to the toilet.

Many children with co-ordination problems have difficulty with bottom wiping and the process of going to the toilet, This can often cause high levels of anxiety for both child and parent.

The following strategies can be used to assist with toileting and learn bottom wiping:

Part One: Using the Toilet

Some children may experience anxiety when having to go to the toilet or bathroom. They could be worried about their balance when sitting on the toilet or the motor skills required to perform the task.

Alternatively, they could be scared of sitting on the toilet as it might feel too cold or too hard. The lighting maybe too bright or too dark or the noise and smells may make them feel overwhelmed or they have difficulty in understanding the sensations of when they need to go to the toilet.

Please see below strategies to consider and try:

  • Make sure your child is supported with their posture when sitting on the toilet – this will provide more stability and control to be able to go.
  • Consider using a foot stool to help increase stability and mark out where the feet need to be placed on it.
  • Think about the design of the toilet seat, is the gap too large could you help to reduce anxiety by using a smaller toilet seat.
  • Think about the feel of the toilet seat, is it too cold or too warm. Could you try a padded toilet seat? Is the bathroom temperature too cold or too warm, could you adjust the heating?
  • To support a feeling of security when sitting on the toilet, consider installing a rail on both sides of the toilet.
  • If your child is scared of sitting on the toilet, demonstrate to them by sitting on the toilet and explain there is nothing to worry about.
  • Some children can be particularly anxious around using the toilet or even scared of poo.

The following links provide further information from external sources around supporting children to feel comfortable.

  1. ERIC – Supporting children to feel more comfortable around poo.
  2. ERIC – Toilet anxiety and toilet phobia in children.
  3. Made for Mums Blog – 10 of the best potty training books.
  • If they dislike the feel of toilet paper on their skin, consider using an alternative brand, cotton cloth strips or try using wet wipes.
  • Please think about the environment — most wipes aren’t flushable — but you could consider biodegradable wipes.
  • Does your child find the lighting too bright and overwhelming, consider using a dimmer switch or smart bulbs to alter the lighting? Additionally, consider changing any heavily patterned walls or flooring and think about painting walls with pastel colours or using a plain slip resistant mat to cover up any patterned floors.
  • Does your child, require additional lighting as they may prefer increased amounts of visual stimulation. Please also be aware that too much visual stimulation could end up being too distracting.

If your child struggles with noise levels in the bathroom, consider the following:

  • Placing towels on the radiators or place slip resistant mats on the floor to help reduce the noise volume in the room.
  • For younger children trial ear defenders during toileting or for older children try Earbuds or Flare Audio buds to reduce background noise.
  • Encourage your child to put the toilet lid down before flushing as this will reduce the noise level. If need be, allow your child to leave the bathroom and give them a warning you are about to flush the toilet.
  • If your child is scared of automatic flushing toilets, please consider placing a sticker or a sticky note over the sensor on the wall.
  • If your child is fearful of urine or water splashing them from the toilet bowl, try placing a piece of toilet paper in the toilet bowl before they use the toilet.
  • If in the community, you may want to consider using a disabled toilet. Some disabled facilities in the UK need to be accessed via a specialist key. These keys are referred to as RADAR keys. The following link below provides information on RADAR keys and how to apply for one: RADAR Key Application.
  • Disabled toilets will often provide you with a quieter environment, increased space, and handrails. If your child is noise sensitive, you may be able to turn the hand dryer off at the fuse switch on the wall to prevent it being accidentally activated.
  • Some children can find it confusing to recognise the sensation of when they need to go to the toilet. Being unable to recognise internal body sensations is often referred to as Interoception difficulties. The following link will provide further information on interception and toileting difficulties Interoception and toileting — ERIC.
  • When children have difficulty in recognising the sensation required to go the toilet it is helpful to have an actual picture of the toilet they use at home or school to help connect the sensation and the environment, Please ensure that this toilet picture is included in their visual timetable.
  • If your child is struggling to communicate when they feel the sensation of needing to go to toilet, please pay attention to nonverbal cues such as increased fidgeting wriggling, passing wind or moving away from you which may indicate they need to go to the toilet.
  • If your child is struggling to initiate bladder or bowel movements, try blowing games and activities on the potty or toilet this will naturally encourage the stomach to push to help pass urine or motions, e.g., bubble blowing, blowing party whistles, blowing bubbles with a straw into a cup,
  • To help increase body awareness when going to the toilet encourage resting hands on the lower tummy and this will help with noticing stomach movements and help to increase awareness of a full bladder.

Part Two: Bottom Wiping

Many children with co-ordination problems have difficulty with bottom wiping and the process of going to the toilet. This can often cause high levels of anxiety for both child and parent. The following strategies can be used to learn bottom wiping and assist with toileting.

  • Encourage your child to get into a routine of going to the toilet so they don’t feel rushed. After a meal there is a gastro-colic reflex that stimulates the bowel, so this may be a good time to try and set up a routine. Encouraging your child to go after breakfast may reduce the anxiety of needing to go at school.
  • Be aware of the impact of your child’s diet on their stools and ability to sense they need the toilet, Avoiding drinking can cause constipation. The fibre in fruit and vegetables makes stools bulkier and softer and easier to pass.
  • Support your child to sit in a good position on the toilet, if your child has poor balance, they may benefit from a children’s toilet seat which helps them to perch more easily. If your child’s feet don’t touch the floor, they would benefit from a step under their feet to help them maintain their posture.
  • Wet wipes are good to use when learning bottom wiping as they wipe more easily and cover a larger surface area.
  • If your child struggles with toileting it may be helpful to have a discussion with school about this in order that they can be aware and possibly make arrangements such as keeping your child’s wet wipes in the toilet for them to use.
  • Getting undressed independently may be difficult for your child, encourage and practice the fastening on your child’s trousers. Ask your OT for additional strategies if your child struggles with dressing,
  • Play games that encourage your child’s awareness of where their bottom is and how to reach it. Try encouraging your child to reach for toys or bean bags and put these in the small of their back. Play games where you pass toys or bean bags through your legs from the back to the front

Practice bottom wiping by playing the ‘target practice’ game.

  • Laminate a picture of a target.
  • Place a small amount of chocolate spread/ baby lotion in the centre of the target.
  • Encourage your child to tear off 4 pieces of toilet roll at a time — placing one hand on top of the toilet roll and one hand around the piece they want to pull off.
  • Encourage your child to fold the paper in half and in half again. Try this on the table first and then on your child’s leg.
  • Encourage your child to use ‘pinchy fingers’ to do one pinch of the toilet roll on the target. Use the target as a guide – give your child a score according to how close they can stay to just keeping the chocolate spread on the centre of the target.
  • After one pinch/small wipe encourage your child to look at the paper and hideaway anything they can see by folding the paper in half.
  • Continue until the target is clean/your child needs a new piece of toilet paper.
  • Once your child has mastered this independently without you helping them physically or giving verbal prompts play the same game but hold the target behind your child’s bottom.

Bottom wiping is often a difficult and embarrassing topic to talk about. Often children do not realise the purpose of the target practice game.

Once they have mastered this, they may need prompting to transfer this skill to bottom wiping. It’s important to help your child to practice this skill independently, allow them to try wiping first before helping them.

When your child is practicing it may be helpful to including washing hands within the routine of going to the toilet.


Education Settings

School & Classroom Strategies

It is estimated between 5 – 16% of school aged children experience difficulties with their sensory processing.

Within the context of the school day, children will be exposed to a large amount of sensory information for example, loud noises, bright lights and a variety of textures and smells which they may find difficult to process.

Classroom accommodations and strategies can help students to cope with their sensory processing challenges to enable them to achieve.

Please see the sections to the right, to find a range of universal strategies that you could try. It is important not to introduce too many changes at once, to allow a period of time to determine if these strategies are successful.

Nursery

Children who experience challenges with their sensory processing in nursery can be reluctant to engage with messy play, be overly touchy with classmates and staff, and even squeeze or nip others. They may avoid hugging or hand holding. Some children may find it challenging to sit and be constantly on the move.

They may avoid going to the bathroom due to noise levels and or odours- Mouthing of non—food objects such as mud, sand, chalk and toys may be seen, Some children may make extra noises with their mouth for example humming or clicking when attempting to self-regulate themselves. Please see below some potential strategies you can try.

To support Messy Play:

  • Never force children to engage in messy play.
  • Give plenty of opportunities to explore a range of textures.
  • Gradually build up tolerance,
  • Start with dry messy play like rice and play dough which have firmer textures.
  • Move into wet messy play, but have the child manipulate the messy objects with paint brushes and utensils.
  • Consider baking activities using rolling pins or cutters.
  • Incorporate familiar toys into messy play.

To support attention:

  • Before focused work and at regular points during the day engage in heavy work activities such as pushing and pulling activities.
  • Provide regular movements breaks between tasks.
  • During circle time consider using a “disco sit floor cushion” which provides discrete movement to support attention.
  • Use visual timers.
  • If seeking or avoiding touch during carpet time, mark out a section on the floor with tape to provide a safe space and boundaries.

To support with going to the bathroom:

  • Consider using ear defenders if the child is sensitive to noise.
  • Consider dimming the lighting in the bathroom or switch to warmer LED lights if the child is light sensitive.
  • Encourage the child to select a scent they find calming and spray on a handkerchief when visiting the bathroom if sensitive to smells.
  • Try using activities that provide deep calming input to the muscles such as pushing and pulling before and after going to the toilet.
  • Allow the child to bring play dough or a fiddle toy to the bathroom.

To provide alternatives for mouthing of non-food items:

  • Try using Sensory Oral chews.
  • Consider using a vibrating toy placed against the cheek for short durations. Please do not try this strategy if the child has epilepsy.
  • Blend different cereals and biscuits to provide safe edible sand.
  • Encourage drinking thick liquids (smoothie or a yoghurt) through a straw-
  • Encourage drinking through a sports bottle at regular intervals.
  • Consider using musical instruments such as a recorder or harmonica.
  • Encourage bubble blowing using a wand or use a straw.
  • Snack on crunchy textures like carrots, crackers, and apples.

Classroom

Children experiencing challenges with their sensory processing in the classroom may appear fidgety, move around a lot in their chair and find it challenging to follow and retain instructions. You may observe some children place hands over theirs eyes because of bright lights or cover ears because of loud noises.

Children may be easily startled or distressed because of loud noises and appear distracted by background noise (such as a clock ticking or other children talking). Some may make humming or clicking noises to help keep them focused on tasks. Others may find it difficult to copy from the board, and/or find it challenging to maintain their attention to the front of class when required.

Potential strategies to try:

  • Make sure the chair is a good fit allowing feet to be placed directly on the floor.
  • If easily distracted try positioning the child closer to the front of the room near the board or consider using privacy boards to reduce visual stimulation.
  • If sensitive to loud noises try using ear defenders for short periods of time.
  • Try to remove buzzing or ticking clocks.
  • Fluorescent lighting can flicker and cause distraction, try using of natural lighting or warm LED light where possible.
  • Use highlighters or sticky notes to help stay focused.
  • Consider using an air—filled cushion (Move ‘n’ Sit Wedge) which can help to provide discrete movement.
  • Consider regular movement breaks to help maintain attention.
  • Provide a quiet corner for children to access if they feel they need to.
  • If struggling to follow instructions, have the child repeat spoken instructions before having them proceed, or try using visual aids.
  • Provide plenty of time to respond to questions give 10-15 seconds before repeating the question.
  • Handouts for lessons can reduce visual demands.

Lunchtime

Lunchtime provides children with a chance to have a break from the learning day and refuel and it also helps children develop their social and self-help skills.

Some children may find lunchtime challenging or overwhelming due to the large amounts of sensory stimuli they are exposed to. Children who experience difficulties with sensory processing may: seem hesitant to sit in the lunch hall, become overwhelmed by loud noises and smells, avoid eating during lunchtime and be uncomfortable with being touched by their peers.

Here are some strategies to try to help at lunchtimes:

  • Allow the child to be first in the lunch hall. This will allow them to gradually adapt to the noises of the lunch hall.
  • Enable open access to ear defenders.
  • Consider positioning the child at the end of the table to help avoid being bumped into or reduce the frequency of being touched
  • Allow the child to explore new foods with their hands and lips before eating.
  • Try to sit down and explain potential new smells and textures to a child to increase their familiarity with new foods.
  • Create a smaller quieter eating space in the lunch hall.
  • Encourage the child to invite a peer to share lunch with them.
  • Alternatively, consider using a quieter room for lunch with a peer and appropriate supervision.
  • Agree in advance menu choices.
  • Talk to the child about taste, textures, and temperatures they like and dislike.
  • Communicate with school kitchen staff about sensory preferences.

Transitions

When transitioning between different lessons, children are exposed to a great deal of sensory input. Such as loud noises, large volumes of people moving about and having to deal with physical contact whilst negotiating busy corridors. Some children may find the experience of transitions overwhelming.

Children who have difficulties during this time may be reluctant or hesitant to move on from one task to another, get upset when asked to move onto a different activity, become overwhelmed while navigating the demands of the corridor or find it challenging to remain calm during class line up-

Here are some strategies to try to help with transitions:

  • Try using a now and then schedule to help the child visualise the progression of daily tasks.
  • Use visual timers to assist with completion of tasks and transitions.
  • Provide clear beginning and end markers to an activity or task i.e. “After you finish your 5 maths equations you are done’*
  • Encourage carrying heavy books and backpacks between lessons as this will help to provide a calm and organising influence.
  • Provide gentle verbal reminders to a child when a task is coming to an end, i.e. “In fifteen minutes, we will line up for music.”
  • Consider using lighting changes to indicate that a change is coming for example dimming lights or changing the colour of the light using smart bulbs.
  • Allow the child to leave 5-10 minutes early to allow them to make their way through the corridors during less busy periods.
  • Allow the child to be at the front or end of the line.

Supporting Parents

Please remember that the school day starts the evening before; so good preparation is key to enable children to their best in school.

Please use these strategies to help support parents/ carers to implement regular routine at home.

Here are some strategies to try:

  • Open a direct line of communication with parents allowing them the ability to communicate important information quickly, such as, their child may need extra consideration for that day due to poor sleep or an unexpected change in routine.
  • Remind parents that if anything helps to support the child at home to inform teacher or school,
  • Encourage parents/carers to discuss any worries or anxiety the child might be having early in the day to promote good communication and reduce meltdowns at bedtimes.
  • Encourage the parents/carers to avoid sugary cereals at breakfast and promote balanced breakfasts high in protein and nutrients as this can help to regulate a child.
  • Promote the implementation of a calm and consistent morning routine at home to help set the child up for the day.
  • Encourage parents/carers to have a consistent night time routine in place.

Early Morning Checklist

Use this checklist to help create and establish an early morning/before school routine with your child!

  1. Go to the toilet
  2. Brush your teeth
  3. Wash your face
  4. Brush or comb your hair
  5. Get dressed
  6. Eat breakfast
  7. Pack your school bag
  8. Pack your lunch
  9. Put on your shoes/coat
  10. Have a good day!

Night Before School Checklist

Use this checklist to help create and establish an early morning/before school routine with your child!

  1. Complete your homework
  2. Discuss any worries or concerns for the next day, as soon as possible
  3. Discuss tomorrow’s schedule
  4. Plan a fun activity for tomorrow
  5. Pack your backpack
  6. Layout tomorrow’s outfit
  7. Go to sleep at the same time every night

These video resources have been produced by Sheffield Children’s NHS Foundation Trust Sensory Processing Service and, with their kind permission, we have been able to include these on our website to support families in Northumberland.

Short videos

To compliment the Top Tips information, we have included some short video demonstrations showing what the strategies look like in practice for a range of daily living activities, such as teeth brushing, nail cutting or hair washing.

We would recommend that before implementing any of the strategies from the videos that you complete the online parent and carer workshops.

Regulating Sensory Strategies

This video provides some key ideas for supporting sensory regulation, for children and young people of all ages and stages.

Steam-rollers for Regulation

Gym balls are a really useful tool for sensory-based regulating activities. This video shows a simple, but effective technique for helping your child to feel more calm and regulated.

Superhero Rocks for Regulation

This video demonstrates one way of using a gym ball that may assist your child’s sensory regulation.

Using a gym ball during static activities

This video shows some really simple ways of using a gym ball throughout the day to help your child to feel more regulated.

“Hands On” technique for regulation

This video demonstrates two simple ‘massage’ techniques that can be used to help calm and relax your child.

Visual schedules

We know that there is a strong link between sensory processing and anxiety. If you feel anxious, your sensory processing difficulties can become greater – which in turn, can make you even more anxious – it’s like a vicious circle. Visual schedules, or timetables, can be a really helpful way to reduce anxiety about what is going to happen, by making the routine, expectations or plan more predictable. This video explains how you could use visual schedules at home with your child.

Interoception: sensations from inside the body

This video explains more about what interoception is and where challenges can arise. It provides some key strategies to help support your child.

Toileting

Problems with toileting can be difficult to talk about, especially as your child gets older. This video provides some insight into the motor, sensory and behavioural challenges that can get in the way of your child using the toilet independently.

Hair washing

The following video may help you to understand the difficulties that your child has with hair washing. The short video will discuss the motor, sensory and behavioural challenges and provide some ideas to help you to address these.

Sensory preferences in self-care

We all have different sensory preferences. This short video talks about helping your child to choose products they like based on their own preferences of taste, scent and texture, to make self-care tasks easier and more appealing.

Showering and bathing

The following video may help you to understand the difficulties that your child has with showering or bathing. The short video will discuss the motor, sensory and behavioural challenges and provide some ideas to help you to address these.

Teeth brushing

The following video may help you to understand the difficulties that your child has with brushing their teeth. The short video will discuss the motor, sensory and behavioural challenges around this twice daily task and help you to make some progress.

Nail cutting

The following video may help you to understand the challenges faced when cutting your child’s finger and toe nails. It may offer you an insight into the motor, sensory and behavioural issues surrounding this task and how you can move forwards together to succeed.

Eating and mealtimes

This video offers some ideas to help your child with eating and mealtimes. It also talks about how certain foods can assist regulation.

Sleep

This video provides tips to help improve your child’s sleep. The video encourages you to think about and identify what makes your child feel comfortable and calm at bedtime.

Dressing

This video offers some tips and ideas to help your child to get dressed and to manage the tactile sensations of clothing.

Going out and about

Getting out and about with your child may be quite stressful, especially if you’ve had some negative experiences. This video offers some ideas to help you and your child plan and manage trips out, including what to take with you in your ‘sensory toolkit’.

Social stories™

Social stories™ can explain situations or concepts to children in a way that they can understand, and can help them know what to expect or what they can do. This can make situations seem more predictable, which helps to reduce anxiety. Reducing anxiety is an important tool for managing sensory processing difficulties. This video introduces Social Stories and shares some examples. For more support in writing them and more examples, look at our resources here, which are free to download.

Managing challenging behaviours

In this video we talk about challenging behaviour. We think about what challenging behaviour is, and talk about some of the underlying reasons for why we might see challenging behaviour from children and young people. We then focus on the relationship between a child’s sensory needs, and their behaviour, and help you to think about why you might see challenging behaviour and what you can do to help.