Join Lindsey and Global Teletherapy’s very own Teresa Iatridis, OT for a special talk on sensory regulation and how OTs can help parents and teachers create sensory diets or other ways to help students master sensory regulation. From balloon volleyball to even bringing in the groceries, Teresa is full of great and practical ideas to help children regulate their senses.
Lindsey:
Good morning Facebook, how is everybody? Hi. I’m so excited to be back here in the studio, which is my couch, but it’s better than traveling. Oh my gosh, I loved spending time in Baltimore, I had a blast. Ah, my phone. Sorry, you guys. Apparently I had it on my phone and then that came through too. Okay. So, welcome everybody. Thank you so much for joining us today. Elana, I see that you’re on here, and we’ve also got Christina, Erika Soto. Thank you so much. I love that I always call you Erika Soto, I don’t know why I just don’t call you Erika, but I know that you love watching the show, so I appreciate you being here. And my phone keeps going off, I don’t know what to do. Sorry.
Lindsey:
Okay. So we have a fantastic show today for everybody. This has been a pretty hot topic, lot of buzzwords going around sensory regulation. Right? So I am one of the school psychologists that are out in California. We talk about sensory regulation all the time, but there is another group of people who talk about sensory regulation, those are OTs. But before we get started, I want you to drop a comment, tell me where you’re watching from, use the hashtag team live or if you’re watching the replay comment with your hashtag team replay. And I do have to give a shout out today. I love it when my mom watches. Hi mom. Awesome. But guess what? It’s her birthday today. Happy birthday mom. Yay.
Lindsey:
All right you guys. So today’s topic, sensory regulation. Sensory overload happens to all of us. From fire drills at the school, you’re in your office you know they’re coming, and they get so loud and you get that… I cover my ears because it’s hard. Right? What about drastic weather changes? Hot to cold. You’re going from your heated car and then you have to walk outside, because I was in Baltimore, it was 35 degrees and I’d be like, this is so cold, how do I get back inside? Got to get to heat. Right? So our body temperature changes, we use sensory regulation for that as well. So sometimes our systems get jolted. So all of us can benefit from sensory regulation tips. So I want to introduce our guest, Teresa Iatridis. She is one of Global Teletherapy’s OTs. She has been in the field for seven years, previously she was a respiratory therapist for over 20 years. This is the second career for her.
Lindsey:
This is her third school year with GT. So she’s got a lot of experience working in this teletherapy world and the virtual setting. And she has worked in outpatient clinics, she’s worked in schools, acute care. In her free time she enjoys spending time with her family, she’s traveling. She loves to attend sporting and music festivals. So I want to welcome everybody, Teresa, welcome to our show. And hi Teresa, how are you?
Teresa:
I’m fine. Thank you for having me.
Lindsey:
I’m so glad that you’re on our show talking about this hot topic, sensory regulation. So I do have to know though, what kind of music do you enjoy listening to when going to these music venues and concerts?
Teresa:
I like all types of music really. I recently attended the… I went back a few years to my college days and attended the Austin City Limits Music Festival with all the college kids. We have tickets to the Symphony that we enjoy. And I live in Metro Atlanta area, so we have lots of concerts and music going on and sporting events all the time. So I just really enjoy all types of music really. I guess my favorite would be probably more like alternative rock, from my college days still.
Lindsey:
Right? I still go back to that section too. So it’s really interesting that you bring up music festivals and sporting events. These are really loud activities, crowds, things like this. To me, I’m like sensory overload for sure. So let’s talk about sensory regulation. What is it? Can you give our guests and our fabulous viewers information about sensory regulation, what it is, and why it’s important? How do you sum that up?
Teresa:
Well, in a nutshell, first of all, it’s a very complicated system. Our sensory system is complicated, but in a nutshell, it’s how we interpret all of the information around us with all of our senses. So, at a music event it’s how we interpret the sound, the crowds, the people touching us, the smells of all the food trucks, and everything around us. So basically it’s our ability to take in information from our senses and process it, and use it to go about in our everyday activities.
Lindsey:
No, that makes a lot of sense. So all of us we have sensory needs and we’re able to regulate them, however, some people aren’t regulating correctly, and that’s where we get that overload. So who does this impact? All of us have sensory regulation abilities, but sometimes they’re impaired. We talk about this with students that might be on the spectrum, but just because you’re on the spectrum doesn’t mean that you can or cannot be affected. So give me your input on that. Who does this impact?
Teresa:
Well, it can impact, as you said, anyone really, we all, if you think about it, we all have sensory preferences. Just going back to the music festival example. Some people tolerate being in crowds. Other people really can’t tolerate that. And us as adults, we just know to avoid situations where we make our own accommodations. Children, oftentimes, they’re not set up with those skills yet and that’s, as an OT, that’s a lot of what I do. But first start with education of the parent, the family, and then the student too, it’s important that they understand that this is something that we all have, a sensory system, and we all interpret things differently. So we want to identify what the student’s needs are and try and match accommodations or adaptations to their environment too, so that they’re not overwhelmed and paralyzed by just their environment.
Lindsey:
Yeah. You bring up a really good point about that word paralyzed. And I know you’ve got an amazing PowerPoint. Everybody in Facebook land, I am going to upload this PowerPoint that you’re going to be able to use. It has information. It is great to understanding our fight, freeze, and flee system, or… No. What was it? I don’t know what’s in front of me. Yeah. So talk a little bit about this and how this PowerPoint can be used to educate the parents or teachers, or anybody in the field that we would need to discuss this with.
Teresa:
Yeah, well, and I don’t want the PowerPoint to mislead people. This is not the global approach to sensory… It’s very complex. So what I discovered that worked best for me was to start with the basics, and really, because if you jump in and you’re trying to create interventions, it really requires lifestyle changes for both the parent and the student. And if you’re just trying to create interventions too, it’s like putting a Band-Aid. If you know they don’t like noise and your using noise canceling headphones, or you’re trying to get them in a quiet space, they need to understand why, and why it’s important. So what I’ve noticed with my students, many of them needed… They had sensory emotional regulation type goals. So that was where this PowerPoint was created, was to address the sensory modulation, particularly the over responsiveness.
Teresa:
So a lot of times what I try to explain to families and to students, if they’re able to understand, I do it on many levels. Sometimes I get pretty scientific for some of my high school students, and other times I’m more basic, but we all have a protective mechanism in our body, it’s called our fight or flight response. And that is designed to help us. It gets us out of trouble if someone’s chasing us. If we’re in a dire situation, where we have to act quickly, it’s our non-thinking brain. It just clicks in automatically, and it takes over. A lot of times students that have problems with social, emotional and over responsiveness, they may be existing in this fight or flight response, continually throughout their day. Their amygdala, the part of the brain that regulates this, automatic, it’s nothing that we can control, is really, really overreacting.
Teresa:
So I try to explain it in terms to families of this is how your brain works, and the good news is, is if your child is existing in this state, the great news is, is they have a really great protective response. That’s fabulous. As parents, we all want our kids to have that, but we just have to address that it’s on overdrive and try to find ways to calm it down and adapt to environment, help us work our way out of these situations that are triggering that response. So that was how I began with this PowerPoint. There’s many, many other aspects of sensory regulation, but I just put that out there because I thought it might be helpful for other clinicians.
Lindsey:
No, I think that’s great. Just starting with the basic foundational information, understanding that why behind the reaction really does help give a clearer picture. And we want to work with these children and do what’s best for them. So you mentioned noise canceling headphones, which are great. There’s also activities that I know that we can do with students. And so not just accommodations and, what do we do when those headphones aren’t there? We really want to help regulate that system. So I like that we have accommodations and that yes, before the student actually can immerse themselves in this environment, then utilize these tools. But simultaneously we want to teach them how to manage this environment without those tools, or when they’re not available, what do we do? So what kind of activities can happen during the session? So for our therapists in the virtual setting and in the traditional setting, when you actually have the student, what kind of things can we work on?
Teresa:
Well, the first thing that I start with is I start with trying to help them recognize how they’re feeling, because think about it, if they’re not perceiving, or if the parent is not picking up on the child’s signals, or if they’re overstimulated, or if there’s too much noise, it’s really hard to even develop a plan. So I start with simple activities, like, I use a lot of emoji faces and let’s look at this emoji, tell me how this emoji is? How are they feeling right now? We might do an art activity. We may act it out, a lot of gross motor, we get up and we move around, that sort of thing. And from that I can move into let’s think about when there is too much noise, what are the situations that are bothering the student, or bothering you, depending on their age, and let’s be detectives, let’s think how we might solve this problem, what do you think would help?
Teresa:
And we just come up with simple plans and changes, and it’s an evolving thing. It’s not, here’s your sensory diet, there you go. It’s all fixed. It’s an evolving, emerging, collaboration with the parent, the child, the teachers, and which leads me to one point that I noticed right away in the virtual world. I wasn’t sure how I was going to actually do OT via webcam. I was like, okay, how’s this going to work people? I’ve been school-based, and I don’t know. In my opinion, and what I tell colleagues that are still in the brick and mortar setting, and they are always asking, well, how are you doing that? It works predominantly because of the collaboration with the family. And you get to see the student in their environment. So where is the learning environment? Where’s the classroom? It’s the home.
Teresa:
So we’re getting to make changes that not only benefit the student as they’re learning, throughout their academic day, it’s also, it’s their home environment too. So it’s changing the way families are able to interact and exist, really. So that’s my plug for virtual therapy with sensory regulation. I’m very happy that I get to see the home environment and sometimes we can make adjustments to it that seems small, but it turns into a really big deal for the student.
Lindsey:
Yeah. You brought up a really good point. You also brought up a buzz word, which was the sensory diet. So we’re going to go back to that in a second. So, as a mental health clinician, I do always wonder like, OT, how does that work? Okay. So Facebook friends, if you have ever wondered like, OT is so hands on, how do they do it in the virtual setting? Put that in the comments, and you’re like, what? And if you’re one of my OTs watching that work in the virtual setting, give us a tip in the comments as to what you do, and how you do your job in the virtual setting, because all of us are just amazed that it works, but like Teresa said, it does work. And so these are skills that we like to transfer into it. So Teresa tell me, sensory diet, what exactly does that mean?
Teresa:
Basically it’s a plan of action. I like to think of as a plan of action, where you are determining what types of sensory input a student needs to achieve their optimal level of regulation, or what we call just right, or alert and ready to learn. I often use those words too. It’s activities, or quiet time, or specific things that you can sprinkle throughout the day that helps the student regulate. Think about us as we work, virtually. We’ve probably all discovered that, me personally, I don’t like to work for longer than two and a half hours straight. I need a break. I need to get up. I need to move around. I need to get some… I always keep water at my desk. There’s things that I do to keep myself alert, and keep my brain working. Students that have sensory processing difficulties, they aren’t in tune with what they may need. The parent, probably doesn’t understand. And then secondly, they may be working on overdrive.
Teresa:
So it’s a process of figuring out where the student lies on the scope of, are they overstimulated or under. And then it’s suggesting activities that the parent can try to actually bring the student back to the optimal level. So it is a process. It takes time, but if the parent has good follow-through, and it’s really possible to change a student’s academic day for the better, absolutely. It’s a lot of work, but it does work.
Lindsey:
So what are some activities that we would put in a sensory diet? So I know when I was at my traditional school, one of the things I would do for behavior observations, I’d watch, and I always worked at middle schools or high schools where they have lockers, or even just in my elementary schools, what I’m looking for is the student who’s walking down the hallway and they’re walking and then they go, boom. And now they’re like walking against the wall and they just want to feel that wall, or they take their hand and they brush the wall. They aren’t seeking sensory input. So you would say that this is a low… Okay. So how I put it in my mind. So right, throughout the day we start getting really tired, and so what do we do? We go and we drink coffee, right? That gives us the energy.
Lindsey:
So I feel like these students are seeking sensory input because they’re not regulating. So they need to feel the wall. They need to push against the wall when they walk through the wall. So instead of having them do that, we would then sprinkle the same type of senses throughout the day. So like one of my students on his break, because he couldn’t work, he would then take gallons of water, and he’d walk down to the front office because that heavy pressure put into that muscles. In a home setting, maybe if a student needed, would you recommend the parent give a bear hug? Obviously at the school setting I’m not going to have my teacher bear hug my kiddo. I don’t think that, that would go over well. But if we’re at home, we can use the caregiver to do things. So what other techniques, if they’re seeking that type of sensory, what are other things, activities, you have that student do throughout the day?
Teresa:
It depends. The first thing I like to find out is what does the student like to do? Because, if you know what they like then use it to your advantage. So for example, I just had a conversation this morning with a mother whose son has trouble attending and focusing and regulating, and he loves being outside. He loves basketball. He loves any kind of ball sport. He loves riding his bike, his scooter, all of that. So we talked about getting a schedule of just 10 or 15 minutes for him to have a break. She said, yeah, but the weather has been so bad. I said, that’s right. So we need to have a plan for inside when the weather isn’t permissible. So I said, what are you doing when he is inside, and can’t go out and do those things? What are you doing for his break?
Teresa:
She says, well, I usually let him watch his favorite television program and, or he can just have quiet time in his room. So then I just explained to her that while we all love to watch our shows and have quiet time watching television, it’s not the same sensory regulation activity as the gross motor heavy work, we call it. So we came up with a strategy to design an obstacle course inside the house, blow up a balloon, play some balloon volleyball, running a vacuum cleaner, chores are also heavy work. So she was like, Oh, that’s fabulous. Most parents are really happy to hear that. So vacuuming, sweeping, carrying a basket of laundry up the stairs, carrying groceries in, from the grocery store, helping out. Those can all be very organizing and gross motor heavy work activities.
Lindsey:
Those are fantastic for inside the home. So if we think about the traditional school setting, what has really been coming up that I’ve seen, especially on Facebook newsfeed, sensory paths. So, yes, I can’t make my student go and carry groceries because we’re in a traditional setting, but we can carry books to the library, things like that. But I’ve been seeing more and more of these sensory paths. So anybody out on Facebook land that’s at a traditional school, are you using sensory paths? Have they been implemented in your school? One of the jobs I had when I worked as the school psychologist in Michigan was, we did… It wasn’t a sensory path like you see where like the hands on the wall and they’re going through, and they have the leapfrog and the jumping, but we actually had sensory stations. And so the aid would take… And this could be used for gen ed kids and it was special ed kids.
Lindsey:
But just students that we noticed that needed to have those sensory breaks throughout the day, twice a day, the noon aide would go through and they would go and walk around campus, and in each point there was an activity like a bear crawl, or maybe they had to do leapfrog, or they did pushups against the wall. So it wasn’t like these fancy sensory paths that we’re seeing on Facebook, but there were more sensory stations. So I’ve seen those in action at my school sites. I want to know if any of you have seen that. And then Teresa, can you talk about this? Is this just a buzzing? Do these things really work? Is it recommended? Is this something that we can implement in the school setting? What is your take on that?
Teresa:
Yeah. I’m glad you asked about it because… And I’ll just give you my opinion, my professional opinion. I think yes and no. I think yes, anything that gets students moving in different positions and doing different motor activities, and if they’re excited about it, and they like it, two thumbs up for that. What worries me about… Two things. What worries me about sensory paths is that one, there is the focus on creating this path and is it taking money away from other necessary supplies that schools might need to serve students? And then secondly, not all sensory paths, a lot of them that I see, they’re not really accessible to everyone, to students with disabilities. And so I think, that’s where I’m like, okay. I don’t know. When I see the children doing it on the videos, and I personally, I had my own version of it, but it wasn’t anything permanent. We would put up cones, and use scooter boards and bean bags, we’ve been doing sensory paths forever, because that’s what we do.
Teresa:
So to me, when I create one, I’m creating it based on each student’s abilities, so that I know that they can get through it. So my issue with it is, is I would just want to make sure that it is something that’s accessible to every student, that every…
Lindsey:
That’s a good point. And maybe it’s not also the same needs. So like you mentioned, the sensory needs and input that we need, maybe that’s not even targeting it.
Teresa:
Yeah.
Lindsey:
You could have the student on a sensory diet, but that’s not the type of diet they needed to be on. So you do bring up a valid point that probably an OT does need to be involved and help figure out where, and what’s missing, or what’s needed for that student, because it does need to be individualized. They’re fun, but like you said, if they’re inexpensive to put in, kids will use them, but they might not. I’m thinking the jungle gym at the school, on the recess playground, those are full… Why don’t you just take the kid over there? But sometimes they need to have something more specific. So definitely interesting. I would love to hear back from any OTs out in the field that actually have these at your schools. What are you seeing? Put that in the comments, I really do want to know. Is this just on trend for just because it’s a buzzword, or is it actually helping students?
Lindsey:
So one of the other questions I had in regards to more exposure therapy. A lot of times I see, like at home, the touch, right? Texture. So at home we have access to a lot more things. So maybe, do you ever bring in home items like shaving cream, or any sort of crinkly paper? What kind of activities can you put into place, or teach the caregiver, or that you run in your session in tandem with that caregiver, to really address the feeling of texture? Because so many times our students struggle with their clothing, jeans, the heavy weight, but again, you might have to wear that. So how do we teach them to regulate when they have this texture sensitivity?
Teresa:
Yeah, that’s a good question. And before I answer that, I’ll just add one other point about the sensory regulation. Heavy work is a great thing, and it actually can be very alerting, and it can be calming at the same time, to different individuals. But if you have a student that’s already hyper, hyper responsive, and they’re running really on a high, high engine, sometimes giving them that gross motor heavy work, just revs them up even more. And so that’s why there’s no one blanket treatment for everyone. You have to really observe and see the signs of how students are responding to things, to know if that’s appropriate for them. Okay. So getting back to textures. Yes, textures are a big issue. I love that I’m providing therapy virtually because I do get to really talk to the parent one-on-one, and with the student, and they can share their struggles with me.
Teresa:
Oftentimes it might be things, brushing teeth, brushing hair, which translates over to, they may not want to hold their pencil, or crayon, if they have tactile defensiveness. So, we at Global Teletherapy, a thing that I really love about Global is they actually send a toolkit out to the student, so that they have the same supplies as I have. So we have items in our toolkit where we can actually do therapeutic activities that help with developing the tactile sense. So we have little balls with spikes on them. We have little pom pom puffs that are soft. We have putty and Play-Doh and all these hand manipulatives that we can use to get their hands, not only working together, but also develop that tactile sense. And then I can also talk to the parent about how to get them through the morning of getting dressed and ADLs, and that sort of thing.
Teresa:
So we can include that as part of the therapy, because if they’re not getting up and getting dressed, and getting to the computer for their class, then that’s an issue. So it has to be inhibiting the educational process, but oftentimes it is. So basically we just look at each student and try to develop the skill that we feel that they’re lacking.
Lindsey:
No, that’s fantastic. Teresa. I really like that we can make this individualized. It is not a cookie cutter recipe. One size does not fit all. Students’ needs are different. When we think about it in adults, we still have to learn how to regulate each of the things. Some of us can tolerate the cold. Some of us can tolerate the heat. So just like in our students, we all have a different window of tolerance. So I appreciate all of these activities that you have recommended that can be utilized in the home setting, or in the traditional setting, and I think everybody does need to be aware. So thank you so much for joining our show today. I really enjoyed having you as a guest and learning more about how OTs work with sensory regulation.
Teresa:
Thank you so much for having me.
Lindsey:
All right, everybody. So next week show, I’m thinking that we should do a little bit of a recap on NASP. I learned so much being in Baltimore and I know not all of you could join me. So what if we discussed a little bit about the resources that I learned, and I can bring that back to you. So would anybody have anything specific they’re willing to share? Maybe they did attend NASP, if you’re interested, we might just do a really short segment in regard to some of the resources that will help you in your practice. So there’s a lot of great information. So if you have any other future topics that you want us to address, please put those in the comments, I love hearing from all of you. So thanks everybody for watching today, it’s been a great show and we look forward to seeing you next week.
