Evaluating or Assessing Sensory Processing

Disorders
● Clinical observation

Observation (Raw, do not interpret) Hypothesis (possible sensory system)

Bites nails Tactile, proprioception, oral

Run without regard for safety - crashes to
the wall
Spinning while looking at the lights
Moves from 1 corner of the room to another Vestibular system, tactile
Approaches anyone gpassing by

● Sensory Profile 2
● Sensory Processing Measure
Those “Other” Senses

Vestibular
Balance, motion and the
position of your body in
space.
When the Vestibular System is a little off…

● Hyper-sensitive: Active Avoider and Overwhelmed

● Fearful reactions to ordinary movement activities
● Apprehensive walking or crawling on uneven or unstable
surfaces
● Seem fearful in open space
● Appear clumsy
● Want their feet on the ground!
● These folks need gentle experiences and support as they
become more comfortable
When the Vestibular System is a little off…

● Hyposenstive Seeker: Actively seek and demonstrate a need for

intense movement experiences (whirling, jumping, spinning, spinning
objects, pacing)
● May includes visual stim
● Be aware: Seeker can become over-excited
○ Needs monitoring
○ “Cap-off” vigorous vestibular activity with proprioception (“heavy
work” or joint compression)

● Under-Responder may need gentle encouragement to engage in

movement activities
Those “Other” Senses

Proprioception

Information from joints

and muscles, responsible
for pressure in and out –
throwing a ball, receiving
a hug, and using a pencil.
When the Proprioceptive System is a little off…

● Clumsiness, a tendency to fall

● Lacks awareness of body position/odd posture
● Difficulty with small objects (buttons/ snap)
● Disorganized….. Materials & Thoughts
● Poor or resistance to handwriting
● Eats in a sloppy manner
● Resists new motor movement activities
 Those “Other” Senses

Interoceptive
Internal sensations – hunger,
fatigue, sickness, pain,
awareness of bodily functions.

A 2nd look at the Tactile System
Protective System
❑ Activates “Fight, Fright, or
Flight”
❑ Born with this system- “Primal”
❑ Stimulated by light touch, pain,
temperature
❑ Processed through the
emotional, excitatory portion of
the limbic system
❑ NOT a cognitive response
Pertains to the sense of touch
Alerts to danger
Gives body boundaries
Helps provide a basis for body image
Localizes touch
Discriminative Pressure Touch
❑ Deep touch/pressure, and
vibration
❑ Activates Parasympathetic
System
❑ Calms and organizes
❑ Allows for more cognitive
response
❑ Helps us learn and think
 Pertains to the sense of touch
Tactile System Alerts to danger
Gives body boundaries
Dysfunction Helps provide a basis for body image
Localizes touch

● Distractibility
● Hyperactivity
● Over/Under Sensitivity
■ Hyper-vigilant
■ Inappropriate pain sensation
■ Avoids getting hands dirty
■ Difficulties with clothing/textures
■ Avoids whole hand
■ Disorganized when touched
■ Intolerant of wearing glasses/hearing aide
● Difficulty with Social Space
● Tactile defensives
Nourishing Your Child’s Sensory Needs
What is Sensory Processing Disorder?
“A neurological ‘traffic jam’ that
prevents certain parts of the brain
from receiving the information
needed to interpret sensory
information correctly.”
− A. Jean Ayres
 Types of SPD
Sensory
Processing D/O

Sensory
Sensory Sensory Motor
Modulation
Discrimination Disorder
Disorder

Sensory Sensory
Postural
Over-responsiti Under-respons Dyspraxia
Disorder
vity itivity
Red Flags for SPD, from Sensational Kids by Lucy Jane
Miller

Infants and Toddlers

● Problems eating or sleeping.
● Refuses to go anyone but their mom for comfort.
● Irritable when being dressed, uncomfortable in
clothes.
● Rarely plays with toys.
● Resisting cuddling, arches away when held.
● Cannot calm self
● Floppy or stiff body, motor delays
Red Flags for SPD, from Sensational Kids by Lucy Jane
Miller

Grade-schoolers
● Over-sensitive to touch, noises, smells, other people.
● Easily distracted, fidgety, craves movement,
aggressive.
● Easily overwhelmed.
● Difficulty handwriting or motor activities.
● Difficulty making friends.
● Unaware of pain and or other people.
Red Flags for SPD, from Sensational Kids by Lucy Jane
Miller

Adolescents and adults

● Over-sensitive to touch, noises, smells, other
people.
● Poor self-esteem; afraid of failing at new tasks
● Lethargic and slow.
● Always on the go; impulsive; distractible
● Leaves tasks uncompleted
● Clumsy, slow, poor motor skills or handwriting.
● Difficulty staying focused
● Unmotivated, never seems to get joy from life.
Nourishing Your Child’s Sensory Needs
How?
Nourishing Your Child’s Sensory Needs

What you see…

What you don’t see…

 Problem solving,
Sequencing, Ability to Cognitive &
Conceptualize, Creativity Academic skills
Reading, writing,
spelling, numbers Perception & Body Concepts, Visual, Auditory,
Tactile-Kinesthetic Perception
Motor Gross Motor, Visual-motor,
Organization Auditory-motor skills, purposeful
Body Concepts, Visual, Auditory, activities & self-control
Tactile-Kinesthetic Perception
Body Scheme &
Gross Motor, Visual-motor, Behavioral Organization
Auditory-motor skills, purposeful
activities & self-control Reflex Integration, muscle tone, eye
Postural Mechanism & movements, balance, Arousal &
Regulatory Functions attention, sucking & eating, tactile
comfort, mother- infant bond

Touch, Seeing, Hearing, Smell, Taste

Tactile, Vestibular, Proprioception
When Problems in Sensory Integration Occur: Participation is Compromised

Processes are not automatic or accurate

Stress and frustration in the course of everyday

occupations

Avoid or reject simple sensory and motor

challenges

Miss important experiences, development of

feelings of competency, useful skills, social
behaviors
 Sensory
Types of SPD
Processing D/O

Sensory
Sensory Sensory Motor
Modulation
Discrimination Disorder
Disorder

Part 2
Sensory Sensory
Postural
Over-responsiti Under-respons Dyspraxia
Disorder
vity itivity
 Setting, Managing and Assessing Sensory Goals
Set a goal which focuses on specific skills. These should enable the child to develop strategies to help them cope when faced
with a difficult sensory experience. A sensory goal could be based on:

● increasing tolerance to an activity or environment;

● decreasing undesirable behaviour or reactions;
● increasing the ability to self-regulate.

Setting goals to be achieved through sensory interventions is helpful as it gives a target and
focus but it’s important to remember that other things could impact whether these goals
can be met.

For example, if your goal was around increasing tolerance during a trip to the supermarket, there are many factors that could
affect this, including:
- the time of day you go
- how busy the shop is
- any music playing
- the length of time in the shop
- the various aisles you are visiting - what the child is wearing
- what you have been doing before
Setting Outcomes
It’s a good idea to use positive phrases.

Think about the overall aim of what you would like the child
to achieve for a long-term goal.

To increase attention span.

To improve the ability to self-regulate.
To enhance social engagement.
To widen tolerance of tactile sensory experiences.
To extend contact with peers.
To build on the amount of foods they will taste.
To develop organisational skills.
To strengthen attention and focus.
To acquire balance and coordination skills.
To create good self-care habits.
To enable regulated emotional and behavioural responses.
To reduce disruptive behaviour.
To decrease disruptive sensory-seeking behaviour.
To maintain a sleeping routine.
Setting Outcomes
 Sensory-enriched Schedule

Adaptation of
Specify Emphasis
daily routine

Changes in Modification
Leisure and
daily of social
Play
environment interaction
TIME KEY EVENTS IN DAY SENSORY DIET ACTIVITIES TRANSITION STRATEGY
Wake up Wake up routine w/pressure input “pressure
sandwich,” or joint traction while singing
Breakfast Oral pressure protocol; oral supports*/heavy work of Review picture schedule
day
Play time/gross motor time Heavy work and play (climbing, pillow play) heavy work Use picture schedule
“chores” such as carrying items, cleaning tables
(scrubbing work!), etc.

Table top or playroom time Wear weighted vest

Play time Sensory social routine** with pressure/ Use picture schedule
traction/compression input
Lunch Oral pressure protocol before lunch with
oral supports/heavy work
Transition to School Pressure play (with rhythm and music/singing if Transition song in car to school;
desired) and use of weighted blanket if child accepts weighted vest in lap

Arrive at school Sensory social greeting routine with pressure input Use picture schedule

Center time at school Wear weighted vest

Play time/gross motor Heavy work and play (climbing, pillow play); heavy
time work “chores” such as carrying items, cleaning tables
(scrubbing work!), etc.
Transition to home Heavy work activity, then
into
house; use picture
schedule
Play time Heavy work with play (climbing, pillow play)

Transition to quiet play Squeeze and hug time w/Mom or Dad;

time wear weighted vest during play time

Dinner Oral pressure protocol before dinner with

oral supports/heavy work

Family time Play wrestle/pressure play time

Bedtime Bedtime routine; pressure rhythm and weighted Use social story
blanket
Misses Environmental Cues Will Seek Out Input
Poor Awareness & Heightened
Slow Processing (Acts as Low Awareness with (Frequently and
if Sensitivity to Low Sensitivity to Intensively
does not hear, misses Stimulation. Stimulation Moving, Jumping,
. Spinning, Touching)
gestures and cues,
sedentary) UNDERRESPONSIVE SEEKER

Can become easily

OVERWHELME ACTIVE AVOIDER
overwhelmed. Will actively avoid
Heightened D High Awareness,
( Complains of things awareness, with (Searching out Escape
“bothering” High Sensitivity High Sensitivity and Areas,
Frequently anxious/upset, but Active Covering ears/eyes,
lacks active Responses.
overreacts to small changes response Aggression to “Protect” self)
in the environment)
 Poor Awareness & Heightened
Low Awareness with
Sensitivity to Low Sensitivity to
Stimulation. Stimulation
.
UNDER-RESPONDER SEEKER
Sensory Processing Disorder:
UNDER-responsive
UNDER-RESPONDER
SEEKER
Increase the use of
Provide sensory
visual supports and
experiences frequently
routines.
&
Structure the environment.
proactively
Time to respond
May need to limit
Careful encouragement to
excitatory experiences
try new experiences
 WHAT TO DO for
UNDER-responsive Child
● Sitting on an exercise ball during activities ● Use bright lights where the child
● Distribute a midmorning or afternoon alerting snacks works and plays.
crunchy - dry cereals, ● Let child jump on a mini
carrots) trampoline.
sour - lemons, pickles) ● Encourage the child to swing as
salty - pretzels fast as he can.
spicy - cinnamon or ● Play loud, fast-paced music.
ginger candy or gum
cold – popsicle ● Bounce a younger child up and
down on your knees.
 Alerting Activities For The Lethargic Child
● Allow the child to sip on ice water in a water bottle throughout
the day.
● Use bright lighting
● Have the child pat cool water on their face as needed
● Take frequent "gross motor" breaks during difficult tasks (i.e.,
jump, hop, march in place, sit ups etc.)
● Encourage an active recess with swinging, jumping, climbing,
playing ball etc.
● Have the child chew strong/flavorful sugar-free gum or suck on
sugar free candies (use sweet or sour gum/candy or fireballs)
 WHAT TO DO
Sensation Seekers
● What sensation is being sought? ● BATHING
○ Touch ● GROOMING
○ Sound ● EATING
○ Movement
● PLAY
● Incorporate sensations to daily
activities – have a “sensory
regimen” ● AIM: Incorporate sensations to
daily activities
 WHAT TO DO
Sensation Seekers
● Errands – buy from a store, get object
upstairs
● Playground equipment
● Hop, skip, jump, climb, crawl, creep,
scoot, march, stomp, clap, push, pull,
squeeze, hold tightly
● Wake-up activities - calisthenics,
movement to music, running, and
jumping in place
● Running, swinging, sliding, and hanging
or climbing on the monkey bars during
recess
● Run messages to the other, carry books,
or move furniture
Sensory Processing Disorder: Hyper-responsive

OVERWHELME ACTIVE AVOIDER

D
Heightened High Awareness,
awareness, with
High Sensitivity High Sensitivity
but and Active
lacks active Responses.
response
Sensory Processing Disorder: Over-responsive

OVERWHELMED ACTIVE AVOIDER

Control the environment Modify the environment
Limit stimulation to reduce the need
Limit change but to escape
prepare for changes Gentle introduction to
when they need to occur. new experiences
Help with Transitions

● Use a visual timer to count down the minutes to

the transition
● Use advance organizers, like week at a glance,
month at a glance
● Anticipate the emotional response and start the
transition 5 minutes early.
● TRANSITION ROUTINE
 WHAT TO DO
OVER-responsive Child
● Firm massage using lotion.
● Use low-level lighting.
● Encourage the child to listen to
quiet, rhythmical music with or
without headphones (Calming music
- <60 beats per minute, most
classical music)
● Encourage the child to rock slowly in
a rocking chair.
● TRANSITIONS USING VISUAL
STRATEGIES
● Suggest to the child who is
sensitive to touch that he or she
line up last
● Create partitions
● Take a five-minute, lights off quiet
break
● Touch firmly and avoid light touch
● Do not approach from behind
● Tell the child that you will touch
him or her
● Prepare child for transitions by
telling her/him what is going to
happen.
● Use visual schedules
 Calming Activities For An Overly Active Child
● Use low level lighting, no fluorescent lights!
● Allow the child to listen to calming music with headphones
● Use a soft voice and slow down your speech and movements
while talking

● Allow the child to lay on the floor in a secluded area with

weighted blankets, heavy pillows or bean bag chairs on top of
them during written work or reading

● Push down heavily on the child's shoulders, with equal and

constant pressure
 Calming Activities For An Overly Active Child

● Avoid rushing the child

● Have the child be responsible for the heaviest work at
clean up time; putting heavy books or objects away,
moving/pushing chairs in, wiping down tables etc.
● Plan ahead, allow enough time between and during
activities
● Make the child the "assistant"; arrange books at home,
giving them "heavy work“ (animal walks) chores carry the
laundry, fetch water, push furniture for you when cleaning.
 Calming Activities For An Overly Active Child

● Provide opportunities for the child to jump on a mini trampoline,

bounce on a therapy ball or sit on one instead of their chair to give
them extra input
● Allow the child to have quiet fidget toys, chew toys/tubing, or
squish/stress balls to squeeze while sitting and listening or during
desk work
● Encourage twirling, spinning, rolling and swinging during physical
education or recess
● Have child do "chair push ups" (raising their body off the chair with
hands next to them on their seat) and/or tie Thera-Band around
their chair and have them stretch it using their legs while doing
desk work
 An Over-Stimulated Child

● Appears like
hypo-responsiveness
● Very slow to respond and
follow
What to do for an over-stimulated
child?

– can help an over-aroused child

calm down, reorganize, and
refocus
– rocking chair
– small tent that can be easily put up
and taken down
– beanbag chairs
 SENSORY-BASED MOTOR DISORDER
●It is category of sensory processing disorder that
involves problem with stabilizing, moving, or
planning a series of movements in response to
sensory demands
TYPES OF
SENSORY-BASED MOTOR
DISORDER:
A. DYSPRAXIA

B. POSTURAL DISORDER
DYSPRAXIA
difficulty with praxis
(greek for “doing, action, practice”)

difficulty in planning and performing

coordinated and voluntary novel
motor tasks
COMPONENTS OF
PRAXIS
IDEATION
MOTOR PLANNING
MOTOR COORDINATION
FEEDBACK
IDEATION
conceptualizing actions
(ability to mentally create a
motor goal and think about
how to achieve that goal)
MOTOR PLANNING
ability to intentionally
plan and sequence the
motor actions needed to
achieve the goal
MOTOR COORDINATION
allows the individual to accomplish
movements with precision

involves not only the execution but

also the refinement with which a skill
is performed
FEEDBACK
involves recognizing whether
the individual was successful
in achieving the motor goal,
and responding to the
consequences
BILATERAL MOTOR INTEGRATION
AND SEQUENCING
refers to the progressive ability of
the two sides of the body to
cooperate with and complement
each other in order to
successfully complete a variety of
motor tasks
Bilateral Motor Integration and
Sequencing
● mixed hand preference
● crossing the midline
● right-left confusion
● catching a bounce ball
● hopping/jumping in a
series of circles
● skipping
● jumping jacks
● symmetrical stride
jumping
● reciprocal stride jumping
● stepping over a moving
object
SOMATODYSPRAXIA
decreased tactile
discrimination and usually by
poor processing of visual and
proprioceptive input
Somatodyspraxia
• supine flexion
• sequential finger touching
• in-hand manipulation
• diadokokinesia
(simultaneous alternate movement of the
palm of the hands)
 POSTURAL DISORDER
shows difficulties in stabilizing the body during
movement and at rest (poor stability, poor weight
shifting and trunk rotation, poor righting and
equilibrium reactions), and inadequate control of
movement and muscle contraction against gravity
 POSTURE
● prone extension ● (tilt board tip, flat board
reach, tilt board reach)
● proximal stability in
quadruped ● neck flexion in supine
● extensor muscle tone ● postural adjustment
● equilibrium/line of
stability
Addressing
Sensory-Motor Disorder
ADDRESSING BODY AWARENESS
•proprioceptive input:
▪ helps the child to be more attentive and
organize
▪ may produce a calming effect
▪ the following activities may be given:
✔ back rubs or massage
✔ wearing tight, elastic clothes such
as stretch pants
✔ heavy work activities (carrying
basket of toys, pushing pail of
water)
 Addressing
Sensory-Motor Disorder
ADDRESSING BODY AWARENESS
✔tug of war
✔ wall push-ups
✔ pressing the palm together ✔ making ‘sandwich’
firmly ✔ playing with stiff clay or
✔ push-ups, sit-ups, chin-ups dough
✔ crawling, crab-walking, seal- ✔ chewing resistive foods (gum,
walking, duck-walking caramels, gummy bears) or
through crunchy foods such as chips,
an obstacle course pretzels
✔ jump rope, jumping jacks,
jumping on a trampoline
 simple exercise to develop core trunk
strength
✔ ‘superman’ exercise
✔ rocking chair
✔ wheelbarrow
✔ sledding
✔ strongman
✔ letter ‘V’
✔ foot wrestling
 ADDRESSING BALANCE SKILLS
● based on input from different sensory modalities
○vestibular system: provides input to the central
nervous system about gravitational pull, motion,
and speed
○proprioceptive feedback: movements in any part
of the body should result in unconscious,
automatic postural adjustments, often subtle, in
other parts of the body
 Addressing SMD
ADDRESSING BALANCE SKILLS
● based on input from different sensory modalities
○ vestibular system: provides input to the central nervous system about gravitational pull, motion,
and speed
○ proprioceptive feedback: movements in any part of the body should result in unconscious,
automatic postural adjustments, often subtle, in other parts of the body
○ visual feedback: as the body moves, so do he visual images that reach the central nervous
system, providing additional cues that the body needs to make adjustments in response to
situation

● important: RESPECT CHILD’S TOLERANCE TO MOVEMENT

● activities:
○ swings, slides, trapeze bars, merry-go-rounds
○ difficulty jumping: jump off a low step or platform onto something that will make noise
○ balance beam, walking/jumping/hopping on a line
ADDRESSING MOTOR
PLANNING
expect that teaching new skills will require considerable practice and repetition

provide first sensory experiences that help the child to be more aware of body sensation,
or that offer vestibular or tactile sensation to help the child to be ready to “listen” to his
or her body (activities that helps in addressing attention and organizational problems)
provide activities that involves tactile discrimination to promote attention to body
cues

give activities that involves imitating body movements or sequences

activities that require rapid anticipation of movement (e.g. dodge ball, badminton))
 A. IMPROVING POSTURE
• tonic postural extension
✔weight shifting while in prone on elbows (POE)
✔weight bearing on extended arms
✔prone extension and supporting full body weight
with the arms (wheelbarrow, scooter board)
• tonic flexion
✔maintain flexion against resistance and the
force of gravity (trapeze, bolster swing)
✔righting and equilibrium reactions
✔elicit subtle reaction to various positions
B. DEVELOPING IDEATION

• familiar objects 🡪 familiar movement

• cognitive approach: sufficient cues to
generate their own ideas
• instructional hierarchy:
○ physical guidance
○ Modeling
○ verbal instructions
○ partial prompts/cues
○ generalization to other settings
C. DEVELOPING BILATERAL MOTOR INTEGRATION

• discrete then sequenced bilateral

movements
• symmetrical then alternating bilateral
movements
• bilateral movements of upper
extremities and lower extremities
• flexing UE and extending LE
activities:
• playing “twister”, “Simon says”, or other
body position imitation games
• paddling with arms and legs using different
patterns
• jumping or hopping games (e.g. Jumping
patterns on trampoline or floor – right, right,
left, left, right, right, left)
• cross-crawls
• drawing shapes using both hands at the
same time (encourage the child to try to
make the right-hand picture look the same
as the left-hand picture)
D. DEVELOPING PROJECTED ACTION SEQUENCE

• simultaneously controlling limb

movements and posture
(Client is stationary, Object is stationary)
e.g. coloring while in prone on elbows, spooling while sitting on
vestibular ball

• navigating in relation to stationary

objects or other person
(Client is moving, Object is stationary)
e.g. shooting rings while swinging
● coordinating the sequence of limb segment movements to
finish at the time of contact or release
(Client is stationary, Object is moving)
e.g. hitting a moving pendulum, kicking a rolling ball

● moving a limb along a path to contact an object or reach

the desired release point
(Client is moving, Object is moving)
e.g. hitting a moving pendulum while swinging, kicking
rolling ball while running
ADDRESSING FINE-MOTOR COORDINATION
● to develop shoulder, elbow, and wrist stability
●child needs to ○ upper body strengthening exercise (wheelbarrow,
learn to hold his animal walks, tug-of-war, pushing/pulling weighted
or her arm, wrist objects)
in a stable
position, while ○ practice fine-motor activities at a vertical surface
isolating finger (placing worksheets on the wall and asking the child
movements to color)
according to the ○ child has difficulty coloring: provide broken crayons
demands of the or chalks as this will help to strengthen the fingers
particular task
○ plenty of doing activities on floor: child lies on his/her
tummy while reading, watching television, or playing
games
○ sitting push-ups
● to develop finger isolation and dexterity
○cup the palm of the hand and try to fill it with
rice or sand, the more the hand can hold, the
better developed are the arches of the hand
○clothespins or clipping objects
○coloring in tiny, miniature pictures
○using tweezers, tongs to pick up objects
○clay activity
○finger pattern games
○play tug-of-war
 ADDRESSING ORAL-MOTOR SKILLS
● practice making faces or imitating facial
movements
● moving the tongue: lollipop
● blowing to strengthen lip closure: whistles,
bubbles
● sucking in a straw
SENSORY DISCRIMINATION
DISORDER

●difficulty interpreting and

distinguishing messages within
sensory systems
●often underresponsive and has
sensory-based motor disorder
Tactile Stimuli
•differentiating touch or completing
tasks without visual cues
•manipulating objects without looking
Visual Stimuli
•perceiving form and space and
relationship among objects
•perceiving depth, distance, location of
boundaries and space between objects
Vestibular-Proprioceptive Stimuli
• knowing position of body in space and its relationship to
surroundings
• gauging correct force to use with people or objects
Auditory Stimuli
• differentiating and remembering similar words and
sounds
• following 2 or more verbal instructions
• focusing on recognizing a specific sound in the
presence of background noise
Taste/Smell Stimuli
•cannot distinguish taste or tell when
food is too spicy, salty, or sweet
•cannot distinguish smells such as
lemons, vinegars, or soap
•may choose or reject food based on
the way it looks
What teachers, other therapists and
parents can do?
• Recognize the problem
so that they know what
the child needs
• Help the child to feel all
right about himself
• Control his environment
• Help him learn how to
play
• Seek professional help
● What can an occupational therapist
do for you?
Fostering the child's participation in
typical everyday childhood activities or
"occupations" is the main goal of
occupational therapy.
Therapist consultation aims to educate
teachers, parents, and older children
about sensory integration and to
develop strategies to adapt to and
compensate for dysfunction such as:
• environmental modifications
• adaptations to daily routines
• changes in how people interact
with the child
• sensory integration therapy
 Less than others More than others
(lower numerical scores) (higher numerical scores)

Key Characteristics Intervention Key Intervention focus

focus (within Characteristics (within
participation participation
routines) routines)
Seeking Does not seek Provide Seeks & Provide more
input Variety enjoys input opportunities

Avoiding Less likely to Provide Bothered by Make less

withdraw organized input input available
input
Sensitivity Less detection Increase More Provide more
awareness detection structured
input
Registration Notices more Provide more Misses more Provide more
familiarity intensity
 Summary
● Active participation of the child
● Activities should be fun and meaningful
● Child should be given a chance to direct or choose activities
(motivation)
● Start with the system/quality that he is comfortable
● A sensory-nourishing environment is important
● Adequate organizing and filtering capacities
● Observe your child
● Ask the “right” questions.