Caitlin Whyte (Host): Welcome to Healing Heroes PDX, a Shriners Children's Portland Podcast. I'm Caitlin Whyte, and with me today is occupational therapist, Eva Ma from Shriners Hospitals for Children, Portland. Today we are learning all about sensory processing. To start us off, can you tell us what is sensory processing and integration?

Eva Ma, OTR/L: So the terms sensory processing and sensory integration are sort of interchangeable. Some people like to call it sensory processing and some people call it sensory integration. But essentially sensory integration is a process. It's sort of like the neurology of how we feel. Like as adults, we are pretty much pretty familiar with some of the sensory aspects of our daily lives.

You know, sometime maybe we feel pretty good after going to the gym, or on a long nature walks that may feel calmer afterwards. Or sometime people might say, oh, you know, I really want to listen to some soft music so that I could calm down. Or sometimes when you exercise, you want music that are really fast and really getting you energized to maybe sense of like spicy food sometimes will wake people up or sometime people say, you know, I need to, you know, chew some gum because I really need to focus on this project.

So most of these are getting all these different senses, processing it together, and then they're impacting our health and wellbeing.

Host: Gotcha. And could you walk us through the sensory systems and functions?

Eva Ma, OTR/L: Oh yes, absolutely. I think most of us would be very familiar with probably the sense of touch, just because we feel with our hands. We feel hot, cold. We definitely feel different kinds of pain through our skin, texture, like, the pillowcase being soft to maybe playing with sand at the beach, or deep pressure versus like a light touch.

Another sense is proprioception. It is relating to how we sense our muscle movement and how our joints are moving to help us with our daily lives. Such as like carrying something heavy, we'll exert more energy to if we are going to have to climb across a set of monkey bars, how much force we need to put up.

And then vestibular. Which is the sense that we have in relationship to gravity. It helps us to balance, say, you know, we need to run really fast and we need to make sure that we are not going to fall, or maybe we need to climb up a set of stairs or a ladder. It's like, okay, how do I coordinate my left side, my body leaning and catching myself if I'm about to fall?

And then visual or sense of seeing, and it's not about whether we have 20/20 vision, it's more about knowing what we are looking at or, I'm at the grocery store, I need to go find some items on the shelf, so I need to screen out other things that are not as important, but to able to find the one particular item on the shelf.

Then we have auditory, the sense of hearing. Because there are just so many different sound sources in the world, so I have to be able to screen or filter out. Just like right now I'm talking with you. There might be noises outside the room, but I know and I have to pay attention to what you are saying and filtering out the noise that is not as important.

Or maybe when somebody is calling out somebody's names and I know, oh, they're not calling my name, so I need, I don't need to pay attention to that.

 The next one is oral, taste and mostly is on our tongue, inside our mouth. So we all like tasting something sweet or maybe sour, maybe salty, bitter. So all these sort of giving us the sense of what we are eating. And then next is the sense of smell, olfactory. So we need to know what we are smelling to have a sense of safety. Something like, you know, we know the difference between something fresh versus something like garbage smell.

 So lastly is our internal sense, and we call it interoception. And that is a sense about, hmm, are we hungry, are we thirsty? When we are nervous, our heart rate goes up. And all of this helps us to know and navigate our environment from day to day.

Host: Wow. Definitely a lot going on when we're talking about our senses. And what are sensory preferences?

Eva Ma, OTR/L: So sensory preferences will be relating to some things that we had already always adapted throughout our lives. When we think about newborn babies, they're just learning. So from a developmental standpoint, most of the time, babies would learn through sense of movement; even though when they are still in utero, in their mommies tummy because they are hearing their mommy's voice, they're sensing the same time when mommy's moving.

So as we grow and as we develop, we might have things that we sort of like. Hmm. Really particular, you know, for some people it might be a particular brand of socks because it feels soft. Or the thickness of it, or the weight of it. Or to somebody maybe certain types of music, certain volume. You know, sometimes some people may say, oh, you know, that's too loud. Turn it down. And might be for some other people, it may just be acceptable range. Even like food. You know, some people may like very spicy food. Some people may say oh oh, no, nothing spicy at all. Each one of us compile to have a profile or things that we generally can tolerate, or we generally really, really love to have.

So a different range of these preferences make us who we are as a sensory being.

Host: Eva, what are some examples of activities for neurotypically developing children?

Eva Ma, OTR/L: Anything the children like to do. That's what I usually tell my families because we really want to see what the child's interest is first. But when you think about developmentally, once again, children, they play peekaboo. they play hide and seek, and experiencing through just action, that sensory motor play, that we have it through our early childhood and preschool, and they are just so rich in, as far as playing with Play-Doh, making different shapes to playing in the sandbox, to even, you know, coloring, you know, we can do face painting on their face, to like vestibular and proprioceptive senses wise, you know, we do a lot of swinging, we do a lot of climbing on the rock wall. Maybe we do jumping, swimming, that sense of water on the skin. So, all those are just providing so much sensory rich experience with the child.

Host: And how can parents of children with physical or movement challenges provide sensory rich activities to promote overall development?

Eva Ma, OTR/L: Yes, that is a challenge, isn't it? Because for some of these kiddos, they are not able to develop their gross motor and fine motor skills, so they're missing out in many opportunities that might be presented. So I would really do a thorough examination and understand the child's movement ability and their sensory preference, and then design what is the just right challenge for the child so that he or she can feel comfortable, sense of safety, and then develop interests and exploration.

Host: What should parents be looking for if they suspect their child might have sensory processing challenges or differences?

Eva Ma, OTR/L: So I would sometimes suggest the parents say, let's try something with big movement first, because that's really foundation for all the other development with the eye-hand or eye-foot coordination. And sometimes we might have to be creative, maybe putting a child in a specialty swing that may have a back support then the child is feeling safe in sitting without having to focus so much on their own balance or their own vestibular sense. And they could enjoy the movement more. And they can experience that with either us modifying or bringing maybe a special tub that could allow them to reach in to play with maybe some sand or maybe some shaving cream, or even Play-Doh, so different textures that they can sense and feel with their hands.

and sometimes maybe modification of the room. I might, get them to a room that I might have the, some of the lights turned down or turned off for the ones that may be too sensitive to light or ceiling light. So I may do one sense more and one sense less. So I may add some music to this room, but I may take the light source away. So there are many creative ways.

Host: And what are some of the sensory motor activities that can promote connection and regulation?

Eva Ma, OTR/L: It's really different for each child. So I really would ask the parents to be more like attuned or more giving me some observation ideas, because some of the times it might be, just new. You know, it may be a fresh idea for the child. It's not like they were not able to tolerate that sense.

So really looking at functionally what is limiting your child? Or what is limiting your interaction with your child that makes it hard to carry out your daily activities, and then we can give you some suggestions or ideas to either modulate it or to create a situation that the child is not as reactive to those stimulation or to those activities.

Host: And what are some of the sensory motor activities that can promote connection and regulation?

Eva Ma, OTR/L: I'm a big, big fan of peekaboo, is just you and the child. You don't need any other tools. You don't need any other expensive toys, and that is just, you know, covering your eyes and pretend that you don't see the child to, you know, you can hide under the child if you guys are sitting at a table. Because that way they, they see, and then you don't see, and then it's like, oh, that person is there to, maybe doing a lot of song and movement.

You can do the sing along.A lot of children, they definitely love to hear the songs like Row, Row the Boat, and you can do some movement or rocking with them. Or like if the child is in a stroller or wheelchair, you can do some stop and go movement with the song, like, Ring Around the Rosie, to just being with the child with even like maybe like nowadays, with the iPhone or iPad, you can do video games together. As long as you guys are together doing something, that is a connection of itself, and you are building experience together, and you are building that relationship together, that joy of playfulness. So, try all of that.

Host: How can parents of children with physical challenges or movement difficulties be provided with sensory rich activities to promote overall development?

Eva Ma, OTR/L: Mm. Yes. I think this is a question that a lot of the parents really want to address. So, I'm just going to say, so you need to go see an occupational therapist, but, but if you are not able to access that right away, I would really encourage you to look at what your child's most interested with. Is your child a mover and shaker?

They like a lot of movement. Or if your child likes to play in the water, they like to have sense of touch or water play. So based on that, you can do a lot, um, movement activity with them or you can, like I mentioned earlier, set up these touch senses, to your child. You know, you can position your child in a chair or, or, on the floor and then present them, with these toys or the activities that they can experience with.

And think about some of the things a typical child might do and then modify it. Bring the world to your child. So, maybe setting up at a table and if the child is not able to go up to a table, think about how you can maybe sit behind your child and do some maybe like hand over hand or hand underhand experience with them.

So making sure that you are positioned, and you can be comfortable handling your child because sometimes that could be quite challenging when you are trying to support your child as well as being the facilitator.

Host: Well, thank you so much for this detailed information. That was Eva Ma sharing her insights on sensory processing. For more information, head on over to shrinerschildren's.org. If you enjoyed this podcast, please share it on your social channels and explore our entire podcast library for more fascinating topics. I'm Caitlin Whyte, and this is Healing Heroes, PDX. Thanks for listening.