Sensory Strategies for Kids with ADHD

How occupational therapists can use a sensory diet to produce results

By Debra Wood, RN, contributor

ADHD Sensory Strategies for Occupational TherapistsChildren with attention deficit hyperactivity disorder (ADHD) struggle with paying attention or even sitting still. Sensory interventions by occupational therapists offer a way to manage the condition.

After performing appropriate sensory strategies, “the system is content and you are ready to learn,” said Heidi Tringali, MS, OTR/L, spokesperson for the American Occupational Therapy Association and owner of Tringali Occupational Therapy Services in Charlotte, N.C. “You are cognitively organized, your body is no longer distracted and you feel socially connected to the person talking, so what they say matters.”

Sensory interventions can be done whether the child is medicated for ADHD or not. Some families do not want their child on medications. OTs receive referrals from physicians, teachers and psychologists.

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Strategies for organizing, calming & connecting

“Some interventions we do are cognitive organizing, affecting the cognitive efficiency of your brain, and some sensory interventions are physically calming,” Tringali said. “Others may help you feel more socially connected.”

Regulation issues in the vestibular, proprioceptive and deep pressure tactile system can make it difficult for children to learn, Tringali explained.

“If we can regulate it, performance improves,” she said.

Children need different interventions depending on their issues. Occupational therapists determine what will work best and offer customized suggestions.

Exercises for cognitive organization affect the vestibular system: swinging, spinning or inversion. Children may do a handstand for 30 to 60 seconds, do cartwheels or somersaults, spin in an office chair, or swing on a swing set. These exercises activate histamine in the brain. It helps with the storage and retrieval of information.

Placing pressure on the joints, stimulating the proprioception sensors, releases serotonin and is calming. The child might carry a weighted ball, stamp their feet, jump rope or jump on a trampoline.

For social connection, the tactile system’s deep touch releases dopamine. Tringali sometimes may suggest a hug or lying under a weighted blanket or a deep firm massage.

Sensory strategies at different ages

With young children ages 3 to 5 years, the occupational therapist would work with the child as he or she completes these exercises. But as children grow older, the youngsters start to realize they need help, and the therapist would teach them how to do the sensory strategies. 

In middle and high school, the children can pick extracurricular activities that meet those needs. Even adults with ADHD tend to select occupations that cater to their condition, perhaps becoming a yoga teacher and not an accountant.

Sensory strategies are sometimes called a sensory diet, “a term used to describe the range or menu of sensory supportive options woven through one's daily routine that help them to engage in meaningful roles and occupations,” explained Tina Champagne, OTD, OTR/L, CCAP, FAOTA, with OT-Innovations and program director for the Cutchins Programs for Children and Families in Northampton, Ma.

Occupational therapy with ADHD individuals or groups

In addition to use with individuals, sensory strategies can be performed at a school or residential or day program to enrich daily routines or support the clients, Champagne said.

In the classroom setting, Tringali plays “Bats and Butterflies” with children. The “bats” hang upside down while the “butterflies” spin gracefully.

Some occupational therapists, including Tringali, specialize in pediatric school-based occupational therapy services and work with many children with ADHD. But she expects most occupational therapists perform some sensory strategies in working with clients with ADHD. 

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Nearly 10 percent of children ages 4 to 17 years have been diagnosed with ADHD, according to the National Center for Health Statistics. These numbers speak to the need for occupational therapists who can offer an alternative or adjunct to medical treatment, and are a strong indication that occupational therapy jobs will remain in demand. 

The U.S. Bureau of Labor’s Occupational Outlook Handbook projects occupational therapy jobs will increase 27 percent from 2014 to 2024, much faster than the average for all occupations.

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