1. Needs Assessment-Creating a Sensory Environment
Objective:
● To provide a needs assessment for FR to develop a multisensory environment to
promote emotional self-regulation through sensory organization (modulation)
Overview:
● Background on Sensory Integration theory
● Summary of literature supporting sensory integration techniques for children exposed to
trauma
● Strengths of FR
● Reason for Sensory Corner
● Description of 7 senses
● Table summarizing recommendations
● Conclusion
● References
Additional Resources:
http://www.ot-innovations.com/content/view/49/57/
2. Introduction
During the four weeks (July 9th, 2014-August 5th, 2014) while interning at Family Rescue (FR),
Melina Marte, OTS, and James Oldenburg, OTS, conducted a needs assessment for
development of a designated sensory area. The staff at FR approached the occupational
therapy students regarding an area in which the children can de-escalate and regulate their
emotions using sensory techniques. Below is a summary of the environmental and contextual
supports that are already in place at FR. In addition, there are specific recommendations that
may help to promote self-regulation in a safe and comforting environment, according to general
sensory integration theory principles of modulation.
Sensory Integration Overview
Sensory integration is the neurological process that organizes sensation from one’s own body
and from the environment and makes it possible to use the body effectively within the
environment (Kielhofner, 2009). Sensory Integration Theory is a model of brain-behavior
relationships and helps to explain why some individuals behave a certain way, plan
interventions to address difficulties, and predict how behavior will change as a result of
intervention (Bundy, 2002). Individuals may seek or avoid sensory input by interacting with their
environment. The interaction between our sensory system and environment is largely an
unconscious process the drives behavior to satisfy or regulate a system that is not in balance.
For example, a person with light sensitivity may prefer a dimly lit room or a child with excessive
energy may be constantly fidgeting in his/her seat.
In addition, the Model of Sensory Processing helps to interpret a child’s behavior from a sensory
processing perspective and proposes that sensory processing impacts functional performance.
That is, an individual with a well-regulated system is able to meet the challenges of the
environment and successfully perform his/her roles and routines; whereas, an individual with an
unregulated system may have difficulty fulfilling requirements and managing responsibilities. In
the context of a classroom, functional performance can be viewed as a child’s ability to attend to
tasks, follow instructions, and adhere to classroom rules and expectations. If a child’s brain is
able to control (i.e. modulate) its response to environmental stimuli then the child will be able to
function within the environment. For example, the brain of a child that gets distracted by ambient
background noises while reading is unable to filter out the unnecessary environmental stimuli,
which then interferes with functional performance (reading). The child’s behavior in this scenario
may take the form giving up on the assignment and distracting other students, fidgeting, or
wandering around the classroom. The solution, in this case, may be to understand what is
distracting the child and designing an intervention to improve participation.
Two key concepts crucial to understanding Sensory Processing are Neurological Threshold
Continuum and Behavioral Response/Self-Regulation Continuum.
Neurological Threshold Continuum: The neurological threshold is the point in which a
stimulus triggers a response. An individual’s neurological threshold is located on a
continuum that varies across all people. For example, a person with a low threshold for
3. noise may perceive the sirens of a passing ambulance as extremely unpleasant;
whereas a person with a high threshold may not even notice the siren.
Behavioral Response/Self Regulation Continuum: Self-regulation refers to the
strategies people use to manage their own needs and preferences (Dunn, 1997 -
Sensory Profile Manual). The two ends of the self-regulation continuum are represented
by:
o Passive Self-Regulation - Children respond passively to their neurological
threshold by letting things happen to them and may respond by complaining
about unpleasant stimuli instead of withdrawing or retreating. Children on this
end of the continuum do not actively seek to control their environment.
o Active Self-Regulation - Children respond actively to their neurological threshold
by attempting to control their environment by seeking or avoiding stimulation.
For example, a child may actively try to add sensory input into his/her experience
by skipping around the room and touching every object in the room. One the
other hand, a student may withdraw or retreat from an activity to reduce the
sensory input from the environment.
How Trauma Affects Behavior: A Sensory Integration Perspective
Literature suggests that young children exposed to early life traumas (early loss, disturbed
caregiver systems, emotional abuse, neglect, sexual abuse, physical abuse, etc.) experience
impairments across various developmental areas (Warner, Koomar, Lary, & Cook, 2013).
Behavioral regulation, however, is the most severely impacted domain resulting in effects on
other areas of development such as cognitive and social-emotional skills, among others. The
Sensory Integration (SI) Theory has contributed to the treatment of mental health especially in
the area of behavioral dysregulation through the use of sensory modulation. Many studies have
used sensory-motor strategies to address arousal regulation manifested as behavioral
dysregulation of children and adolescents who have experienced trauma (Warner, Koomar,
Lary, & Cook, 2013). These studies consulted occupational therapists specializing in SI theory
for individualized sensory-based treatment or to develop environmental modifications to
residential facilities. Sensory rooms were developed for children to have the opportunity to learn
new self-regulation strategies. By targeting behavioral dysregulation through sensory-motor
input tools, children were better able to process traumatic experiences and disruptions within
their daily lives.
Strengths and Supports
● FR Employees
○ Values and Beliefs: Staff at FR are interested in learning more about sensory
integration theory and how to incorporate these strategies into the children’s
program. The staff has an understanding of the benefits of sensory input in order
to foster healthy emotional regulation. Given FR’s belief in sensory integration
strategies, they would value having an environment designated to the children’s
sensory needs.
4. ● FR Environment
○ Social Support: The adult program provides a social support network for the staff
at the children’s program given their shared interest in promoting healthy
behaviors. Both services collaborate and periodically have meetings to discuss
areas of improvement.
○ Social and Economic Systems: Given that FR is a non-profit organization, it is
important to consider the resources available for improving the children’s
program. The staff has demonstrated their commitment to investing resources on
constructing a sensory environment. Information from this report may serve as a
guideline for facilitating the process of drafting a federal grant proposal.
○ Culture and Values: The program at FR is intentionally designed to promote
structure and a sense of safety throughout the day. The staff at FR values the
social and emotional needs of the children and is committed to providing an
environment for children to develop basic social and self-regulation skills.
○ Built Environment and Technology: The classrooms are located on the garden
level of the facility. The built environment provides a generous amount of space
for activities. The area proposed for the sensory corner is located in the northeast
corner of the facility. A bank of windows that run on the east and, north, and
south provide ample natural light.
● FR’s Impact on Child Performance
○ With the proper supports, children are able to develop skills necessary for gross
and fine motor tasks, play, activities of daily living, education, and social
participation.
● FR’s Impact on Child Participation
○ Children appear motivated to participate in the children’s program through their
enthusiasm and positivity. The program provides many opportunities to support
the children’s engagement through structured group activities, play, and
community integration (field trips).
General Recommendations
Negative behaviors (aggression, defiance, obstinate, etc,) observed at the children’s program
may be a manifestation of limited opportunities to obtain needed sensory input in order to self-
regulate. These behaviors are then perceived as a hindrance to performance and participation
in group activities, community outings, social engagement, and play. Providing opportunities to
receive sensory input throughout the day may have an effect on observed behavior issues, thus
improving performance and participation. In addition, a designated sensory environment may
address some of these behavioral concerns by providing a safe environment for the child to de-
escalate and regulate his/her emotions using specific sensory organization strategies. Below is
a description of the seven sensory systems followed by a tabulated summary of recommended
items. It is important to note that the following list is not an extensive representation of materials
available but examples of how to address certain sensory needs.
1.) Vestibular Sensation (awareness of movement related to gravity)
5. ● Definition: Sensation coming from stimulation to the inner ear that is caused by moving
through space (e.g. swinging or spinning) and moving one’s head in different directions
(hanging upside-down). A healthy vestibular system helps with maintenance of vision
and posture. Unmet vestibular needs may contribute to the behaviors listed below
(Sensory Observations in table).
Sensory
Observations
Recommendation Possible
Solutions
Availability/Cost Examples
Children enjoy
swinging on
playground
Provide linear,
rhythmic movement
as a calming
vestibular input
Harmony
Kids
Standard
Rocker
$55.65
Amazon.com
Children seek
being carried
(e.g. piggy back
rides, fly like
superman)
Provide input that
elevates the body
off of the ground or
allows use of
balancing skills
Hanging
Canvas Seat
Swing
Cost: $199.99
Fun and Function
http://funandfunction
.com/hanging-
canvas-seat-
swing.html
Round
Seesaw
Cost: $164.69
Amazon.com
Gonge
Riverstones
Cost: $58.99
Amazon.com
6. Seesaw
Balance
Board A
or
Circular
Balance
Board
Cost: $49.99
Funandfunction.com
Cost: $58.99
Funandfunction.com
Children seek
spinning
sensation
Provide continuous
circular movement
for arousing (fast) or
calming (slow) input
Tilt and Turn Cost: $139.99
Amazon.com
2.) Proprioceptive Sensation (awareness of body position in space)
● The sensation of one’s body in space and in relation to itself. The sensation comes from
stimulation to muscle, and to a lesser extent, joint receptors, especially from resistance
to movement. An example of proprioception would be with eyes closed, knowing the
position of one’s limbs (e.g. hand is above head or arm out to the side). Children with
underdeveloped proprioceptive systems have trouble controlling their body. Children
may appear clumsy and have trouble using both hands to catch a ball or may like the
feeling of running into doors/walls/people. Children with unmet proprioceptive needs may
seek input into muscles and joints, which may take the form of behaviors (Sensory
Observations in table) listed below.
Sensory
Observations
Recommendation Possible
Solutions
Availability and
Cost
Examples
7. Children
enjoy
movement
activities
including
jumping and
hanging
Provide options
for vertical
movement to
allow more input
to joints and
muscles
Mini trampoline
hopper balls
Cost: $27.00
Walmart.com
Aeromat
Therapy Burst
Resistant
Peanut Fitness
Ball 40 cm
Cost: $26.00
Opentip.com
Ball Bounce &
Sport Fun
Hopper
Cost: $13.17
Amazon.com
Children
commonly
burrow their
bodies within
objects (i.e.
beanbags) or
hide in
isolated
spaces
Provide various
weighted or
resistance
materials to
provide deep
pressure and
receive more
feedback from
larger surface
area
Air Lite Barrel
Roll
Cost: $159.00
Amazon.com
Body Pod
Sensory Sock -
medium
Cost: $35.99
Amazon.com
8. Comfort
Research XXL
Fuf Chair
Comfort Suede
Cost: $99.00
Walmart
Children
throw, pull,
and kick
objects during
positive and
negative
emotional
reactions
Provide safe
objects and
environment to
push, pull, hit,
and throw
Big Time Toys
Socker Bopper
Power Bag
Cost:$18.18
Amazon.com
Skil-Care Crash
Pad
Cost: $150.00
www.mainstmed.
com
The Beam Store
Royal Blue 2-
Inch Thick
Folding Panel
Mat
Cost: $148.99
Amazon.com
3.) Tactile Sensation (touch)
● Sensation derived from stimulation to the skin is referred to as tactile information. This
information allows individuals to interpret physical contact with the external world. For
example, using the hands to feel the textures on a leaf’s surface involves processing
tactile information. As described below (Sensory Observations in table), children with
unmet tactile sensations may demonstrate behaviors in which they touch objects
constantly within their environment. On the other hand, children with difficulty processing
tactile information may avoid physical contact with objects in their environment.
Sensory
Observations
Recommendation Possible
Solutions
Availability and
Cost
Examples
9. Children are
open to
exploring new
and familiar
textures using
hands within the
natural and built
environment.
Some children
are more
resistant to new
textures and
dislike certain
feelings on
hands.
Provide options for
types of tactile
stimuli to decrease
tactile sensitivity
and promote
tactile exploration.
Vibrations and soft
textures for
calming strategies.
1 lb weighted
tactile
beanbags - set
of 5
Cost: $22.99
Amazon.com
Tangle
Creations
Tangle Relax
Therapy
Cost: $6.62
Amazon.com
Tactile cube (6
pc.)
Cost: $188.99
Amazon.com
Flashing
Spikey Ball
Light UP Party
Cost: $2.99 each
Amazon.com
10. Super Duper
Frog
Massager
Cost: 15.95
+$7.99 shipping
Amazon.com
Senseez
vibrating
children
pillows
Cost: $39.99
Walmart.com
Create homemade
sensory bins with
everyday items of
various textures
(e.g. rice, beans,
sand, and flour).
As a calming
strategy, include a
small cup inside
for rhythmic
pouring or small
textured objects to
find.
Sterilite 16.5-
Gallon (66-
Quart) Latch
Storage Box,
Set of 6
Cost: $47.82
(set of 6)
Walmart.com
4.) Visual Sensation
● Information entering through the eyes and processed by the brain provides visual
sensation and interpretation. Visual input provides information about time and space
from the environment. Children with unmet visual needs may have a higher interest in
bright lights and colors, for example, and attempt to obtain this input in their natural
environment. On the other hand, some children may experience sensitivity to visual input
and present with behaviors such as avoidance, frustration, or disengagement.
Sensory
Observations
Recommendation Possible
Solutions
Availability and
Cost
Examples
11. Children notice
colorful or bright
items in
environment
Provide some
visual stimuli
using cause and
effect
relationships as
well as tactile
input
Playvisions Light
Up Molecule Ball
Cost: $6.43
Amazon.com
Some children
display aversion
to bright lights
Provide an
enclosed space or
eye covers to
reduce visual
input
Explorer Dome
- small
tent/dome
Cost: $21.99
Funandfunction.
com
Dream Zone-
Earth
Therapeutics
Sleep Mask
Cost: $8.99
Amazon.com
Children’s
energy levels
change with
lighting
Allow the option
for
limited/dimmed
lighting to reduce
visual stimulation.
Consider
modifying natural
lighting as well by
opening/closing
window blinds
Starry string
lights - 20 ft.
Cost: $24.99
Amazon.com
5.) Auditory (Hearing) Sensation
● Auditory sensation comes from sounds entering the ears and is then interpreted by the
brain. This sensation, like visual input, provides information about time and space in the
environment. Children with unmet auditory needs may seek objects that create different
sounds or may produce noises with their mouth such as humming, singing, whistling. On
the other hand, children with sensitivity to auditory information may have an aversion to
certain types of sounds (i.e. loud, high pitched noises) and may exhibit avoidance
behaviors such as covering ears or becoming emotionally upset.
Sensory
Observations
Recommendation Possible
Solutions
Availability and
Cost
Examples
12. Children’s high
energy levels
may be
modulated with
music or
instruments
Slow music for
calming and
relaxation effects.
Can be used as
ambient noise
while exploring
other sensory
stimuli within
environment.
I Can Relax! A
Relaxation CD
for Children
Compact Disc:
Cost: $17.99
Amazon.com
Digital
Download:
Cost: $9.99
iTunes
120 Nature
Sounds
Digital
Download:
Cost $9.99
iTunes
20" Chilean
Cactus Rain
Stick Musical
Instrument
Cost: $12.00
Amazon.com
6.) Olfactory (Smell) Sensation
● The sense of smell comes from receptors in the nose that are processed in the brain.
Children with unmet olfactory needs may use smell to interact with people/objects or fail
to notice unpleasant odors. Some children experience olfactory sensitivity, in which they
react strongly to smells and are easily bothered by certain odors.
Sensory
Observations
Recommendation Possible
Solutions
Availability and
Cost
Examples
Some children
are sensitive to
unfamiliar odors
and others enjoy
various scents
(i.e. coffee,
perfume,
aerosols)
Provide natural or
artificial odors that
promote calming
sensations. If
natural odors are
prefered, consider
making a potted
garden with
scented flowers.
Aromatherapy
Sleep
Lavender
Vanilla Body
Lotion (6.5 fl
oz)
Cost: $11.26
Amazon.com
13. Aromatherapy
oils (Lavender)
Cost: $10.99
each
Amazon.com
Wallflower
fragrance plug
and
Wallflower
fragrance refill
(pack of 2)
Cost: $4.50
Bed Bath and
Beyond
and
Cost: $6.50
Bed Bath and
Beyond
7.) Gustatory (Oral) Sensation
● Gustatory sensations provide information from the mouth to the brain about taste, pain,
temperature, feeling, and movement. Children with unmet oral needs may prefer certain
textured food items or constantly have items in their mouth (i.e. pencil, gum, toy).
Children who experience difficulty with oral sensations may avoid certain food textures,
gag easily, or dislike tooth brushing.
Sensory
Observations
Recommendation Possible
Solutions
Availability and
Cost
Examples
Children often
feel urged to
place items in
mouth constantly
(toys, unfamiliar
food-like
materials)
Provide children
with an item that
will promote oral
stimulation and
oral-motor activity
(chewing, biting,
sucking) for
soothing
Red chewy
tube (other
types/textures
available)
Cost: $8.53 ea.
Amazon.com
14. sensations
Flexible Straws
(in a jar)
Cost: $1.25 (50
ct)
Walmart
Office snacks
Sugar-free
Pops (or other
candy)
Cost: $24.60
Walmart
Conclusion
The use of sensory strategies can be beneficial in the recovery process of children exposed to
traumatic experiences. These techniques offer the opportunity to self-regulate in a moment of
emotional disturbance, as well as other moments throughout the day. It is important to provide a
safe, comforting environment where children can de-escalate. A designated multisensory
environment will allow children to have a sense of control in how they explore and obtain
sensory needs.
The occupational therapy students would like to thank Family Rescue for providing the
opportunity to apply our current educational background in order to suggest recommendations
for a sensory environment. We hope that you will find this information useful and valuable as
you continue the process towards developing a sensory environment.
Signatures
15. References
Warner, E., Koomar, J., Lary, B., & Cook, A. 2013. Can the Body Change the Score?
Application of Sensory Modulation Principles in the Treatment of Traumatized Adolescents in
Residential Settings. Journal of Family Violence, 28 (7), 729-738. Retrieved from
http://link.springer.com/article/10.1007/s10896-013-9535-8#page-1.