Identifying and Helping Students with Sensory Integration Issues


Guest blogger,  Loren Shlaes is a registered pediatric occupational therapist and regular contributor to the special needs blog at Pediastaff (where this post is also being published). This is the final post in a series from Loren about how to help students who may be challenged with attention, sensory, or other issues be successful in the classroom. Most likely, you have at least a few students with these challenges every year, but even if you don't, the information in these posts are relevant to all teachers.

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This is the last post in the series and I want to thank Rachel and her fantastic website, Minds in Bloom, for giving me the opportunity to share what occupational therapy has to offer the children who are struggling in their classrooms. Thanks also to Heidi at Pediastaff, who suggested the collaboration.
For this last post, I want to help teachers identify who in their classrooms could use some extra assistance from a sensory integration therapist and give them some suggestions for what they can do to help. Very often people don't know about occupational therapy and how it can help, so I am starting by defining who we are and what we do.
What is Sensory Integration/Occupational Therapy?
Occupational therapy assists people who for various reasons cannot meet their responsibilities and are not functioning at their highest potential.  A child who is not succeeding in school and can’t meet the grownup's expectations falls into this category.
Sensory integration based occupational therapy can be very helpful to a child who is struggling in the classroom by strengthening his body, correcting delays in his neurological maturation, improving the way his senses take in and respond to his environment, and helping him become more emotionally flexible.  School based therapists also work on helping the child with his hand eye and fine motor coordination, handwriting, social skills, and anything else a child needs to succeed in the classroom.
What Does Sensory integration Mean?
Sensory integration refers to the ability to take in, perceive, and act on sensory information in an accurate way.  Our behavior is based on our perceptions of the world around us.  If a child cannot correctly perceive and interpret what goes on around him, or if his balance is off and his coordination is poor, his behavior and actions are going to reflect that.  
  • Children who could benefit from sensory integration therapy are notable for being unable to meet the expectations of the grownups.  They are “out of synch” in the classroom.An “out of synch” child may have some of these issues:
  • Can’t maintain focus in a noisy classroom
  • Can’t sit still
  • Has a hard time internalizing and following the unspoken expectations and routines of the classroom and acts as if every day is the first day of school
  • Has continual difficulty controlling impulses
  • Lashes out when others come into his personal space
  • Refuses to interact with classroom materials such as paint, chalk, clay or glue
  • Has difficulty transitioning between activities
  • Is emotionally rigid, can’t roll with the punches, needs to be in control, has difficulty socializing in an age appropriate way
  • Has a tough time modulating behavior; can go from zero to 60 in a second; his responses are often not appropriate to the situation
  • Slumps over his desk; rubs his eyes; his handwriting is painful, illegible, and slow, with a poor grasp; he may use too much force and break his pencil frequently; he has difficulty organizing his work on the page
  • Appears to not understand what is said to him; can’t pick out teacher’s voice over other noise in classroom; can’t recall or follow long strings of instructions
  • Is easily distractible; looks up at every ambient sound or movement and then has a hard time refocusing
  • Is clumsy, trips and falls frequently, holds onto the handrail and uses step to step gait pattern on the stairs, can’t do what the other children do in gym or on the playground
  • Behaves in unexpected or inappropriate ways in noisy or chaotic environment
  • Is frequently tuned out, not present
  • Requires constant redirection and guidance from adults; takes up more than his fair share of attention
  • Does not like to play in groups, mostly chooses to play alone
  • Sits with a frozen expression in class, especially when it’s noisy
  • Is obviously bright but can’t get his work done on time; poorly organized
  • Does not have a flexible attention span; he is either unable to focus at all, or he is so hyper-focused that he is in his own world
  • Has a short attention span, poor frustration tolerance, is unable to self soothe or self regulate in an age appropriate manner
  • Is anxious, needs constant reassurance, seems lost and can’t follow directions.
If you have a child who is struggling in your classroom with any of these issues, a referral for an occupational therapy evaluation is in order.
How Can I Help a Child With Sensory Issues?
Here are some easy things you can do to help a child who is struggling:
  • Children who are easily distracted do best when they are sitting with their backs covered.  Providing a child who is bothered  by people walking by with a chair tucked into a corner can lower anxiety levels and allow the child to focus.  

  • Children who are very sensitive to noise don’t do well in noisy classrooms.  Some things that might help: providing him with a quiet corner to do his work, providing him with earplugs that dampen but don’t block out sound, allowing headphones that play soft music or cancel noise during busy times, providing the child with something to chew (chewing dampens sound by activating the muscles that protect the eardrums). 

  • A child with visual issues needs to sit close to the board and would probably have an easier time reading with his work placed vertically in front of him.  This reduces visual distortion and helps the child sit more easily by allowing him to keep his head upright.   An inexpensive slant board can be rigged up by taping together several old fashioned ring binders. 

  • Gum, candy, and fidget toys may be the bane of a teacher’s existence, but for a child who has a hard time sitting still or staying alert, they are a necessity.  Chewing is grounding, calming, and organizing.  Sucking pulls the eyes in close together which makes it easier to see close work.  Sucking on a strongly flavored candy like a Warhead or a Tearjerker is especially arousing and alerting.  

  • An object to manipulate, and busy hands makes sitting still infinitely easier, which anyone who has made a chain of paper clips, folded a gum wrapper into an origami shape, doodled a cartoon, or systematically torn the label off of a soda bottle during a long meeting knows only too well.  

  • I send a little ziploc bag of toys to school at the beginning of every school year for the teacher to hand out to my little friends when appropriate.  Stretchy frogs, Bucky Balls, and miniature transformer toys are excellent for discreetly keeping hands busy and minds alert.  If none of those things are available, there are always drinking straws and paper clips. 

  • If there is room in your classroom, a large cardboard box, like the kind a washing machine comes in, can be a very handy place for any child who is overwhelmed by the busyness and noise in the classroom to regroup.  Put a few cushions in there and leave the flaps on so the child can have some privacy when he needs it.  No following him in there and forcing him to do his lessons while he’s hiding; let him come out when he’s ready. 

  • Many children with visual issues can’t copy from the board, so an email home with the assignments would be helpful, or he can be assigned a buddy who can make sure he’s copied everything down correctly.

A Final Thought
In order for children to feel safe and secure and to trust the grownups, they have to know that the grownups are strong, wise, and can keep them safe. Don’t be afraid to have high standards, clear expectations, and strong boundaries in your classroom.  Your children will love you for it. 

If you have been following this series (or even if this is the first post you have read) we would love to hear your thoughts in a comment!
Want to read more from Loren? Here are the other posts in this series:

Loren Shlaes is a pediatric occupational therapist who specializes in sensory integration, handwriting remediation and school related issues. She is also a manual therapist and a certified teacher of the Alexander Technique.  Her informative  site won the  "favorite resource for therapists" poll conducted by   Her writing has been featured on, and she is a regular contributor to the special needs blog at Pediastaff.   She is in private practice in Manhattan.
Minds in Bloom would also like to thankPediaStaff for collaborating with Loren to make this series possible. PediaStaff places pediatric therapists in schools, clinic, and hospitals throughout the country. In addition to their highly informative blog, they also have a huge Pinterest presence with over a hundred boards pertaining to education, child rearing, special needs, and various kinds of therapies. This post can also be viewed on the PediaStaff Blog.


Brandy said...

I am so sad to see this series end. It has been highly informational. I have been printing each one and will be referring to them often. Thank you!

Tif_V said...

Thank you for this series. My first grader is struggling with many of these issues (and has for his entire life). He currently receives some special education services but was denied OT. Its very frustrating and easy to give up on finding the appropriate assistance for him! I needed to read today. Thank you again!!

Rachel Lynette said...

I am so glad you both found this series worthwhile, and I know Loren will be too. I felt so honored to host her!

My son also has some special needs. He is doing great in college now, but it was a long road to get him there. I wish I had known some of this stuff back then!

Melissa said...

I need help getting my son's teachers on board. He frequently gets in trouble for self soothing behaviors with finger fidgets and whatnot. He is borderline ADHD, but after reading your list of "symptoms" (things to look for) may also benefit from a referral...however, he is now 12 and in middle school.
Any ideas?

Thank you so much for putting all this valuable information in such an easily accessed place seem by so many.

fourcornerslife said...

Just found this series--great information! I could identify many former students by name when reading the descriptions. I'll be researching how ot can help in my district!

Therapy sites said...

This post is informative and educational for us teachers. I very much appreciate this. I will suggest this to my fellow teachers having some problem with their students. I am amazed in the series of this post. Thanks a lot!

Karen said...

I was so excited when I saw the topics that you were talking about on this blog!!! I have been a preschool special education teacher for 20+ years and and for the last five have been an Itinerant Special Education teacher! This information is perfect for me to share with my regular education preschool teachers!

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I redirect from other websie, but at last, I found it very knowledgeable. Thank you for this informative post. I had learned a lotfrom it.

mlf said...

Interesting insights. I have tried fidgets and mostly what happens is the child becomes absorbed in the fidget and pays no attention the lesson. How would you handle this? Can people get through a day of lessons when each one requires movement breaks every seven minutes? Do you think a lot of this would be resolved by more free play outdoors at home?

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