Your child’s sensory profile is a unique description of how your child processes the sensory information from his/her environment. Five sensory areas that OTs often evaluates include the following:
- Vestibular/balance& movement
- Oral/sensations of taste, texture and temperature in the mouth
How is this information used?
Occupational Therapists often use this information to understand how the child is interpreting the world around them. Sometimes, if the child is under- or over-responding to information from these areas, it can impact their ability to engage in daily occupations, such as sleeping.
By understanding both the patterns of response (either over-responding or under-responding) and the sensory areas that are affected, we can help parents design activities and modify environments to help their child cope better with the world around them and more successfully engage in their daily tasks.
A story to illustrate one part of a sensory profile:
(Name and context are fictitious and only used to illustrate these points – they are not related to an actual client/child.)
Dylan is a bright and alert 8 month old boy. He loves being out and about, and looking at the world around him during his daily stroller walks. He rarely falls asleep in the stroller. He loves looking at faces and his big brother dancing around him. If the TV is on in the house, he is drawn to the fast-paced images on the screen. He sometimes gets fussy in a busy environment where there is a lot going on. His OT assessment indicated that he over-responds in the area of visual processing. Dylan’s OT talked to his parents about how his busy visual environment can alert his nervous system and make him feel irritable. It was recommended that his environments be dampened later in the day to help him wind down and that stroller walks be taken after he has woken up rather than used as a strategy to calm him prior to sleep time. The OT was also able to recommend specific calming strategies and some environmental modifications to his sleep zone to help him calm down rather than ramp up due to visual stimulation.
What does this mean?
We know that parents know their children best. That’s for certain. Applying this knowledge to their daily routines and adapting activities and modifying environments can help your child to cope better during the day and be more able to successfully engage in their daily play and self care (sleeping/eating) tasks.
Do you need more ideas or recommendations to help your child?
An Occupational Therapist can help. Contact us to discuss your child’s sensory profile and how it may be affecting their ability to cope with the day to day activities in their life including playing, eating, and sleeping.
Daytime Awake Periods for Infants and Toddlers
It’s an incredible thing when you think about it... A newborn baby is only able to take in about 45 minutes of the world at a time, and only a short 12 months later, they have developed enough to manage to stay awake and process all that is going on around them for about 3 hours at a time. So much is happening in those first months!
All babies have an age appropriate awake time during the day. This is the time that they are able to cope with the world around them, interact socially, and learn through play and observation. There comes a point, though, where they need to reset, rest, and have a break from the world around them. As a baby reaches the end of their awake time, they will become drowsy and signal that they are ready for sleep.
Babies have different tired cues at different ages:
-Very young babies may start to look away and no longer engage in eye contact, start to suck on fists, or to arch their body away. They may also show some physiological/autonomic signs like sneezing, yawning, and hiccupping.
-Toddlers may show increased clinginess, irritability, refusal to cooperate, biting, or pushing.
At any age, it’s apparent that the child’s ability to cope with the demands of the world around them is decreased and they need a break. Getting your child to sleep before they cross into their over tired zone is important and will help them to get off to sleep easily.
Table of ages and awake times to help guide you in putting your child down for naps before they become overtired and have difficulty settling
Amount of time awake between waking and next sleep
45 – 80 minutes
90 – 150 minutes
2 – 3 hours
3.25 – 4.5 hours
4.5 – 5 hours
5 – 7 hours
We all have sleep associations, those parts of our routine in the evening that signal our body that it’s time for sleep. Whether a bath, a hot drink, or tucking your duvet around you in just the right way, there is typically some sort of ritual that you use to prime you for sleep.
What about our children? For babies, sleep associations are specific sensory experiences that they use to fall asleep and stay asleep. There are two types, those that help prime us for sleep and calm us before sleep such as a warm bath, and those that actually help us fall asleep, like a sleep position. The calming associations for your baby are what you do in their bedtime routine. The association that actually gets your baby to fall asleep is a sleep soother.
A Lovey is a sleep soother. As babies reach the 4 month mark, it’s a good thing for them to have sleep soothers they can use independently so they can fall asleep and re-settle to sleep without your help.
A Lovey is a small stuffed toy that your little one can use for comfort when falling asleep, and for resettling to sleep at night. Your baby’s Lovey is the best sleep soother they can have, and one that most little ones take to quite easily.
Younger babies (newborn to about 3 months of age) don’t need Loveys as you’ll be the one soothing them when they need to get to or return to sleep. You can start to introduce your baby to a Lovey at 4 months of age, but do not put it in the crib with them until they are consistently rolling both ways. Also, try to keep your Lovey baby-safe and smaller than your child’s head.
If your child is heading into the 12-18 month range, it’s not too late to introduce a Lovey. In fact, at this stage it will be quite useful, and they will take to it well.
How to select and introduce a Lovey:
- Choose a Lovey that is small enough to take with you in your diaper bag and that is not a risk for suffocation.
- Keep your eye on a replacement, or buy two and stash one safely away.
- Have mom sleep with the Lovey tucked in her pyjama top for a couple of nights before introducing it to baby.
- Introduce it by giving it to your child every time they fuss whether it be from pain, irritation, or tiredness.
- Give your child a hug, comfort them, and tuck the Lovey into their body, offering a cuddle with the Lovey cuddled in between you and your child
Naptime and bedtime can be a challenging time for parents with more than one child. Once you have two or more children, getting through the pre-sleep routine can feel like a marathon. And then when one partner is not able to be there, you can find yourself struggling to figure out what to do with your older child while you are settling your little one.
One strategy that can make managing naptime and bedtime alone run more smoothly is a ‘busy box’. The ‘busy box’ is a box that contains novel quiet activities that only come out before naps and bedtime. This is helpful to occupy an older child when a parent is settling a younger child or infant to sleep. The key is that these activities are special for use only during pre-sleep times/quiet times. They can be much loved activities or new ones.
Busy Box Ideas:
- Puzzles (ensuring that they are the just-right challenge and will not cause frustration)
- A basket of play silks/scarves
- Lacing games/beads
- Open ended activities such as: Duplo, bristle blocks, magna tiles
- Magnet letters, shapes, pictures
- Pom pom activities: sorting colours with tongs and placing into a container
- Special selection of books: lift-the-flap books, simple look and find books, sticker books, Melissa and Doug’s On-The-Go Water Wow books
- Listening to special music or an audio book: the library often has a good selection of loved children’s books with the accompanying audio recording
It is important to keep the activities fresh and interesting as well as limiting them only to before naps and bedtime. Additionally, although the purpose of the ‘busy box’ is to keep an older child entertained, ensure that they are still being supervised, as little hands can quickly get into trouble.
You can find more ‘busy box’ ideas on the Sleepdreams Professional Sleep Consultant pinterest account: Busy Boxes for when you are putting your youngest to sleep
We talk a lot about sleep in the context of a child’s whole day and supporting sleep via many approaches, including ensuring that your child has enough of the right amount of movement and at the right time of day. Active movement woven through the day expends energy. The by-product of this expenditure is a biochemical called adenosine. When adenosine builds up, our body is signaled to rest to restore the balance of adenosine. Therefore, if we are not active enough, our body will not biologically be ready to sleep. This is just one piece of the sleep puzzle, but it’s a very important one.
Here are some ideas to help you maximize the energy expenditure for the most active little people in our lives – toddlers and preschoolers! These are park ideas.
- For your early walker, have him walk on different surfaces – uneven, gravel, sand, grass. All these challenges will engage his large motor muscles more than just walking on a flat, even, predictable surface.
- Blow bubbles and have your child chase them and pop them by clapping. Try to blow them up high so they reach up to pop the bubbles.
- Slide down the slide on his bottom or tummy (feet first).
- Roll down a grassy hill like a sausage.
- Practice hanging on the monkey bars.
- Jump off of low equipment or wooden beams with an adult’s help.
- And of course, lots of time on the swing, respecting the child’s tolerance for how high or fast to push.
Enjoy your park time. And if you want to build up your biological drive to sleep, too, you may want to have a game of chase or tag. You’re IT!
To combine these ideas with other strategies, get to the park in the morning to expose your child and yourself to daylight and set your circadian rhythm. Use activity soon after your child wakes so that you can wind down closer to sleeping time.
Healthy Families BC/Participaction/CSEP recommendations support these ideas by suggesting that parents minimize the amount of time children are restrained or sitting (car seat, stroller, high chair, etc) to no more than one hour at a time. Then it’s time for a movement break. Screen time is not recommended for children less than 2 years old, and for children 2-4 years old screen time should be limited to no more than one hour per day. Less is better.
There are lots of ways to support healthy sleep. Taking a close look at the amount, type and timing of activity can certainly help to promote healthy sleep for all the members of your family, from the youngest to the oldest.