PAP 101:

Sensory Challenges: What to Know & What You Can Do

with Nikki Perez, OTR/L

Our sensory systems are how the brain processes all the information that’s around us. When one or more of the sensory systems is off kilter, it creates challenges in moving through the world from day to day. And these sensory challenges can often trigger anxiety and/or negative behavior. In this episode, I’m talking with occupational therapist, Nikki Perez, about all things sensory — from the different sensory systems, what behaviors may be caused by sensory avoidance or sensory seeking, and what you can do at home to help ease your child’s sensory needs. There are many activities and tools and resources mentioned in this episode. Don’t miss it.


Resources in this Episode

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My Guest

NIKKI PEREZ, OTR/L
Nikki Perez is a Licensed and Registered Occupational Therapist in the state of New Jersey. She attended Quinnipiac University in Connecticut where she received her Bachelors of Science degree in 2007 and went on to achieve her Masters of Occupational Therapy. Nikki has worked in pediatrics for 11 years, employed primarily in an outpatient hospital for the first 9 years and private practice where she has collaborated with disciplines such as speech language pathologists, physical therapists, physiatrists, psychologists and behaviorists. She also has experience working in early intervention and in a school setting specifically designed for children with disabilities. Nikki has experience with a variety of diagnoses and conditions including, but not limited to Autism, Traumatic Brain Injury, Down Syndrome, Developmental Coordination Disorder, Sensory Processing Disorder, Cerebral Palsy, prematurity, visual impairments, neurological impairments, mental health disorders, feeding difficulties and learning disabilities

Thanks for joining me!

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Penny Williams (00:01): Welcome to the Parenting ADHD Podcast, where I share insights and strategies on raising kids with ADHD, straight from the trenches. I'm your host, Penny Williams. I'm a parenting coach, author, ADHD-aholic and Mindset Mama, honored to guide you on the journey of raising your atypical kid. Let's get started.

Penny Williams (00:01): Welcome back to the Parenting ADHD Podcast. I'm really thrilled today to be talking to Nikki Perez, an OT, and we're going to talk a lot about sensory: sensory input, sensory challenges, what you can do to help your kids when they are having some sensory struggles, even sensory seekers who are looking for more sensory input, we can help them and to try to mitigate some of that, as well. So we're not just talking about sensory avoiders here. Welcome to the podcast. Nikki, will you start by sharing who you are and what you do?

Nikki Perez (00:41): Yes. Hi everybody. My name is Nikki and I am an occupational therapist. I work for Montclaire Speech Therapy in New Jersey, and I primarily work with children.

Penny Williams (00:55): Awesome. I have to say the biggest aha for me, starting out when my son was diagnosed with ADHD, was when we started occupational therapy. Our occupational therapist started explaining all sorts of reasons why things were happening. And it was so good that we connected with OT pretty early on because he was super hyperactive. And so I was able to realize that that was really sensory stuff at play there that was creating a lot of that. He would crash into walls on purpose. He would throw himself on the floor. He would stand on his head on the sofa. He was just that kid who was constantly crashing. And so when she really explained the sensory issues and challenges behind that, it was so incredibly helpful to us to not just understand it, but then know what we could do to support him better. And it was really, really powerful stuff. So I'm excited to have this conversation with you for everyone who's listening. Let's start by just talking about what do we mean when we talk about sensory? Most of us know sight, taste, touch, smell, but there's more to it than that.

Nikki Perez (02:12): There is more to it. And one of the main takeaways when we're talking about sensory is just to kind of remember it's the brain's ability to process all of the information that's around us. So all of the five senses that we know and we learn about, but then also adding into that, the vestibular system and also the proprioceptive system, which is what you were just talking about when I came to your son, seeing movements that kiddos kind of do, their proprioceptive system is looking for that input. So basically just giving some deep pressure to muscles and joints, and that feels really nice for a lot of kids. And then on the flip side, a lot of that running around and jumping and spinning, and all of that is seeking out for the vestibular system.

Penny Williams (03:00): Then sensory avoiders are the kids who loud noises really upset them or they avoid a variety of different things, like crowds.

Nikki Perez (03:09): Absolutely. So the auditory system for those avoiders, you'll really notice that a kiddo is covering their ears in noisy environments, or they're going to be making their own noise to kind of drown out the sounds that they don't typically like to hear. A lot of times, the parents will come to me during the initial evaluation and they'll say the sound of a dog barking or my doorbell or the blender or the vacuum, my kid is petrified. And that is just so sad because these are things that are a part of everyday life. So when they're avoiding these types of things, we need to figure out a way to help them cope and be able to live every single day without being fearful and without their sensory system going on overdrive because of the sounds.

Penny Williams (04:00): Yeah. And I've learned over the years that a lot of it really is sensory overwhelm. So much behavior comes from that, the inability to process it correctly, or the inability to maybe deal with it, to be okay, to feel okay in different sensory situations. There's so much to it. And I think kids can be both a sensory seeker and a sensory avoider.

Nikki Perez (04:27): Absolutely. We see that all the time. That's where it gets a little bit confusing. So one thing that's confusing for a lot of parents is, is it sensory or is it behavior? And that's confusing for a lot of therapists too, right? And doctors too, because they are so interchangeable a lot of times and sometimes it looks like it's a negative behavior or like a child may be doing something purposefully. Right? We hear that all the time. "Oh, they're just doing that on purpose." Not knowing that their body, their insides, their brain... they just cannot control it when it comes to behavior. And then sensory seeking and sensory avoiding again, you could have a child who's both. They could be wanting to seek out all of that movement and the crashing and the banging, but, on the flip side, if they touch playdough or sand or soapy water, their hands are instantly avoiding and they're reacting to that. So yeah. Kids can be avoiding and seeking at the same time.

Penny Williams (05:27): Yeah. My son definitely is. He's almost 18 now. So he doesn't struggle as much with a lot of that sensory stuff that he did when he was really young. But I found it really confusing myself to say, well, when there's a siren or a train coming or something, he's completely jumping out of his skin with anticipation even before it's loud, and yet, he's crashing his body into things. And he talks really loudly and he's really active. And the two didn't seem to kind of gel for a long time for me, until I realized that they really were separate systems and they really could be very different in the same child.

Nikki Perez (06:10): Absolutely. And I think one of the things with the auditory system that's challenging, a lot of families will say, "I read this on the internet and one of the things is headphones or earphones." That definitely is really helpful for a lot of kids. It's going to drown out that sound, that external stimuli that's really challenging for kiddos. And parents don't want their kid to be a part of that stigma in my experience, but not knowing that they could do something in the comfort of their own home and do different types of listening programs and listen to classical music with these headphones on that will really kind of help to cope with those sounds and to decrease that avoidance of the the more loud sounds that you can't avoid.

Penny Williams (07:03): Yeah. And things like that can cause a lot of anxiety, which then causes that avoidance. For a long time, my son would not go anywhere that he didn't have any experience with. He just for years would say, "Nope, not going, no, not going." And we would use headphones and we would do some different things in some instances where he did enjoy it, if we could just mitigate some of that louder noise, like fireworks on the 4th of July. But it was really hard to get him to a place where we could say, "we have some tools to use if you have these problems and we want you to try it and you can always leave." It's real easy for kids to get stuck in that place where, "this was really bad for me last time, so I'm not even going to try something now."

Nikki Perez (07:51): Absolutely. Because so many kids have that memory that they remember how they felt and how their body felt that one time they were put into that uncomfortable environment and then they want to avoid it. And then, it's that place where... then one thing turns into another and they don't want to deal with the anxiety, and the anxiety turns into a behavior, the behavior turns into a meltdown. And it's just one of those things that's really challenging for so many kids.

Penny Williams (08:18): Yeah. And parents can start to recognize some of those triggers. We definitely know that loud, crowded places will be triggering. He's pretty much at the point where he's not going to melt down any more for that, but it certainly was something that happened in the past. Or even a visually chaotic place, that didn't have to be sound, just anything that was a lot and kind of overwhelming was really triggering. And when parents start to realize where those triggers are, we can either, like we were talking about mitigate them, use tools and strategies to help, or find a different way to enjoy that particular activity. And then also we visit our OTs and we get therapy for these things that they're struggling with so that there can be improvement.

Nikki Perez (08:56): Absolutely. And I think one of the main things too, that I always kind of tell my families and my kids, is preparation is huge. Preparing the kid for what's to come, if it's a child who's a little bit younger, reading books to them, showing them videos of a place where they might be, taking a video of your own child in a place that may have been overwhelming at one point, but then they were able to get through it, and a video of them being happy in that place. Because, at first, a child may remember a negative experience there, but a lot of times it winds up being a positive experience.

Nikki Perez (09:46): So parents having pictures and videos to kind of remind the kid, "at first you were nervous, but then remember, this happened." A lot of times I find that's really, really helpful too, because the child's able to see themselves enjoying themselves, having a good time and getting over that initial, overwhelming feeling. And that's really beautiful too.

Penny Williams (10:08): Planning is so huge because I think a lot of kids who have sensory struggles also have some anxiety, even if it's completely driven by the sensory struggle and it's not its own standalone diagnosis. I have anxiety myself, I have a daughter with anxiety and I have always found preparation — making a plan for all the what ifs that our worry brain comes up with — can be super helpful to then be okay with going forward and trying this new place or this new activity, as well. And saying, "if it all goes wrong and you just can't handle it, then we will work that out."

Penny Williams (10:46): We're not gonna keep you here struggling and suffering. I think our kids, in that catastrophizing, that's where they go, "Oh my gosh, I'm going to go to this place. It's going to be so awful and I'm not going to be able to leave and everything's going to be bad."

Nikki Perez (11:01): Absolutely. I totally agree with that. And I think that working so closely to the speech therapist, I've learned that social stories really help a lot of those younger kids to get through those more challenging situations, as well. You know, the internet has everything now and if your child has their own private speech therapist, making a social story for a situation that might be a little bit more challenging, it's definitely helpful. And I know the company that I work for, we work so closely to collaborate with each other on each specific child and a speech therapist will say to me, "Hey, Nikki, I really need help with this." And I could give them tips and guide them with some sensory stuff to add into their social story. So that's always a really beautiful thing as well.

Penny Williams (11:54): Yeah. Let's talk a little about what you do in OT when you have a child and you're working on either sensory seeking, sensory avoiding, or both. What kind of activities can parents kind of expect to see the therapist doing with their child, but also to be asked to do in the interim between appointments? Because it's really important, of course, to keep working on what you're working on there in your clinic, at home and in between with our kids.

Nikki Perez (12:24): Absolutely. So for me, I'm one of those OTs, I absolutely love obstacle courses. I can use them all day long for so many different diagnoses, for so many different reasons. An obstacle course is so beautiful because you could add in some heavy work. And what I mean by that is just anything that the child can do that incorporates using their muscles, to put it into parent friendly terms. So for me, animal walking I love it. Bear crawling, crab, walking, wheelbarrow, walking, all of that is going to give a child some deep pressure input and some heavy work, all that to their muscles and their joints to their core, to improve their strength. And that's going to really help a child to kind of calm down and relax a little bit. In addition to that, when we're seeing the kids with an obstacle course, the transitioning is really, really great.

Nikki Perez (13:24): They're following an adult-directed sequence. So they're doing something that may be moving around, such as the jumping, the animal walking, climbing, and swinging, and then transitioning to something else, which may be, I'm sitting down to do some type of fine motor tasks to help them improve their attention. So at home, parents are like, "well, we don't have all that equipment that you have. We don't have a swing, we don't have a rock wall. How do you want us to do that?" It's easy. Anything that you have at home, we can adapt. If you have couch cushions that come off the couch, you can use that for kid crawling across or walking across it. That soft texture is going to be a little bit harder to maneuver over and around. If you have a towel or a blanket, roll it up, let's use that as a balance beam. The kiddo has to use their muscles to stay on the balance beam or jumping over it to make it like a line. So we can definitely teach the parents and work with the parents on the proprioceptive input at home and the heavy work at home. For sure.

Penny Williams (14:29): Yeah. And at school too, I know a lot of times parents will ask teachers to have their child carry maybe the gym equipment out to recess, the big basket of balls and jump ropes, or to carry a stack of books to the library. I know we also used crunchy snacks and gum — gum was a big one because it kept him from chewing everything else in the world when he could chew gum. And there's so many products and tools, we had chew necklaces and so many of those little things that really help at school that aren't so obvious to other kids, because some kids are really sensitive to that.

Nikki Perez (15:15): Starting it off as soon as they wake up in the morning is really key, too. As soon as they wake, they get up out of bed, they can stomp like a dinosaur to brush their teeth. Then we're going to use like a vibrating toothbrush. Or a really minty flavor toothpaste that they like. And just really target that sensory system just as soon as they wake up. And then throughout the day, incorporating just like you said before, crunchy snacks. So for breakfast, giving them some cereal or that bacon or something like that, and then a snack, the apple or the carrots and celery, if your kid isn't that much of a picky eater and they want to eat those crunchy snacks, pretzel rods, animal crackers. I think that's really important to just incorporate that throughout the day as well.

Penny Williams (16:05): And so that's basically kind of feeding our sensory seekers. We're giving them those heavy work activities and things that they are kind of lacking that sense. I guess I'm not very good at explaining this. I understand proprioceptive input of course, because that was huge for my own son. But, my understanding is that there's a lack of that sense. And so they're getting that sense by crashing into things or chewing something crunchy or pulling something like maybe a big elastic or something like that.

Nikki Perez (16:39): And the pulling stuff too. I love that. You just said that because that's something that's super easy to incorporate. If you get a yoga band or a therapy band, you can just tie it right at the bottom of the chair that they're sitting in and your kid can put their feet right on it and move it back and forth. And it just works as a really nice fidget for their feet.

Penny Williams (17:00): Yeah. We had a hop ball and he would do homework on that hop ball bouncing up and down. He would do everything. He would motor around the house, bouncing up and down on that hop ball for a long, long time, probably a few years until he outgrew it. Trampolines for families who have trampolines, that's a really good one for sensory.

Nikki Perez (17:24): Absolutely. And I love that. You just said that you let your son sit on that ball during homework. Because I think that's something that's really big too. A lot of parents will say, "I just want my kids to sit down and do their work." Unfortunately, that's just not how their sensory system is working right now. So learning to adapt and modify those times that you may see your kid acting out, what you think is acting out. So letting them stand up and sort of sit down, sit them down on a wiggle seat, put something underneath their feet so that they could wiggle a little bit. Let them take a break after five minutes, get up, do some jumping jacks, just like you said, if you have a trampoline jump on that trampoline for a little bit, do some wall pushups, do some wall sits and then come back to homework. So just giving a little bit more time so that they can have some sensory breaks is really key for kids of all ages from the preschool level all the way throughout.

Penny Williams (18:21): Yeah. I mean, we all focus in different ways and for sensory seekers, it's often by getting that stimulating input that then helps them to be able to focus more. I learned very young, at age six, that he was going to have to figure out a different way to do his schoolwork. Not just from a sensory perspective, but he also has dysgraphia. So, writing homework was a big challenge as well. And we just decided to get really creative and kind of let him lead. If he needed to stand on his head on the sofa to do his reading work fine. It's not hurting anything or hurting anyone. It's not the traditional way to do your homework, but does it matter? You know, that's a lot of this special parenthood, getting creative and challenging your own beliefs that kids have to sit at a desk and sit still. And it has to be quiet in the room to study in the most effective way. That's completely untrue for a lot of people. And it's especially more true for more of our population of kids with ADHD.

Nikki Perez (19:32): Absolutely. You kind of touched upon something in that everyone's sensory system is definitely different. So I always tell a new parent who's new to the OT world, "We all have our own ways to decompress or to manage our emotions. So sometimes people sit there and they'll tap their knee or you'll troll your hair or you'll chew gum. And these are ways that you're coping with something that may be causing you, as an adult, anxiety. And you realize that you're giving yourself this type of input, right? And sometimes these kids just need help to figure out what works best for their body, for their sensory system." What's going to get them through a challenging situation? What's going to get them through their work? So I think that's important too, for families to also kind of take a look at themselves and kind of say, "all right, this is what I do when I'm upset about something. This is what I do, when I'm feeling a little bit overwhelmed," and a lot of parents will quickly realize, "wow, we do a lot of things to adapt throughout the day."

Penny Williams (20:34): Yeah. We all have our adaptation strategies. And as a parent, you may have your own set of those strategies and your child might be completely and utterly different. My kids and my husband and everybody in my house except for me, needs music constantly to focus, to get something done, to feel even comfortable in their own space and skin. I, on the other hand, cannot focus at all if there's any other noise. I know lots of people talk about going to the coffee shop and sitting there and being able to then focus and do their work or write an article or something that they couldn't do at home. For me, I wouldn't get anything done. I would not get one word on the page.

Nikki Perez (21:25): Nope. That's perfect. People watching opportunity.

Penny Williams (21:29): Right. You can see how different people are in different environments or that way. But we have to really recognize that just because something was very true for us doesn't mean that it's at all true for our kids. And if I said, "No, you cannot have music while you do your homework. You can't get anything done that way," then I'm actually handicapping them because they get more done that way. And I have really just trusted myself on my own needs without understanding and acknowledging that our kids' needs can be completely different from our own. And ADHD is very genetic. We have lots of parents who also have ADHD themselves, but you can still be very different in your needs and your strategies and the way that you work and focus than your child who has the same diagnosis, but it looks different. Every individual with ADHD is an individual.

Nikki Perez (22:33): And it's all so different. Right? And another thing that I'll always tell the families of the kids I'm working with is to create a calm down box for your kid or a comfort box for your child. So just get like one of those really big bins that you can buy at Target. It's nice and clear and see through, whatever it is and really figure out what it is that calms your child down. Something that they really, really love and try to kind of touch on all those senses. So I'll say, "Hey what smell does your child like? What do they really love?" A lot of times I'm like, "Oh, you know what? My kid loves the smell of citrus or lavender." So get some essential oils that smell like that, throw it in the box. My kid has this one textured blanket that they absolutely love and it is really comforting for them.

Nikki Perez (23:20): It calms them down. Well, let's see what that material is, and let's get them to throw that in the box as well. Coloring books for some kids are really calming, for others, it's totally opposite. It sets them off. So, every kid is different. Let's figure it out. Some kids just like to do a puzzle, right? Figuring out those puzzles, jigsaws, get a box, throw it in something that is going to cause comfort for a child in those situations where they're feeling a little bit overwhelmed or over-aroused. That's really helpful to just have somewhere to go pull that out and present your child with all of those things that we know that they love already.

Penny Williams (23:59): Yeah. And it's a process to figure out what works for your child. People ask me all the time, "well, what tools do we use for calming down?' While there's a lot of them, not every tool works for every kid. So you really have to experiment with that. A big one for us is a weighted blanket, because again, that proprioceptive input and we've used the weighted blanket of course, to sleep, but we also have pulled it out during a frustrating period in homework and he puts it on his back like a cape, and he's getting that input that he needed.

Nikki Perez (24:33): Absolutely. Doing the hard homework laying on their stomach and putting it over them while they're writing and doing their homework or reading something, same thing, you can use it not just for sleep.

Penny Williams (24:45): Yeah. So let's talk about sensory avoiders. I think that leads into this conversation because they're often looking for more soothing, I think in general — that's a very big generalization, I know, but what do sensory avoiders look like? What kinds of activities are going to be helpful? What do you do in occupational therapy with those?

Nikki Perez (25:11): Yeah. So let's touch upon the tactile sense. The sense of touch. That's probably one of the biggest types of kiddos who I see coming and parents will say, "You know what? They really do not like their hands messy. They do not want their face messy when eating. Like this is a really big challenge." So for me, a kid will come in and it looks like play to answer your question. OT looks like play. We'll get shaving cream, we'll get kinetic sand, playdough, silly putty. Just even sometimes soap and water and we'll play. I'll ask the families all the time, "What does your child like? Superheroes, dolls, Barbies, trolls, cars, whatever it is that I know is going to motivate that child, I'm going to take it. And I'm going to play with them with their preferred activity, with these sensory activities.

Nikki Perez (26:03): That may be a little bit more difficult. So that shaving cream might be snow, right? We're going to put up the troll in the snow and then we're going to get them all clean. We're going to throw it into a soapy water bath. It seems really silly, but that is what really will start to get the kids to understand, "this isn't so bad" slowly. I'm never going to take their hand and shove them in. We may start with gloves. Sometimes we may start with just me touching it or the child holding my wrist and guiding my hands into these different, scary textures for them. It may start with just their fingertips or just the back of their hands. Then allowing me, and I'll always ask, is it okay if Miss Nikki does this? Is it okay if she puts this on you? I want them to know that they can trust me. I want them to know that I'm not going to hurt them and that whatever I'm presenting to them is going to be okay.

Penny Williams (27:06): Yeah. That's so important. Finding that line of how much to push and challenge and where we're crossing the line and we're doing more harm than good can be really hard. Sometimes taking it slow as you're talking about, really breaking it down into far smaller steps than most of us would naturally think about doing, is really key when we're challenging those sensory issues that kids want to avoid. When my son started when he was, I guess, six or seven, he was a swing avoider, he would not get on the swings on the playground. And it always really was so confusing to me. This kid crashes into walls, why is he not swinging? He was super little and we didn't know ADHD or sensory or any of these other pieces yet, so it just seemed really odd that there was this one kind of big movement activity that he avoided.

Penny Williams (28:08): And I remember in therapy, they would start by figuring out was there a different swing or a different direction that worked for him. And they ended up starting with, I think, a hammock and turning it. So he was swinging sideways instead of forward, swinging for a really short amount of time, and then building a little longer and a little longer. And then maybe they turned the swing, and this was over weeks and weeks of time. He still would never choose to swing on the playground. There were many other things he would prefer to do, but he no longer avoided. And he got to the point where a hammock chair hanging from the ceiling in our house is one of his favorite places to go. Even now as a teenager it's comfort for him. And he doesn't swing it like crazy, but just that sort of suspension and the squeeze that it gives you when it wraps around you with your weight in, it was really magical for him.

Nikki Perez (29:08): Definitely. Lycra material is really, really nice.

Penny Williams (29:11): Yeah. Or even the rope, like now we have the rope kind because he's man-size. So we had to get something that was adult. I've tried to remember and pull from that experience as often as I can with him, when I need to challenge him with something, how far can I break that down? How tiny of a step can we start with so that it's not overwhelming? So it doesn't feel like I'm just pushing him to be something he's not or do something he's not comfortable with.

Nikki Perez (29:49): Yeah. I think that's really important. Thank you for even bringing that up because I think one of the first steps for many, many children, depending on how over or under aroused they get is just that exposure. So even if the child avoids yogurt, just the family have that yogurt in their visual field, being able to tolerate something just around you is really the first step. And I think that's so hard for families to kind of understand because they were like, "Oh, I just want them to eat this one food or just play with this one thing. "And this child, their brain is telling you, "Oh my goodness, you can't even look at it. Never-mind, smell it, touch it, taste it." Small steps up a hierarchy and just making sure that even being around them is okay and comfortable for that child.

Penny Williams (30:45): Yeah. And I would really recommend for families to do this with the help of an occupational therapist. We didn't do occupational therapy for the last 11 years straight. We've done two different year-long stints in OT to work on different things at different age brackets. It's not something that you have to do all the time. I'm sure you do this too, every OT I've ever met or talked to gives you the ideas. The strategy is the knowledge that you need to then be able to carry this out at home and continue through with it. And I think sometimes when you're pushing those avoidances, you have to be so, so careful and it really could be most helpful to do that with an occupational therapist.

Nikki Perez (31:36): Absolutely. And we will always give the family an individualized sensory diet that they could follow at home and the things that the teachers can incorporate throughout the day so that the child is comfortable and being able to really succeed and maximize their potential in all of their environments — at home, during play on sports teams, whatever it is, we will individualize it for your child. Early intervention is really key, detecting these little things that may get bigger when they get older. I think attacking it as soon as you first realize it is so important. And if you don't realize it as a parent, that's okay too. But when you do finally realize it, coming on in and being able to work with your child and get them the help that they need.

Penny Williams (32:30): Yeah. And the way that we interpret the world through our senses then incorporates the autonomic nervous system, which is our self-regulation. Even things that we see as parents of kids with ADHD that we wouldn't automatically say are connected to something sensory likely are,. I've been working on studying polyvagal theory and the vagus nerve a lot lately. And I've had a couple of episodes prior to this already on that talk about it. And what I'm realizing more and more is that sensory is fueling a lot of behavior. Even if it doesn't look like it at all. And using what we know about the autonomic nervous system can really help us mitigate a lot of challenging behavior. It can help us make our kids more comfortable in different situations. And so very much of that is fueled by their sensory experience and for all of us. Even for those of us who don't have ADHD or autism.

Nikki Perez (33:41): Absolutely. Another important thing to remember is that every child is different. I know we've said that so many times, but just something that you may read on the internet that worked for one child that really might not work for yours. There are so many different things out there and so many amazing tools and adaptations that can be made for your child. No matter what it is, we can always figure it out. And there's always something that's going to help him or her to really succeed.

Penny Williams (34:09): One last question I have for you before we close is many of us are now going into the fall school season and going back to school. And many of our kids are doing that virtually at home. I know that our school system for high school age, which my son is, is 100% remote learning. How do we manage these sensory needs and help kids to focus in an environment where they don't typically have to? My son is like, "I don't do school at home. I don't want to do school at home." It's been a struggle already. And so I think a lot of us are really scared to be honest, scared of how it's going to go and are our kids going to engage? And are they going to learn now that this is something that's going to continue? At the end of last school year, we thought, "okay, well this is short term." Well now we know it's not short term. And I think sensory play can really be helpful.

Nikki Perez (35:20): It can absolutely be helpful. And here are some tips that I've been telling all of my families. I actually have it all written down to share. Everybody using a picture schedule with the day's events. If you can do a picture schedule, just something that will prepare for what's coming next, that consistency and that predictability is so important. Allowing your child to stand up at the desk or the dining room table or wherever it is instead of having them just sitting down. As you mentioned before, getting a therapy ball for your child may be really, really helpful or getting a fold-up trampoline that you would take out, let your child bounce a little bit, getting those breaks in between the classes and in between these Zoom meetings that are happening. Decrease the number of paper and pencil type activities.

Nikki Perez (36:13): Incorporating movement and multisensory instruction instead using a timer is so helpful. Tell your child, you have five minutes to do X, Y, and Z. And when that timer goes off, I'm going to need you to come back and focus again, Buddy. Creating that calming space or that common area where a child can go to decompress. Getting a beanbag, a weighted blanket, a small tent or a tunnel for the little ones... That's super helpful. Filling up a little Mason jar full of pompoms or cotton balls. Every time you see a child being able to transition or focus or attend for a certain amount of time, giving them that positive reinforcement and telling them, "you can do this."

Penny Williams (37:09): And I think for younger kids, it really is an opportunity to be so creative. When my son was in first or second grade, he wasn't writing well, it wasn't legible. When we did spelling homework, we did spelling with dried pasta. We had a whole bucket of alphabet and number cookie cutters and a bucket of playdough, and he would spell words that way. Or he would hop on his ball up and down and tell me one letter at a time. There were so many ways and he had the knowledge and he was learning it.

Penny Williams (37:50): He just didn't do well with written output. And there are so many options: spelling it in shaving cream on the desk. I know that's a big one. Just really getting creative could save your sanity a bit.

Nikki Perez (38:06): Two of my favorite ones for the summer so far have been putting the sight words inside of hopscotch, go outside, with some chalk and write the words inside of squares, do hopscotch. Or find a wall, go to the school yard, go somewhere where you have like a nice brick wall and throw a bean bag or a tennis ball and have your kid throw it and then spell it. Just make it fun, just make it more fun. I think that's the biggest takeaway is learning for kids with ADHD doesn't have to be boring. We can make it fun and keep them interested.

Penny Williams (38:41): Yeah, we absolutely can. And it's just a matter of really looking at how they learn what their sensory needs are and then incorporating creativity. And I think for a lot of kids with ADHD movement is super helpful and some tactile input. My son had Velcro on his desk for a long time so that he could rub that rough part of the Velcro and get some sensory input when he did need to sit at his desk for a period. I'm just really thinking about all those things and making it fun. It feels so overwhelming, I know, I'm not playing down the pandemic at all. I have struggled with it like anybody else and maybe more at times, but we have some control in how our kids have to learn and then be able to do their schoolwork and participate with whatever school looks like for them, it can be a myriad of different things. It can look totally different. And I think thinking outside the box like that can really save us as parents. It can really save our sanity.

Nikki Perez (39:53): I totally agree with you and just adapt it to your child's needs, like as it happens. This is new territory for everyone. Really learning to cope with it together as a team, I think is really important.

Penny Williams (40:05): Yeah, absolutely. This has been such an enlightening conversation. I am so thankful to have connected with you and for you sharing a little bit of your time and wisdom with the audience. I encourage everyone listening to absolutely find an occupational therapist to work with for a while and really get to know your kid on that level, because it really does impact so much of what's going on with them.

Nikki Perez (40:32): Absolutely. Thank you so much. I really appreciate you having me and giving me the opportunity to share my beautiful profession with everybody.

Penny Williams (40:40): So lovely. For everyone listening, you can get the show notes at parentingadhdandautism.com/101, I will have links to Nicki's website. I think there's some social media as well, where you can connect and learn from her and her colleagues further. And as I always do, I encourage you to do that. I encourage you to explore some more and find out what else you can learn from the experts that we are so thankful to have on the podcast. So with that, we're at the end of the show and I will see everyone next time.

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