Ep #73: Understanding Sensory Processing with Claire Heffron

Welcome to the Raising Healthy Kid Brains podcast where moms and teachers come to learn all about kids’ brains, how they work, how they learn, how they grow and simple tips and tricks for raising the most resilient, kind, smart, compassionate kids we can. All while having lots of grace and compassion for ourselves because you know what? We all really need and deserve that too. I am your host, Amy Nielson. Let’s get ready to start the show.

Amy: Claire, welcome. We’re so happy to have you on the show.

Claire: Thank you so much for having me. I’m happy to be here.

Amy: This is so fun. I am so excited to talk about this. And I think it’s so fascinating, the field of occupational therapy for pediatrics. And so I’m so excited to get to talk to you. Tell me a little bit about how you got into what you do.

Claire: Sure. So I had a little bit of a weird path coming into occupational therapy, not the usual journey, I would say. So I actually started with a bachelor’s degree in journalism, so completely unrelated to the health sciences at all. But I was a writer and I really loved to write, I still do. And I also grew up with a sister with special needs. And so I was very familiar with the world of all the therapies, physical therapy, occupational therapy, speech therapy, all of that. And so that was kind of in my experience, I was familiar with it, but I didn’t necessarily think that’s what I wanted to do.

And I participated in an AmeriCorps program after college. And part of one segment of what we did was environmental education in the schools in Atlanta. And we had one particular school that had a classroom and there were children in this classroom with more significant physical and cognitive needs going on.

And we were not scheduled to do a class with them. And I was like, “Well, wait, why not? Can I just take what we’re doing and I’ll figure it out?” We didn’t have anything adapted or anything. I said, “I’ll just figure it out. I’ll take it in there.” Because I wanted them to have something too.

And I really remember that moment, the first day of bringing these materials in and just sort of intuitively kind of knowing they’re going to need things to touch. They’re going to need things to pass around. They’re going to need movement, just sort of framing it in a different way. And the first one I did, I was like, “This is it. This is what I want to do.” And somehow, it could have been anything, I guess it could have been special ed or any of those fields. But somehow OT really drew me in. And I ended up going back to school to get my Master’s degree, in 2005 I graduated.

And then started out my career in the schools. And that’s where I met my business partner, Lauren Drobjnak. She’s a physical therapist. We worked together a lot and we had a lot of the same kids, so we would co-treat a lot and just had the same kind of mindset. And together that sort of led us to create our online business called The Inspired Treehouse. And that is where we share all kinds of resources and activities and ideas and printables, anything under the sun related to child development.

And then in 2017, we also kind of spun that off into an in-person playgroup format at our non-profit called The Treehouse, and that’s located here in Cleveland. So kind of a weird journey.

Amy: I love that though. Well, mine’s super weird too. So it’s always fun to kind of find out that you can find your thing. If you didn’t know what it was at first, you can find your way into it, which is amazing.

Claire: Definitely, yes.

Amy: So beautiful. I’m so excited. And the work you’re doing is just amazing. And of course, we’ve been kind of in this world together around each other a little bit for a long time but haven’t really had a chance to meet and chat. So I love that we get to have this conversation today and talk a little bit about sensory processing. So tell me, I think when we do, with preschool, we’re talking about the five senses. And everyone’s always talking about the five senses, but how many are there actually?

Claire: Okay. So this is sort of an interesting twist on sensory. We learn those sensory systems, we know about them and then lo and behold there are not only five, there are actually eight. The three key ones are kind of missing from that basic instruction that we get growing up in school. And so the missing ones that are kind of hanging out there in the balance are our vestibular system, our proprioceptive system and our interoceptive system. So those are kind of the three whatever, we call the lesser known or forgotten sensory systems kind of.

Amy: Okay, so tell me about why it’s important to know about all eight, why does that matter? Because obviously we’ve only kind of heard about the five I think typically. So why does it matter to know about all eight?

Claire: Yeah. So when you hear it, you might have heard the term, sensory processing or sensory integration. And sensory integration just means that connection between all eight, not five, but all eight of those systems. And the reason this is so important is because it really determines how we show up in the world and how it really impacts our behaviors and our demeanor and really kind of some of the components of our personality even. And so when we have a really good understanding of all eight of the sensory systems, in our work with children, we can gain such a deeper understanding of the child as a whole.

And I think most importantly, as moms, parents, caregivers, teachers, whatever our role is, sometimes that understanding can kind of help us break down our frustration that we have with some of the behaviors that are going on that we think are just maybe defiance or just they’re not listening, they never listen. We always run into the same roadblock. And a lot of times there can be sensory concerns kind of hanging out in the background behind that.

And then overall my biggest push for this as a therapist is that having this really deep understanding of children as sensory beings allows us to have a really deep connection with kids. And that’s the goal as a parent or as a therapist or other professional, you’re not going to get to the point of any of what you want to do until you have that really deep trust. And I think it helps kids when we understand them in that way, feel respected and valued and understood. We see the behaviors follow, they kind of fall into line because they feel they’re being understood.

Amy: It’s so good. I love, I think it’s a quote from Dr. Becky and she would always say that connection always increases cooperation. So I love that idea that yeah, that connection and being able to understand. And so I think these other senses feel a little bit different to me. Some of the basic five ones that we normally hear about feel like our way of interacting with the world. But some of these other ones kind of seem like they give us more insight to more of our inner self and how we connect maybe with other people both in a physical space and maybe on the inside a little bit.

I want to know more about these. So can you give us a little more detail on these three lesser known sensory systems?

Claire: I think that’s actually a really great way, the way you just said it. There’s sort of these inner kind of, they’re hard to put words to. They’re harder to explain because they’re kind of existing not so obviously and so visibly as the other senses, but just as important, if not more important. So I can kind of go through them and then you stop me if [crosstalk] a question on any of them.

But also we have the proprioceptive system. And this system is the way that our joints and our muscles send messages to our brain and that helps us coordinate our movement. So the receptors send signals when our muscles and joints stretch or compress. So if you think of activities like jumping, stomping, crashing, pushing or pulling anything against, when you’re working against resistance, those are all proprioceptive activities. And to kind of put it in the way, like we’re saying, it may be a little more hidden or not as obvious to put it in a way that you might be able to be like, “I have seen this before.”

Some kids might crave more proprioceptive input. And these kids we can identify because they’re the kids who play really, really rough. They’re always pounding into the other kids, pushing, jumping. They may even use too much force in their play so they’re breaking their toys. And sometimes, again you perceive it as a behavior. You’re like, “Oh my gosh, you just hurt your friend or oh my gosh, you just broke that or threw that so hard.”

And while it can look like it’s a decision that the child is making, what may actually be happening is that they’re seeking out this sensory input and filling in need with that kind of more intense play. So that’s sort of the proprioceptive piece of things.

And then you’ll see online very often two ideas for heavy work activities. Then those are also lumped into this proprioceptive category. These are anything where a child is moving or pushing or pulling against resistance. And for many kids who appear out of control or overstimulated from a sensory perspective, these heavy work activities can be really useful in providing that grounding, organizing input to the body.

Amy: It’s so interesting because I had a kid that struggled with this. And I’ve learned recently about this other sense that I didn’t know about, but I’m thinking back to when she was young and this was a challenge. And she would hurt people in her attempts to just play with them or love on them and she didn’t mean to. And I was like, “Oh, what’s happening?” And trying to figure out how to correct that. And she got better at it over time.

But I think, oh, my goodness, I wish I’d had the knowledge and the words to say, “I realize this isn’t you trying to hurt anyone.” Because it was all in affection and love, too. She was just very overly physical sometimes. And so learning that that was just maybe something that she needed some extra, the things that you do to help them ground or find their space. So I love that we’re having this conversation because I needed it a while back.

Claire: Yeah. And hopefully other people might have this new awareness and it can kind of change the way they look at things, again, in the classroom, in therapy, at home with your own kids, it’s across the board. And I love what you said too, I think this is definitely the way I like to operate when I’m working with kids with sensory processing.

And my own kids for that matter, especially my youngest, who kind of tends toward this category, real rough, real intense play is talking about it with them in very open terms, in very observational terms. Like, “Oh gosh, I really notice that every time we come here”, whatever it is, maybe the gym or something. “Every time we come here, you crash on those pads so hard. Do you notice that you do that?”

And very often, kids will be like, “Yeah, I do, do that.” And then you can kind of have this open normalizing conversation like, “Guess why you do that? This is why. I think your body is looking for this. What are other ways we can do this?” And we’ll get into that a little bit more.

Amy: Yes, I love it. Okay, this is so good. Okay, keep going. I’m feeling all the things about it so keep talking.

Claire: Great. So the next one is our vestibular system and this is a movement based sensory system. So this one has to do with our balance and our movement. And it’s related to shifting and movement of fluid inside our ear. So our vestibular organs are located deep inside our ear. And when this fluid shifts and moves, it gives our brain information about essentially where our head is in space, but really our spatial awareness as a whole. And so if you can picture leaning to the side of your chair. That’s offsetting that fluid and your brain’s saying, “Whoa, I’m leaning to the left. Don’t lean too far, you could fall.” Or I’m tripping, I’m going to fall. That’s our vestibular sense.

And this comes into play, any kind of activity where we’re moving, where we’re leaning, turning upside down, even faster movement like driving in a car or riding a bike, spinning around, swinging. Those are all things that really stimulate that vestibular sense. And like we talked about our kids who are maybe craving more of that proprioceptive input, we also see some kids who crave more of this type of input, this vestibular input. And in this case, we might see kids who spin around and around and around, and they seem like they never get dizzy.

And that’s something that they’re drawn to do, whether it’s on a swing or just in the living room, they’re spinning. They like somersaults. They like cartwheels. They like rolling down the hill, all of those kind of really intense vestibular experiences. For kids in the classroom it might look like rocking in their chair. They have a hard time sitting still. Or they’re always up, always finding a reason to approach the teacher or go out of the classroom or whatever. And so that’s kind of on the side of kids who are seeking out that type of vestibular input.

And then we also have kids who need a lot less of the vestibular input. And in these cases, we might call that hypersensitivity, or you might hear the term gravitational insecurity. And these kids avoid this stuff at all costs, they will not get on a swing. And it can look, it will be very much a fight or flight reaction to having their feet off the ground. If you’re playing with a kid and you turn them upside down when you’re holding them in your arms, they would avoid that as much as possible. So we can kind of see both seeking part of that and then also a hypersensitivity to that kind of sensory input.

And so one little tidbit as a side note, since we talked about heavy work. We can talk about types of vestibular input and what we see as a result of those kinds of input in kids. So if we think of linear, rhythmic, repetitive, predictable movement. That tends to be more calming for most children’s nervous systems. It’s why we rock our babies. It’s why moms tend to find ourselves swaying from side to side all the time because it tends to be a calming sort of input to our kids.

Whereas rotary, spinning or unpredictable stop and go spontaneous kinds of movements tend to be alerting. They wake up the nervous system. So it’s kind of a good little background knowledge on what types of vestibular input might have different types of outcomes.

Amy: Fascinating. So when we’re doing some of those kind of more playful things and I don’t know, kind of more rough play like turning them upside down or all those kinds of things. It is actually kind of stimulating them more. So it’s kind of maybe not the thing we want to do right before bed. Whereas the rocking, we know, I think this, but this is why. We understand maybe more now with it being part of the vestibular system. That’s fascinating. This is so good. Keep going. I love it.

Claire: The last one, finally to the eighth one. So we have our interoceptive system or interoception. And this one, I think is the coolest one and is usually the one that when we talk about it, people are like, “What? I’ve never heard of that before.” And it’s not something that we’re taught about. And I will say even as an OT, it was not something that I learned about in OT school. This was in continuing education much later, which is cool because it says that it’s sort of coming to light more and becoming more of an understood topic which is a great thing.

So interoception refers to our perception of what is going on inside our bodies. And it’s responsible for feelings like hunger, thirst, nausea, any kind of other sickness, pain, having to go to the bathroom, tiredness. These kind of, like you said at the beginning, it’s hard to put words to, but it’s just this thing, this feeling that we have inside. And what’s really interesting about interoception is that it’s also very closely associated with our sense of well-being and our mood and our emotional regulation as a whole, and that makes such good sense.

And I can speak right now, I have a scratchy throat. I’m getting a cold right now. And this morning I had to text my husband and be like, “Gosh, I’m sorry I was such a jerk this morning.” Because it makes you grumpy. These internal sensations that are sort of hard to put words to and it really impacts the way you show up as a person in the world. And like we talked about these hypersensitivities and both sides of the coin for each of the senses, same thing for interoception.

So we can have hypersensitivities which can be kids that perceive really extreme discomfort when these interoceptive experiences show up for them. So if they’re hungry it’s so intense that it’s almost painful. If they have to go to the bathroom, it’s so intense that I had one child in my practice who would avoid going to the bathroom. Because that feeling of knowing that he had to go was so scary and uncomfortable and verging on painful for him. And that, of course, rolled out into a bunch of medical problems because he was constipated and he refused to go to the bathroom. And there was a lot of kind of working through those things with him.

And then on the other side of the coin, we also have kids who may have less sensitivity to those interoceptive cues, and this is potty training. This is such a big deal. If they don’t have those cues, they’re going to have an accident because they don’t have that perception of oh, wow, I have to go or whatever it is. I’m hungry, maybe kids don’t have that element where they never feel hungry. They could go all day without having a snack or lunch and never say anything about it. So it’s really interesting. I think that one’s a really interesting area of sensory processing to learn about.

Amy: That is so fascinating. So a question that I have and I don’t know if this is related, but I’m going to ask it because I can. Are there some kids that just seem to be more aware of what’s going on in their bodies? I don’t even know if it feels like it’s causing them more pain or something necessarily than another kid, but they’re so aware of, I feel yucky inside or I feel this. Or it just seems they’re more aware of it than most kids that are just like, “Oh, I’m going to go play. Yeah, my stomach feels a little weird, but I’m just going to go play”, because there’s people playing.

As opposed to it just being hyper aware and can describe sometimes in great detail all these details of how they’re feeling on the inside, is that normal or is that part of this?

Claire: Yeah, that’s great. I’ve never thought of it like that. I could totally say, I have three boys and I could totally say that exact thing about my oldest is if he’s sick, even the tiniest bit, everybody knows about it. He’s going to tell us. He’s like, “I have to rest.” Whereas my middle could have a fever and be off at school and never told me anything. And so that’s really interesting. I think that that can be a lot of things all rolled up into one.

It could genuinely be this sensory difference, one child perceives more than the other. I think for our younger kids, there could be a language component. Maybe one child just is more verbal and more able to put words to what they’re feeling. I think it can also be temperament. Just some of these things are also, just innate personalities and there’s really no way to separate at all. This sensory part is just as much a part of our response to our environment as any of those other aspects. So the answer is yes, it could be. Some kids are sort of in this different ranges of sensitivities for different areas of input.

Amy: Interesting. I’m so fascinated. And I don’t know that it changes anything necessarily but it’s so interesting to have that understanding. And then like you talked about earlier, just being able to respond differently and have a different mindset kind of addressing some of these things or having conversation around them with your kids as you’re working through things. It’s interesting to think about, so I’m so glad that we’re having this conversation. Thank you for coming on and chatting with me about it.

So what does this mean for parents? As parents, we’ve got these kiddos and we’re just doing our best and trying to help them. So what does this mean for us when we’re seeing different behaviors or challenges, what does that look like?

Claire: Yeah. So we talked a little bit about the different sensitivities and seeking out this kind of input versus being sensitive to it. And I think it’s really important for us as parents and professionals to understand and know that all people, adults and kids have different sensory makeups, just like we were talking about just now. We all have these quirks and these little things that come up, they might be sensitivities or what we call aversions to things that we don’t like. This is across the board. And there’s sort of a spectrum of those things where they can be more or less intense depending on the person.

But these things show up not just in the three hidden senses that we just talked about but also for taste and the oral sensory system. This is picky eating when we have hypersensitivity. So these things come up as developmental obstacles or roadblocks, whatever you want to call them, for many families. And this sort of gives a little explanation behind it, but you might see it in the auditory system. Kids who, as soon as you walk into an unfamiliar place, their hands are over their ears. So they’re hypersensitive maybe to sounds, overstimulated by the sounds and their environment.

We might see it with touch. So kids who can’t stand the feeling of the tag on their shirt or the seams on their socks. And every single morning it’s impacting your ability to get your kids dressed and ready for the day. So when we understand it, we can really help kind of get to the bottom of some of those tricky behaviors that sometimes we’re just like, “Oh, this is just what it is. This is just another morning.” When really, well, if we pick apart a little bit of what’s going on and even if we can just have a conversation with our child, “Hey, I think this is what’s going on. What do you think?”

It can kind of minimize the intensity of it and really start to build those connections that, like you said, I think you said the Dr. Becky quote, can really kind of lead to more cooperation. And I think a lot of parents too, ask about, “Well, what can I do? I want to do all of these sensory play experiences with my child.” And you’ll see things online and in your Instagram feed and all of that. But I think that really just keeping it simple is the best tip that I can give. And you don’t need a lot of equipment. You don’t need fancy toys to do this.

Sensory play can be so basic and still give your child all of the things that they need to develop and grow. So it’s really just a matter of looking really closely at each child and seeing what are they more drawn to or what are they shying away from. And then joining in with them. So I recommend that a lot. If I see a child that I’m having hard time connecting with in therapy, I really just stop with my agenda and step back and see where do they go in the room? What are they into? How do they move their bodies? And then how can I join in with that?

And that almost every time results in the kids like, “You’re going to come to my level, you’re going to join in with me.” And then from there we can start to work in the other things that we need to get done, whatever that may be. I also find, as the mom, who my personal sensory preferences are very different from my boys. So I have three very loud, very energetic boys. And I have auditory hypersensitivity that has just gotten worse as I’ve gotten older. So I’m constantly running into that where I’m like, “You guys, it’s so loud in here.”

Really just trying to realize, especially when they were younger, that they weren’t trying to drive me crazy. They were getting what they needed through crashing and jumping on the couch and all those things. And that helps when you have that sort of lens to look through and say, “Okay, this is serving a purpose for them. And how can I build it in, in a way that’s not going to make me crazy?” Usually it’s going outside for us. Let’s all go out for a hike. You can run and scream and do what you want, finding those ways to make it part of your play and part of your routine, that can kind of meet your child’s needs along the way.

Amy: I love that so much because I think too, these things have been around for a while and then maybe we just would label someone as less patient or something like that. But really, there’s a specific sensory need or a specific sensory overload or something like that. And yeah, if we can bring words to it, we could say, “This is, I think, what’s happening.” And there are solutions around this. Kids want to play, they want to be loud.

So do we move to a different floor and they can continue their play that they’re having this amazing time doing or do we take them outside like you said and let them run and yell out in the great outdoors? Which is amazing because they’re getting it out and they’re getting that need met and it’s not causing relationship issues with the people in the same house. I love that. It’s so valuable. So if you have a parent that might feel like they have a child with sensory processing stuff going on, maybe just some concerns, what are the resources that they can look into?

Claire: Yeah. So this is a really important question because you’re right, I think we talk about this and the knowledge about it is great. And for very many kids, these simple solutions are enough. And then we’ll have some parents who are like, “Oh my gosh, that wouldn’t even come close. What we have going on here is much more intense.” And I think it’s really important to kind of frame things in the way of how does your daily routine look?

And are the things that are going on with your child so intense and so challenging that they interfere with your ability to do typical things like brushing teeth, taking a shower, brushing hair, a haircut, riding in the car, getting dressed?” If every step of the way is so challenging that you are running into that obstacle every single time, community outings are a big one. So parents being able to socialize with family members or friends. If that is impeded, then that is going to impact everybody in the household’s well-being.

When we see that, it’s really important to know that. That’s not what we’re talking about when we talk about, let’s work these things. You still can work strategies into your day. But I really think in those cases it’s so important to call on a professional for help. And typically what I suggest is for families to go to their pediatrician as sort of the first line of defense because usually that’s a doctor who has followed your family, may know all the siblings in your family and kind of can help segue to the different services that might be needed.

And typically what they will do is refer for occupational therapy. And that’s typically the professional that you would see to address sensory processing concerns in most cases. There may be other things going on as well that are identified through that process and in that case they can refer you to other professionals too.

Amy: Sure. This has been so good. We are out of time, but please let us know where I can send people to get more information because I think you share so many amazing ideas that would work for a lot of people that have maybe more minor sensory things that need to be negotiated. But yeah, let us know where we can send people to find you.

Claire: Sure. You can find everything, our hub is theinspiredtreehouse.com. And from there you can hook into all of our social media. We’re very active on Instagram and Pinterest and all those things so you can find us all over. But the links are all there at theinspiredtreehouse.com.

Amy: Thank you so much for coming and sharing. And this has given me some new insight. I feel like I learn something every time and it’s just amazing. And I have things going on in my brain now. So I know our listeners will too so thank you so much for sharing your time and your wisdom with us, I so appreciate it.

Claire: Yes, thank you so much for having me. I really appreciate it.

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Thank you for hanging out with me today for this fun chat on Raising Healthy Kid Brains. If you want to see more of what we’re doing to support kiddos and their amazing brains, come visit us on our website planningplaytime.com. See you next week.