Sensory Issues and the IEP

By Lindsey Biel, OTR/L

Sensory problems — such as issues with touch, sound, movement, vision, and body awareness — frequently interfere with students’ abilities to take advantage of their educational programs. If parents or teachers suspect that sensory issues are interfering with a child’s function at school, they should request an occupational therapy evaluation.

While some strategies and accommodations can be worked out informally with cooperative teachers, others need to be negotiated with the school and added to the IEP to ensure compliance. An Individualized Educational Plan (IEP) is a legal document that spells out a child’s levels of function and unique needs, and the school’s obligation and plan to meet them. IEPs include long-term goals and short- term objectives, and are generally written annually with periodic reviews and modifications.

The law mandates only those related services such as occupational therapy, strategies, and accommodations that are written into the IEP for an individual student. While it may be quick and cost- effective for a parent to supply inexpensive items like a pencil grip or "chewy," the school must allow the child to use such devices — or a costly piece of assistive technology, behavioral strategy, or intervention — only if it is on the IEP.

Sensory Diet Activities to Implement During the School Day

Sensory diet activities give a child’s body the input needed to reach and maintain a calm, alert state, and may be added to the IEP. "Ingredients" should be individualized for each child and collaboratively developed with the school, parents, child, and therapists. The school OT may work directly with students in individual or group sessions, or join the classroom and work with the teacher to incorporate:

• Warm-up activities that prepare the student for learning, such as therapeutic deep-touch pressure (brushing), bouncing on a therapy ball, Brain Gym exercises, stretching, jumping jacks, and "heavy work" such as pushing or pulling. For example, a brushing session may benefit a child before art, and rolling over a therapy ball may ease the transition from the playground to the classroom.
• Items that provide sensory input or "snacks," such as a vibrating pen, weighted or compression garment, ball chair or inflatable seat cushion, fidgets, or a "chewy."
• Adaptive devices to stay calm, organized, and focused, such as a sitting wedge, vibrating pillow, timer, or slant board. Keep adaptive devices generic to allow for changing sensory and academic needs.
• Sensory strategies to avoid overload, such as a short break from work or a designated "safe space" to retreat to for brief durations.

"Sensory Smart" IEP Strategies and Accommodations

Here are some strategies and accommodations that may help.

• Touch: Firm touch to obtain attention; preferential positioning at the front of the classroom, the end of the line, and head of a table to avoid light touch by others; hand fidgets or chewable items for self-regulation.
• Movement: A five-minute walk approximately once every 90 minutes; no loss of recess or outdoor time as punishment for inappropriate behavior; permission to sit on a cushion or positioner with back support during floor time.
• Sound: Lunch in a quiet, low-stimulation environment; an FM unit to bring the teacher’s voice to the foreground; advance notice for fire drills; headphones, earplugs, or earmuffs to reduce noise in the cafeteria, assemblies, recess, or fire drills, and to calm during "quiet time."
• Vision: Permission to "block off" the visual sense by avoiding eye contact in order to attend to verbal instructions or when speaking; a picture or written schedule of daily activities; both oral and written instructions; prescription eyewear, prism lenses, sunglasses, and colored lenses.
• Motor planning: Ample time to answer questions; extended time, a separate room, and/or answers recorded in any manner for test taking; a checklist or backpack check to assure all items are there; extra storage space to improve organization.

An Example of a "Sensory Smart" IEP Goal with Objectives

• Long-Term Goal: Katie will stay focused and organized for 80% of the school day.
• Short-Term Objectives: Katie will:
  1. - work at her desk, sitting in her chair using an adaptive seating device, for 10 minutes; use stretchable tubing for 15 minutes to avoid kicking the table;
  2. - do "heavy work" such as carrying books or stacking chairs at least three times daily;
  3. - remain on her floormat while listening to music through headphones during rest time;
  4. - use her "safe space" to self-calm fewer than 10 times daily.

Be "sensory smart" when writing IEP goals and objectives.

Resources For more on sensory diet activities, sensory strategies and accommodations, and practical solutions for home and school, read Raising a Sensory Smart Child: The Definitive Handbook for Helping Your Child with Sensory Integration IssuesRaising a Sensory Smart Child: The Definitive Handbook for Helping Your Child With Sensory Integration Issues, by Lindsey Biel, OTR/L and Nancy Peske.

Lindsey Biel is a pediatric occupational therapist in New York City, and the co- author of Raising a Sensory Smart Child: The Definitive Handbook for Helping Your Child with Sensory Integration IssuesRaising A Sensory Smart Child. Visit her website at www.sensorysmarts.com. This article is adapted from an article in the September-October, 2005 issue of Autism Asperger Digest, a bimonthly magazine on autism spectrum disorders. Adaptation with permission of the publisher.]

[Initially published in New Developments: Volume 11, Number 4 - Summer, 2006]