OT Corner: The Sensory Diet
By Amy Wagenfeld, Ph.D, OTR/L
Originally printed in December, 2005

As Part Three of a series on Sensory Integration, this month we will take 
a look at sensory diets.  It is my pleasure to introduce you to Tina Monaco, 
who helped prepare this column.  Tina is a COTA working in Billerica, and 
has been bitten with the “pediatrics” bug… a good choice if I may say so myself!

Let’s start with the theory behind a sensory diet.  A sensory diet is thought 
to help a child achieve optimal functioning in his environment, and to help 
him perform to the best of his ability.  According to Carol Kranowitz, 
author of The Out of Sync Child, a sensory diet helps a child to be “focused, 
adaptable, and skillful.”  A sensory diet is composed of a number of 
activities designed to organize, calm, or increase the state of alertness 
in a child.  A note: a sensory diet is NOT a substitute for formal sensory 
integrations services; it is usually a supplement!

So, who needs a sensory diet? Sensory diets are usually prepared for children 
who demonstrate disorganized, over-aroused, or under-aroused sensory systems.  
For instance, a child who is showing signs of hyper (over)-arousal will be 
provided a diet designed to encourage a calmer state of being, and one who 
is hypo (under)-aroused will be given a diet that is designed to get things 
moving, so to speak.  According to Wilbarger and Wilbarger, a mother-daughter 
OT duo who have provided groundbreaking work on sensory defensiveness, what 
is perhaps most important about the sensory diet is to “help the child feel 
calm, alert, and organized most of the time by using special activities 
scheduled throughout the day.”  Sensory diets are highly individualized, 
and require a commitment from not only the therapist, but also parents and 
other caretakers.  As a parent, an open mind is of key importance as your 
child(ren) participate in this diet.  Since each child responds differently 
to sensory diets, and results of sensory diets are not the same for every child, 
your child(ren)’s therapist will be your best guide in terms of sharing with 
you when you may begin to see results from the sensory diet. 

If you feel as if your child(ren) is/are experiencing sensory difficulties, 
you may want to seek the advice of an occupational therapist who specializes 
in sensory integration therapy.  The therapist may elect to do a full-scale 
evaluation or an observation and checklist, and based on results, discuss any 
outstanding sensory-based issues with you. From there, the occupational 
therapist may develop a personalized sensory diet for your child(ren).  
It’s really important at this point in the process (or for that matter, at any 
time you feel you need to be heard!), of meeting with the therapist that you 
make your needs and concerns known.  It is really important, that you, the parent, 
feel comfortable with the plan of action, AKA, the sensory diet.  We really stress 
this point, because in order to see results, the sensory diet needs to be made a 
very important part of your child’s day.  Keep your limitations (time, time, time!) 
in mind as you work with the therapist on developing a sensory diet.  Make it one 
that is workable for all of you.

Wilbarger and Wilbarger suggested that a sensory diet should contain the following 
four components.  First of all, the diet needs to contain prescribed activities 
that are completed on a specific schedule.  Activities must be done under the 
supervision of an adult who is able to monitor a child’s reaction to over-stimulation 
or stress, either as a result of the diet, or as a result of other unexpected 
events.  A sensory diet must also contain activities that provide for a lot of 
intense heavy work and deep pressure, as well as movement, and oral motor 
experiences.  Above all, a sensory diet is based on activities that not only 
have a sensory component, but also are fun for a child.  If your child(ren) 
are having fun with a sensory diet, it is going to be far more rewarding than 
if it is just another unpleasant thing to do during the day.  An added bonus; 
if it is fun for your child(ren), it is probably more fun for you too!

A sensory diet may take several forms- but all are directed towards a specific 
purpose, that of regulating the sensory system.  For instance, if your child(ren) 
experiences difficulties with tactile issues, the diet will be geared to either 
increase or decrease tolerance to tactile input.  Other sensory diets may be 
geared towards integrating the proprioceptive or vestibular systems, or for 
providing the whole body with calming, alerting or organizing experiences.  
Auditory, gustatory (taste), smell, and visual systems are also helped through 
a sensory diet.

The upshot of all of this information is that if you feel that your child may 
benefit from a sensory diet, consult an occupational therapist that has a strong 
background in sensory integration who may be able to help your child(ren).  Next 
column, we will take a look at the potential relationship between sensory 
integrative issues and autism.  Until then, have a great month, and keep the 
topic ideas coming!

FYI - A good read for those who want to know more about sensory integration… 
The Out of Sync Child, by Carol Kranowitz, published in 1998 by the Berkeley 
Publishing Group.