Sensory Craver Signs
SUR, High threshold, Active seeker
Craves intense sensory input and never seems satisfied
More sensory input leads to greater disorganization, not calming
Visual: Likes flashing lights, spinning objects, prefers TV/video games
Auditory: Uses loud voice, makes background noises, seeks noisy environments
Taste/Smell: Chews or licks non‑food items, smells people/objects, prefers strong flavors (spicy, sour, sweet)
Vestibular: Constant spinning or swinging, seeks fast movement (running, biking, roller coasters), enjoys being upside down
Proprioceptive: Excessive jumping, crashing, pushing, wants tight clothing or weighted vests, grinds teeth
Tactile: Constant touching, seeks messy play for long periods, mouths or bites objects
Sensory Craver Interventions
Provide organized, goal‑directed movement (movement paired with purposeful tasks)
Use intermittent and limited vestibular input (short bursts of swinging/spinning followed by organizing activities)
Emphasize heavy work (slow, sustained pushing, pulling, carrying like vacuuming or taking out trash)
Use small or defined spaces to help with boundaries and organization (tents, forts, marked play areas)
Avoid highly stimulating environments (malls, carnivals) that increase overarousal
Sensory Overresponsitivity SOR Signs
SOR, Low threshold, passive
Sensations feel too intense, too easily, or last too long
Strong fight, flight, or freeze responses to sensory input
Vestibular: Avoids climbing, swinging, spinning
Tactile: Avoids sticky, gooey, or messy textures
Auditory: Becomes disorganized in noisy environments
Visual: Discomfort in bright light; may need sunglasses
Olfactory: Runs from strong smells (e.g., cooking food)
Taste: Eats a very limited range of foods
Proprioceptive: Dislikes pressure through feet/legs; avoids jumping, hopping, skipping
Interoceptive: Feels internal sensations (like stomachaches) very strongly
SOR Interventions
Work with an OT trained in sensory integration (SI)
Use an intensive treatment model with clear parent-identified goals
Focus on arousal regulation and a strong therapeutic relationship
Pair calming input (proprioception) with challenging input (e.g., vestibular)
Introduce feared sensations gradually within play-based, safe, and successful experiences
Build confidence so the child can tolerate and eventually engage in previously avoided activities
Sensory Underesponsitivity SUR SIgns
SUR, high threshold, passive
Appears quiet, passive, and “low and slow”
Often seems oblivious to sensory input
Visual: Loses place when reading; eyes tire easily
Auditory: Does not respond to name; hums while working
Olfactory: Does not notice strong odors others detect immediately
Taste: Unaware of spicy vs. bland foods
Vestibular: Avoids playground equipment; prefers sedentary tasks
Tactile: Does not notice bumps, injuries, or touch
Proprioceptive: Slumps, leans on walls, weak muscles, poor body awareness
Interoceptive: Toileting accidents, unaware of hunger, poor internal body signals
May not notice pain, temperature, or pressure; movements are poorly graded
SUR Passive interventions
Use “fast blast” sensory input to increase alertness and arousal
Provide fast, intense movement (e.g., swinging high and fast, active play)
Encourage movement even when the child prefers sedentary activities
Use interactive video games (e.g., Wii, Xbox Kinect) to promote movement
Increase sensory intensity through food (spicy, crunchy, chewy textures) and strong smells (garlic, onion)
Identify motivating interests and use them to increase engagement and participation
Focus therapy on engagement and relationship building
Sensory integration therapy with a well‑trained, mentored OT to support:
Increased arousal and alertness
Improved social participation
Better self‑regulation
Improved self‑esteem
Sensory Modulation
Ability to regulate and respond appropriately to sensory input. Filtering/attending
ex) Responds too strongly or little, seeks input
Sensory Discrimination
Ability to notice, interpret, and make sense of the qualities of sensory input
ex) where the body is, how musch force to use, what is touching, where sound is from
Sensory Integration/Processing
Organizing input so the brain produces useful responses
Adaptive Responses
An appropriate action in which the individual responds sucesfully to some type of environmental demand, purposeful and goal directed
Sensory Discrimination Disorder Interventions
Visual: category games (e.g.,
find everything in the room that’s a
circle, while driving point to all foodrelated signs)
Interoceptive: Talk about how your
body feels at times when you are happy
versus worried. Say things such as, “I’m
so happy, I can feel my heart beating
fast!” or “I always feel nervous when I
[fill in the blank]. My stomach feels like it
is flipping over.” That way the child will
begin to understand the body sensations
related to emotional content.
Auditory: Play the same-and-different
game, “I’m going to say two words,
and you tell me if they are the same or
different. Then it will be your turn to try
to trick me.”
Proprioceptive: Play Simon Says or
Mother May I? performing unusual, novel
body movements
Postural Disorder SBMD Signs
Poor core strength and low endurance; fatigues quickly
Poor balance and postural control; difficulty sitting or standing upright
Slumps, leans on furniture, props head, or uses wide base of support (e.g., W‑sitting)
Inefficient movement and poor body awareness
Slow, cautious movement with preference for sedentary activities
Difficulty on uneven or moving surfaces (e.g., curbs, bumpy ground)
Poor muscle co‑contraction (muscles don’t work together automatically)
Poor bilateral coordination (difficulty using both sides of body together)
Often feels unstable or insecure, with low self‑confidence and trouble keeping up with peers
Postural Disorder Interventions
Use play‑based intervention (play is more effective than exercises)
Scaffold activities so they are challenging but successful to build confidence
Focus on improving core strength, endurance, and postural control
Use gravity‑based “heavy work” (climbing, pulling, carrying light loads)
Incorporate whole‑body movement (squatting, reaching, crawling, obstacle courses)
Challenge vestibular and proprioceptive systems together through dynamic play
Emphasize social participation during therapy, not just motor skills
Coach families to support a sensory lifestyle, not rigid home exercise programs
Interventions are individualized based on child and family priorities
Dyspraxia SBMD SIgns
Difficulty with motor planning, including ideation, sequencing, and/or execution
Clumsy or awkward movements
Poor body awareness
Poor sequencing of tasks
Slow motor reactions
Difficulty learning new motor activities
Difficulty climbing and navigating new environments
Dyspraxia SBMD Interventions
Practice ideation through pretend play; prompt the child to generate ideas (“What should we do next?”)
Use guided prompts, moving from general to specific, without directing play
Break motor learning into small, manageable steps
Provide repeated practice to support planning and execution
Focus on planning and sequencing daily routines (plan the day, week, month)
Use visual planning tools (e.g., schedules, refrigerator planning boards)
Encourage play involving body awareness and movement in space (Twister, charades, obstacle courses)
Let the child build and design activities (e.g., obstacle courses)
Emphasize success and self‑esteem by building on strengths
