There is a lot of talk about autistic burnout in the neurodivergent communities right now. This can happen for both children and adults on the spectrum. If someone is not diagnosed with autism, this may look like dissociation, shut down, and/or depression. As we learn more and more about the autistic brain and how it functions, we can begin to see the crossover with mental health issues. 

A person can get autistic burnout from being in environments that have excessive demands that put a lot of pressure on a nervous system that is wired differently. If there is a constant push for a child to fit into a particular mold (often seen in school situations, especially public school), or if there is a lot of chaos in the home situation with siblings and/or parents, or an otherwise high level of demand to perform or behave a certain way from a parent may be exhausting to someone with autism. Also, simply having to constantly navigate unclear social expectations and change in routine can be exhausting and overwhelming for a person on the autism spectrum. 

Autistic burnout can have many characteristics. An intensification in any of these things that is beyond what is usual:

• Sensory overwhelm: this can include heightened sensitivity to sounds, visual stimulation, clothing textures, foods (leaning into strong food preferences), smells, or movement. 
• Increase in rigid behaviors: inflexibility with changes in routine, wearing specific clothing, eating specific foods, attempts to control social behaviors (like dominating rules of games, need to win, dictating what happens between friends in social circles, rejection of siblings)
• Intensification of behaviors: this may include social withdrawal, stimming behaviors (flapping, spinning, lunging, rocking, etc), increase in intensity. or duration of meltdowns, moving into only one room and isolating
• Emotional changes: highly volatile, reactive, anxious, depressed, loss of interest in things that are normally enjoyable.
• Exhaustion: unable or unwilling to get out of bed, little to no willingness to participate in activities of daily living (such as bathing, eating, brushing teeth, changing clothes)

If your child is experiencing any of this and has sensory challenges or is on the autism spectrum, you can take certain steps to help them. 

Immediate supports for the acute phase:

• Reduction of demands: allow for rest, give space
• Encouraging journaling or art to express and release heavy emotions
• Using essential oils or natural scents to create a quick shift of mood
• Using an ice cube on the bridge of the nose or face as a reset
• Quick, short burst of exercise/activity; outside is best such as walking a pet, walking to the park or playground
• Nourishing foods as much as possible, and mood boosting supplements like B and D vitamins, magnesium, 5HTP, vitamin C, probiotics, omega 3s

Long term supports to help keep burnouts from happening:

• Therapeutic support: occupational therapy and psychotherapy can help over the long run
• Healing foods, supplements + medications 
• Prioritizing intermittent breaks, rest, and self care 
• Setting up accommodations in school through an IEP or 504 
• Setting up regular outlets for movement, focusing on muscle work such as climbing, riding a bike, hiking, and jumping on a trampoline

Autistic burnout is real. If your child is acutely experiencing this, please try the suggestions for acute management. If your child is not experiencing burnout, start applying some of the long term suggestions and get ahead of it. Most importantly, know the signs of burnout so that you can more quickly identify it and start applying some of these suggestions. 

We have all felt the desire to hunker down, rest, and cozy up as the colder weather arrives. And this is a necessary moment for us; to gather ourselves near the proverbial hearth, to eat the foods that we have harvested in the warmer months, and allow for rest and re-set. 

Many children with sensory processing differences struggle with time and seasonal changes; the temperature changes, as well as the diminished sunlight and outdoor time. Especially those that need more movement who are in school environments who restrict outdoor time in colder months. Here are some ideas to make the most of the shorter and colder days with your sensory children. 

• Get in your daily dose of movement. We know that children benefit from movement; especially sensory children. Find ways to stay active in the winter when the days are shorter (as they are in the northern hemisphere). Make sure that your kids have gear to play in lots of kinds of weather; cold, wet, snowy. Walk to school (even part way), get to the playground, walk a pet, or play on the trampoline. Being outdoors is one of the best and most effective types of experiences, and it’s free. 
• Family outdoor time. Maybe it’s a hike, a brisk walk, or even walking the neighborhoods to see the holiday lights after dinner. Doing a nature scavenger hunt can also be fun–looking for pinecones and acorns.
• Have some indoor movement alternatives. You don’t need to have a full on sensory gym in your home; you can use what you have around the house to construct mini obstacle courses: pillow cushions, broom sticks to jump over, step stools for height variation, and/or using rolled up socks or beaning babies to toss items into a bucket or laundry basket are a few ideas for ways that you can use what you have. (See below for an some at-home obstacle course tips)
• Build cozy forts for nesting. You can use pop up tents, blankets, pillows, Flashlights may be fun for reading while in a fort. 
• Nutrition and vitamins for health. This is a great time of year to up vitamin C intake for the natural “sunshine”: think oranges, citrus fruits, elderberry. If you have a very picky eater, you may try gummy supplements of vitamin C or elderberry.
• Epsom salt baths (for ages 4 years +). These warming baths can combat the colder weather and also help to soothe the nervous system with the magnesium. They are especially helpful after a cranky day.
• Making homemade holiday cards. Go ahead and get messy! Work with a variety of mediums such as paints, crayons, cotton balls, glue and stickers. Incorporating sensory play into fine motor activities (such as crafting) is very stimulating for the brain. 
• Using tight fitting long underwear under clothing may help with the seasonal clothing changes. Many children have issues with the tactile nature of clothing when moving from wearing short sleeves to long sleeves or shorts to pants, or even tolerating wearing coats, hats or gloves. 
• Massages after bath with lotion or oil. Use the warmth of your hands to help massage lotion or oil into your child’s skin after bath time. This firm pressure touch is deeply healing and soothing for the nervous system. If your child is sensitive to your touch, you can have them rub it into their skin by themselves. This may also improve the toleration for various foods if your child is a picky eater.
• Create a natural aromatic experience on the stovetop. You can warm apple cider or a milk product with cinnamon, orange peel, and star anise. Then you can add honey to sweeten (for milk based brew), sip on it and enjoy it. If your child is sensitive to smells, try using natural scents such as citrus and peppermint (essential oils should be handled by adults only, or used in a diffuser).

And, here are some tips for creating obstacle courses at home:

• Find objects at home, such as cushions, pop up tunnels, step stools, broom sticks, empty laundry baskets, beanie babies, balloons, squishy toys, etc. 
• Allow your child to engage in the planning. This can be written or drawn, if you’d like to add some fine motor elements. If they have trouble planning (this may be indicative of issues with ideation–the ability to plan out an unfamiliar task), offer some ideas, and help them. The skill of ideation really improves with repeated practice of doing unfamiliar, or novel, tasks. 
• Novelty is key! If they have completed a course successfully a few times, ask if there is any way that they can change the set up to mix up the challenge. This is supportive for brain executive functions. 
• Bring in balance components such as walking on stools, and walking on a rolled up blanket–the long, thin way.  
• Bring in visual-motor components: have them place squishy toys, beanie babies or even rolled up socks around the course to pick up and throw into a laundry basket or bucket. This is highly impactful for the nervous system. 

I hope that some of these tips are helpful for you to navigate the shorter days and colder weather. Sensory-rich play is so effective in helping children’s development. Make sure to put down your devices, and play with your kids this season! Adults need more play….

This is currently a question that people are getting more and more curious about. What if sensory sensitivities are also linked to empathic abilities? Let’s first define the word empath. Oxford Languages defines it as “a person with the ability to perceive the mental or emotional state of another individual.” As a highly sensitive (including sensory sensitive) person, I have experienced this first hand. But it is important to note that, for most of my life, I thought that was I was feeling was entirely my own. This could range from physical symptoms, to moods that suddenly appeared. 

After becoming a mother, my empathic and intuitive abilities became very strong (I believe that this is more common than most would know), after having “turned them off” for over a decade to complete studies, and begin my career. When this occurred, I had been working with children for about 8 years as a therapist. I suddenly became curious about the sensory sensitive children I was working with. Could they too, be empathic like I am?

It is not secret that part of the presentation of neurodiversity–especially ADHD–comes with a lot of emotional dysregulation. These children (and adults) are deep feeling individuals. I have witnessed many children with sensory sensitivities have powerful emotional outbursts, sometimes referred to as “meltdowns”, that can be high in frequency, duration, or both. Sometimes these sensitive children even seem to become the “emoters” of–and for–the family: when the adults or older siblings are avoiding or otherwise unable to process their own emotions, for any number of reasons.

I often think of people with sensory sensitivities and  neurodiversity (especially ADHD) as having huge antennae, that connect them to others, events, and more. I have seen these children seem to intuit/name/feel deeply what a peer is thinking, what they are feeling. I have witnessed children becoming overly concerned with how peers are feeling, especially if they are having a hard time–both in classrooms and in the therapy gym. This can, of course, extend to the home environment, with this playing out with family members as well. In my experience as a neurodiverse person, having biological neurodiverse children, and working with neurodiversity since 1997 is that many of these sensitive children seem to have heightened empathic ability. . 

So, how can we help support our sensitive children who are empathic?

1. Provide plenty of opportunities to release stored emotion. This can include physical outlets, (such as sports and free play–especially play that engage a lot of muscle work), talking about feelings, journaling or creating art to release the emotions. 
2. Ask: “Does this feeling belong to you, or someone else?” Your child might surprise you with an answer. If they don’t know, it’s OK. You can invite them to “Let any feeling that does not belong to you, leave your body.” (As an adult, I use “Return to sender with consciousness.”)
3. Create cozy corners, and safe spaces at home. I recommend creating a safe space in the main part of the house, as sometimes children want to be close to family when they are having a hard time. A safe space is NOT a time out. It’s a place to go to have some space to process intense feelings. 
4. Time in nature. Getting outdoor play, going to the parks, hiking, etc. Nature is a great way for our children to ground their energy, release stored emotions, and be soothed. The natural elements are extremely healing, and supportive to our nervous system. 
5. Clean water, clean food, sleep. This can be tricky for sensitive children. If your child has food avoidance or ARFID, you can try supplements to enhance their nutritional content. If they have sleep issues, limit screens, get a lot of physical input in the day, and consult with your therapist to help you create strategies and learn techniques for improved sleep and help with picky eating. 

Things are intense for our deep feelers, our sensitive and neurodiverse children, our empaths. The sooner that you can identify and support your children, the better. Sometimes, when a parent/caregiver opens up about the possibility of their child being empathic, the children will just begin to share their experiences, unprompted. I have experienced this multiple times. Get curious, and see what happens. 

As a parent, I completely understand (and have experienced, multiple times) just how challenging it is to witness your child struggling. Whether it is academically or socially, parenting a child going through hardship can trigger our own wounds, and, even with the best intentions, can send us into a reflexive response (fight, flight, freeze, or fawn) even in finding a “solution”. 

We may want to go immediately into fix it mode. We may feel angry and want to address it with another parent or educator involved. We may want to bury our head and let our partner deal with it, possibly because it’s triggering our own wounds that have not fully healed. 

Having my own children experience life (especially the painful parts) certainly brought up my old wounds as I witnessed them experiencing similar things that I did, that were really difficult. I think, even in the very early realization of what’s going on with our kids, it’s good to look at ourselves and our own responses as well as our children’s. While listening and supporting our children, it is very important to take the opportunity to get support to feel through our own pain and get any necessary support. 

There is a lot of chaos in the world right now. When things in the external feel chaotic, is tends to trigger our own unhealed wounds. We may be more reactive, sensitive, or self-punishing. Our sensitive kids are certainly feeling this; even when we keep news to a minimum, and do our best to shield them of the harshness of reality. It’s just sort of, “in the background”. 

It is so helpful to first listen to our children. You will likely hear a self sabotaging, or negative voice emerge about it. If this happens, it is a great opportunity for a reframe. But first, it’s important to listen and reflect back to them what they are saying (in a neutral voice). Validate their feelings, and then offer a different lens to view the situation through. This reframing can help stop the negative self talk, and unnecessary thought loops that can arise from challenging situations. It can be incredibly empowering for your child. 

Here are some step by step things to try when your child is experiencing a challenging situation:

1. Notice your reaction to their experience. Are you going into fight, flight, freeze or fawn? Slow down. Have them repeat some details. Breathe. Breathe again. Take these moments to ground your own energy and calm your system.
2. Change the scenery. Ideally, go for a walk, or get outside into the garden. Move to another room. This simple action is incredibly effective for getting a new perspective. These actions help shift the visual system and also the body (if moving or going for a walk) which can immediately have a positive neurological impact.
3. Listen–without offering a fix. Embody the role of a reporter; repeat back the details. 
4. Validate any associated emotions. This is simple, but often skipped. 
5. Encourage a growth mindset. Instead of “I can’t”, encourage “I’ll try”. 
6. Get curious by asking if there is anything that your child could have done differently. It is OK if they cannot think of anything. 
7. Offer your own perspectives and stories to help provide examples. Children usually love to hear these stories; of how we also struggled, and shifted perspectives. This is a great tool also if your child is stuck. It will often help them to understand and be able to shift their own perspective.
8. Role paying can be helpful to fully map out how to handle challenging situations. This is especially effective for children who have any motor planning/praxis challenges. Literally, get up, move around, and play a part. Real time practice can really help–it’s like theatrical blocking (when actors memorize lines when moving around the stage or set) and helps lock in the memory.

In summary, tend to any wounds that you experience when your child is going through something challenging. It’s an opportunity for us to reframe our own painful experiences. Pause, and notice any inclinations to go into “fix it” mode. Breathe. Listen and validate your child. Meet the situation with curiosity. Offer your own stories and how you handled it. Reframing can develop the ability to take on various perspectives, and also the ability to move into more of a growth mindset. 

I think that many people collectively agree that routines are important. They help us stay organized, and for many children (especially neurodiverse children, anxious children, and children who struggle with executive functions), they can help us to stay regulated. Experts suggest that creating routines into habits takes about a month, and to establish a healthy habit, it is recommended that it is practiced consistently for 30 days. 

Routines can help children feel safe, and manage anxiety, as they can better predict the flow of daily-weekly-monthly happenings. If your child is struggling with anxiety, a visual schedule is highly encouraged with younger children to establish the predictability. This can be done with pictures, simple drawing, or words. Some children do better knowing in advance, so a weekly family visual planner is recommended. For others, it is enough to know what is happening on the day, in which case a daily visual chart will be helpful. Going over the routine verbally for the day during breakfast, or while driving to school can also be helpful to reinforce the awareness. 

Tech wise, this can be super simple and low tech (such as written or drawn visual lists that are in plain view), sticky notes, and lists that you can cross off. For kids that struggle with the change of routines (summer to school), or are having an acutely stressful time, visual planners for regular routines (nighttime routine or morning routing) with checklists are very helpful. As children get older, a handwritten planner is ideal (as handwritten notes stimulate different areas of the brain, and physically checking of items on a to-do list gives us a dopamine boost), and also familiarization with planning apps on tablets or laptops such as Monday, Click Up, and Smartsheet (which all have good reviews). 

So, now that we’ve discussed some of the simple reasons on why routines help children, let’s consider why it is also important to break routines for optimal health.

1. Improves neuroplasticity. Shifts in routine, especially with travel, can significantly enhance neuroplasticity, which is the brain’s capacity to make new connections. Visiting a place where different languages are spoken, exposure to different cultures, different foods, opens up the awareness of different cultures. 
2. Introduces novelty. Novelty helps our brain break rigid patterns. When we get too stuck on rigid routines, it can negatively impact us. Novelty keeps us alert, on our toes, and can broaden our perspective. 
3. Challenges the brain. The brain does like routine, but too much routine is very limiting for us. The brain is challenged with new routines, and forces us to adapt, break from familiarity, and when we do this, we grow new synaptic responses and connections. 
4. Improves cognitive flexibility. When we are exposed to new situations and things, we can adapt to challenges that come up within our normal routines with greater ease. We learn to get curious about different perspectives, and we are more able to identify or move out of being “stuck in a loop”. We can be more creative with problem solving in real time. 
5. Boosts mood and creativity. Exposure to novelty is very stimulating for our own creativity. Seeing and experiencing new things is eye opening and can lead to greater creative pursuits. It can inspire us to modify the way we view things, or how we do things. 

For many children, change in routine can feel scary. Some children are very rigid about types of foods that they tolerate, change in restaurants, or any other change in routine; especially if they are sensory sensitive, have trauma, or have anxiety. The best way to support children who struggle with this is to discuss things with them, show them pictures, and offer some ideas on the need for support or to take a break when experiencing the novelty. Build a lot of physical breaks into vacations, or trips, and scale back the overscheduling or overbooking of events, offering opportunities for down time a the pool, in the hotel or rental home, and getting outdoor time. Try to have a plan B for your sensitive child. If you are eating at a new restaurant, it’s OK if you need to bring an emergency snack or food; the combination of the new environment AND new, unfamiliar food may be too much. Baby steps are helpful for these kids. 

So, there are clearly benefits to having routines, and to breaking them. And even though this article is discussing children, we must also remember that it is equally as good for us adults. Mix it up now and again! A change in routine can help to change your outlook on life, to boost your mood, and even to grow new neuronal connections for you, as well as for your child. 

Interoception is a complex mechanism that registers different internal sensations for homeostasis (such as registering hunger, bathroom needs, heart rate) as well as connecting us to our internal emotional landscape by registering associated feelings with the sensations. For example, if the sensation of a waistband on clothing is strongly perceived/felt, identifying that the accompanying emotion of annoyance is a big step to building interoception.  

Interoception works through a vast network of sensory receptors in the body: the skin, the muscles, the fascia, the bones, the internal organs, and the inner ears are all examples. Ideally, when our interoception is functioning sufficiently, we can feel our hunger cues and eat when hungry, stop eating when full, know when we have to use the bathroom, and know when we need to rest. With good interoception, we have a connection to our internal emotional landscape. We recognize our feelings when they arise, and can make necessary accommodations or take appropriate action steps. We can advocate for ourselves, and tend to our needs (or ask for help when we need to). 

Why do so many people have difficulties with interoception? Well, it has been identified that interoception is not well developed in neurodiverse individuals. It has also been identified that people who have experienced trauma can also have insufficient interoception. And if you think “I’ve not experienced trauma”, I think that we all have to some capacity–including living during a pandemic and also under uncertainty in the world. 

Here are some examples of poor or insufficient interoception that you might see with your child:

• bladder/bowel accidents due to lack of feeling the urge
• not registering hunger or fullness until too late (resulting in “hanger” or being “too full”)
• diminished ability to identify feelings/numbness
• being too sedentary
• needing a lot of movement
• needing a lot of muscle work
• not registering food on their face
• not noticing that shoes are on the wrong foot or if clothes are on backwards
• not being able to problem solve how to fix something or feel better if annoyed
• becoming explosive very quickly (not registering the build up of feelings)

Sometimes, we diminish our child’s interoception–with good intentions–by negating an experience for them. An example of this: “Wait, didn’t you just eat? You can’t be hungry again, it’s only 20 minutes later!” Even though this is a fairly innocent remark (and that when saying this, you are trying to help build your child’s interoception) it actually can backfire. It teaches your child that they don’t know what their body needs. That they should rely on an external cue, such as how much or little food they’ve eaten, versus the internal cues from their own body.

Kelly Mahler, OTD, OTR/L, has created a wonderful body of work called The Interoception Curriculum. This work encourages us to start paying attention to sensory sensations and link the sensations to emotions. You can use these simple steps to begin to help your child (and notice more about your own interoception). 

1. Pay attention to a sensation–start on the outside of the body, like the hands or feet, when washing hands or being barefoot, for example. Ask your child to describe the sensation of the experience. 
2. Get curious about how the sensation makes your child (or you) feel. It could be comfortable, fun, happy, sad, frustrated, uncomfortable, etc. 
3. Wonder, “is there anything that needs to be done right now?” For example, if there is an uncomfortable feeling, is there anything to do to help your child feel better?

A couple of things to consider when trying this with your child:

• Your child may not be able to do ANY of this….yet. If they cannot identify any (or any part) of these 3 things, model some things that YOU sense or feel. One example: “Oh, when I’m washing my hands, it feels warm/cold, and bubbly. That makes me feel relaxed, and I keep doing it until I have all of the soap off of my hands.”
• If your child gives an unexpected response, simply get curious. You can ask “Oh, wow. Tell me more about that.”
• It’s important to validate your child throughout the process. 
• When you model something for your child, make sure that you are sharing your experience, not what their experience should be. It will help to give them a clue. 
• Carve out a time to do this during daily routines: bath time, washing hands, or sensory play are good times to practice.

When practicing these ideas, know that this is a process, and not a quick fix. The more we can help build our children’s interoception through curiosity and validation, the more that they can effectively self-regulate, as interoception is a key building block for self regulation. Taking the time to notice, get curious, and validate your child’s experience will go a long way in getting them to trust themselves, and advocate for their needs. 

I became an occupational therapist (OT) primarily because I could have benefitted from occupational therapy as a child. My mother, who worked as both a speech and language pathologist and a special education teacher, often says to me, “Where were you when you were growing up?”. This is especially touching, since she was the one who set me on my path of becoming an OT years ago. 

I was that sensitive child who (despite being highly articulate) would lose all sense of myself and break into meltdowns when I got a wrinkle in my sock. I was that kid who hyper focused and tuned everything else out–my mom would often say “Earth to Katie…” as she had a hard time getting my attention when I was hyper focused. I was that kid who grew into that adult who had extreme rejection sensitivity, and who had a hard time reading social cues. The one who knew what other people were feeling, even without them saying a word. The one who was/is sensitive to crowds. The one who experiences such things as “time blindness”. I now recognize these as signs of neurodiversity (which includes ADHD, OCD, ASD), as well as my history of trauma (including childhood trauma). 

Becoming an OT was not a straight path for me. I was on the fence about becoming an OT until I studied pediatric therapy and the work of Dr. A. Jean Ayres. Though I didn’t fully grasp all the concepts at the time, I felt them. I sensed that this work was deeply healing and therapeutic. I began to understand myself better, and even started applying some of the OT work to my own development.

One of the biggest shifts came after I became a mother. My intuition kicked in strongly, and I began remembering talking to imaginary friends, seeing and feeling things others couldn’t as a child, and even communicating with people who had crossed over. I could see visions, and interpret things that simply had no other explanation. To make it through school and appear “normal,” I had pushed much of this awareness aside. But around 2007, it all came rushing back. It led me to a question that has shaped my work ever since: What if some of the neurodiverse children I work with aren’t just sensitive to sensory input—but also intuitive?

These experiences taught me something essential: many children—especially neurodivergent ones—are incredibly intuitive. They sense more than they can explain. When given a safe, nonjudgmental space, they share things that might otherwise be dismissed as “imagination.”

I began to see a pattern: children who were sensitive to sensory stimuli often seemed equally sensitive to energetic or emotional stimuli. These weren’t just “behaviors” to manage—they were signs of deep perception and vulnerability.

As I deepened my work, another layer emerged: trauma. According to epigenetic research, we can inherit the trauma responses of not only our mothers, but of our ancestors. This multigenerational trauma relies on several factors, including environmental triggers. In other words, we can feel trauma from our ancestral patterns deeply if we are traumatized or experience traumatic events in our lifetime, especially in early childhood.

Some argue that being neurodiverse is itself, traumatizing. Not only because of the challenge with the regulation of sensory information coming from the environment or from within the body (interoception), but because our daycares, schools, and jobs are not set up to honor the needs of a neurodiverse person. Outdoor play and engagement with the natural environment is becoming more and more limited in schools. Recess is taken away as a punishment (this is one of the most challenging things that I witness). Academics are prioritized over experiential learning, socialization, and emotional regulation. We are trying to build skyscrapers without a foundation, put simply. This is challenging for any person, but all the more challenging with someone who is neurodiverse.

So, how does intuition fit in with trauma? If you have experienced trauma in your lifetime, you will understand that safety becomes the primary goal. You may learn to “read the room” very very quickly. You become adept at anticipating or sensing the needs of others, and to make sure that everyone has their needs met (ahead of your own needs) to ensure safety. This is an example of the “fawn” response. You may become hyper focused on the needs of others, because you feel the needs deeply yourself. 

So, how does this all fit together? Does neurodiversity cause trauma? Does trauma present like acquired neurodiversity? Does trauma create heightened intuition? Does neurodiversity mean having a bigger “antenna” to other realms? Does having heightened intuition cause trauma? Honestly, I believe that they can all influence each other. I think that there are a lot of interesting questions to ask, and perhaps more surprising things to come from this contemplation. I have seen recent phenomena like the Telepathy Tapes begin to connect the autistic community to intuitive abilities like telepathy. I have heard trauma experts talk about the similarities between neurodiversity and trauma, and I have also heard people discussing having heightened intuitive abilities as a result of childhood trauma. 

I believe we have a lot to continue to learn about the intersection of trauma, neurodiversity, and intuition. I think as we open up to consider these things, the more we can understand ourselves, our children, and how to support each other. Keeping an open mind and an open heart is a crucial step in navigating the complexity of these factors. 

If you suspect that your child or yourself has any or all of these traits, know that you can get support. Seek out help with a therapist who is open minded about these matters. Get support for any trauma that needs attention, consider a diagnostic evaluation for yourself or your child–especially if you are looking to have school or work support or modifications. Make sure to get movement (muscle work is very grounding), eat and sleep well, and get plenty of time in nature. Unplug from time to time. Learn to trust your gut. Meditate to begin to cultivate or more deeply cultivate your intuition.

If you are looking for support for your sensitive child, the AboutPlay team works with children this way. Additionally, I see children for intuitive consultations at AboutPlay. If you are seeking help as an adult for cultivation of your intuition, check out some of the offerings at The Energetic Heart. As always, get out and play. Move your body. Love your neighbor. Let’s support each other in our understanding and evolution as humans. 

Did you know that occupational therapy was founded in 1917 by a group of people in Clifton Springs, NY, who wanted to provide a more humane environment for folks in mental health hospitals?

These folks (namely George Edward Barton, William Rush Dunton, Susan Cox Johnson, Thomas Bessel Kidner, Isabel Newton, and Eleanor Clarke Slagle) untied mental health patients from their beds, and gave them activities to “occupy” their hands and minds. Activities such as gardening, basketweaving, and painting were taught as a way to give people a purpose, regardless of their perceived abilities. 

Our profession has evolved and grown so much in the last 108 years; branching from solely being in the mental health arena, to physical disabilities, to pediatrics, growing into wellness spaces. and so much more. Even within the scope of pediatrics, there is so much diversity! Hospital settings, Early Intervention, outpatient clinics (like AboutPlay), school therapy. And from there, each team has its own unique flavor, as the healing modalities that are available are V A S T. 

Our founders were rebels. They went against the norm of restraining people with mental health challenges against their will, by literally untying them, bringing them out to “occupy” their hands and minds, connect with others, while improving their mental health. This was, for the most part, unheard of in these times. Several of our OT pioneers were also rebels, in their own way. We celebrate the work of the late Dr. A. Jean Ayres. With a fascination for neurology, she began to study it while working with children with Learning Differences in the 1960s. Dr. Ayres put together the puzzle pieces and began to notice that there was far more going on with the children that she was working with than just in their minds; there were physical and postural differences, sensory processing differences. 

Our field continues to grow, change, and evolve in exciting ways. It is stretching into new areas, and claiming wellness based models instead of disease based models. OT is ultimately about finding what is resonant, purposeful, and meaningful to a person, and then helping that person achieve it. A person’s “occupations” may include many things; we look at needs of a person in the context of home, work or school, and leisure or play. We look to inspire, find the “edge”, create activities based on meaningful goals. We take cultural beliefs, identity, religious and spiritual beliefs into consideration when working with people. We get creative!

At AboutPlay, we consider ourselves as rebels in our own way. We infuse our more traditional modalities (Ayres’ Sensory Integration, Reflex Integration, DIR/Floortime) with holistic Integrative Health practices including aromatherapy, energy medicine (Reiki and other quantum practices), yoga, and reflexology. We work intuitively with the children, and are always learning new things to enrich our practices. 

It is likely that you, or someone you love, will benefit from OT support one day, if you haven’t already. We are in schools, hospitals, daycares, skilled nursing facilities, homes, clinics, and more. You may even take an adaptive yoga class, a breath work class, or get coaching from an OT. Our field is growing and changing shape with each year. It’s truly an exciting profession to be a part of!

If you know an awesome OT, give them a shoutout this month. 

This month, I wanted to stay on the theme of Fight, Flight, Freeze responses, and also add in the Fawn response. Below, you will find out more about what is going on in the body from a neurological and physiological standpoint, and learn new ways to handle these common responses. 

You have probably heard about the Fight, Flight, Freeze and Fawn reactions; our popular culture has had increasing awareness of these reactions in recent years. Let’s go ahead and break down a few things, including, what causes these reactions, the breakdown of the stress response, and how to help your child when they are stuck.

What causes these reactions?

These reactions occur in a split second; they are reflexive. They are not thought out, plotted out, or conceived. The responses are ingrained in us to help keep us safe when we are in danger. The stress response happens when we experience an environmental threat (like a car driving fast as you are crossing the street, a person or animal threatening harm) or an internal threat (a past memory of harm or abuse or even the threat of it–think PTSD).

Sometimes, we notice that our children have a very strong inclination to having these responses frequently, in extreme expressions, or both. They may come from trauma (“Big T”: separation/divorce of parents, car accident/extreme injury, a death of a loved one or pet, abuse, neglect–or even “Little T”: brief separation from a parent, change in friend group, bike accident, change in school or class, or a move). The trauma may be from infancy or early childhood; we hold trauma in every cell of our bodies. 

Additionally, we live in our modern day, with too little time outside, too many screens, and too many processed foods. We (generally speaking) are set up for a heightened stress response with fewer foundational elements that support us. 

What’s more, Epigenetics points to the idea that we can carry the stress responses of 10 generations (yes, that’s right) in our DNA. We are literally born wired to have strong responses, and then we get a helping of our own personal experiences.

Breakdown of the Stress Response

A series of things happen very quickly, before one is even conscious of what is happening:

• Amygdala (alarm bell in the brain) gets triggered and communicates to the Hypothalamus 
• Hypothalamus (in the brain) signals the Autonomic Nervous System–specifically the Sympathetic System
• Sympathetic System acts like the GAS pedal
• Hypothalamus releases Epinephrine (Adrenaline) into the bloodstream, which releases more glucose into the bloodstream for the organs for quick energy, increases blood pressure and heart rate, suppresses appetite, and stimulates lung capacity
• Prefrontal Cortex (executive “thinking” part of brain) becomes inhibited

The specific responses are varied. Your child can experience Fight, Flight, Freeze, or Fawn. Or a combination. Let’s break down the response and what it may look like:

Fight

The fight reaction can include physical fighting. Think of a “meltdown”. Your child may hit another person (including you), or react with strong physicality. If they are not reacting physically, they may threat to; and it may include screaming, yelling, becoming destructive with things in their physical environment. When a child is in this response, they engage with others; they are looking for engagement. A smaller presentation of this response is being argumentative. The Fight response involves the Moro primitive reflex.

If a child is escalated into this reaction, it is best to give them space to ride it out; while setting boundaries to help keep themself, yourself, and any others safe. Offer alternatives for them to punch or slam a pillow down, or to try to pull apart a towel with their hands. Muscle engagement helps. Try to not escalate to match them; even though they may want that. Hugs help to integrate the Moro response.

Flight

The Flight reaction includes trying to escape, avoid, or run away from a situation. It may involve literal running away, wanting to escape into their bedroom, or even wanting to hide. This reaction usually indicates that the child needs alone time, or wants to be by themselves. A smaller presentation of this response is avoidance. The Flight response also involves the Moro primitive reflex. 

If a child is escalated into this reaction, you will need to make sure that they are safe, first and foremost. If this happens in shops or out in public, your child may endanger themselves. If it happens in the home, let your child know that you understand that they need space. Give it to them so that they can try to self-regulate, and let them know you understand what they are feeling. Check back in and let them know you are there for them when they are ready. Again, the use of hugs is great here, to integrate the Moro.

Freeze

The Freeze reaction includes a literal freeze: no movement, their eyes become wide, and they hold their breath. Children experiencing Freeze (one of the most primitive reflexes–it’s an intrauterine response) typically have a hard time separating from parents to go to school, social events, or appointments. They may want to sleep in your bed, and not want to be alone. They may avoid sleepovers as they get older. A smaller presentation of this response can be challenges starting new things, or not being able to address things–a stronger form of avoidance. The Freeze response involves the Fear Paralysis primitive reflex.

If a child is experiencing a frequent Freeze response, they need to know that they are loved. They need the attention and love that they are craving. Rhythmic body and facial tapping, massage, and rhythmic rocking can be supportive. Deep breathing exercises are very important for this, as shallow breathing keeps us in the Sympathetic Nervous System state. Set aside screen free (parents, you too) quality time to play with your child each day. 

Fawn

The Fawn reaction includes when a child is always checking in to make sure another person (who has become upset)’s needs are being met–over their own. This is usually a result of some kind of trauma. The child fears the response of others greatly, and tries to make sure that the others’ needs are taken care of over their own. 

If a child is experiencing a Fawn response, you can coach them on how to advocate for themselves. This response may also indicate a need for psychological support through a counselor or play therapist. 

More Ways to Help

• MOVE! If your child is having stress, help them to regulate with movement. The stress hormones need you to move them out. Take a walk with your child, get outside, get on swings, go for a bike ride, play on a trampoline.
• LABEL THEIR FEELINGS FIRST! As parents, we often try to rush to the solution, without honoring the feelings that need to be expressed. Show them that you see, hear, and understand their fears, worries, anger, frustration, and just BE with that for a few moments. 
• BREAK THE LOOP!  If your child is stuck in a loop (kind of like a broken record) and AFTER you have acknowledged their feelings, bring in a distraction (“Hey, did you see that bird?!”, or “Who did you eat lunch with today?” or even “What color are your socks?”). The distraction will bring them back up to the Prefrontal Cortex (which has become inhibited in stress). It will sometimes be enough to help them to move on, and if not, they may be more available to solutions. 
• OFFER LIMITED CHOICES FOR SOLUTIONS! Don’t overwhelm your already overwhelmed child with open ended questions or limitless choices in times of stress. Favor “Would you like alone time, or do you need me with you now?” instead of “What do you need?”. 
• SEEK SUPPORT! If you are feeling in over your head, and your child is really struggling, make sure to get support from an OT or person trained in primitive reflex integration. If trauma is suspected or known, make sure that your child has access to psychological support such as counseling or play therapy. 

If you are curious about how you can help yourself, with more information about how to handle this as an adult, please use this link to look at my blog post on adult stress responses on The Energetic Heart website.

Many children who we work with in our occupational therapy practice have amplified fight, flight, and freeze responses. These are responses that help with our survival, simply stated. We have a split second response when we are in danger: imagine crossing an intersection and a car tears around the corner towards you. Your body reacts quickly to get out of danger. This is one example; this survival mechanism is pre-cognitive, a “reflex” to keep us safe.

Fight, fight, and freeze responses can become exaggerated in us, for many reasons. And just to add to the conversation, they can be “activated” by thought or memory alone–external physical danger is not required to tip the body into a stress response. Some potential reasons for exaggerated responses of the nervous system are sensory sensitivities, amplified worry/anxiety, long sustained periods of stress, and trauma (trauma can include exposure to neglect and threat). 

To take this a step further, the fight, flight, and freeze responses have specific primitive reflexes that are associated with them. In short, primitive reflexes are important for our development; they emerge to help us attain motor skills in infancy and early childhood. They are physical responses to stimuli, which are ideally repeated until they integrate into the body; and when they do, a wider range of motor skills are possible. When they do not fully integrate (for many potential reasons) or, alternatively, they become unintegrated with physical or emotional trauma, emotional and physical development and capacity become stunted.

The body’s The fight/flight response involves having an active Moro Reflex. This startle response emerges in early childhood and is meant to become integrated within the first year of life. For many people, it does not fully integrate, or if it has integrated, it may have un-integrated due to trauma. When this reflex persists, we see explosive or fleeing behavior in fight/flight patterns, heightened sensory sensitivity, irritability, and poor or lack of ability to self regulate their emotional state.

The freeze response is related to the Fear Paralysis Reflex. This reflex emerges in utero, and is meant to be integrated before birth. When this reflex persists, people can become stuck in a freeze: their eyes widen, and they hold their breath. They have a hard time advocating for themselves in the moment (they may think of a better response to any given person or situation after the fact). When this reflex is overactive, we see separation anxiety in children from their parents during the day (think school drop off), or night (sleeping alone). It can feel and be paralyzing for children to move ahead in their lives to the point that they remain stuck in fear and avoidance patterns. It is one of the most primitive reflexes that we address. 

So, how can you help your child if they are experiencing these responses? 

Here are tips for fight/flight (Moro Reflex integration):

• Hugs! Using the flexor muscles of the body is the opposite of the physical startle/Moro response (which stimulates the extensor muscles). 
• Name the emotion that your child seems to be experiencing BEFORE trying to “fix” the situation or even offering solutions. For example, “It looks like you are feeling ____. It’s a big feeling!”
• Soothing salt baths with magnesium (epsom salts). Children must be 4 years old or older. 
• Humming, swaying or rocking the body, and deep breathing together (even if your child refuses, if you do this with/around them, mirror neurons help them to experience the benefits). 
• Change of scenery. Even if it’s 5 feet away, or in another room. 
• Go outside. Play, walk, or bike in nature. Nature helps to soothe and heal the system. 

Here are tips for freeze (Fear Paralysis Reflex):

• Deep breathing, inflating the belly on the inhale, deflating the belly on the exhale. Fear Paralysis involves holding the breath, so deep breathing helps!
• Massage, body tapping, facial tapping. 
• Facial massage. 
• Swaying, rocking, humming–these stimulate the Vagus nerve, which soothes the nervous system. 
• Change of environment, get outside if possible! Engage in a nature scavenger hunt (acorns, rocks, pinecones, etc.)
• Staying with your child; hold them and comfort them. Reassure them that you are there for them.

Notice that none of the recommendations include using screens (iPad, phone, computer, TV). Using screens for soothing actually creates more long term issues for your child. When you go in to soothe them or to help them with emotional regulation, please also remember to put your devices down, and to be fully present with them. 

If you are wondering about receiving specific support for your child if they are having issues with either of these, please look for an occupational therapy practice that is versed in Primitive Reflex Integration and Sensory Integration Therapy.