I’m Allison Miron, a pediatric occupational therapist and owner of Root to Rise Pediatrics Occupational Therapy Group. People often ask me what does an occupational therapist (OT) do with kids? Isn’t “occupational” similar to an occupation or a job? Well, yes it is and children have jobs too! They are learning to learn, to play, to eat, to sleep, to dress, to take care of themselves, to be social and lots more. So as a pediatric occupational therapist, I help grow those skills and amongst many others.

Our Senses

People often throw around the word sensory without fully understanding what it means and the depth of how our sensory experiences influence our life. Our brain functions are based on information taken in from our environment and within our body. The information is registered in the form of sensory input which will generate a response in the body. We all have 8 senses: vision, hearing, smell, taste, touch, vestibular (movement of head in space), proprioception (information from the muscles and tendons to know where body is in space) and interoception (sensations within the body such as hunger, tummy ache or location of pain). We will focus on the five external senses which influence how our body feels and reacts to the environment around us: vision, hearing, smell, taste and touch.

Reducing Arousal Means Promoting Sleep

Creating a “sensory friendly” space to promote sleep means reducing arousal levels or alertness. Most people need a low arousal level to slow down and sleep (while we need a high arousal level to play at the playgroup, perform during a soccer game or respond to a threat.) When we lower the arousal of the nervous system, the brain starts to produce different brain waves which will allow us to shift into sleep. Conversely, when the brain perceives a threat, it shifts the nervous system into high gear enabling the flight/fight response to protect us. This creates high alertness, hyper focus, high blood flow to muscles, increase heart rate as well as breathing so the body is ready to respond to the perceived threat. When we experience high stress situations which are dysregulating or shift us into a high arousal sympathetic nervous system response, chemicals are released in the brain to enable the body to solely focus on the threat or perceived threat. The key to remember here is that the area of the brain that turns on the fight/flight response does not analyze the threat before actually turning on the response. Sometimes the flight/fight response may be turned on when there is no actual threat. Think of when you hear a huge BANG and you are immediately startled and highly attentive until you realize it is the construction site down the road and there is no danger.

Example of an ideal bedroom set up Photo credit Sherri Graby Dasilva — Example of an ideal bedroom set up
Photo credit Sherri Graby Dasilva

For people who’s sensory system is working differently, they may experience a response to sensory inputs that most people won’t respond to such as a car driving by, the school bell ringing, a microwave beeping or the floorboards cracking. Although I am describing the auditory (hearing) sensation in this example, the same experience can occur from any of the other sensory systems. When we are trying to fall asleep, our body will be unable to slow down into sleep mode if we are constantly being aroused to a threat or perceived threat.

Become a Detective

This is important for sleep because if someone’s body is constantly being shifted into dysregulation due to perceived threats (real or not) in their bedroom such as harsh lightning, overwhelming decorations, specific noises, textures of bedding or clothes, room temperature, smells, or sudden noises, it will be very difficult for that nervous system to shift from high arousal all the way down to lower arousal. This will make it very difficult to fall asleep! Since each person’s sensory systems is different, the information described above will affect all of us to a higher or lesser degree. Most people, even if their sensory system isn’t impacting their participation in daily activities, will likely react to the sound of broken glass in the middle of the night before investigating whether a picture frame simply fell or a window is shattered. If you observe your child’s sensory systems are impacting daily participation, then you will need to put on your investigation glasses to understand what perceived threats they may be experiencing at bedtime that will make it more difficult to fall asleep.

To apply this information to sleep; think about how you can create a ‘safe’ environment for your child. A safe environment will look different for each child so you will need to investigate and experiment what that looks like for your child. You will need to try different modifications and observe your child’s response to determine whether you keep those changes over time or drop them.

Some Tips to Help Your Investigation

Look at when your child is most likely to shift into high arousal due to any one of the five senses. Observe in your day to day life what activities can shift your child into high arousal and then break them down.

SMELL- Burning? Moldy? Heavy smelling items like bananas? Cilantro? Specific foods?
VISION- Busy spaces? Disorganized space? Crooked lines/table/art? Fluorescent lighting?
HEARING- Vacuum? Sirens? Unexpected noises? Buzzing?

* Keep in mind that all of our sensory systems are different so although these recommendations will benefit most people. Observe your child and try different changes to see what helps their unique systems slow down.

When you make changes to your child’s environment, allow enough time for this change to become familiar to really know whether that is impacting your child’s sleep. However, you might try something and observe that your child’s fight or flight response is activated. That will tell you either your child can’t tolerate such a big change so you need to make the change more progressive or the sensation you have changed is not comfortable for your child.

Tips to Create a Sleep-Promoting Bedroom

Example of an Overstimulating NurseryPhoto Credit by Carnet Deco — Example of an Overstimulating Nursery
Photo Credit by Carnet Deco

Choose a neutral, calming, relaxing paint color instead of a vibrant, loud, or intense color. Think pastel blues and grey instead of reds and yellow.
Avoid having too much ‘stimulation’ in the bedroom. Instead of covering the walls with pictures and art perhaps choose your favourite one or two and leave the rest of the wall space empty.
If you keep toys in the bedroom; create an easy system to put the toys away as bedtime comes around. You could have a big chest or open bins that slide into a shelf.
Avoid harsh, bright lighting. Choose lightning options that are soothing or dim; try having your child fall asleep without a light as darkness stimulates the brain to produce natural melatonin which helps you fall asleep. If you need a light, perhaps try a salt light with a dimmer on it.
Explore music that is calming for your child to include in your bedtime routine. This might be classical music, nature sounds or rhythmic music. No genre of music is wrong; it is simply a trial and error to determine what sounds support your child with sleep.
Perhaps try exploring different scents using essential oils. Dr. Axe, Wellness Physician, recommends using lavender, frankincense, cedarwood and bergamot for sleep. Depending on the age and how sensitive your child’s sensory system is; you may need a couple of drops or a dozen! Research each individual oil prior to using it to understand safety precautions that specifically for your child.
If your child is startled easily by loud noises, maybe trial different white noise tracks so that as your child is falling asleep he is not startled (and shifted into high arousal - fight/fight).

Put on your investigator glasses to notice trends when you make different changes to the sensory aspect of the environment.

As you apply this information to your environment, if you are noticing differences in your child’s sensory systems that you aren’t sure how to support, reach out to an occupational therapist. A pediatric occupational therapist can assess your child’s sensory system using assessment, observation and sensory questionnaires to better understand their sensory experience. With that information, modifications can be made to support your child in functioning better as well as treatment to gradually help your child better tolerate sensations that will continue to challenge them throughout their life.

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Bio

Allsion Miron Registered Occupational Therapist.png

Hi, I’m Allison! I would describe myself as a passionate problem solver. As an occupational therapist, I look at each child as a whole person. I want to understand why they are having a difficult time with a task and how it's affecting everything else. This allows me to come up with innovative, personalized strategies to teach your child in a motivating and playful way. I meet kids where they are in the moment; if they are melting down I am the calm that helps them regulate and if they need a boost I am the energetic motivator.

I have always been inspired to work with neurodiverse kids. As a young adult, I taught adapted swimming lessons and volunteered with the Special Olympics before attending University. I went to McGill University for a Bachelor's in Rehabilitation Science and then a Master's in Occupational Therapy. Through extensive additional training in various areas, I have developed my own style prioritizing connecting with the child and family, building emotional regulation skills, empowering the families to have the tools when they are no longer my clients and growing the skills that are missing to achieve their goal.

I have always taken clients privately outside of my full time work. I love getting to spend more time with kids so I took it to the next step and made my private practice official!

Meet Root to Rise Pediatrics | Occupational Therapy Group. Check out my website at www.risepediatrics.com or on social media via facebook and instagram. You can always also contact me via email info@risepediatrics.com or by phone (403)466-1315.