Occupational Therapy, Your Child, and the Great Outdoors


Courtesy Flickr/Philipe Put

Springtime has arrived, which means more opportunities to get outside and enjoy what our world has to offer: dirt, mud, water, grass, leaves, trees, vines, mountains, hills, beaches, rocks, sticks, worms, insects, and endless other forms of life and experience. For some children, this is exciting news, and they can’t wait to hit the ground barefooted and running. For other children, the dawning of spring isn’t such a big deal – reading a book in a quiet room may be more appealing than rolling down a grassy hill.

But what about kids with sensory dysfunction?

If it is not a passion that is keeping a child indoors and more sedentary, but instead it is an avoidance of (or anxiety about) exposure to certain sensory input or motor challenges, then steps should be taken to help your child more appropriately process and respond to sensory input so he can participate in outdoor activity and social participation with peers.

For children with sensory processing issues, there are a wide range of reactions.

Jimmy may be a “tactile-seeker”, constantly touching objects, Alice may be a “tactile-avoider”, avoiding touching certain stimuli. Billy may be a “vestibular-seeker” – constantly running, swinging, or “on the go” – whereas Sally may be a “vestibular-avoider”, highly cautious when presented with movement activities or challenges. David may have decreased proprioception (body awareness) and motor planning challenges that prevent him from feeling successful during physical activities, in turn causing him to avoid any physical activity or interactions with “typical” peers. No matter the type or degree of sensitivity a child may have or how coordinated they are, how a child is able to control her response to that input or physical challenge often determines the degree to which their lives (and their family’s lives) are impacted.

For more than four years I have worked as a leader in supplemental therapy programs for children receiving occupational therapy due to sensory processing challenges. My favorite such program (and the reason why I became a pediatric occupational therapist) is Clay White’s “Outdoor Sensory Adventures” program. One reason why I love this program is because it recognizes the wonderful potential that the outdoors has to be used therapeutically with children having sensory processing and motor planning challenges. No matter your child’s challenges, guided opportunities to play and explore in the outdoors can provide them the “just right” challenges needed to develop more integrated sensory processing and motor skills.

Let’s go to the woods for OT now.

Every plan should cater to your child’s individual needs, challenges, and personalities; however, the same activities/challenges presented in slightly different ways with different levels of difficulty or intensity can be mutually beneficial to any of the children mentioned above.

Here’s the general plan:

Go to the woods with a known mission – having a purpose when participating in an activity is crucial for engagement and learning. Pirate mission? Princess mission? Explorer mission? Scientist mission? Gold mining expedition? Fun afternoon with Mom, Dad, the siblings or cousins? I don’t know what your child’s interests are – YOU do! Tie them to the outdoors to help motivate them if they are not excited about the outdoors.

Let’s use pirate mission as an example: Draw up a treasure map and bury clues in plastic bags out in the woods. Don’t bring shovels, though, because we are looking to satiate your child’s cravings for tactile input (or work on increasing tolerance for novel or non-preferred tactile input), so their hands will be the best tools. The possibilities are endless.

Cover some serious ground and get down to the creek to look for mica, quartz, or even GOLD! Climb over rocks, walk across logs, duck under branches, walk up and down leafy hills and mountains. If your child is a movement-seeker, give him the movement and intensity that he craves. Challenge him with bigger rocks to climb, steeper hills, and move at a pace that pushes him (even if you end up a little winded). For a movement-avoider with coordination or motor planning challenges, give her the “just right” challenge. Make her challenges achievable with enough struggles that they are developing new skills and increased self-confidence. Have her walk across a log with a helping hand or give her a knee to stand on when climbing over a rock if needed.

After the treasure hunt, dig in the mud and find some worms or look under rocks for lizards (but watch out for snakes). Splash in the creek or river and skip some rocks. The woods can be dirty, muddy, wet, grassy, leafy, etc. Let your child experience all the variety of tactile input. If he is hesitant or avoids the tactile input, start with a modified or safe way for him to have fun with the mud or water. Throw large rocks or logs into the water (heavy work and proprioceptive input is beneficial for all kids). Poke sticks into the mud. Maybe some accidentally gets on your shoes, legs, hands, maybe your child trips and falls, then trips and falls again, and again, and again… No big deal… Don’t rush to clean the dirt off or let your facial reactions lead him to a scared conclusion. If it needs medical attention, get on your way, but if not, move forward and encourage your child for persevering through the challenge.

Within the general structure of your adventure, be sure to have free/exploratory time for your kids.

Who wants to be told what to do every minute of the adventure? Let them make their own fun or facilitate games if necessary! For intensity seekers, this is their opportunity to challenge themselves and satiate their cravings. For avoiders, this may be an opportunity for cautious exploration or a time when they can watch others interact with “scary” movements or tactile media.

After your adventure take a step back and look at your child’s arousal state.

Is she in a more organized, modulated, available arousal state? If not, what could you do different to challenge them more or possibly ease off? How can you regularly give your child the opportunity to have these neurologically organizing experiences?

Although Jimmy, Alice, Billy, Sally, and David all have different nervous systems and coordination skills, the outdoors offers them a natural playground with limitless potential for sensory and motor development. Whether it’s the rigorous mountain trail that provides Billy the opportunity to get much-needed high intensity vestibular and proprioceptive input in order to modulate his arousal state or the small hill that provides the achievable motor planning challenge to Sally and David to increase their skills and confidence, all kids have the potential to uncover their own successes and skills in the woods if those opportunities are presented to them.

Help yourselves. Help your children. Get outside and enjoy what is out there.

Charlie Johnson, Occupational Therapist

Following are some ideas for outdoor activities that can help for different sensory processing motor skill deficit areas. How can you use some these to challenge your children and help them to feel good outside (or feel better when they are inside afterwards)?

Visual Perceptual Skills:
“I Spy”
Treasure Hunts
Map Reading/Orienteering
Navigating land contour when walking
Bird Watching
Nature Photography
Sunglasses or No Sunglasses
Hat or No Hat

Motor Planning Skills:
Rock Climbing
Tree Climbing
Walking on uneven surfaces or in creek beds
Stepping over/ducking under branches
Going around the poison ivy patch
Casting/reeling and rigging fishing equipment

Vestibular Processing:
Rope Swing
Log Rolling down a hill
Walking/scooting/balancing across a log
Trail Running
Rock Hopping

Auditory Processing:
Birds Chirping
Rivers, Creeks, Waterfalls, Waves

Tactile Processing:
Dirt, Mud, Grass, Moss, Sand
No Gloves
Tree Bark
Tree Branches
Spider Webs
Worms, bugs, insects, salamanders, lizards, fish

Oral motor and processing:
Edible plants (be sure they’re edible…)
Chewing gum while you hike

Proprioception (body awareness):
Heavy Work – pushing a log up or down a hill, building a dam in a creek, rock/stick/log throwing, challenging climbing, hiking, jumping, swimming, paddling, REELING IN A MONSTER FISH, log-scooting

Olfactory (smell) processing:
Flowers and other plants

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