Sensory room design encourages stimulation and relaxation for sensory impairments

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Sensory room design aims to meet a wide range of needs; from encouraging positive actions for those with sensory impairment to promoting rest and relaxation for the agitated or stressed.

What is Sensory?

Our senses tell us about the world in which we exist. Our sense of smell, taste, touch, sight and sound provide the foundation for our understanding and actions. It is only when one or a number of these senses are impaired that parts of the world are less accessible and understanding is diminished.

Sensory rooms aim to meet a wide range of needs; from encouraging positive actions for those with sensory impairment to promoting rest and relaxation for the agitated or stressed. Different needs require different approaches to care and as such different sensory room design.

No one method works every time, there is a common theme throughout – eliciting a response to a stimulus – from the active striking of a switch to enabling relaxation and sleep in a comforting and secure environment, individuals are just that; individuals.

Sensory rooms support interaction, discovery and communication. Enabling faster learning and development through increased awareness of the surroundings. These environments encourage stimulation of all the senses - sight, sound, touch and smell.

Who can benefit from a sensory room?

Children with sensory processing and neurological issues including but not limited to autism spectrum disorders, ADD/ADHD and Down syndrome. Young children with typically developing nervous systems love to explore these sensory rooms. Also adults who want to spend a quiet moment with (or without!) their children.

A sensory room is therapeutic for both children and adults with sensory processing disorders, from mild to severe. In fact, anyone in the general population could benefit from spending time in a sensory room! By the term "sensory room", we are talking about a SPECIFIC room, with specific sensory equipment and activities, to benefit specific sensory processing difficulties.

Although a sensory room will be tailored to address an individual's unique needs, (and ideally would be set up with input from a knowledgeable professional such as an occupational therapist) there is also certain equipment which can have therapeutic sensory system effects on most anyone.

The reason for this is because it will become therapeutic depending on how, when, and why the equipment or activities are used. The professional guidance needs to come in regards to how, when, and why...it can then benefit anyone on opposite ends of the sensory processing continuum.

Remember, the point of a sensory room is to calm or stimulate an individual through each of the senses. Also keep in mind, when we are talking about sensory processing, we like to refer to the 7 or 8 senses instead of the usual 5, so be sure to include them all in your sensory room!

Historically, sensory rooms had been used primarily with people with moderate to severe disabilities and older adult populations with cognitive impairments. The idea to expand the use of sensory rooms to acute inpatient mental healthcare settings with varied populations is a more recent application, incorporating a variety of sensory modulation approaches and modalities. An essential part of this mission is to maintain an emphasis on engaging in meaningful therapeutic activities and in recognizing the relatedness and importance of the therapeutic use of self. The enhancement of the physical environment, including the use of sensory rooms, affords a more nurturing and recovery-oriented therapeutic environment. Skilled nursing facilities, day treatment centers, schools, long-term care facilities, respite care homes, hospitals, and hospices are the organizations most commonly utilizing sensory rooms at this time.

Occupational therapists are taking a leadership role in the planning and implementation of the use of sensory approaches across mental healthcare settings, including the focus on environmental modifications and enhancements, such as sensory rooms. As in other areas of practice, the education and knowledge base of occupational therapists helps to justify the unique role of the OT as the qualified professional to supervise the development and implementation of the "sensory room" and other sensory approaches. Currently, occupational therapists are also collaborating with administrators and other disciplines to ensure staff trainings and competencies are developed, implemented and maintained. Program evaluation is another important component of any new program initiative, and occupational therapists are also playing a key role in this area as well.

The development and implementation of sensory rooms and sensory enhancements across settings is a process that typically evolves over time. This affords the ability to get staff and consumer involvement and assistance throughout the entire process. Thus, it is possible to start a room on a very low budget and to slowly develop the space. One of the differences between the types of sensory rooms is in the shift from spaces filled with expensive technical equipment, to a more normalizing and replicable environment.

Safety considerations within locked acute care settings as well as the need to offer options that the consumers can replicate outside of the hospital setting are some of the other reasons behind the differences in both approach and décor. Snoezelen rooms and the kinds of sensory rooms Champagne promotes are also different from the sensory integration style treatment rooms used specifically by occupational therapists that are trained, certified and competent to use such specialized equipment and techniques. Hence, it is necessary to understand these distinctions due to the very different purposes of each of these sensory-related therapeutic environments.

Ultimately, the use of sensory approaches and sensory rooms has increased the focus on each individual's unique system's tendencies, patterns and preferences. Thus, the skilled use of sensory approaches has brought a host of more humane and recovery-focused therapeutic tools to mental healthcare services, which appears to have significantly influenced the quality of therapeutic exchanges occurring in mental healthcare service delivery across the world. Providing such skilled and supportive options empowers staff and consumers and embodies a person-centered approach to care. This is a significant culture shift and it is important to recognize that any significant change in the culture of care takes time, an interdisciplinary team effort, a lot of work and dedication.

It is essential to involve both staff and consumers in each step of this process. Meaningful items and themes for rooms can only be determined through actively involving staff & consumers who will be using the treatment space. Therefore, no sensory rooms are ever the same because this is not a cookbook process. The information and lists provided on this web site are provided to assist with starting up a room, are not all-inclusive and the ideas presented may not be suitable for all settings or populations. Clinical reasoning and brainstorming sessions with staff and consumers are essential in order to individualize your sensory space, from the ground up. In this way, it will surely become a unique and meaningful therapeutic space!

Ideas for involving staff & consumers in the process:

* Post a flyer on your unit stating the plan to create a sensory room, sensory area, sensory cart, sensory bins, bags or baskets.
* Ask for any suggestions and/or donations of time to help with the organizing of the whole project.
* Post sign up sheets to determine who is interested in helping to plan and create the room.
* Circulate a unit survey to staff and consumers for ideas regarding how to decorate the room, what to offer in the space, on the cart, theme ideas, what to call the room, etc.
* Include everyone in the process of creating and decorating.
* Ask for volunteers to help you provide educational in-services to assure staff are qualified to utilize the space and the items in a manner that is appropriate each person's cognitive/emotional/physical status and that things get washed as per policy.
* Ask for ideas when creating the policies and procedures for use of the space and the items in the space.
* Provide opportunities for staff to explore their own sensory tendencies, preferences and to think about how these tendencies influence their daily routines and work habits.

Developing the policy & procedure

Sensory rooms all must have a policy and procedure for use. It is important to create a policy and procedure specific to the purpose and kinds of equipment in your sensory room.

General Considerations Prior to Purchasing Equipment:

* One good rule of thumb before purchasing equipment is not to buy it if it can't be washed in the washing machine or in hot soapy water. * Anything electrical always needs to go through your facility's inspections prior to being brought onto or used on the unit. * Most units require rugs, curtains, beanbag chairs, and similar items to be made with fire resistant materials. Request this information prior to ordering, Certificates are often available upon request from companies who assure products are fire resistant.

General treatment precautions:

* Be aware of those consumers who have allergies and complex partial seizure disorders. Do not use items with people if there is any possibility they may be hypersensitive to it. * Always ask the person if they have any hypersensitivies to what you are planning to use PRIOR to use. * Be aware of any respiratory or cardiac precautions

Many consumers have created sensory spaces within their group homes with the assistance of staff. Others have created various types of "sensory spaces" within their own homes. Residential educational settings often request occupational therapy consultation services to create more "sensory-friendly" spaces and sensory rooms within classrooms and living quarters.

Items to consider for a sensory room for adolescents and adults:

* Bubble Lamp(s) with safety bracket(s)-acrylic mirrors behind * Large beanbag chairs * Rocking chairs & glider rockers * TV with VCR/DVD * Large scenic posters/mural * A comfortable rug * A book shelf * A variety of self-help books * A locked cabinet * Stereo * CD players with headphones * Assorted types of music * Nature and relaxation CDs * Yoga mats * Therapy & exercise balls * Lighting/projector–various options * Ceiling effects–various options * Weighted vests/weighted blankets/weighted lap pads * Wrist & ankle weights * A sound machine * A flowing water fountain * Bins with assorted items for each sensory area * Aromatherapy diffuser kit * A meditation bell * Journaling & Art supplies * A guitar * A keyboard * Window treatments * A dimmer switch for the lighting

For people with moderate levels of cognitive impairment:

* Basic knitting or crocheting * Material squares to sort and/or manipulate of all different materials (burlap through fleece) * Assorted large-sized lacing activities * Assorted Lotions: scented and unscented * Weighted blanket/ weighted lap pad * Sound machine * Assorted laminated pictures to look through, all types * Lap pads with manipulatives attached * Bubbles * Large sized puzzles * A projector with color &/or scenic slides * Basic crafts * Sand paper and assorted pieces of wood * Coloring/colored pencil activities * Large sized cross words/word searches * Small & light weight boom box * Assorted CDs: classical, 30’s/40’s/50’s tunes, relaxation CDs, national tunes, cultural music, etc… * Relaxation, humor, sports, & old time TV show videos * A TV/VCR/DVD - to be kept on the cart if it is large-sized * Water toys & manipulatives * Nature/bird/flower/sports magazines * Clay * T Foam cubes

For people with mild levels of cognitive impairment:

* Rock waterfall * Sound machine * Stuffed animals * Snuggly blankets * Weighted blankets/weighted vest/weighted lap pad * Wrist/ankle weights * Aromas/lotions * Items to create/decorate a “Self-soothing or Grounding kit” * Objects to use when practicing “Mindfulness” * Deep breathing techniques * Progressive relaxation tapes * Nature/national parks/under the ocean videos * Crafts * Models * Sewing/knitting/crocheting bins * Jewelry/beadwork bin * Art supplies: paint by number, watercolor paints, crayons, markers, colored pencils, pastels * Collage items * Mandalas to color/paint * Karaoke machine * Create a mini herb garden * Have a beta or small fish tank * Fidgets/stress balls * Playing cards * Games * A portable stereo * CD player with headphones * Assorted types of music * A TV/VCR/DVD (kept on the cart if big enough) * Hot balls/Gum/Lollipops/Sour Candy (individually wrapped) * Desk top sized lava or bubble lamps * Knitting, crocheting or latch hook (only for patients who are safe and demonstrate the ability to do these activities and use these tools) * A basket with seasonal items to explore (in the fall: small pumpkin, Indian corn, cinnamon sticks, gourds, Macintosh scented candles, cinnamon apple scented tea bags, etc.)

Visual Input And Lighting:
A good sensory room will have controllable light sources and light "therapy". Most importantly, make sure there are absolutely no flourescent lights (they are bothersome even to people without sensory processing disorders)! Color cubes, fiber optic light sources, rope lights, and/or low wattage pastel colored light bulbs are all good ideas. Additional visual accomodations and equipment can include; play tents/huts, lava lamps, bubble columns, wall water fountains (or tabletop), and liquid light projectors.

Be sure to include as many sensory experiences and "stations" as possible.

Work on 1-2 senses at a time; for example, soothing music while feeling different textures, or deep pressure input while using light/visual therapy and stimuli. Use the room as "therapy", i.e. 5-7 days a week, 1-2 times per day, depending on the individual's needs. Encourage all senses to be explored and used. Pay attention to your child's reaction to various stimuli. Give him more of what he is seeking, the best input to calm or stimulate.

Don't force anything. Be creative in activities and ways in which the sensory stimuli is introduced. Watch for signs of overstimulation, /overarousal, or extreme fears. And, above all...have fun! This should be a pleasurable, calming, organizing, exploratory experience!

Tactile / Touch / Feel:
Tactile experiences will be the easiest to supply in your sensory room, afterall, everything has it's own texture and feel. However, popular tactile input activities will include; playdoh, funny foam, "gak", "glop" (see playdoh recipes) , zyrofoam, textured balls, tactile walls, boards and books, and/or textured puzzles, sensory brushing with surgical brush (using Wilbarger brushing protocol), coloring over textured materials, fingerpaints (regular, or using pudding and/or Kool Aid mix, etc.), koosh balls, using various materials (i.e., satin, carpet swatches, silk, lambswool, washcloths, cotton balls, etc.), and don't forget massagers and vibrating kids toys.

Tactile Input:

Tactile toys and balls * textured walls and materials * textured puzzles and books * surgical brushes (if prescribed the Wilbarger Brushing Protocol) * vibrating toys and vibrating baby seats * vibrating mattresses , vibrating pillows , and play mats or vibrating stuffed animals * vibrating recliners, chair, or mats * vibrating teethers and oral massagers * vibrating hairbrush or vibrating toothbrush * "Koosh" balls, wigglers, and squishy balls * shaving cream or Funny Foam * play-doh, gak, glop, and other fun recipes * sand and water tables * "Bumble Ball" * ball pits and ball pools * finger paints * textured bean bags * vibrating pens * "Somatron" vibrating mats and cloud chairs * tactile mats *  

Vestibular Input:
If you are setting up a sensory room in your own home, and are looking for a cheaper alternative, hammocks, hammock chairs, glider swings, and glider rockers can give you some of the same effects. Either way, the gentle swinging motion can be both soothing or stimulating depending on its use. Other vestibular activities include regular swings, slides, balance boards and discs, tubes to roll in, rocking or bouncing horses, and/or zip lines.

Vestibular (movement) Input:

bolster swings * suspended platform swings * glider rockers * hammock swings or relax chairs * cocoon swings * riding toys, bikes and scooters * rocking toys * jolly jumpers * infant swings * teeter totters * tire swings, sling swings, toddler swings and swingsets * jumpolenes and backyard bouncers * "Dizzy Disc" * zip lines and backyard trolleys * sea saws * glider swings * "Airwalker" * "frog swing","biorbital accelerator" swing, dual swings, spring swings, "moon swing", disc swing, and/or tube swings * "Sit ‘n Spin" * "Whirley Bouncer" * rocker boards * balance boards and balance beams

Proprioception:
Sensory rooms beg for good proprioceptive input! (Click here for an in depth understanding of proprioception) Anything which will allow the individual to be "squished" or "hugged" will give the deep pressure input their bodies crave.

You can use therapy balls to roll on top of them, weighted vests and blankets, big floor pillows, bean bag chairs, lycra swings, and hammocks. Deep pressure input applied correctly and at the proper time will calm, relax, and soothe even the highest energy kids!

You will also want your sensory room to provide opportunities for activities which give muscles and joints significant use and pressure. Some great ideas are; scooter boards, moon shoes, jumpolenes, tunnels, hippity hop balls, mini trampolines, squeeze/fidget toys, and things to climb or hang on.

Proprioceptive Input:

Pogo sticks * jumpers and bouncers * weighted vests , weighted blankets , and shorts * wrist, ankle, shoe and/or finger weights * scooter boards * play tunnels * "moon shoes" * scooters (3 or 4 wheel scooters for the younger, or less coordinated) * rollerblades * "Disc-o-Sit" or "Movin’ Sit" cushions * "Theraband" * jungle gyms * indoor rock walls * "Hippity Hop" * trampolines * "Jump-o-lenes" and/or backyard bouncers * jump rope * therapy balls * "Theraputty" or silly putty * any vibrating product (massagers, mats, toys, teethers, baby seats, etc.) * weighted balls ("medicine balls") * "The Steamroller" machine * resistance tunnels * "Body Sox" (lycra stretch bags for the body) * bop bags * bean bag chairs * ball pits and ball pools * bubble wrap (to pop with fingers and hands, or jump on) * pegboards * "T-Stool" * air mats * crash pits * net climbers * push toys * weighted backpacks * "Co-oper Lycra Blanket" * "Rapper Snappers" * squeeze toys
* weighted neck wraps and/or weighted lap pads *

Taste (oral / oral-motor):
Supervised licking, sucking, tasting, or chewing a variety of foods, liquids, gum, or candy is a great activity to include in your sensory room. For hyposensitive individuals include sweet, salty, spicy, and/or sour flavors. For hypersensitive individuals, just one new taste or texture at a time!

Meet them at their level! Do not force them to eat anything they are extremely anxious about. If you must, due to extreme sensitivities, give them many opportunities to explore the food through their other senses (i.e., sight, smell, feel etc.) before introducing it orally.

Also beneficial to both hyper- and hypo- sensitive individuals are oral massagers; to be used prior to eating and/or trying new foods and textures. Use the oral massagers to stimulate mouth, cheeks, tongue, palate, and lips to decrease hypersensitivities or increase input they are craving.

Oral Input:
vibrating teethers •vibrating toothbrushes •blow toys •whistles •musical instruments (real or play ones) •rubber tubing (dip it into flavored foods or drinks if you want) •sweet, sour, spicy, chewy foods and gum * "Nuk toothbrush" •textured spoons •straws with thick drinks •sports bottles * "Blow Darts" * "Blo-pens" •bubbles •party favor blowers •kazoos •facial and oral massagers * "Z-vibes" * "Jigglers"

Auditory:
Lastly, we musn't forget the soothing sounds! They come in all types of mediums; sound pillows, sound eye masks, CD's, tapes, nature sound machines, white noise machines, indoor windchimes, etc. Nature sounds, white noise, classical music, or new age music are the most popular choices for calming, organizing input.

Calming Auditory Input:
sound therapy * guided imagery tapes/cd's * relaxation tapes/cd's * classical music * nature sound machines * heartbeat sounds stuffed animals and/or blankets * metronomes * self-hynosis programs *  

Smell (Olfactory):
Aromatherapy is quite beneficial to children with sensory processing disorders. For this reason, you will want to include some variety of particular aromas which can be used via different mediums in your sensory room. The various "mediums" can include scented oils, scented candles (if safe for the person you are using it for), aroma diffusers, scented markers, scented playdoh, toys, scented stuffed animals or blankets, and/or scented neck wraps, eye masks, scented potpouri and sprays. Remember, the particular scents you use will vary with the effects you are trying to achieve. For example, great calming scents include (among many others!); vanilla, lavendar, peppermint, or jasmine. Stimulating scents include (among others); cinnamon, strong sweet or sour smells, floral scents, or spices.

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