Understanding and Supporting Young Children Through Occupational Therapy

Introduction

For infants and toddlers, the ability to process and respond to sensory information plays a critical role in every aspect of daily life—from calming down when upset to engaging in play, learning new motor skills, and participating in routines like dressing, eating, and sleeping. When a young child struggles with sensory processing or emotional regulation, it can affect development in multiple domains and lead to challenges for the entire family.

Occupational therapy (OT) in early intervention offers evidence-based strategies to support sensory processing and self-regulation in young children. By working within natural environments and family routines, OTs help children interpret sensory input more effectively and develop the ability to stay calm, focused, and engaged throughout the day.

This article explores the importance of sensory processing in early development, how occupational therapists assess and address sensory differences, and what families can do to support regulation at home.

What Is Sensory Processing?

Sensory processing is the way the nervous system receives messages from the senses and turns them into appropriate motor and behavioral responses. This includes not only the traditional five senses (sight, sound, taste, smell, and touch) but also:

• Vestibular system (balance and movement)
  
  
• Proprioception (body awareness and position)
  
  
• Interoception (internal body signals, such as hunger or needing the bathroom)
  
  

Most children develop the ability to filter and respond to sensory input in a flexible way. However, some children experience difficulties such as:

• Over-responsiveness (hypersensitivity): Reacting strongly or negatively to sensory input (e.g., crying when hands get messy, fear of swings or loud noises)
  
  
• Under-responsiveness (hyposensitivity): Missing sensory cues or requiring more intense input to respond (e.g., not noticing pain or being touched)
  
  
• Sensory seeking: Craving movement, touch, or other sensations in ways that can be disruptive or unsafe
  
  

These sensory differences can impact a child’s ability to self-regulate—i.e., to maintain a calm, organized state suitable for engagement, learning, and interaction.

What is the Connection Between Sensory Processing and Regulation?

Self-regulation in early childhood refers to a child's ability to manage emotions, behaviors, and attention across different situations. For children with sensory processing differences, regulation is often a central challenge.

Examples of sensory-regulation difficulties include:

• Meltdowns during transitions or in crowded environments
  
  
• Avoidance of grooming or feeding routines
  
  
• Hyperactivity or difficulty sitting still
  
  
• Inconsistent attention or withdrawal during play
  
  
• Trouble falling or staying asleep
  
  

Research from the Infant Mental Health Journal and Journal of Occupational Therapy, Schools, & Early Intervention consistently highlights the connection between sensory processing patterns and challenges in emotional and behavioral regulation in early childhood.

What is the Role of Occupational Therapy in Supporting Sensory Processing?

Occupational therapists are uniquely trained to evaluate and support sensory processing and regulation in young children through the lens of meaningful daily activities. OT in early intervention focuses on building regulation through relationship-based, play-centered, and routine-integrated strategies.

1. Sensory Evaluation

OTs assess sensory processing using:

• Standardized tools (e.g., Sensory Profile 2, Infant/Toddler Sensory Profile)
  
  
• Parent interviews and caregiver questionnaires
  
  
• Observations in natural environments (home, daycare, playground)
  
  
• Collaboration with other providers (e.g., PTs, SLPs, early childhood educators)
  
  

Therapists look for patterns of over- or under-responsivity, behavioral indicators of dysregulation, and environmental factors contributing to challenges.

2. Creating Individualized Strategies

OTs develop personalized sensory strategies that help children become more organized, calm, and responsive. These may include:

• Proprioceptive input (deep pressure, heavy work) to support calming
  
  
• Vestibular input (gentle swinging, bouncing) to improve attention or arousal
  
  
• Tactile play to build tolerance for messy activities and grooming tasks
  
  
• Environmental modifications (e.g., reducing noise or visual clutter)
  
  
• Movement breaks and sensory diets tailored to a child's needs
  
  

OTs teach caregivers to recognize early signs of dysregulation and implement strategies proactively.

What Is a Sensory Diet?

A sensory diet refers to a customized set of sensory activities provided throughout the day to help a child maintain an optimal state of arousal. This concept was developed by occupational therapist Patricia Wilbarger and is often used in early intervention to prevent meltdowns or improve attention.

Examples of sensory diet activities include:

• Jumping on a mini trampoline
  
  
• Carrying heavy objects (e.g., laundry basket, books)
  
  
• Using chewable or fidget toys
  
  
• Doing animal walks (e.g., bear crawl, crab walk)
  
  
• Engaging in tactile bins (e.g., rice, beans, sand)
  
  

The key is consistency and integration into natural routines—like adding deep pressure hugs before transitioning from bath to bed, or using rhythmic movement to help a child wake up and get dressed.

How do OTs Help Families Support Regulation at Home?

Family coaching is central to sensory-based OT in early intervention. Therapists empower caregivers to:

• Understand their child’s sensory profile
  
  
• Modify routines to reduce stress and increase participation
  
  
• Use co-regulation strategies (e.g., deep breathing, holding, rhythmic rocking)
  
  
• Implement calming or alerting activities throughout the day
  
  
• Prevent escalation by recognizing sensory triggers early
  
  

A study in Topics in Early Childhood Special Education found that parent-implemented sensory strategies led to improved emotional regulation and reduced challenging behaviors in toddlers receiving early intervention services.

Real-Life Examples

• Dylan, a 2-year-old with tactile defensiveness, began engaging in messy play by first using tools (e.g., spoons, brushes) and then progressing to hands-on activities over several weeks. With OT support, his tolerance for tooth brushing and feeding also improved.
  
  
• Maya, a 30-month-old who was constantly on the move and unable to sit for meals, responded well to proprioceptive input (e.g., pushing furniture, weighted lap pad) before mealtimes, resulting in longer engagement and reduced throwing of food.
  
  
• Leo, a 3-year-old with frequent tantrums during transitions, benefited from visual schedules, sensory fidgets, and movement songs between activities to ease transitions and support self-regulation.
  
  

When to Seek OT for Sensory Processing and Regulation

A toddler may benefit from sensory-based OT if they:

• Seem overly sensitive to sound, light, movement, or touch
  
  
• Avoid messy play or grooming activities
  
  
• Display frequent meltdowns or intense emotional reactions
  
  
• Have difficulty calming after being upset
  
  
• Seek constant movement or crash into things frequently
  
  
• Struggle with transitions or changes in routine
  
  
• Appear inattentive or disconnected during play or learning
  
  

Referrals can be made through early intervention programs, pediatricians, or directly to a licensed occupational therapist.

Conclusion

Sensory processing and regulation form the foundation for a child’s participation in everyday life. When toddlers struggle in these areas, occupational therapy in early intervention provides families with the tools, knowledge, and support to create positive change.

By understanding each child’s sensory needs and embedding strategies into daily routines, OTs help young children move from dysregulation to connection, participation, and joy. Early support not only improves behavior and engagement—it builds the emotional resilience needed for future growth and learning.