Inspire Skill Builders by Inspire Pediatric Therapy
Clinician Packet
Clinician Reference
Sensory Processing Clinician Packet
A clinical reference for pediatric OTs addressing sensory processing — assessment considerations across all 8 systems, sample goals, grading strategies, caregiver coaching, and documentation language.
What's inside
Assessment considerations across all 8 sensory systems
Inspire Skill Builders by Inspire Pediatric Therapy
Sensory Processing · Clinician Packet
Clinical foundation
The 8 Systems — Clinical Summary
System
Clinical description and key clinical considerations
Tactile
Touch receptors in skin detecting pressure, temperature, texture, pain. Two branches: discriminative and protective. Over-responsive = tactile defensiveness. Under-responsive = sensory seeking through touch.
Vestibular
Inner ear — detects movement, gravity, head position. Foundational system connecting to all others. Over-responsive = gravitational insecurity. Under-responsive = craving movement and speed.
Proprioceptive
Muscles and joints — body position and force grading. Almost always organising. Seeking behaviour (crashing, chewing) indicates under-registration. True avoiding is rare.
Auditory
Sound processing and filtering. Over-responsive = hypersensitivity to sound intensity and unexpectedness. Under-responsive = seeking loud environments and making constant noise.
Visual
Light, colour, contrast, movement, and visual clutter processing. Over-responsive = sensitivity to fluorescent light, busy environments. Under-responsive = seeking visual stimulation, staring at moving objects.
Smell — direct limbic connection makes this the most emotionally potent system. Over-responsive = distress at common scents. Under-responsive = seeking strong smells, smelling everything.
Interoception
Internal body signals — hunger, thirst, temperature, pain, emotional body sensations. Under-registration = missing hunger, pain, bladder fullness. Over-registration = hyperawareness of body states.
Critical clinical distinction: Sensory processing difficulties present as seeking (under-registration), avoiding (over-registration), or discrimination difficulties (registers but cannot interpret). A child may show different response patterns in different systems simultaneously. Always assess all eight systems independently — do not assume a global pattern from one or two presenting behaviours.
Assessment considerations
What to Assess and How
Standardised tools
Sensory Profile 2 (Dunn) — caregiver and teacher questionnaire across all 8 systems
Sensory Processing Measure (SPM-2) — home and school forms, ages 2–87
STAR Frame of Reference — assessment and treatment framework for SPD
DeGangi-Berk Test of Sensory Integration — ages 3–5, vestibular/proprioceptive/bilateral
Time of day and fatigue — when is dysregulation most common?
History of sensory-related behaviours since infancy
Family history — sensory differences often run in families
Sleep quality — sleep and sensory regulation are bidirectional
Diet and oral sensitivities in detail
Current regulation strategies the family already uses
Goal bank
Sample Goals — Seeking and Avoiding Profiles
Tactile — Over-Responsive (Avoiding)
STG 1
Child will tolerate light touch on hands and forearms during a structured table task for 5 minutes with no more than 2 protest responses, in 3 of 4 sessions.
LTG
Child will independently engage in messy play (playdough, paint, or sensory bin) for 5 minutes using tools initially, progressing to hands, with no more than 1 verbal cue for tolerance, in 4 of 5 opportunities.
Vestibular — Under-Responsive (Seeking)
STG 1
Child will remain seated during a 10-minute structured tabletop task with no more than 2 movement breaks, following prior vestibular input, in 3 of 4 sessions.
LTG
Child will independently use a scheduled movement break strategy to regulate vestibular needs during classroom tasks, demonstrating reduced disruptive movement, in 4 of 5 observed classroom periods.
Proprioceptive — Under-Responsive (Seeking)
STG 1
Child will use a heavy work activity (wall push-ups, carrying, resistance band) as a self-regulation strategy prior to a demanding task with no more than 1 verbal prompt, in 3 of 4 sessions.
LTG
Child will independently initiate proprioceptive input strategies when arousal is elevated, demonstrating improved regulation during 3 of 4 targeted daily activities across home and school settings.
Auditory — Over-Responsive (Avoiding)
STG 1
Child will tolerate the noise level of a classroom environment for 20 minutes with access to noise-reducing headphones and no more than 2 escape attempts, in 3 of 4 sessions.
LTG
Child will participate in a school assembly or similar loud structured event for 15+ minutes using self-selected auditory regulation strategies with no more than 1 support prompt, in 4 of 5 opportunities.
Home, school, community — variable and unpredictable
Sensory diet principles
Caregiver Coaching — Building a Home Sensory Diet
Core sensory diet principles to teach families
Proactive not reactive — strategies before dysregulation, not after
Scheduled input — predictable sensory activities at consistent times
Heavy work first — proprioceptive input before any demanding task
Watch the response — the effect is what matters, not the theory
Cumulative load — a full day of sensory demand depletes the account
Afterschool decompression — low demand period after school before any requests
Key teach-back cues for caregivers
"Heavy work before a hard task — like putting petrol in the car before a long drive"
"Watch what happens after — did it calm, alert, or organise? That tells you if it worked"
"The same activity can calm one child and alert another — follow your child, not the label"
"5 minutes of organised input is worth more than 30 minutes of unstructured movement"
"Their account was already low when they got home — that is why the afterschool meltdown happens"
Documentation language
Sample Phrases for Progress Notes and Reports
Describing current performance
"Child demonstrates significant tactile over-responsivity, exhibiting distress with light unexpected touch, refusal of messy materials, and food selectivity attributed to oral sensory sensitivity. These patterns are impacting participation in classroom fine motor activities and social mealtimes."
Documenting a session
"Addressed tactile processing using graded desensitisation approach. Child tolerated 3 minutes of playdough with tools with 1 verbal support cue — improved from requiring hand-over-hand to exit activity at baseline. Proprioceptive heavy work provided prior to tactile tasks as regulatory preparation."
Justifying continued services
"Sensory processing differences continue to significantly impact participation in classroom activities, peer interaction, and family routines including mealtimes and hygiene tasks. Skilled OT is required to address sensory modulation, develop a home sensory diet, and provide caregiver coaching for generalisation."
Discharge language
"Child has met sensory regulation goals — tolerating classroom sensory environment with use of self-selected strategies and demonstrating significantly reduced escape behaviours. Home sensory diet established and family trained in implementation. School team provided with written recommendations for ongoing support."
