#293 - Sensory Processing Red Flags in Infants and Toddlers

What are some things that we often see in infants, toddlers, and school age children that indicate sensory processing challenges?

We list out our top sensory processing red flags for infants, including colic, missed milestones, and challenges with feeding.

We then list out our top sensory processing red flags for toddlers which include avoiding playground equipment, covering ears for everyday noises, and avoiding messy play.

Finally, we provide our top sensory concerns for school age children, including any of the previously mentioned challenges plus big emotional outbursts and difficulty with reading at age level.

And of course we leave you with our tips and strategies at the end!

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Transcript

Jessica: 0:00

Difficulty tolerating hygiene activities like taking the bath, nail clipping, hair brushing, diaper changes, if your infant is unable to tolerate those without screaming and crying every single time, that's a red flag that there's something going on. Maybe from a tactile processing standpoint, a vestibular processing standpoint for when they have to lay down in the bath or when they're laid down for a diaper change. So those are some different sensory red flags that we always want to keep an eye on.

Rachel: 0:38

I'm Rachel.

Jessica: 0:38

And I'm Jessica. And this is all things sensory by Harkla.

Rachel: 0:42

We are both certified occupational therapy assistants and together with Harkla, we are on a mission to empower parents, therapists and educators to help raise confident and strong children of all abilities.

Jessica: 0:53

On this podcast, we chat about all things sensory, diving into special needs, occupational therapy, parenting, self care, overall health and wellness and so much more.

Rachel: 1:03

We're here to provide raw, honest and fun strategies, ideas and information for parents, therapists and educators as well as other professionals to implement into daily life.

Jessica: 1:14

Thank you so much for joining us.

Rachel: 1:20

Hey, everyone, welcome back to all things sensory. Welcome. If this is your first time listening, we're so happy to have you here today.

Jessica: 1:28

Today, we're going to talk about sensory red flags in infants, toddlers, and school aged children and hopefully, you're not upset at us for using the term red flags, because apparently, that's the thing. Now, we're gonna go ahead and use the term red flags, because these are things that should alert you that something might not be right or something might be off.

Rachel: 1:53

Yeah. And in that alert, it's important to get help and to seek help. And I think that if we don't use verbiage like this, like a sensory red flag, you aren't going to or anyone listening or anyone in the world isn't going to realize this isn't necessarily a typical thing for a child to do this specific sensory activity or not do this specific sensory activity. Now, we don't want older adults or older children or autistic individuals, who are listening, to this to think that there is anything wrong with having sensory differences, or we're shaming anyone like that. You know, that's not our jam and that's not why we're here. Our goal with this episode is for anyone listening to hear something that makes them think, Oh, my child does that. I didn't realize that was a sensory concern. So you know, let's look into it. Let's figure it out. Let's dive a little bit deeper and get to the root cause. So we're really just spreading awareness in a kind way.

Jessica: 2:56

Yeah, if you've listened to any of our other episodes, you know that we never promote the idea that there's something wrong with your child. Because there's nothing wrong with your child, we all have sensory quirks. We all have our own unique challenges. So there's nothing wrong that needs to be fixed. But like Rachel said, it just is an alert for you that if something resonates for you in this list that we're going to go through for infants, toddlers, and school aged children, then it's just a sign to dig deeper, see if you can find the underlying cause, and get services for your child so that these challenges, these sensory challenges that are happening are not going to continually, negatively affect their life.

Rachel: 3:45

If you're listening and you have a child under the age of three, you can get early intervention services with an OT, or PT, or speech.

Jessica: 3:52

Yep.

Rachel: 3:52

And you can work on that in the early intervention space, which is really helpful. If you are listening and you have an older child or a teen, you can get OT services, occupational therapy services and we do recommend in therapy services with a professional who is trained in sensory integration and primitive reflex integration, because we love that. But we just want you to make sure that you are going to get services, if possible, because it's it's always better when you have someone in-person helping you and guiding you and teaching you along the way. And we really promote advocating for your child and doing what they need in order to thrive, like Jessica mentioned.

Jessica: 4:31

So yeah, and just keep in mind that if any of these things do resonate with you, that it's just we've already said it 1,000 times I feel like, just a sign to look deeper and a lot of the things we're talking about are common in infants and children. But that doesn't necessarily mean that they're normal or that they should be happening right. Just because it's common doesn't mean that it's what we want.

Rachel: 5:01

Yeah, and we actually talk about that we have an entire module on common but not normal things and infants and toddlers in our new infant and toddler sensory development course that is now AOTA approved. Depending on when you're listening to this, the timing is a little bit weird because when we're recording it, it's not. but when you listen, when you're listening to this, it probably will be. But it's been completely redone. We've added more content to it. It's really a course for everyone, every parent, every caregiver, just to learn sensory and primitive reflex integration activities and strategies and just to set you up on the right foot from the time your child's born until they're three, four years old.

Jessica: 5:41

Yep. Okay, enough jabbering. There is a link in the show notes for that. So you can just scroll down to your show notes and click on that link and check it out. And without any more jabbering from us, let's dive into some sensory red flags that we might see in infants.

Rachel: 5:59

Okay, so without more jabbering, but we are going to continue jabbering.

Jessica: 6:03

That's true, it is a podcast.

Rachel: 6:05

We are going to jabber about important stuff now. That's all important.

Jessica: 6:08

It was all important.

Rachel: 6:09

Okay, so in infancy. So this is like, zero, would you say, zero to 12 months?

Jessica: 6:15

Yeah, I would say so. Even 18 months. I feel like toddlerhood starts as soon as the child starts walking, right? Yeah, for some reason that's when toddlerhood starts.

Rachel: 6:22

Yeah. Yes. Okay. So zero to 18 months, give or take. Okay, so if the infant is struggling significantly with colic, that's always one that gets brushed under the door. It's normal. It's fine. Like, is it really normal? Is it fine? Like something is clearly bothering them? They are distressed. They're in fight or flight. Yeah, so that's definitely a red flag when someone says hey, my child had colic. Okay, great to nothing.

Jessica: 6:48

Yeah, totally. Difficulty tolerating hygiene activities like taking a bath, nail clipping, hair brushing, diaper changes. If your infant is unable to tolerate those without screaming and crying every single time, that's a red flag that there's something going on maybe from a tactile processing standpoint, a vestibular processing standpoint for when they have to lay down in the bath or when they're laid down for a diaper change. So those are some different sensory red flags that we always want to keep an eye on.

Rachel: 7:24

If they're uncomfortable with different clothing textures, blanket textures, maybe they only will sleep when they're swaddled, maybe they absolutely hate to be swaddled, and this is like significant, right? Like this is we're talking like they will not sleep in a certain sleep sack or they will only sleep in 69 degree weather temperature room. I don't know. With everything completely blacked out, the sound machine is at a 49% volume level, their arms are tucked in exactly like really specific requirements for sleep. I went on two different ones there, but clothing, textures and specifics.

Jessica: 8:12

Yes.

Rachel: 8:12

You're picking up what I'm putting down?

Jessica: 8:14

Yes. The next one is missing or skipping milestones, specifically rolling, being able to sit up independently, and crawling. Those are big red flags for us as therapists because it tells us that something was missed.

Rachel: 8:32

They are struggling with latching in infancy, maybe they've had a tongue tie or lip tie, maybe you've got it resolved, maybe you haven't, maybe they're struggling with like their rooting reflex, maybe they're struggling to start solids. They are really uncomfortable with messy play activities when they're starting solids. You're just noticing that they're choking or gagging.

Jessica: 8:58

Like constantly spitting up.

Rachel: 9:00

Yes, like this is cause like, of course, gagging, spitting up like all that is normal to an extent. But like we're talking significant, like they're throwing up every time they're eating because they can't handle the texture. So really struggling with food in general and nursing or taking a bottle.

Jessica: 9:17

Another one is unable to tolerate tummy time. We all know how important tummy time is and we also know that in infancy, it's difficult initially for the infant to be able to sustain tummy time, but with consistent exposure and repetition of that tummy time your baby should be able to tolerate it and even thrive in that tummy time position. But if over several months, they've never been able to tolerate it, that's for sure a red flag

Rachel: 9:46

If they're constantly spitting up, and like projectiles spitting up after every feeding, even if you shouldn't be waiting 30 minutes after they feed to lay him down on the ground and play and stuff. But if they're just constantly spitting up, that's another question as to why is this happening? Maybe it's lasting up until they're a year 18 months and they're still really splitting up. That's definitely something we want to be aware of.

Jessica: 10:10

And then the next two are connected. Either, if your baby is uncomfortable being picked up, or and held. Just seems uncomfortable, like connecting being held up against gravity, or on the opposite end, if they refuse to be put down, those are things we want to look at and better understand why their body isn't able to process those movements of being picked up or put down and tolerating that.

Rachel: 10:39

Yeah. So if you're noticing any of these, and you have an infant right now, then bring them up with your pediatrician, and advocate because oftentimes, our pediatricians aren't necessarily well versed in sensory processing disorder. They can't know everything, right? And it's important for you to say, look, I've been noticing these things. I've been learning about this. I feel like there's something just off and I want to help my child. So push me in the right direction.

Jessica: 11:03

Yep. Next are toddlers and this is a bit of a longer list that we're gonna go through for toddlers, because they are very complex beings. The first one is going to be avoiding playgrounds, or swings, or slides. If you take your toddler to the park, and they consistently refuse to do those climbing, swings, and slides because they're fearful. That's something we want to look into.

Rachel: 11:31

Another one that they skipped crawling is a big one or if they didn't crawl on that asymmetric hands and knees crawling pattern, if they scooted on their bum, or they had a janky crawl and had one leg up or like a kickstand out that is another red flag as to why did this happen.

Jessica: 11:48

Going along with going back to like the playground and the swings of the slides, if they are nervous or fearful when their feet leave the ground and that can contribute to them avoiding the playground activities,

Rachel: 12:00

Even if you're picking them up and tossing them in the air, like a fun activity, and they're like, like holding their breath and really uncomfortable in that position.

Jessica: 12:09

Yeah.

Rachel: 12:10

On the flip side, if they're seeking movement and climbing and very unsafe movement activities that they're craving, and it's to the point of they're disrupting their daily activities, that is another sign. Like wow, like we cannot meet their needs.

Jessica: 12:25

Yeah. Going along with that if they're spinning without getting dizzy for long periods of time. I've seen kids who can spin just in a circle for a minute or two at a time and it doesn't affect them at all, that's a sign that their body is very unresponsive to vestibular input and we want to take a look at why.

Rachel: 12:44

Or if you use spend them one time on the swing, and they complain and throw up and get really uncomfortable, that's on the other side where it's affecting their ability to get through their day and play. If they are struggling with self injurious behaviors, hitting themselves, biting themselves, pinching, pulling hair, biting, kicking, hurting themselves in any way, that's definitely it can be related to a sensory need that's not being met.

Jessica: 13:14

Next is if they are covering their ears or melting down going into fight or flight, when there is a loud noise, like the vacuum or the blender, or on the opposite if they seek out those noises or they make noises all the time, just for the sound of it. I mean, toddlers make all kinds of random noise. But this one would be a concern if they are unable to do other things and all they're doing is making these noises.

Rachel: 13:44

If they startle easily, and you walk into a room and it scares them, or you close the door, and it scares them or you touch them on their shoulder and it scares them. They're startling really easy, that's another thing to be aware of.

Jessica: 13:57

Running and jumping, we want our toddlers to be able to run easily, jump up and down, balance, and if those things are difficult, we want to look at why.

Rachel: 14:11

If they refuse to participate in social activities, even after exposing them multiple times. Of course, the first time they go to something new or different, there'll be little shy and curious and hesitant, but with consistent exposure, it should be able to get a little bit easier and they'll warm up but if they are never warming up, and you're in a social activity and they're glued to the side of your leg and they never end up participating. Like that's something to be a little bit concerned with. Like we want to figure out why and how we can help them with social occupation.

Jessica: 14:45

The next one is around food and we actually just had an interview with Britain about food and picky eating and food exposure and so keeping in mind that all toddlers go through a picky eating phase. But if your toddler has very limited food report, has very few safe foods, that is something that you want to look into. Maybe they only have five foods that they will ever eat and that would be something to be concerned about. If they're not gaining weight and they're malnourished, because they're not eating enough foods with good nutrients, then you want to look into that.

Rachel: 15:24

Yep. Another one is if they're over stuffing their mouth while they're eating and they are like pocketing foods in their cheeks and it's a safety concern a choking hazard or if they're not noticing messy food, or things on their face, or on their hands are just really under responsive to that, and they're just, they're not aware of those feelings.

Jessica: 15:46

Or if they're drooling all the time, they're unable to control their saliva.

Rachel: 15:50

Yep.

Jessica: 15:51

If they're unable to fall asleep independently, in toddlerhood, we want our toddlers to have gained that ability to fall asleep independently. Where you tuck them in, it's hard, but we want them to be able to do that on a fairly consistent basis and then also sleeping through the night on most nights.

Rachel: 16:14

I just gave Jessica the teeth like emoji.

Jessica: 16:18

Maybe it's a sensory red flag for trip.

Rachel: 16:20

I know. Gosh, we're all doing the best we can. Okay, the next one is w-sitting. There w-sitting, we I say static w-sitting, where they're their feet are pointing out, the inside of their ankles are on the floor, they're not crossing midline, their

Jessica: 16:38

bum is all the way flat on the floor in that w-sit.

Rachel: 16:40

Yep, and they aren't moving in and out of it. They're just sitting there and playing and not moving in and out of different play positions. That's definitely something we want to look into.

Jessica: 16:51

Next one is if your toddler is grinding their teeth throughout the day, and I was just thinking we don't have it on the list, but it made me think of this grinding teeth at night, as well as look at their sleeping mouth posture. If your toddler is an open mouth breather during the day, but also if they are an open mouth breather at night while they sleep, those are things we want to take a look at. Because our natural resting mouth posture is with our mouth closed and the tongue resting up against the roof of our mouth so that we're breathing through our nose and if your toddler is constant mouth breather, snoring at night, grinding their teeth at night, breathing through their mouth at night., those are things we want to look into.

Rachel: 17:38

Another one is not recognizing wet poopy diapers. They're not recognizing if they're hungry, or if they're thirsty, they're just really struggling to not only process it from a tactile standpoint, but from an internal standpoint, right? And if they're really struggling to potty train and recognize when they're going to the bathroom after three years old, that's definitely a sign that maybe they're not processing the sensory world properly.

Jessica: 18:04

Another one is if they seem clumsy, or if they're running into objects constantly. This would be one like at home, where the furniture and the environment is always the same, furniture is always in the same place and your child still bumps into things all the time, even though they walk around it all the time. It's just a sign of some body awareness challenges potentially or if they're clumsy and they're tripping a lot, those are some things we want to look into.

Rachel: 18:31

Or if they're falling off things like chairs, right? If they're sitting.

Jessica: 18:37

All the time. Yeah, because there is this really funny video of Logan. When he was like two or three and he was playing with playdough at the kitchen table and he's putting the playdough in the little toy oven and he just he was right on the edge of the bench and he just fell right off. But it didn't happen all the time. Right? It was an occasional occurrence. So we're talking about this happens on a regular daily basis.

Rachel: 18:59

It's the best video.

Jessica: 19:00

It is a really funny video.

Rachel: 19:02

So great. Okay, the next one, they are uncomfortable with bright lights or with walking outside in the sunshine, they get their eyes really sensitive, they cover their eyes, they always need sunglasses, that's definitely something we want to be aware of.

Jessica: 19:22

Another one is always mouthing non-edibles. Now in infancy, our babies learn about their environment and toys through mouthing them. But we want to see this stop before two years old and so if you have a toddler who's two plus years old, and they're always putting toys in their mouth, always putting their fingers in their mouth, chewing on things that are not food, we want to look at. If they're ingesting non-edibles, we want to look at pica. But if they're just putting things in their mouth to chew or suck on, then that could be a sensory concern.

Rachel: 20:01

And the last one here on this list that we came up with is avoiding messy activities, crafts, hand painting activities, finger painting, getting their clothes messy or wet, getting their face messy, they're just really uncomfortable by those like typical age appropriate craft activities, or play activities, or even just eating activities that are uncomfortable there. So that is our list. It's not an all inclusive list. It is just the main things that we hear about and we see with clients, and we just hear often, and it's just some things to be aware.

Jessica: 20:39

And I think the other thing we need to mention here is there is a difference between sensory quirks and sensory challenges or sensory red flags. And so the things that we've listed off for our toddlers and our infants, if those sensory concerns that we've listed off, maybe sensory concerns is better than red flags, I don't know, if they are negatively impacting your child's ability to get through your day that's when we want to dive in deeper, right? But if it's just a sensory quirk, where like your toddler occasionally doesn't want to do messy play, or your toddler occasionally drools a little bit when they're talking, but it's not an everyday occurrence, it's not negatively impacting them, then it might be more of just a sensory quirk. Still doesn't hurt to check it out and dig deeper, but also

Rachel: 21:31

support them

Jessica: 21:32

and support them. But also, if your toddler has multiple things on this list that we just listed off, then that's another sign that there might be some underlying reason.

Rachel: 21:43

Yep. So we're gonna talk about school aged children. Next. But really, the big thing is that everything that we talked about already applies to our school aged children and our older children or, frankly, adults, right? Everyone.

Jessica: 21:58

Yeah, if your older child struggled with anything that we've already listed off in infancy or childhood, there could be some sensory challenges going on.

Rachel: 22:08

Yes. And we're just going to add a few like, academic, learning school based things that are important to be aware of for our older kiddos. Like their below age level in reading or writing, because that does require a lot of sensory attention in order to complete and be successful in reading and writing.

Jessica: 22:32

Or if they're always getting in trouble at school, we want to look at why. Is it because they can't stop talking? Is it because they can't sit still in their seat? Is it because they're constantly dropping things off their desk? Like why are they having trouble at school.

Rachel: 22:49

If they're unable to make friends, or keep friends, or socialize, or go to social events, that's another thing we want to be aware of.

Jessica: 22:56

Another one is big, emotional outbursts on a daily basis. Kids have big emotions, and some kids have bigger emotions than others. But if your child has big, emotional outbursts every single day, around things that are maybe more of small problems, like they broke their pencil, and it causes them to have a 15 minute meltdown, or they spilled their milk on the floor and you're like, Okay, well, let's clean it up. But for some reason, that sends them into fight or flight for 15 minutes. You know, those big outburst every single day, that's something we need to dig deeper on.

Rachel: 23:39

Yep and then the last one here we're going to chat about is wetting the bed at night. If they are older than 5-6-7 and they're still wetting the bed at night, that's something that we want to figure out. Look at our reflexes, look at the sensory system, see what we're missing here, and how we can support them.

Jessica: 23:56

Now that we have scared you to death with all of our things that we're saying could be concerns, what do you do? First, we always say this, we want to find out why is your toddler avoiding certain foods? Why is your toddler grinding their teeth at night? Why is your school aged child having big emotional outbursts every day? Why is this happening? Because once we figure out why, then we can create more personalized strategies.

Rachel: 24:28

If maybe this is like one of your first time listening to our podcast, you're like, Okay, how do I find the freaking why, thank you very much. Honestly, you can go back through a lot of our episodes and we break it down. Like if they're struggling with reading and writing, let's look at their visual system, let's look at their ocular motor skills, let's look at their reflexes like weeks. We break it down. We explain. That's like our old less like our MO is to find the why and so we talked about that in a lot of our previous episodes. But also we've mentioned this we want you to seek out a trained specialist, either OT, PT, speech, myofunctional therapy, just someone to help guide you and to help you find that why and to support you.

Jessica: 25:05

Yep. We want to rule out certain things. So when we're looking at feeding issues, feeding challenges in infancy and toddlerhood and older children, too, we want to rule out any structural deficit. So tongue ties, a swallow deficit, things like that, because those are safety concerns, but they also impact the child throughout their entire life. So we want to have those looked at.

Rachel: 25:32

Yeah, even just like having your child, like, follow how you're moving your tongue in your mouth. Like, can they imitate what your tongue is doing or is their tongue not doing what it needs to be able to do? That's a really important thing to be able to do, and especially with eating. So really simple things like that, we want to make sure that they can do.

Jessica: 25:50

Yeah. We do have a couple of courses that you could check out as well. We have our infant and toddler course, that I think Rachel mentioned at the beginning of this episode, but we also have a sensory diet course, where we teach you how to identify sensory preferences, we teach you how to meet the sensory threshold, and we teach you how to create sensory diets. So if your child is struggling with seeking sensory input, or avoiding sensory input, then a sensory diet course is perfect for you. Because we teach you how to do all of that.

Rachel: 26:28

We also recommend filling out a sensory checklist to identify some sensory preferences. We will link a nonstandardized checklist in the show notes for you to use and to check out just to have kind of an informal idea of what their preferences are. And then just goes mentioning sensory diets, we do have a couple of episodes that can help guide you in your sensory diet routine making. If you're not ready to jump into the course, episodes, 39, 129, 224, and 123. So check those out, we'll link those in the show notes as well. And then we also have a free sensory diet webinar and it just gives you the basics on sensory diets and sensory system. So we have a lot of free resources. Even our YouTube channel, we have a ton of free content for you to learn as much as you can about this. But if you want it all in an organized, systematic way easy to implement, I would definitely check out a course. Okay, all the things. We're going to wrap this up. We want you to know that we're here for you. If you have questions, don't hesitate to reach out. If this episode was helpful, and you were like, Oh, wow, I learned something, let us know. Leave us a review on iTunes or Spotify, send us a message on Instagram. That's where we hang out at all things sensory podcasts. We'd love to chat with you take a screenshot share this episode with someone who needs it. Please help us get the word out. Please, I beg

Jessica: 28:01

I love it when Rachel sings ono the podcast. Alright, that's it for today. We'll talk to you next week. Bye.

Rachel: 28:07

Ok Bye. Thank you so much for listening to all things sensory by Harkla

Jessica: 28:12

If you want more information on anything mentioned in the show, head over to Harkla.co/podcast to get the shownotes.

Rachel: 28:20

If you have any follow up questions, the best place to ask those is in the comments, on the show notes, or message us on our Instagram account, which is at Harkla_family or at All Things Sensory Podcast. If you just search Harkla, you'll find us there.

Jessica: 28:36

Like we mentioned before, our podcast listeners get 10% off their first order at Harkla. Whether it's for one of our digital courses or one of our sensory swings, the discount code sensory, will get you 10% off. Head to Harkla.co/sensory to use that discount code right now. We are so excited to work together to help create confident kids all over the world. While we make every effort to share correct information,

Rachel: 29:13

constantly changing science and art.

Jessica: 29:15

One doctor or therapist may have a different way of doing things from another.

Rachel: 29:19

We are simply presenting our views and opinions on how to address common sensory challenges, health related difficulties, and what we have found to be beneficial that will be as evidence based as possible.

Jessica: 29:31

By listening to this podcast you agree not to use this podcast as medical advice to treat any medical condition in either yourself or your child.

Rachel: 29:39

Consult your child's pediatrician or therapist for any medical issues that he or she may be having.

Jessica: 29:45

This entire disclaimer also applies to any guests or contributors to the podcast. Thanks so much for listening