Sensory Integration Education

This guest blog highlights key findings from a qualitative study carried out by Dr Beth Elenko where the key aim was to understand the experiences of occupational therapists (OTs) using sensory diets in early intervention (EI) (ages birth to three).

Occupational therapists (OTs) in early intervention (birth to three) are often tasked with developing sensory diets for infants and young children, yet guidance specific to this young age remains limited. 

Much of what informs practice is drawn from clinical reasoning and school-based practice evidence. This qualitative study explored how OTs implement sensory diets with infants, young children, and their families, offering insight into how these strategies are conceptualized and applied in natural environments. 

A sensory diet is a personalized set of activities designed to provide the sensory input an infant or toddler needs to maintain an optimal level of arousal to participate in daily routines. 

When working with infants, young children, and their families, this process is inherently dynamic, requiring OTs to adapt strategies to rapidly changing developmental needs and family contexts. 

Infants and young children present with a range of sensory processing differences. Some seek constant movement and input, while others become distressed by touch, noise, or transitions. Still others show challenges with regulation, including difficulty settling into routines or maintaining a calm state. Given the rapid neurological development that occurs in the first three years of life, OTs play a critical role in helping caregivers interpret these behaviors and respond in ways that support participation. 

Analysis of OTs’ experiences revealed four key themes that inform best practices in sensory diet implementation with infants: 

1. There is no one-size-fits-all approach 

Sensory diet development is highly individualized. OTs described themselves as creative problem-solvers, emphasizing that effective strategies cannot rely on standardized protocols or predetermined activity lists. Instead, they integrate knowledge of the infant or toddler’s sensory processing patterns, temperament, and developmental level with an understanding of family routines, values, and environmental contexts. 

Rather than introducing specialized tools, OTs prioritize familiar and meaningful resources already available within the home. Everyday items—such as blankets, pillows, and laundry baskets—and naturally occurring activities—such as caregiving routines and play—become the foundation for sensory diet strategies. Sensory diets are therefore co-constructed, reflecting both the infant’s needs and the family’s experiences.  

2. Embedding strategies into daily routines 

A consistent finding was that sensory strategies are most effective when embedded into everyday routines, rather than presented as additional tasks. OTs integrate strategies into activities such as feeding, dressing, bathing, outdoor play, and sleep routines. This routine-based approach supports generalization and reduces caregiver burden. 

Importantly, OTs emphasized flexibility over adherence to a prescribed plan. Given the unpredictability of life with infants and young children, strategies must be flexible and responsive rather than rigid. Embedding sensory diet activities into naturally occurring activities allows strategies to be sustained over time and across contexts.  

3. The role of caregivers in early intervention

Caregivers play a central role in the successful implementation of sensory diets as they spend the most time with the infants and young children. OTs in the study focused on building caregiver capacity through education, coaching, and collaborative problem-solving. A key component of this process is supporting caregivers in interpreting their infant's or toddler’s behavior as communication. 

By helping caregivers understand the relationship between sensory input and behavioral responses, therapists support caregivers in recognizing their infant's or toddler’s needs. As caregiver understanding deepens, so does their ability to implement and adapt strategies independently as situations change. 

This shift allows caregivers not only to be implementers, but also active partners in incorporating sensory diet strategies into their family's daily routines.  

4. Prioritizing feasible and accessible strategies 

OTs emphasized that effective sensory strategies do not require specialized or costly equipment. Many families face financial and environmental constraints, and even when resources are available, replicating a clinic-like setting in the home is neither necessary nor desirable. Instead, OTs highlighted the importance of designing low-cost, practical strategies that align with family routines and environments. 

This approach supports equity and ensures that strategies are accessible, sustainable, and meaningful. The goal is to enhance participation using what is already available, rather than introducing unnecessary complexity. Thus, strategies are designed to be as natural as possible. 

Supporting the sensory needs of infants and young children is not about implementing a standardized protocol. It requires ongoing clinical reasoning, collaboration with caregivers, and responsiveness to the young child and family context. Sensory diets, when individualized and embedded in daily routines, can support regulation, participation, and engagement in early occupations. 

These findings reinforce the importance of flexible, family-centered approaches in translating sensory-based strategies into meaningful everyday practice for infants and young children and their families. 

By Dr Beth Elenko

Dr. Elenko earned her degree in Occupational Therapy (OT) from Eastern Michigan University in 1987 and her master’s in 1995 and a doctorate in 2000 from New York University.

Her OT career has focused on working with infants and young children and their families in Early Intervention (EI). She is an Associate Professor at New York Institute of Technology and is a fellow in the American Occupational Therapy Association (AOTA).