Sensory Integration Education

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 conceptualised and applied in natural environments. 

A sensory diet is a personalised 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 behaviours 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 (Putting your thinking cap on) 

Sensory diet development is highly individualised. OTs described themselves as creative problem-solvers, emphasising that effective strategies cannot rely on standardised 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 context. 

Rather than introducing specialised tools, OTs prioritise 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 (Common experiences with sensory diets) 

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 generalisation and reduces caregiver burden. 

Importantly, OTs emphasised 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. Caregivers as primary change agents (Caregiver role in early intervention) 

Caregivers play a central role in success and carry over 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 or toddler’s behavior as communication. 

By helping caregivers understand the relationship between sensory input and behavioural responses, therapists promote caregivers in recognising the infant's or toddler’s needs. As caregiver understanding deepens, so does their ability to implement and adapt strategies as new situations or changes occur on their own. 

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

4. Prioritising feasible and accessible strategies (Impact of resources) 

OTs emphasised that effective sensory strategies do not require specialised 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 as natural as possible. 

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

These findings reinforce the importance of flexible, family-centred 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).