E11. Sensory Strategies for ADHD

Welcome to ADHD Crash Course! Today, I'm going to put on my occupational therapist hat and we're going to talk about sensory strategies that can change your energy level and your attention level.

Now, when we're talking about these levels, in therapy, we're talking about nervous system levels. You often just refer to this energy and attention level as your arousal level, your nervous systems arousal level. I just say energy and attention level if I'm working with adolescents, because usually arousal level is tied into sexuality for them and that's hard for them to separate and not find funny every. time. I. say. it., but you're adults, you can hang with me.

Now, the cool thing is, that you're already doing this, just intuitively, you're already using sensory strategies to change your level of energy and focus throughout your day. We use sensory inputs to help calm us, help alert us or wake us up. In a meeting where you're just struggling to pay attention and you start bouncing your leg or you're doodling or you're twirling your hair or you're chewing on a straw, you're seeking out sensory input that's helping bring your arousal level up.

What about if you're running kind of high? Let's say you're excited or irritable or angry. Have you ever been on a really important phone call, like a phone interview or something that mattered a lot to you and you had to pace? That's a sensory strategy, that input is helping regulate you. Stress eating; even though the media and movies tend to really make light of this and use it as kind of relatable humor, it's really understandable from a sensory standpoint that people are seeking out that kind of input when they're feeling stressed and elevated.

One of the main contributors in why stress eating tends to be calming and regulating for people is that it's intense sensory input, stress eating absolutely floods the proprioceptive system. There was a program that I use when I worked in pediatrics that helped kind of describe these concepts to kids. And in this program, they talked about nervous system levels and sensory strategies that we can use to change your nervous system level.

One of the analogies they used is that everybody has a car engine inside of them. And it's an engine that can run low, it can run high, or it can run in that middle zone. This program equipped kids to use sensory strategies to change their engine level. That's basically what we're going to be doing today. There are situations where a high or a low engine is the right fit. If you are cheering at a football game and you're so excited; that elevated, high-running nervous system is fine. It fits. It doesn't interrupt what you want to do, it might even enhance what you want to do (as long as you don't get really carried away).

The same with an engine that's running low. If you are kind of "couched out" for movie night, or maybe you're just trying to go to sleep and you're gearing down, then your engine running at a low level make sense. It fits. It's adaptive for what you want to do. But for most of us, a good part of our day, we need to be at that middle zone where we're high enough that we can pay attention, we can focus, we can stay awake, but we're not so high that it's difficult for us to settle in and connect and pay attention to what we need to pay attention to.

Now on to the strategies. One of the most powerful sensory strategies that you can use (and I already mentioned it) is input to your proprioceptive system. This is the system that judges where you are in space, and it uses information that you're getting from your joints and your muscles to tell you where you are.

If you close your eyes and you lift up your arm, you have a general sense of where (you arm) is because of your proprioceptive system; you aren't looking at it. Your joints and your muscles are telling your brain where it is. So, this system is a really powerful system when it comes to regulating your nervous system levels. The cool thing about proprioceptive input is that this kind of input can actually bring up your arousal level or it can bring it down.

It's a great input for regulation. How do you get proprioceptive input? Anything that is giving your muscles and your joints heavy input, things like pushing, pulling, jumping... I've had clients who have noticed doing rebounding (jumping on those mini trampolines) actually helped with their anxiety. That makes total sense because that is flooding this person's body with proprioceptive input. My client who saw a decrease in anxiety symptoms was seeing the regulation from proprioceptive input.

You can do little dips, hold your body up in your chair, you can do a wall push up, you can do some squats, take a walk or do something. It's not necessarily super intense input but its input and the thing that I really want to emphasize here is that you're not trying to exhaust yourself, you're not trying to wear yourself out with exercises.

That's a totally different approach that might work for some people goal is not that you have to do 100 pushups or that you have to do tons of chair dips; the goal is receiving the sensory input. As you experiment with this, you will see how much of it impacts your nervous system. Sometimes it's a relatively small amount. This is not "workout" mentality. This is sensory input mentality. There is a pretty big difference between the two.

That can keep you regulated for hours, especially the system, the proprioceptive system, this input keeps you regulate for a long time. This is also one of the systems in play when it comes to weighted blankets and why those are really effective at calming, it's a lot of deep input to your body. You can get that in more active ways or passive ways.

The next system that we're going to talk about is the vestibular system. A lot of you have a little more familiarity with the vestibular system. This is the sensory system that gives our body information about where we are in space about movement about our head position. This is our movement sense. Just like proprioceptive input, this is what I would call a "heavy hitter" for changing your energy and your focus level.

Vestibular input is often really powerful. Once again, its effects last longer than just the time that you're doing it. Slow and rhythmic and steady and predictable vestibular input is often calming, relaxing, and it brings your nervous system level down, whereas irregular, erratic, fast movement tends to alert your nervous system and brings it up.

Many babies want to be rocked, either in a rocking chair or pacing around, to help them regulate and calm. Babies often need help regulating because they have immature nervous systems. What does it look like to use vestibular input to regulate our nervous systems? This is one that I really encourage people to experiment with, because although we know generally that some kinds of vestibular input tend to give us one effect, and others tend to give us another effect there's a lot of variability in here.

It can actually change throughout your life. I used to be someone who loved really intense, really crazy amusement park rides, I can now officially say that is no longer true of my body. I went to the fair this last weekend with my kids. I rode one of those really crazy, spinny rides and I got so sick. I am no longer interested in that kind of input for my sensory system (it doesn't really come up that often), but that's no longer my thing.

Unlike proprioceptive input, which you just can kind of load up on, vestibular input can be a little tricky, but it also is one of those inputs that has a big impact on us. So if rocking in a rocking chair, swinging, anything where you're moving through space, like a bike or a skateboard or you're in motion: notice how that input affects your body. Does it bring your energy and attention level up? Do you calm with certain kinds of vestibular input? That can be a helpful tool for regulation.

The third one that I want to talk about is the touch system or the tactile system. Proprioceptive and vestibular input are really impactful, but they're not always accessible. If you're in the middle of a classroom, if you're in the middle of a meeting, you can't always just go do some squats and pushups or go swing on a swing or get these big inputs that help regulate you.

Sometimes going through a more subtle system makes more sense. Often in the classroom, it's much easier to give kids tactile input that's not disruptive to them or to their classmates. The same is true for us, that if you're in the middle of a meeting, you can't necessarily engage in some of this input as easily as fiddling with something, using a fidget, or doing something that's giving you tactile input. When I have coaching calls, I doodle non-stop. That does two things; very often I'm writing something that I want to remember, but I don't want to interrupt the person I'm talking to, and I want to make sure that we circle back to something that I've noticed and I think is important. Because of my memory issues that is what works for me.

But doodling and drawing and fiddling with things has always been the way that I help regulate myself and maintain focus. When I'm still and not moving, my nervous system dips really low, which of course looks the opposite of hyperactive, but it's a regulation issue. This is true for a lot of people with ADHD; when they're getting no sensory input or low sensory input, it's hard for them to regulate. People who tend to demonstrate dysregulation on that high energy, high engine-running end of the spectrum, they're much more likely to be identified not only as having ADHD, but as needing sensory strategies. If you're running on that low end, it's just as important for you to get the kind of sensory input that helps bring you to the middle.

Back to tactile input/ touch input: this is one that I think a lot of people are more familiar with, at some point, I don't know, years ago, the whole fidget spinner trend brought this to awareness, that fidgeting is helpful for some people to help them focus. Usually, with a fidget and kids, you have to put the parameters that this can't be an activity in itself, and it can't be distracting to the child or the people around them.

As adults, of course, we want to have that awareness as well about how the tools that we're using impact us or impact those around us. Now, moving from these three "heavy hitters" this proprioceptive, vestibular and tactile input, we're going to go into some inputs that also can be really helpful, but they may not pack the same punch that some of these other systems do in terms of regulation.

They still may, but the one thing about regulation that is absolutely true is that everybody is different. We're going to start with the auditory system. Just like vestibular input, the tendency is that rhythmic, steady movement tend to be calming. The same is often true for auditory input; the rhythmic steady sound things like ocean waves, things like steady drums, those are often calming for people. That auditory input that tends to be irregular, loud, fast, intense, tends to be arousing for people's nervous systems.

It's very common for people with ADHD to have sensory processing issues. Very often people are under or over responding to sensory input. This includes all the inputs, but definitely more of the inputs we're about to talk about, auditory input is one of them. Some people operate in a very defensive place with auditory input and when they're looking at their sensory diet, and how they're going to impact their nervous system level, it might just completely be about getting less of it.

"Dialing down" some of the input and making the input more predictable. What often happens when somebody is defensive, sensory wise, is they end up in this really elevated nervous system state, that's an irritated state. They're not high-energy running around hyperactive, they're irritated, they're irritable, they're on edge and that is very often how that "too high" nervous system level presents an adult.

Now, how you decrease that auditory input depends on the situation you're in, but one thing to remember with any of these sensory inputs, if you're defensive, your nervous system level will change with that defensiveness, and it's not going to come down just because the input is gone. So, if you've been in a crowded place, a noisy place, a chaotic place, and that has really bumped up your nervous system level and you feel really irritable and on edge, don't expect that as soon as you leave that situation that your nervous system level is going to drop back down.

That's not the way this works. You actually might have to use some of those other strategies that we were talking about the proprioceptive input, the vestibular input to help you come back down to that middle zone. What about when we're talking about the other end, somebody that is running low and how they can leverage auditory input?

I know for me that if I'm a little low and I have to do something that's really physical, like cleaning, something, putting on some really loud, fun, fast music absolutely brings my nervous system level up is very useful for me and kind of energizing me and making me more alert. A lot of people experience that with auditory input.

Now, one word about studying; a lot of kids with ADHD really like to use music with studying. It's very often good to experiment with that, because this can be helpful. Like the fidget situation, if you have auditory input and the music or lyrics are distracting, then those in themselves are becoming an activity and distracting a child. That may not be the kind of music that works for them. But some kids do fine with it. So, there's no pat answer for every person. Auditory input is definitely one to play around with as far as changing your energy and attention level.

The next sensory system I'm going to talk about is the visual system. This is a biggie for people with ADHD, a lot of us (myself included) find ourselves very sensitive to visual input. This is the heart of some of that visual distractibility that a lot of us deal with, it's also a really big factor in why some people hit a point of overwhelm with a really chaotic and messy environment. Many people that I've worked with shut down, if it's too chaotic. They stop seeing it because it's so overwhelming to them that they actually completely shut down. They're in this defensive place because of all the visual input.

One of the things that I recommend when you're looking at your visual system/your visual input, is that you pay attention to what kind of lighting changes your energy and attention level, just notice, notice if your energy and attention level responds to certain kinds of conditions. If I'm in artificial light for long, my energy level and my focus level tank.

If I need to regulate, one of the best things that I can do is get outside. That tends to reset me and help quite a bit. I'm very sensitive to visual input. Sometimes if my energy level is dipping and my focus level is dipping, just closing my eyes and allowing myself that visual break of not processing any more visual information (can help).

I know I've already mentioned this in another episode, I can't remember which one, but we process tons of visual information. Much of our brain is involved in some way with the processing of visual information, just closing your eyes and giving yourself a reset even if it's for five minutes, even if it's for two minutes can really help change. I've noticed that it really helps change my focus level and my energy level and it's restorative for me and helps me get a big break sensory wise.

Our last sensory system that we're going to kind of lump sum together; we're going to talk about the gustatory system (which is that taste system) and our olfactory (which is smell) and oftentimes these are really interrelated. I know I'm kind of like a broken record on this point, but this is one of those systems, or these two systems, that something that I find calming and relaxing, might do the opposite of somebody else's nervous system.

I have this bath salt that I love, and I find it really calming and comforting. It's this lavender chamomile salt and my husband can't stand it. It does truly opposite things to our nervous systems. It makes me nice and calm and relaxed, and he just really feels irritable, getting that kind of input. Some of the general trends that we notice with this sense is that scents like vanilla, some of the floral scents, can be calming. Things like citrus or cinnamon, things that have a little more spice and heat to them tend to be alerting.

Temperature is one of those tricky ones that falls maybe more in the touch system, it's one of those doesn't really have a home, but cold temperatures tend to be alerting, arousing and the warm ones tend to be calming and relaxing.

When you're looking at how you're going to leverage different inputs, then you might want to be looking at temperature as well and see what that does for your nervous system. Do you notice an impact, if you have a cold drink versus a warm drink? If you have a lukewarm shower versus a hot shower? I won't be experimenting with this because I already know that I have a very strong preference for hot water. My husband thinks I have nerve damage (and I think he's kind of a baby), see what works for you see what helps change your nervous system level.

I wanted to just mention one more thing in this category: many people with sensory defensiveness deal with defensiveness in what they're eating. Often that falls more in what we would consider the touch/tactile category, because very often, the things that people feel defensive about are texture related, definitely, some taste. What's usually the culprit in a lot of food defensiveness is texture.

Wrapping up today, I know that we just barely scratched the surface on this entire topic of sensory strategies that we can use to change our energy and attention level. Using sensory strategies is a tool that I find really valuable. I found it valuable for myself, for clients, and for my children. It's something that I use, probably daily, in helping me manage ADHD and helping me have awareness and some control over how I show up in my day.

I would love to do a deeper dive on this topic because there's so much to cover, but I tried to get as much as I could and jam it into our episode today in order for you to get started with sensory strategies and get an overview of this whole concept.

If you need more ideas for specific sensory activities that fall under all these sensory systems. I have a free printable on my site that you can use as a base to get started. It's the ADHDclaritycoach.com and you can find that sensory strategy sheet there.

Hopefully, you have what you need just to get started and to start noticing because that's where it's at; noticing what these inputs do for you how they change your energy and attention and it's going to be different between people. Start noticing, start experimenting, and see how you can impact your energy and attention level by leveraging sensory inputs.

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