Home > Sensory Processing Disorder Screening

In addition to providing piano-occupational therapy services, Occupational Piano offers sensory processing evaluations, home program, and in-person or over-the-phone consultation options.

Defining Sensory Processing

When your child has a breakdown in sensory processing at the level of the brainstem, your child has difficulty either becoming regulated or staying regulated. Your child is either needs a lot of input to become regulated or your child becomes overwhelmed with just a little bit of input. The terms to describe these types of dysregulation are low arousal and high arousal.

Low Arousal

This child has an under responsive or “cold brainstem.” He or she is always wanting more. This child can flip-flop between showing high activity, like a Tasmanian Devil, or by showing low activity with low motivation and interest.

High Arousal

This child has an over responsive or “hot brainstem.” The child has “system overload” with too many messages to the brain, which results in increased adrenaline and cortisol. This child can be high activity, such as acting out aggressively, or low activity, such as hiding under a table.

Using A Sensory Diet

There is a specific order in which to do the sensory diet with your child based on what chemicals are released in the brain. If these programs are done consistently and frequently, the child will show increased self-regulation to the point where he or she does not rely on on the sensory diet. The goal of the videos is to provide parents with examples of how a sensory diet can be put together and what some of the activities look like. To determine how often to implement in the sensory diet, length of time, and progression away for the sensory diet, parents should rely on at least monthly consultation.

These videos were made in conjunction with licensed behavioral psychologist Claire Thomas-Duckwitz, L.P., Ph.D., NCSP. Dr. Thomas-Duckwitz specializes in children and young adults ages 3 to 25 diagnosed with developmental disabilities, particularly ADHD, Austism, and trauma, and PSTD.

Contact Dr. Claire Thomas-Duckwitz


Low Arousal

The input given in each activity should be unpredictable, new, & arrhythmic.

1) Child experiences vestibular input

2) Child experiences active proprioceptive input

3) Child experiences tactile input

4) Child experiences passive proprioceptive input

High Arousal

The input given in each activity should be predictable and rhythmic.

1) Child experiences tactile input

2) Child experiences passive proprioceptive input

3) Child experiences vestibular input or Child experiences vestibular input

4) Child experiences active proprioceptive input

Additional Activities

Active Proprioceptive Activity and Active Proprioceptive Activity

You can use a bin of sand, rice, or beans with manipulatives as a tactile activity.



To determine whether your child would benefit from a sensory diet, which sensory diet is right for them, and/or you are interested in an individualized home program, please contact Natalie Mannherz OTR. For an evaluation and therapy, please contact Dr. Claire Thomas-Duckwitz.

For the Parent: Answer These Questions

  1. Does your child act silly, seem like he/she is not in control of his/her actions, or go into fight or flight during certain times of day, during certain activities, or in specific environments?
  2. Does your child lash out aggressively, run away, or hide when he/she gets upset?
  3. Does your child have good days or hours where nothing is an issue and bad days or hours where everything is an issue?
  4. Does your child flip-flop between acting like a tornado (i.e. engaging in multiple activities very quickly) and showing a decreased desire to engage in anything (i.e. flopping onto the couch or floor)?
  5. Would you describe your child as controlling, bossy, or a perfectionist? Does your child have difficulty transitioning from uncompleted activities?
  6. Does your child have big emotional responses to the environment (what is going on around him/her, who he/she is playing with)?
  7. Does your child have big emotional responses to specific tasks (handwriting, homework, motor activities)?
  8. Do you feel like you are walking on eggshells to appease your child?
  9. Does your child have difficulty with transitions between activities, from the house, to school, etc.?
  10. Does your child have a short attention span, need constant movement, and/or      have difficulty initiating or finishing activities?
  11. Does your child engage with you, others, or the environment in a predictable  way (e.g. needs routine, prefers familiar activities and environments, likes to know what is going on) or in an unpredictable way (e.g. you do not know what your child is going to play with next or how his/her body is going to move)? (Think about how your child acts overall or most of the time)

If you answered yes to #’s 1, 2, 5, 8, this suggests SPD high arousal. If you answered yes to #’s 1, 4, 10, this suggests SPD low arousal. Questions 1, 3, 6, 9 suggest SPD, but do not specifically indicate high or low arousal.

If you would like further information or would like to discuss your child, please Contact Occupational Piano.

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