“COVID-19” is a novel virus, from the Coronavirus family, that was discovered in December 2019. It has since become a global pandemic.
In recent weeks, we – our children included – have seen the ripple effects. As of today, a national state of emergency in America has been declared and “Stay at Home” orders have been initiated, leading to school and store closures, discontinuation of sports activities, and more.
Fortunately, we understand how to decrease the risk of infection. More information on prevention can be found through the Centers for Disease Control and Prevention and World Health Organization websites here:
This article provides insight on how this pandemic may affect our children’s sensory systems and strategies to address this topic with them.
We have 8 senses in our bodies: vision, hearing, taste, smell, touch, proprioception, vestibular, and interoception. Lifestyle changes related to COVID-19 may affect these senses, and lead to dysregulation in our children. Dysregulation can look like distractibility, meltdowns, anxiousness, aggression, or fatigue.
In general, we can decrease dysregulation by listening to our children’s concerns and having age-appropriate discussions regarding these changes. We can provide validation (i.e. “It can be scary to see people in gloves and masks for the first time”), remain present, and provide comfort by stating facts (i.e. “Many people are working hard and doing their best to stop people from getting sick” or “We can avoid getting sick by taking healthy steps like washing our hands”). We can answer their questions in a simple and clear manner (i.e. “A lot of people are sick right now, so we have to stay home from school until they feel better”).
Below are examples of how specific sensory systems may be affected by the lifestyle changes related to COVID-19. Some of the examples may apply to your child, some may not. Every child is unique. Each category can be further analyzed and tailored to your child specifically with occupational therapy services. The purpose of this article is to promote awareness of these factors, as it can influence our overall well-being during this time.
- Long lines to buy groceries
- Empty shelves at the stores
- “Social distancing” of at least 6 feet when interacting
- Parents and caregivers are now home
- New weekly morning routines
- Emergency items and extra food at home
- Signs on the store windows saying they are closed
- Signs reminding others to maintain social distance
- Signs stating new store hours
- Buildings removing furniture or items to reduce items to clean
- People in protective equipment (i.e. gloves, masks, gowns)
- People discussing COVID-19
- Create a visual schedule to maintain mutual expectations
- Routines can promote comfort and security because expectations are being met.
- Verbally discuss these visual changes with language they understand.
- Create story books by drawing out these changes to promote understanding. Examples can be found here – https://www.cdc.gov/cpr/readywrigley/books.htm
- Create a visually calming space (i.e. blank walls or with pictures of loved ones, their favorite characters, etc.) where a child can retreat to if they become visually overwhelmed.
- Point out kindness when they see it take place within the community.·
- Visually model appropriate ways to cough or sneeze (i.e. into the insides of their elbows) and effectively wash hands.
- Hearing more worry in our tone of voice.
- Increased volume in the house because more people are home.
- If parents are working from home, they may have difficulty adjusting to the expectation of quietness around a workspace.
- Calming music
- What is “calming” to them?
- Do they enjoy music with lyrics or without lyrics?
- What instruments do they prefer to listen to?
- The volume and the pace of the music also matters.
- No auditory background at all
- Nature sounds
- Storytelling (i.e. reading books with them)
- Make note of what sounds may increase dysregulation
- Create a quiet space
- Use a timer to designate quiet time
- Priming them before quiet time – i.e. “Mom has to talk with her work in 10 minutes. We need to stay quiet, so she can hear.”
- Many restaurants have limited their services to take-out only
- Grocery stores may run low on certain foods, which may lead to missing out on favorite foods or having a limited selection of what is offered at home
- Create a visual aid by taking a blank sheet of paper with a vertical line down the middle of the page. On the left side of the line, write “Have” and on the right side of the line write “Need”. Write a list of their favorite food items under the appropriate heading. Feel free to use pictures, as well.
- Create a menu, so meal expectations are clear (this may be a fun activity to work on together!).
- Ask them what food they would like for a better understanding of what foods may bring them comfort (portioning and nutrition education can promote a healthy balance). The key is to make food and mealtime fun and enjoyable, especially during this time.
- If access to food is limited, please contact local agencies or reach out to school districts, as some have offered continued lunch services for their students. Proper nutrition is imperative for your family’s health at this time.
- Frequent use of cleaning agents exposes us to more chemical scents, which can overwhelm our sense of smell. Children who are sensitive to smells may not outwardly verbalize their discomfort, so it is important to be aware of this in order to recognize their discomfort and make appropriate changes.
- Change the environment.
- Open doors and windows, as long as it’s safe.
- Clean before you leave the area in order to give the scent time to dissipate.
- Inform your children before cleaning, so they know what to expect.
- Spend time playing outside for fresh air, while maintaining precautions.
- Social distancing is a new social norm for how we go about greeting others and our expectations of personal space. As with adults, this can be awkward for children to navigate.
- Avoiding touching their face, especially their nose, eyes, and mouth may take some time to get used to.
- With all of the sanitizing, the textures of surfaces, door handles, toys, furniture, and even the dryness of their hands may change.
- Surfaces and items may feel wet from cleaning or they may feel grainy when the sanitizing agents dry.
- Items may need to be replaced due to being worn down.
- Clothing or bedding textures may feel different due to the frequency of washing.
- These changes may contribute to our children’s emotional state, especially if it is unexpected or if they forget.
- Inform your children before cleaning so they know what to expect.
- Incorporate your child in the cleaning routines, as long as it is safe.
- Have the child pull the laundry basket.
- Use visuals to demonstrate appropriate social distancing by placing a sheet of paper on the floor to mark 6 feet, then have the child stand on one paper and another person stands on the other.
Hand hygiene deserves its own category. This is something your child will be doing more often. The effective way to wash hands is wet hands with warm water, lather soap on all areas of the hands (including between fingers, under fingernails, above the wrists, and to the front and backs of the hands) for at least 20 seconds, rinse under warm water, use a towel to turn off the faucet, dry hands completely, and toss the used towel without using hands to open any garbage lids.
In this sequence, a wide range of touch is involved.
- Consider the temperature of the water
- Consider the type of soap you can use (i.e. foam, beaded)
- Consider the water pressure
- Consider the texture of the towel
- Consider the height of the sink, as this affects their ability to reach all items, which affects their frustration tolerance during this activity
- Model the task for them
The vestibular sense refers to detecting balance and movement through a structure in your inner ear.
- More idle time
- Fewer opportunities for movement
- “Red Light, Green Light”
- Jumping Jacks
- Sit N’ Spin
- “Eye Spy” while pointing out objects on the ground, in the sky, to the sides of he child
- “Pin the Tail on the Donkey” *involve the blindfold and spinning component
- “Easter Egg Hunts” around the yard
The interoception sense is defined as sensing what is happening inside our bodies.
- Stress-related changes affect their bodily function, such as hunger, heart rate, breathing, or pain
- Model mindfulness using age-appropriate language
- “I feel thirsty after our walk, I will drink some water.”
- “My leg hurts from sitting for too long, I am going to stretch.”
The proprioception sense refers to understanding where your body is in space through receptors in your joints.
- Decreased time running on the playground
- Decreased time on playground equipment (i.e. monkey bars)
- No longer walking to school with a backpack on
- No recess may mean fewer contact sports (i.e. basketball, handball, dodgeball, tetherball)
- Safely push or pull heavy objects, such as large pillows
- Crawl through pillow forts
- Jump rope
- Draw with chalk on the ground while in a tabletop position
- Squat and tip-toe while drawing on posters on the wall
- Squeeze sponges while helping to wash the car
- Squeeze lemons to make lemonade
- Climb upstairs
- Run uphill
- Play with PlayDoh
- Knead slime
- Supervised baths
- Weighted blankets
- Napping in tucked in sheets
It is important to maintain precautions in all activities in order to ensure health and safety at all times. Consult with your pediatrician or your occupational therapist, if you have any questions regarding the above information.
If you made it this far in the article, that is telling of how much you care – and caring at this time is important. We hope this article provides insight for your overall health, too. Breathe, and remember to take care of your mind and body. Make time for your well-being and keep in mind that we are still in it together.
Wishing you all good health and peace at this time!
American Occupational Therapy Association, Inc. (2008). Frequently Asked Questions About Ayres Sensory Integration®.
Centers for Disease Control and Prevention. (2018, October 15). Center for preparedness and response: Books. https://www.cdc.gov/cpr/readywrigley/books.htm
Centers for Disease Control and Prevention. (2020, March 12). Coronavirus disease 2019 (COVID-1): Checklist for teachers and parents.
Centers for Disease Control and Prevention. (2020, March 23). Coronavirus disease 2019 (COVID-1): Frequently asked questions.
Centers for Disease Control and Prevention. (2020, March 18). Coronavirus disease 2019 (COVID-): Protect yourself.
Centers for Disease Control and Prevention. (2019). Personal needs: Emergency supplies kit basics. https://www.cdc.gov/cpr/npm/00_documents/2019/CPR_PrepMonth_PersonHealthPrep_personal-needs_blog.pdf
Children’s Hospital of Orange County (2020, March 6). 7 ways to help kids cope with coronavirus (COVID-19) anxiety.
Children’s Hospital of Orange County (2020, March 2). Hand-washing 101.
Nicholson, T., Williams, D., Carpenter, K., & Kallitsounaki, A. (2019). Interoception is impaired in children, but not adults, with Autism Spectrum
Disorder. Journal of autism and developmental disorders, 49(9), 3625–3637. https://doi.org/10.1007/s10803-019-04079-w
Official California State Government Website. (2020). California coronavirus:
COVID-19 response toolkit. https://toolkit.covid19.ca.gov/
World Health Organization. (2020, March 9). Q&A on coronaviruses (COVID-19).