Oral health is a critical part of overall well-being, but for many children in the United States, particularly those with autism spectrum disorder (ASD), it remains one of the most unmet healthcare needs. As the prevalence of ASD continues to rise—with 1 in 36 children now diagnosed (Stein Duker et al., 2023)—dental providers are encountering more patients with unique sensory needs that impact both home-based oral care and in-office treatment. But, we can create sensory safe dental experiences for these kids.

Children with ASD often experience sensory processing disorders (up to 95% of them, according to Cermak et al., 2015), leading to heightened sensitivity to common dental stimuli: bright lights, the taste and smell of oral care products, tactile sensations in and around the mouth, and the loud sounds of dental instruments. These overwhelming inputs can trigger distress, uncooperative behaviors, and even physical resistance, making routine dental visits especially challenging.

Research shows a clear link between sensory integration difficulties and poorer oral health outcomes (Potter et al., 2018). Parents frequently report difficulty with at-home brushing, sometimes resorting to physical restraint due to their child’s sensory sensitivities (Mansoor et al., 2018). These challenges highlight the urgent need for dental professionals to not only understand the sensory profiles of their patients but also to be equipped with strategies and tools to accommodate them.

Occupational therapists (OTs) bring valuable expertise in sensory regulation and behavior management. By working together, OTs and dental teams can co-develop care strategies tailored to individual sensory needs. This partnership can be transformative—not only for patients, but also for families and dental professionals seeking more effective and compassionate care approaches.

Desensitization Strategies

Here are some desensitization strategies to help provide sensory safe dental experiences for your children that will gradually expose them to the feared stimulus in a controlled and safe environment.

• Storytime: Read books about visiting the dentist. Choose stories that feature characters going to the dentist, explaining what happens during the visit. This can help kids understand the process. Here is a social story you can watch together.
• Role-Playing: Set up a mock dental office at home. Use toy dental tools and let your child take turns being the dentist and the patient. This can help reduce anxiety by familiarizing them with the environment.
• Dental Hygiene Demonstration: Show your child how to brush and floss their teeth properly. Use a large model of teeth to demonstrate the correct technique. This activity emphasizes the importance of dental care.
• Create a Visual Schedule: Make a visual schedule of what will happen at the dentist. Include pictures and simple steps (e.g., check-in, waiting, seeing the dentist) to help your child know what to expect.
• Talk About Feelings: Have a discussion about feelings related to visiting the dentist. Allow your child to express their thoughts and feelings, which can help normalize their emotions and reduce fear.
• Craft Activity: Have your child create a “dentist visit” booklet where they draw or paste pictures of what they think they will see or do at the dentist. This can be a fun way to engage them and reinforce learning.
• Watch a Video: Find a short educational video about a dental visit designed for children. Visuals can help kids understand what to expect during their appointment.
• Practice Deep Breathing: Teach your child deep breathing techniques to help them relax before and during their dentist visit. Practice together so they feel more comfortable using these techniques.
• Discuss Rewards: Talk about the rewards they might receive after their appointment, such as a sticker or a small toy. This can create a positive association with the visit.
• Visit a Dentist: If possible, visit a local dental office prior to your child’s appointment. The office can give a tour, can explain their roles, answer questions, and possibly show some dental tools in a friendly way.

Other Items to Consider for Sensory Safe Dental Experiences

• Have parents provide deep oral pressure or vibration using an electric tooth or Z-vibe prior to dental the visit.
• Engage in sensory circuit/heavy work right before the appointment (i.e. pushing/pulling/lifting/jumping).
• Have child eat something very chewy prior to their appointment.
• Bring child’s favorite pair of sunglasses to wear for the appointment.
• Wear a heavy/tight beanie, earmuffs, noise reduction earplugs, or listen to calming/rhythmic music over headphones.
• A fidget toy or a favorite stuffed animal to hold.
• Bring a weighted blanket/vest or ask to wear the x-ray apron throughout the appointment.

References

1. Cermak, S. A., Stein Duker, L. I., Williams, M. E., Dawson, M. E., Lane, C. J., & Polido, J. C. (2015). Sensory adapted dental environments to enhance oral care for children with autism spectrum disorders: A randomized controlled pilot study. Journal of Autism and Developmental Disorders, 45(9), 2876–2888. https://doi.org/10.1007/s10803-015-2450-5
2. Mansoor, D., Al Halabi, M., Khamis, A. H., & Kowash, M. (2018). Oral health challenges facing Dubai children with autism spectrum disorder at home and in accessing oral health care. European Journal of Paediatric Dentistry, 19(2), 127–133. https://doi.org/10.23804/ejpd.2018.19.02.06
3. Potter, C. N., Wetzel, J. L., & Learman, K. E. (2018). Effect of sensory adaptations for routine dental care in individuals with intellectual and developmental disabilities: A preliminary study. Journal of Intellectual and Developmental Disability, 44(3), 305–314. https://doi.org/10.3109/13668250.2017.1409597 
4. Stein Duker, L. I., Como, D. H., Jolette, C., Vigen, C., Gong, C. L., Williams, M. E., Polido, J. C., Floríndez-Cox, L. I., & Cermak, S. A. (2023). Sensory adaptations to improve physiological and behavioral distress during dental visits in autistic children: A randomized crossover trial. Journal of American Medical Association Network Open, 6(6). https://doi.org/10.1001/jamanetworkopen.2023.16346 

Summer is winding down, but there is still time for road trips, beach days, and backyard projects. But before you start lifting heavy luggage or moving patio furniture, let’s talk about keeping your back happy and healthy. Your back works hard during these activities. Long car rides, heavy suitcases, and yard work can all stress your spine. The good news? A strong core is your best defense against back pain, and these easy core exercises can help!

Your Core Matters More Than You Think

Think of your core like a natural back brace. These muscles wrap around your middle and support your spine all day long. When your core is weak, your back muscles have to work overtime. That’s when pain strikes.

Your core includes more than just abs. It’s actually four main muscle groups:

• Deep abdominal muscles
• Back muscles along your spine
• Pelvic floor muscles
• Diaphragm (your breathing muscle)

Easy Core Exercises You Can Do Anywhere

Dead Bug

Lie on your back with knees bent at 90 degrees. Slowly lower one arm overhead while extending the opposite leg. Return to start. Do 10 reps each side.

• Why it works: Teaches your core to stay stable while your arms and legs move.

Modified Plank

Start on your knees and forearms. Keep your body straight from knees to head. Hold for 15-30 seconds.

• Why it works: Builds strength in all your core muscles at once.

Bird Dog

Start on hands and knees. Lift opposite arm and leg at the same time. Hold for 5 seconds. Do 8 reps each side.

• Why it works: Improves balance and teaches your back and core to work together.

Smart Lifting for Activities

Whether you’re loading the car or moving a grill, proper lifting saves your back. Here is a safe lifting checklist:

• Get close to what you’re lifting
• Bend your knees, not your back
• Keep the object close to your body
• Lift with your legs
• Don’t twist while holding something heavy

Pack Smart for Travel

• Use a suitcase with wheels
• Pack heavy items in smaller bags
• Take breaks during long drives to stretch

Beat Travel Back Pain

Long car rides are tough on your back. Here’s how to arrive feeling good:

Before You Drive:

• Adjust your seat so your knees are slightly higher than your hips
• Place a small pillow behind your lower back
• Make sure you can reach the pedals without stretching

During the Trip:

• Stop every hour to walk and stretch
• Do simple stretches at rest stops
• Stay hydrated (dehydration makes muscles tight)

Quick Stretches for Busy Days

1. Cat-Cow Stretch –  On hands and knees, arch your back up like a cat, then let it sag down. Do 10 slow movements.
2. Knee-to-Chest –  Lying down, pull one knee toward your chest. Hold for 20 seconds each leg.
3. Child’s Pose – Sit back on your heels with arms reaching forward. Hold for 30 seconds.

When to See a Physical Therapist

Most back pain gets better with simple exercises and smart habits. But see a PT if you have:

• Pain that lasts more than a few days
• Pain that shoots down your leg
• Numbness or tingling
• Pain after a fall or injury

Your Back Health Action Plan

1. Start small: Do 5 minutes of core exercises three times a week
2. Practice good lifting: Use your legs, not your back
3. Move often: Don’t sit in one position too long
4. Listen to your body: Rest when you need to

Remember, preventing back pain is much easier than treating it. A few minutes of daily core work can save you weeks of discomfort later. Make your back health a priority. Your future self will thank you when you’re still enjoying activities pain-free!

As we age, staying on our feet becomes more than just a goal – it’s a key to living well. One in four older adults falls each year. But falls are not a normal part of aging. You can take steps today to prevent falls, stay independent, and keep your balance strong and stay safe.

It’s important to know your fall risk. Ask yourself:

• Do you feel unsteady when walking?
• Have you fallen in the past year?
• Do you hold onto walls or furniture when moving around your home?
• Do you worry about falling?

If you said yes to any of these, talk to your physical therapist about a fall risk check-up.

Simple Tips to Prevent Falls

• Keep moving daily. Walking, aquatic exercise, resistance training, or tai chi can make your legs stronger and help your balance.
• Check your home. Remove things you could trip on like throw rugs or extension cords. Add grab bars in the bathroom. Make sure all of your rooms have good lighting.
• Get your eyes checked once a year. Poor vision can lead to falls.
• Review your meds. Some medications can make you dizzy or sleepy. Ask your doctor or pharmacist  to look at all your meds, even over-the-counter ones.
• Wear good shoes. Choose low-heeled shoes with non-slip soles. Skip the slippers and avoid walking in socks.

How Physical Therapy can Help

A physical therapist can be your best ally in fall prevention. Your PT will:

• Test your strength and balance
• Assess your specific fall risks
• Create an individualized plan
• Teach you exercises to help you stay strong
• Show you how to get up safely if you do fall

Don’t wait for a fall to happen. Take the first step to improve your balance. Call our office to set up a fall risk check-up. Our team can help you build strength, improve your balance, and keep doing the things you love. Remember, you can prevent falls and remain independent. Small changes today can help you stay safe, strong, and independent tomorrow.

Sleep is an essential part of our daily routine, yet many of us overlook the importance of our sleep posture. The way we position our bodies while we sleep can have a profound impact on our overall health, affecting everything from our spinal alignment to our quality of rest. In this blog, we will explore the importance of sleep posture and tips for achieving the best sleep posture for a rejuvenating night’s sleep.   

Tips for Achieving the Best Sleep Posture

• Invest in a quality mattress and pillow. A supportive mattress and pillow can make a significant difference in your sleep posture. Choose a mattress that suits your sleeping style and a pillow that keeps your head and neck aligned. One trick I like to give patients is rolling a hand towel up and placing it inside the pillowcase for added neck support.   
• Use pillows strategically. If you sleep on your side, place a pillow between your knees to maintain hip alignment.  Women may also benefit from a small pillow under the narrow part of their waist to keep their low back in good alignment. For back sleepers, a small pillow under the knees can help relieve pressure on the lower back. Sleeping on your stomach is not generally recommended but if you must, use a thin pillow or no pillow at all to avoid neck strain. 
• Practice good sleep hygiene. Establish a consistent sleep schedule, create a relaxing bedtime routine, and ensure your sleep environment is comfortable and conducive to rest.  
• Be mindful of your position. Pay attention to your sleep posture as you drift off. If you find yourself shifting into a less favorable position, gently adjust back to a more supportive one.  
• Consult a professional. If you experience persistent pain or discomfort related to your sleep posture, consider consulting a healthcare professional for personalized advice.  

Sleep posture is a crucial aspect of achieving restorative sleep and maintaining overall health. A good night’s sleep is not just about the number of hours you spend in bed. It is also about how you position your body while you rest. Prioritize your sleep posture, and you’ll wake up feeling refreshed and ready to take on the day!  

Our tone of voice is how we communicate thoughts and emotions. It comprises five components. These are pitch, volume, rate of speech, prosody, and word emphasis.

Pitch is how high or low our voice is. Our pitch is driven by how fast or how slow our vocal folds vibrate and is based on our anatomy. Women have a higher pitch and men have a lower pitch. A higher pitch indicates excitement and a lower pitch indicates seriousness or authority. By varying our pitch, we communicate the emotion behind our thought.

Volume is how loud or quietly we speak. A loud voice communicates seriousness, frustration, and even anger. A quiet voice elicits calming or conveys an intimate conversation. We adjust our vocal volume based on the context in which we are communicating.

Rate of speech is how quickly or slowly we speak. When we speak rapidly, we may not be heard or understood. If we speak too slowly, our listener may disengage or view us as boring. We need to use a pace that is comfortable for our listener.

Prosody is the rhythm of our speech, the natural rise and fall of our speech. Using appropriate rhythm makes our speech more pleasant and engaging. Alternatively, a monotone voice lacks this rhythm and sounds flat and uninteresting.

Emphasis is placing importance on certain words or phrases. It helps focus a listener on the key information we wish to communicate. We achieve emphasis by changing our pitch, loudness, and intonation.

Tone of Voice Plays a Key Role

Tone of voice plays a key role in communication. It conveys our emotions and attitudes and helps our listener understand our position on a topic. How we say something is as important as what we say. For example, we can say the word “sorry” with sincerity or sarcasm just by changing the tone of our voice. Tone of voice is also crucial to effective communication. A calm, quiet voice in a tense situation can facilitate understanding, whereas a harsh or excessively loud voice may increase confusion or anxiety. Monitoring and adjusting our tone of voice has a direct impact on our ability to communicate by facilitating or impairing communication.

As occupational therapists, we often emphasize the importance of foundational skills in a baby’s development. One of the simplest, most powerful ways to support that development is through floor time. In Part I of this 2 part floor time series, we will explore how floor time is beneficial for babies.

What is Floor Time?

Floor time is exactly what it sounds like — time your baby spends on the floor, engaging with their environment through play, movement, and exploration. While it might look like simple tummy time or scooting around, what’s really happening is essential brain and body development.

Why does floor time matter for babies? Here are a few key areas of development supported by floor time:

• Motor Skills
  • Gross motor skills: Rolling, crawling, and sitting all begin with strong floor-based movement.
  • Fine motor skills: Reaching for toys, transferring objects between hands, and exploring textures lay the groundwork for later hand skills.
• Sensory Development
  • Babies experience a range of sensations — from the texture of the mat to the feeling of shifting weight.
  • Floor time promotes body awareness, balance, and coordination.
• Cognitive and Social Development
  • Through floor time, babies learn to solve simple problems (like reaching for a toy) and engage in back-and-forth interactions with caregivers.
  • Early play-based social interaction is critical for emotional development and bonding.
• Independence and Exploration
  • Floor time allows babies to take initiative and explore, which builds confidence and independence — key goals in pediatric occupational therapy.

How Much Time?

Start with short, frequent sessions — especially for newborns. Just a few minutes of tummy time, 3–5 times a day, can make a difference. As babies grow stronger and more curious, you can increase the duration and variety of play. Make the most out of floor time.

Create a Safe, Stimulating Space: Use a clean mat or blanket on a firm surface. Add a few safe, age-appropriate toys to encourage reaching, rolling, and visual tracking.

Get Down on the Floor With Them: Engage your baby face-to-face. Make silly sounds, mirror their movements, or play simple games like peek-a-boo. Your presence is their best motivation!

Mix Up Positions: Alternate between tummy time, side-lying, and back play. Each position offers unique benefits for motor and sensory development.

Follow Your Baby’s Cues: Watch for signs of fatigue or frustration. Floor time should be fun and relaxed, not forced.

If your baby avoids tummy time, has trouble lifting their head, seems unusually floppy or stiff, or isn’t meeting milestones (like rolling or sitting), an OT can help guide next steps and provide customized strategies. Come back next week to learn more about the benefits of floor time for toddlers.