Occupational Therapy Consulting, LLC

 

Glass half full

Fidget or fun?

The word “fidget” has come across my radar multiple times this week, and while the word itself doesn’t sound inspiring, the difference it makes for those who need it, really can be.  To help highlight the significance of this little word, I give you some background or context as to why it holds such relevance for me in my practice.

One role I play as an OT, is to help establish “sensory diets” for the kids with whom I work.  A sensory diet is exactly what it sounds like…making sure a child gets their daily requirements of necessary sensory inputs to fuel the brain and body, to optimize function or health of the nervous system.  Every person has individual preferences and needs for certain types of inputs, based on their individual neurological systems.  Some people need more movement, some people need more sound, some people need more chewing, and some people prefer to touch everything they can get their hands on. The theory is (and I’ve seen it work) when a person gets the inputs they need, their nervous system is more organized and efficient and that person can function more optimally to meet the demands of what is going on around them, whether it be work, school, conversation, or reading a book.  Case example, one young boy I worked with had difficulty staying awake at school but when he was awake spent much time touching other people, invading their space, and/or touching their belongings.  He was constantly seeking food or drink and the ongoing requests for snacks or walks to the water fountain became disruptions to the classroom routines and the learning for other students.  Not to mention the negative social interactions and aggression that ensued, when this boy invaded other people’s personal space and belongings.  In OT, we implemented multiple activities for him to do at school at various intervals throughout the day, such as use of a bite and suck Camel Bak water bottle (see previous post), trigeminal face-tapping 2-3x/day, use of an inflated seat cushion, chewing gum, use of therapy putty to squeeze, regular walk-breaks, and use of deep touch pressure in the form of a steam roll, as often as could be provided.  This young man no longer falls asleep on the floor, he is able to complete approximately 80% of his written work vs. refusing all of it, he remains in class x approx. 20 min’s at a time vs. 5 min’s and while he still seeks food and drink and touches other people way too often, he has decreased those incidents by nearly 30%.   While this boy has received multiple interventions in addition to his sensory diet including medication, therapy, and behavioral incentives, he is now able to ask for the input he desires or needs, and clearly changes his ability to participate in class, when he is using them.   This boys “sensory diet” included fidgets, which helped him meet his daily needs of various sensory inputs.  Fidgets can be like little snacks throughout the day that prevent us from needing a larger meal or tide us over until it’s time to really eat.  By tuning into our small activities that help us focus or “feel better”, like fidgeting, we can begin to help ourselves function better in multiple environments and for kids with problems of attention, offering fidgets can be one way of helping them learn to manage some of the more difficult tasks they face.

Many people are familiar with the word “fidget” as a verb, meaning to move around nervously: to move around in a restless, absent-minded, or uneasy manner (Bing dictionary).  But in my (OT) world it can also mean doing an activity that uses a sense other than that required for the primary task (think doodling while talking on the phone, clicking a pen while giving an oral presentation, or listening to music while doing homework or reading the newspaper).  According to Sydney Zentall, Ph.D., fidgeting can enhance performance in children with ADHD. A great overview on use of Fidgets: Toys or Tools can be found at KidCompanions blog.  They reference several books that are now on my work list of books I want to read.  If a person shows a need for fidgeting, putting something in their hands to hold, manipulate, feel, or play with, could actually improve their concentration.  In the case above, the young boy I worked with was able to improve his class participation by adding things he could do at the same time as his classwork or lessons (water bottle, chewing gum, therapy putty, wiggling on the seat cushion).  These types of inputs likely work because our sensory systems are all designed to work together simultaneously and spontaneously.  When one sensory system (or several) are not doing their job(s), the brain and body struggle to make sense of what’s going on around us or to figure out how to automatically respond.  Thus some people (and many of the kids I work with) seek out more input.  It is the nervous system’s inherent way of getting the input it needs to make sense of the world.  A child who is touching everything, may be looking for more touch input.  A child who is constantly moving, may need that movement to get more information about where he is in space.  If holding or playing with something in the hands gives more input through the sense of touch and the small movements of the fingers and hands, why not use it?  If it becomes a distraction in and of itself, that item clearly isn’t meeting the need and other options may need to be explored.

I talk with teachers, parents, and direct service staff about how to use “fidgets” appropriately, all the time.  Unfortunately, people assume that giving a child a “stress ball” will limit temper tantrums, and is in and of itself a “sensory diet”.  This is not the case.  My general approach is to use fidgets as “helpers” and small doses of increasing the tactile input a child might get throughout the day.  If a child reaches the point of being so upset or so distracted that they are aggressively interacting, or they have already created or engaged in a power struggle, we’ve missed the opportunity for a “fidget”.  Small hand-held items are not going to offer the intensity of input that child needs to re-organize.  Additionally, there are kids who look like they are “seeking” extra input when in fact they are looking for ways to self-calm, and so identifying the root of why that child is moving around so much, becomes the primary task.  If the fidget isn’t working, a referral to an Occupational Therapist trained in sensory integration, may be in order.  It’s not the fidget that failed, there may be underlying sensory processing problems that need to be addressed in order for that child to improve their function.  Carol Stock Kranowitz (author of “The Out of Synch Child”) writes in her blog, about look-alike conditions such as SPD & ADD, and gives an overview of the sensory diet concept.

Locally, The Dancing Bear Toy Store, is one source for many enticing and developmentally appropriate fidget toys, like stress balls and magic mud.  Online, Fun and Function  offers many fidget options like squoosh pets, therapy putty, and theraband.  Parents can likely find many fidget options at a party store near them (finally a use for those trinkety little party treat bag toys I routinely throw in the garbage).  Use of fidgets within the context of a sensory diet can make a significant difference for people with sensory processing and/or challenges of attention and for those without significant attention problems, can serve to make things, just a little more fun!  Who doesn’t want that?!

 

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