Wednesday, August 28, 2013

Sensory Smart Clothing Choices

Lindsey Biel, OTR/L

Addressing sensory processing challenges is a multi-tiered endeavor. It is a combination of finding therapy and instruction that will benefit the child, as well as putting together a daily sensory diet that optimizes varying levels of nervous system arousal. And, while all of this “good stuff” is working to ease the child’s sensory sensitivities, it’s essential to be proactive about making the world a more comfortable place for an uncomfortable child.
Previous Sensory Smart columns have addressed the impact of sensory processing problems on behavior and learning at home, at school, and in the community. A child may struggle with the odor of harsh cleaning products used in schools, or the distracting flicker and hum of fluorescent lighting, or the constant irritation of clothing tags, seams, and waistband. One of the great challenges of parenting or teaching a child with sensory issues is knowing when to push him (sometimes uncomfortably) forward through these issues, when to back off entirely (and perhaps try another day), and how often, and to what extent, we should accommodate the issues (change the environment). When a child feels physically or emotionally distressed by sensory experiences, he cannot function at his best. If a child is truly uncomfortable or in pain, it’s best to keep all three options in mind. Yes, you do want him to be able to tolerate all kinds of experiences eventually; yes, you do want to avoid situations that he is simply unable to tolerate yet; and yes, it’s a good idea to accommodate his sensitivities so he can function at his best right now.

Clothing: A Great Starting Point

Many individuals on the spectrum, from babies to adults, have strong likes and dislikes when it comes to clothing. Sensitivity to fabrics is often one of the first things a new parent notices. A baby may have a meltdown whenever she gets her diaper changed. This may be a sensory-based reaction to changes in body position, powders or lotions, the diaper, or the way she is being handled. Later, there may be particular textures and fabrics the child just can’t tolerate. The child who is ultra sensitive to tactile input may be feeling his sock seams or his shirt cuffs all day long. What a distraction to attention and learning! I have worked with many young clients who come home, tear off their school clothing, and put on cozy sweatshirts with the hood up and sleeves pulled down to their fingertips. That’s fine, but it becomes a real problem when a child insists on wearing sweatpants and shearling boots in summer or sandals and a miniskirt in winter. Clothing challenges can be physically and emotionally painful for the teenager who wants to fit in but can’t tolerate the feeling of the latest fashions, like tight blue jeans or super baggy pants.
In her wonderful foreword to my book, Raising a Sensory Smart Child, Dr. Temple Grandin wrote that, “Scratchy petticoats and wool clothes were like sandpaper against my skin. I still wear my underwear inside out so that the stitching does not rub against me. I wear old, well-washed, soft T-shirts under my new shirts to make them tolerable.” Fortunately, we’ve come a long way since the days of petticoats–and there are many companies who are tuning in to tactile sensitivity issues among both the special needs and neurotypical population.

These cute training socks for kids have easy-to-grab loops to help kids pull them up. Most have adorable animal designs on them. For supersensitive feet, select the solid colors that eliminate decorative stitching. These socks have flat but well-crafted seams.

   Fun and Function,
A great assortment of “Sens-ational Hug” clothing: short and long sleeve shirts that provide calming, gentle compression can be worn alone or under clothing, plus compression and weighted vests many kids find soothing.

   Hannah Andersson,
High quality, soft clothing and undergarments for babies, children, and women. Outstanding for its selection of sensory-friendly underwear for boys and girls that tends to not ride up or have irritating waistbands.

These adorable baby and toddler shoes and sandals have Velcro closures, wide openings, and squeak with every step. If your child walks on tiptoes, ask the company to place the squeaker toward the heel so it only squeaks when your child’s heel strikes the floor, providing auditory feedback to reduce toe walking.

   Prince’s Sensory Delights,
Tagless tee shirts with a horse appliqué that can work as a built-in hand fidget, pants that are designed to accommodate light weights (sold separately) in the pockets, and more.

A great assortment of very nice soft, tagless, tops, bottoms, cardigans, and dresses.

   SPIO (Stabilizing Pressure Input Orthosis),
These therapeutic compression garments are made from Lycra-like material that provides deep pressure to improve limb and body awareness, muscle and joint stability, and movement. Their use should be discussed with your occupational or physical therapist. Styles include a vest, shirt, and pants that can be worn alone or under clothing.

   Teres Kids,
I was the OT consultant on this beautiful 100% organic clothing line for kids with tactile sensitivity. With both short and long sleeve shirts, dresses, and pants for boys and girls, these products are great for kids who crave soft, tagfree, seamfree clothing (seams are flat sewn on the outside).

For more on tactile sensitivity and other sensory processing challenges–as well as practical strategies for dealing with them–see Raising a Sensory Smart Child and visit
Disclaimer: Lindsey Biel does not receive any compensation or benefit from recommending products in this column, including those from Teres Kids, for which she consulted on a pro bono (unpaid) basis.

10 Parenting Strategies

When it comes to clothing, it pays to become extra resourceful and creative.
1. If a child can only tolerate really well laundered clothes, wash new clothes multiple times in hot water. This will remove the sizing that can make clothing stiff and uncomfortable.
2. Use an unscented fabric softener or a scented one only if your child likes the smell.
3. Consider buying “preconditioned” clothing from a consignment or thrift shop.
4. Take your school-age child shopping with you: let her feel more in control of what happens to her body by giving her the chance to pick out her apparel.
5. Work on tactile desensitization with your occupational therapist, and learn how to give your child deep pressure, such as a firm massage, or therapeutic “brushing” before dressing.
6. Avoid or remove typical clothing irritants: tags, labels, itchy threads on seams, elastic cuffs, ankles, and waistbands, tight collars and turtlenecks, and scratchy appliques. Run your fingers along sewn sections to feel for scratchiness or bumps.
7. Buy only soft fabrics: cotton, fleece, flannel. Avoid polyster blends that pill.
8. Put high quality skin moisturizer with glycerin or lanolin on your child’s body before dressing, especially in winter when skin is dry and itchy.
9. Some parents are reporting very good results with flax seed oil or fish oil supplements—not just for mood and behavior, but also in reducing sensitivity to clothing.
10. Explore different clothing options such as seamless socks or socks worn inside out; snug tights, leggings, and tops beneath regular clothing; clothing alternatives such as soft sweatpants or leggings instead of blue jeans. 

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