64. How Sensory Processing Disorder Can Majorly Affect Your Child's Eating, Toileting, and More with Amanda Mathers
In this episode of the Nourishing Autism Podcast, Amanda Mathers, a pediatric occupational therapist (OT), dives deep into the realm of sensory processing. She explains how our senses affect daily living and emphasizes understanding sensory experiences to manage behaviors effectively, especially in children with sensory processing disorder and autism.
Join Brittyn and Amanda as they discuss her journey from working in clinics to providing in-home early intervention for children, highlighting the importance of involving parents in the therapeutic process. This episode also explores the vital and often overlapping roles of dietitians, speech therapists, and OTs in promoting children's development, particularly in feeding therapy and potty training. Listen in for practical advice on recognizing and addressing sensory issues, the significance of nutrition in therapy, and how to communicate effectively with therapists to ensure comprehensive support for your children.
For Amanda's free resources, courses, and 1:1 coaching visit: https://stan.store/yourpediatricOT
Follow Amanda on Instagram: @yourpediaticot
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TRANSCRIPT
Hi, I'm Brittyn, a Registered Dietitian and autism sibling. I have a passion for helping parents of neurodivergent kids navigate nutrition and wellness for their child, one small step at a time. Here we'll explore practical nutrition tips, learn from top autism experts, break down the newest research, and share inspirational stories that will empower you to utilize nutrition to help your child feel their best and thrive.
Listen in while picking kids up from school, sitting in a therapy waiting room, taking a quick walk or wherever you find yourself, looking for some inspiration and a friend to guide you along this journey. This is Nourishing Autism.
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Visit aeroflowurology.com/nourishingautism. [00:02:00] That's aeroflowurology.com/nourishingautism and let them know I sent ya.
Hi everyone, welcome back to the Nourishing Autism Podcast. I am so excited today to be sitting here with Amanda. Amanda, thank you so much for being here.
Amanda: Yeah, I am so excited to be here. I have been following your page for so long and I send parents over to your page all the time that I work with, so.
Brittyn: Thank you so much.
I know, I think we've been mutually following each other for a while cause I share your posts often with my clients as well. And you know, when it comes to these adjacent professions, like dietitians and OTs and speech, there's so much overlap. And so I'm excited to talk about some of that overlap today.
Amanda: For sure. And it's not, you know, a one man band. I think a lot of people, they ask me questions and I'm always so open to being like, actually, I think a dietitian would be a better fit to answer that question. Or, you know, a speech therapist might have a better scope of understanding on that topic than I do.
[00:03:00] So I love having people I can refer families to.
Brittyn: Yeah, I think that's an important thing, because a lot of people come to me with extremely limited diets, and yes, I can help, but also, we want to get an OT on board. We want to get a speech therapist on board, or a feeding therapist, or whoever it might be, so that is something I want to talk about too, of the differentiation between
some of these professions, and so we'll dig into that later, but for us to get started, I would love for you to share who you are, what you do, and how you support families.
Amanda: Yeah, I am a pediatric occupational therapist. I got my master's degree from the University of St Augustine in Florida back in 2019. And I have been working with kids ever since I graduated. I started out in more of a clinic based setting. And just realized that I could be of better use if I can actually be in the home with families supporting them and getting the parents more involved in the process of therapy.
And honestly, especially when it comes to feeding and potty training [00:04:00] and sensory processing, because they can be extremely regulated when they're with me in a clinic,
but if they can't be regulated while they're at home with their parents, the vast majority of their time, then, you know, it's not really impacting their daily function. So now I do mostly early intervention, birth to age three in homes. And I do see some kids up to age four or five after they graduate from the early intervention program.
And I really see a lot of families in those early diagnostic phases of autism, you know, parents are just starting to see those differences at those ages,
one, two, three, and they're starting to, you know, notice differences from their peers and those sensory processing things are really starting to come up.
So it's a really unique place to be at for OT.
Brittyn: Absolutely.
So I talk about sensory processing disorder a lot or sensory processing challenges. Can you explain a little bit about what that is and how you support [00:05:00] kids with sensory processing disorder?
Amanda: Yeah, it's a condition that affects how your brain processes sensory input and unfortunately right now it's not a standalone diagnosis in the DSM 5 which can be really confusing to parents,
other practitioners, but the experience of sensory processing disorder is very real.
At the moment, it's only coupled with autism, but I think there are a lot of children and adults, you know, that deal with sensory processing differences that don't have a diagnosis of autism attached to it as well. But I think it's really important and just helping parents recognize what things are maybe related to a sensory experience.
I think there's a lot of punishment for meltdowns and things, which I totally, you know, can relate, a kid's having a meltdown. It's like, what is going on? You know, what caused this? But when we can really help parents problem solve and think back on the day, was there some kind of big experience that happened?
Has there been a life change recently? [00:06:00] Was there a really loud experience or they were spending a lot on the playground earlier that day, and they're not seeing the effects of that. Their sensory system isn't processing it until way later. And so we might see meltdowns and behaviors happening way after this adverse reaction even happened because it takes their brain and their body that long to process it.
So I think just supporting families and recognizing what these signs of sensory dysregulation are and how to best cope with them.
Brittyn: Definitely. And I think that's a good point that you make, it's not just going to be a meltdown in the moment. It's like, can be a lot later and it can be hard to narrow down.
Okay, what are they processing through at this time as well? And is it related to what happened earlier on in the day? So it can be really difficult to identify, especially I think sometimes parents do understand from the sensory processing piece. Maybe they themselves have sensory processing challenges and they can empathize and understand.
But when you haven't experienced that, for yourself, [00:07:00] it's hard to identify what the child also might be feeling and you're not an expert. So it's hard to identify that, I think.
Amanda: For sure, and I like to use a visual, and a lot of OTs use the same visual, but it's you think about a cup and kids have different levels of, you know, sensory processing.
And so someone that has a really low threshold might have a super small cup. So it only takes a little bit of sensory input and drops to make them be overflowing and going into that meltdown mode. And they are hitting that maximum capacity really easily. And then we have the sensory seekers that can never seem to get enough input.
Their cup is so big that it's never getting filled. So no matter how much they are jumping and spinning and eating crunchy foods and doing all the things, their cup is never getting quite to that median level.
Brittyn: Totally. I agree. I talk about it in that way all the time. Sensory bucket, sensory cup, but, because we see that at mealtime, where kids are already, their cup is about to overfill, and then we put all of [00:08:00] this sensory
rich experience in front of them with food, instant meltdown, or instant
stimming or overstimulation behavior and no success with eating and it's we have to look back and be like, okay what did they experience
earlier on in the day that's adding to this and then how can we also help them with coping with that in the future exactly like you said, so I love that.
So when you see kids with sensory processing disorder, autism, as an OT what are some of the typical skills that you might be helping them with. You mentioned feeding and toileting.
Amanda: Yeah, those are two big ones. But, you know, just those play and social interaction skills and anxiety plays a big role.
I think for these little kids at an early age, they learn early on and their brain starts to understand and remember situations and things that caused them distress in the past. So I think there's a lot of play skills and interactions where children, you know, especially that are more avoidant [00:09:00] to sensory input, start to not want to engage with peers because they're afraid they're going to
tackle them or yell in their face or be too much. And so I think just really working with them as well on building some of those social skills. But also unrelated, there's a lot of fine motor things and visual motor things and balance and coordination that all ties into sensory processing.
We have some parts of sensory that I think a lot of people don't know. We learned about the five senses early on in school. You know, you got vision, smell, hear, touch and taste. But we also have proprioception, which is our ability to process movement and vestibular, which is our balance system.
And then our interoceptive system, which is our internal body awareness, which is so related to feeding and understanding hunger, toileting and understanding whether we're full or
have to go, and so I think there's just a lot of aspects that when you understand sensory processing, you can understand its relation to every aspect in a child in an adult's life.
Brittyn: Totally. I talk about the [00:10:00] interoception function all the time because kids are often not recognizing they're hungry and full or need to go to the bathroom, and yeah, if kids aren't recognizing that they're hungry,
we might not be getting enough food in them throughout the day to be able to keep their blood sugars at a good point, and then we're seeing symptoms that are related to low blood sugar or just being
undernourished, which can show up as meltdowns or that hanger behavior, which, like, I have been there when I have not eaten enough during the day, and I don't feel good, but for not being able to
communicate what they're feeling, it also, you know, translates into the behavior that we're seeing.
So, I just find that really interesting. So, whenever you're working on helping them detect some of those internal senses, I've always wondered what does that look like as an OT?
Amanda: Yeah, and I think it is kind of difficult, and it is challenging with those early ages because they're just starting to learn language and obviously
children that are in therapy often have delays in [00:11:00] communication and language, but I love using any kind of body scans and
identifying how our body is feeling at any given time, communicating experiences that I might have, but not putting my experience on someone else because the way I feel when I'm hungry might not be the way you feel when you're hungry. So really helping kids, if I notice they had an accident, how did you feel when you had to go potty?
How did that make your tummy feel, when kids are sick, does your head feel hot or cold, and just really helping kids tune into their own body and using those
mindfulness practices really early on as well as yoga. I know it's one of those things where it's like, oh, yoga, but I really think helping kids be able to slow down and work on identifying
our body parts, where we're at in space and really connecting and slowing down enough to know how things feel in our body and where we're at helps children build just that internal sense. And it's something I didn't have as a child. You know, people were just constantly telling you, this is what you should do.
This is how you should feel. This is what's happening. And [00:12:00] I think letting kids have that experience and give you answers for themselves and problem solving it is going to help them just grow up so much more aware of their own internal state.
Brittyn: Totally. And we actually have research studies on yoga and autism and how it really helps kids turn in, and it helps them understand how to, I'll actually have to pull up some of these research studies.
It'll be really interesting to read. Yeah. You do have very clear studies that show us the benefit, especially in autism. It's amazing.
Amanda: Yeah, I would love to read through some of them. I'm always looking for good, sturdy research articles to help share with parents as well, because I think yoga is one of
those almost, I don't know if taboo is the right word, but a lot of people are like, oh yeah, yoga, like, I've tried yoga, it doesn't work for me,
but especially kids starting out early on, their brains are so fluid and able to learn and take in all this information, and I just think starting these kind of practices super early on is really beneficial.
Brittyn: Totally. Well, so, [00:13:00] kind of separate question, when you are working on feeding as well or maybe some of these other skills with kids. I mean, it kind of overlaps with what speech therapists are doing. I also work on feeding, but it's in a very different way. So I'm kind of curious to hear what is an OT's role in feeding?
And how does that differ from what a speech therapist does if both of them are feeding therapists?
Amanda: Yeah, for sure. We definitely have a lot of crossover. A lot of the courses that are offered to specialize in any kind of feeding are offered to both OTs and speech therapists. We both have a similar background in our schooling based on the oral motor skills.
I think when we differentiate is if a child is needing help with the actual motor skills of feeding, scooping the food, the coordination of the upper extremities and bringing food to the mouth, that's
definitely more in the OT scope and speech, if your [00:14:00] child has any problems with choking, if they have had any problems with aspiration in the past, that's definitely more a speech realm because they deal with the swallowing piece.
But when it comes to the mouth, we really cross over a lot on chewing, tongue and lip ties. I think it just really is important to find a therapist that does have at least some kind of extra training in it because just coming out of school, we learned so much, you know, an OT, we learn in school, the whole lifespan we're
taught to teach kids from birth up until end of life. And so we don't get a lot of focus on those things. And so, especially in smaller areas, that's where I think it's so
helpful now that so many practitioners are able to help families virtually through consults because it's hard to find therapists, especially in small areas that
really do have a true understanding of speech therapy and OT, so I think we cross over a lot when it comes to feeding therapy.
Brittyn: Totally. And [00:15:00] I will also ask this kind of follow up question, too. Not all speech therapists and not all occupational therapists are experts in feeding, correct? Or have that extra qualification?
Amanda: Correct. Yeah. And even myself, I've done some courses and I've had some really good OT mentors in my first few years of working, which I'm so grateful for, that
have just kind of, taught and dumped me all of their brains of their knowledge in all things OT, but especially in feeding.
So it's helped me have a better grip on our role, but I work with a lot of speech therapists and I learned from them as well. And I'm able to carry that stuff over into my practice, but there are definitely times where I'm like, whoa, that is outside of my knowledge. And I think as a practitioner, you have to be confident enough to say I'm not the right person for that.
If you really aren't.
Brittyn: Yeah, I think that really differentiates a good practitioner because our role is to support our clients and if we are going past those boundaries of what is within our [00:16:00] realm, we don't serve anybody. And so I think that it's a really good thing to be able to pass off, hey, this is the expert that's going to help you pass this point.
And it stinks not being able to be the one to help somebody, but in passing them off, you help them even more. I think a lot of people, again, come to me because they're like, hey, my child only eats a few foods. And when I do see kids who are eating five or fewer foods, typically fewer than 20 foods, I'm also flagging, hey, we probably want to get a feeding therapist on board as well.
Because my role as a dietitian, I help identify foods that are going to meet their nutrition. needs. That are going to meet their sensory needs and also a lot of what I do is walking parents through
the steps that are going to set them up for success inside the home, which I see overlap a lot with OT and speech.
And so I'm usually saying, yes, I understand how we need to get kids in a good position for eating and the 90, 90, 90 position. Like I can introduce them to those ideas. And then going further to say, we need [00:17:00] to work on this in speech and OTE, and so I think there is so much overlap, and it's definitely being able to know where our boundaries end and how we can support people in our realm too.
Amanda: Yeah, I want to pick you up and place you into Charleston, South Carolina to work with all of my families because your knowledge would be so helpful. You know, it's just, it's a very different scope than what we're taught in school and we don't understand, unless you're doing extra research on just the nutrition aspect and how that can affect
all different realms, which I've started to dive into more as I'm working more on potty training with these constipation things going on and other things, I'm really starting to understand the role that nutrition plays. And I think everybody really should have to take a course in it, especially pediatricians, speech therapists, OTs, to really help get a better idea instead of just giving the typical Miralax or this'll pass with time, just, you know, whatever recommendations I think there's
a lot of importance that nutrition plays, especially with our autism [00:18:00] population.
Brittyn: Totally. I know. I'm like, oh, don't even get me started. Cause I agree. I think that every profession needs to have a baseline understanding of nutrition and then also know when to pass off. And that's, again, I can get on to that because I actually just posted a reel yesterday about how frustrating it is when pediatricians will not refer kids to feeding therapy whenever
they're in the 50th percentile, even if their parent is really concerned and they're eating five foods, there's so much more to health and nutrition than your percentile on a weight chart. And so I'm just like, if we just had more education around that, and also more education around autism, I feel like so many kids, so many more kids would get the support that they need. So I'm with you for sure. And I'll hold myself back on that.
So you're talking about potty training. It sounds like that's a really big area of where you're supporting kids and I noticed that a lot of the information that you share online is really incredible potty training information for [00:19:00] kids with sensory processing disorder. And I know autism wraps up in that too.
So just briefly too, how do you find yourself supporting kids in that sense?
Amanda: Yeah, I think, you know, I had posted a video almost a year ago now, just kind of like giving a brief breakdown of what the three day potty training method was. And I didn't have a true good understanding of potty training.
I had kind of helped support parents here and there, but I was just posting, I had a random idea about it. And the amount of comments and messages and just the way it blew up, I was like, wow, there's a huge need for parents to be supported in this area. And you know, a lot of people online and I think that they are great, you know, but it's a lot of parents just speaking their own experience with their neurotypical child that was potty trained in three days.
And I think it could be really disheartening for a lot of parents that their children don't have that same experience and they don't have a way to problem solve through it. So I have recently been helping parents and families just dive deeper into what [00:20:00] is going on, is there sensory issues going on?
Is there constipation underlying because potty training with an underlying constipation, especially chronic, it's just not going to happen. There's pressure on the bladder. They're not able to hold it. They're uncomfortable. Their whole sensory system is thrown off so,
constipation impacts the whole thing. And so I've really just dove into that. And I do a lot of one on one coaching calls with families now, just helping them problem solve because their pediatricians are kind of pushing them off. And it's unfortunate, it's not an area that should be pushed off and taken so lightly.
So that's the role that I've been playing and trying to just help parents have a voice and understand what's going on and how they can support their child because daycares
want them in and potty trained before they can even start school and it impacts their whole life if they're not potty trained by their third birthday, so.
Brittyn: Yeah, I love that you brought up how constipation can really affect so much more than just toileting too. Also [00:21:00] when it is pressing on their bladder or maybe
pressing up on their stomach, it can affect how hungry they are, if they're feeling nauseous, they're able to potty train, if they're able to succeed with really
expanding their diet because maybe they don't feel good, which is I mean, if I'm constipated, I don't feel good, and I don't want to eat all these different new foods,
and especially when I might be feeling overstimulated in the first place, so I think that's one thing that, yes, I overlap with you a lot, and my role as a dietitian in the
constipation space is making sure that kids can comfortably go, especially when they're not getting the nutrition that they need to
help them do that because they might have an extremely limited diet from sensory processing.
So there's all these systems wrapped up in it. But my last question for you is what advice would you have for a parent who maybe isn't working with an OT yet and is
like oh my gosh, I'm doing all of these other therapies, and I haven't started OT, but it sounds interesting or sounds like I need it.
What would you recommend to [00:22:00] them kind of getting started out?
Amanda: Yeah and know that the therapy team understands this, especially if you're doing in home clinic base, I mean, any of them, we understand because we work with a plethora of kids every day, so we understand how much you guys have on your plate.
And we're not trying to add something extra to your agenda that's going to be stressful for you. I really think we are really good connecting therapy, I think
we cross over with a lot of the other professions in our scope of knowledge, you know, PT and speech and nutrition and all these other places where I
think that we really do have a good base knowledge in order to help you guys make connections.
So I think just going into it, one with an open mind and two, really communicating with your OT exactly what the deficits are and what you want out of therapy and what you want out of your therapist. I think a lot of times, especially when it comes to clinic based therapy, kids go back for therapy, they come back out from [00:23:00] therapy and you don't get time to sit down and even learn what your therapist is working on.
So I think if you make that connection from the beginning of, hey, I really want to be an active participant. I would love to get one or two things to work on outside of therapy each week and communicating that early and often will really help you be successful in therapy with OT.
Brittyn: I think that's great advice. And I think you're absolutely right. I mean, therapists understand that parents have a lot on their plate when it comes to all these different therapies and IEPs and all of these different moving parts. And so I think it's helpful to have that open communication from parent to practitioner.
And I think that just makes it so much more doable and manageable because I've definitely been working on something and given people a list of things
to work on and they're like, I'm doing my best, but I also have this huge list for my speech therapist or my occupational therapist and sometimes I will lose track of that even as a practitioner.
So I love it when parents are like, can [00:24:00] we focus on one thing? Or like this, is it actually realistic for me? I'm like, of course. Let's pull back and make it more manageable.
So I love when I have that open communication with people as well. Yeah. So where can people find you? Where can they find your resources?
I know Instagram is a good place.
Amanda: Yeah. Instagram. I'm @yourpediatricot on Instagram and TikTok. It kind of depends where I'm posting more based on the week. I'm also in the process of starting a YouTube channel. I'm really excited about that. Yeah. I have no idea about editing or how that side of things work.
So it's taking a lot of research, but it's been a really fun process. So I'm hoping to have that up and running as well. And I do have a website where I share free downloads,
my Amazon storefront, a link where you can book one on one calls with me and hoping to upload some future online courses here in the future, in the next few months.
So if you follow me on any of my social medias, I'll be posting about those as they come about.
Brittyn: That's amazing. Thank you so much. And [00:25:00] I can also vouch you are an amazing follow. I learned so much from you as well. So, yeah, Instagram's where it's at and YouTube, I'm in YouTube now. I mean, this video will be here on YouTube.
People might be listening to this as a podcast as well, but I absolutely love YouTube. It's a fun place.
Amanda: That's so exciting.
Brittyn: Yeah. Well, thank you so much, Amanda, for being here with us. I learned so much and I know my listeners will as well. So thank you so much for being here.
Amanda: Yeah, thank you. [00:26:00]
Transcribed by Descript
About Brittyn Coleman, MS, RDN/LD
Brittyn Coleman, MS, RDN/LD, is a distinguished Registered Dietitian and Autism Nutrition Expert, known for her innovative, sensory-friendly feeding approach to nutrition for children on the autism spectrum. As the founder of the Nourishing Autism Collective, and as an autism sibling herself, Brittyn brings both professional expertise and personal understanding to her work. She empowers families with her expert guidance, helping children receive essential nutrients for optimal health and development. Her strategies are tailored to the unique dietary needs and sensory preferences of each child.
Brittyn's influence extends beyond her membership site through her active social media presence and her popular podcast, 'Nourishing Autism'. Her educational content on Instagram, YouTube, and other platforms has established her as a leading voice in autism nutrition, providing valuable resources, practical advice, and a supportive community for parents and professionals.
