The Sensory System and Bedtime with Courtney English
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It has been a while since I posted an ask the expert series post, but when I discovered Courtney English on Instagram I knew she had to be the next person I interviewed. Courtney is a pediatric occupational therapist supporting parents in meeting their child’s sensory needs. She has a plethora of useful information to help children with emotional regulation, bedtime, and meeting their general sensory needs. I was so excited to be able to interview her and speak about some of these things!
The world of occupational therapy and the “invisible senses” is something I had little to no experience with before having my son. Learning about the vestibular and proprioceptive systems since has unlocked a huge variety of ways I can support my son, his sleep, and his regulation. I discovered Courtney on Instagram after I posted a reel sharing how a blanket swing has helped my son with emotional regulation and with bedtime. In addition to the blanket swing, I have learned of many more tools as well from her since then.
Our bedtime routine now involves an electric toothbrush for oral motor stimulation, followed by a “bubble mountain” (blowing soapy water into bubbles with a long straw) for oral heavy work, blanket pulls of his sister for proprioceptive input, and a blanket swing for vestibular input into bed.
Coming from a Montessori perspective I have a lot of familiarity with how Montessori encourages movement to be connected to learning and her theories on a young child’s need for certain movement such as maximum effort. In this interview, you will see how some of these observations of Dr. Montessori a century ago are now backed up by modern science. It is cool to see, especially as someone who loves child development! It also might unlock a whole new way to understand your child!
Can you tell me a bit about your background and what you do as an OT?
Hi! I became an OT in 2015 when I graduated from my master’s program. I actually worked in hand therapy as an OT for 6 years before I switched to pediatrics. I had always wanted to work with kids and my daughter motivated me to switch! When she was born, I felt lost and wanted to learn more about child development. I also wanted more schedule flexibility and more room to grow within my career.
When people think about senses and sensory systems they generally think about sight, smell, hearing, taste, and touch. Those aren’t the only ones though. What are the others and how do they work?
The “invisible senses” are the vestibular, proprioceptive, and interoceptive sensory systems.
The vestibular system senses where our head is in space and gives us information about movement and spatial orientation. It is also responsible for muscle tone which is the normal resting state a muscle must remain in order to support the body in a functional way. This also helps us maintain our posture and stabilize our head and body during movement. Vestibular processing impacts bilateral coordination as well as visual processing skills. If a child has challenges with vestibular processing, many activities of daily living can be impacted.
The proprioceptive system gives us information about where our body is at in space (body awareness), how much force to grade (when writing, closing a door, hugging a friend), supports motor development, timing, and helps all other senses function properly and in synchrony. Proprioceptive input is a powerful sense because it is known to have a calming effect on us. It has the ability to alert, calm, organize, and regulate a child. For example, if a child spins and gets dizzy (and feels silly or dysregulated) we always recommend doing “heavy work” or proprioceptive input afterwards to help regulate and calm a child.
The interoceptive system gives us information about the internal organs and works closely with the autonomic nervous system. It tells us when we are hungry, thirsty, need to us restroom, etc. It will tell us information of our feelings and emotions through bodily reactions such as heart racing if afraid or butterflies in stomach if feeling nervous.
Maria Montessori wrote about how young toddlers as soon as they can walk will want to lift heavy things. In Montessori this is referred to as maximum effort. I love learning about the science behind some of these concepts I learned about through my Montessori training. I understand it is the proprioceptive system at work there. Could you talk a bit about that?
Yes! Heavy work is so important for self-regulation for all humans: toddlers to adults. We all need grounding, regulating, and organizing sensory input to help us balance our nervous system. This is proprioceptive input. Our nervous system is meant to shift between different states to function safely and properly in our environment. There are times when we become overstimulated by the multi-sensory experiences we go through or any other high demands we work through on a daily basis. If we do not give ourselves enough heavy work, eliminate overwhelming sensory input, or take time for mindfulness- it can cause us to have a difficult time managing our emotions and participation in daily tasks.
I have been really interested lately about how regulating vestibular input can be. We have found it really helps my son when he is having a tough time and also helps him settle for bed. Can you talk about why that is? Why might it help him settle at night?
All children have different thresholds or “cups” that need to be filled for each sensory system in order to feel calm, focused, and safe. Some children benefit from more vestibular input and some tend to need less depending on their unique sensory system. Often when children move in linear motions, they are receiving organizing and regulating input. Think of babies, we would rock and sway them to soothe them when upset. This sense is still regulating for kids as they develop. The interesting thing is that as we get older, we tolerate less (hence why adults can get dizzy more easily). Always follow up with some type of heavy work after vestibular to help “seal the deal” with the sensory experience.
I’ve heard to avoid spinning at bedtime because it can be alerting. Why is that? Which activities should be saved for different times of day and which are good at bedtime?
Spinning is very alerting because it activates multiple canals in the inner ear that control balance and vestibular processing. This can sometimes confuse the system and cause dysregulation. We often recommend (if spinning), try to spin 5-10 times one way and 5-10 times the other way then do jump/crash/push/pull/carry afterwards. However, some children do need more rotary (spinning) input to feel calm and regulated. That is why we have to be our child’s “sensory spy” and make sure we are seeing the signs of dysregulation to know how much can be tolerated. At bedtime, I would stick to linear input (back and forth, side to side).
How does someone know if their child is getting too much or not enough of a sensory stimuli?
They will show signs of dysregulation. Some signs include, but not limited to:
Hyperactivity, physical behaviors (difficulty grading force with others), uncontrollable laughter, seeking out intense input such as crashing, spinning, touching, shut down or frozen state, difficulty paying attention or following directions, changing their mind about what they want, easily irritated. (Just to name a few!) haha!
We’ve been using a blanket swing a lot and doing blanket drags where he drags his sister on the blanket if she’s up for it, especially at bedtime. What are some other good activities to incorporate? I know a lot of parents are solo at bedtime. Do you have any ideas for them to try?
I actually made a whole freebie list for this on my page if you’d like to check it out, it has a whole outline with a variety of ideas for each step!
Is there anything else you think people should know about your work as an OT or the sensory system?
All kids, both neurotypical and neurodivergent, can benefit from sensory input for regulation and development! It is my goal to normalize this.
