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Focus Program

The Focus System by Integrated Listening Systems (iLs) is a music based therapy program for improving brain function. The individual listens to specially modified music over headphones while completing movement activities.

The Focus System contains multiple programs to improve:

  • sensory processing
  • body organization
  • learning, academic
  • attention
  • auditory processing
  • cognitive efficiency
  • memory
  • TBI/head injury
  • stroke recovery

The Focus System emphasizes subcortical processing which must be in place for efficient cortical (cognitive) processing. Listening and movement together improve neural interconnectivity.

The Focus System works to improve:

  • fine motor control
  • perceptual (spatial, visual, tactile)
  • gross motor coordination
  • balance and proprioception
  • muscle tone and posture

Please contact me with any questions or if you would like to inquire if the Focus System is appropriate for you or your child.

Safe & Sound Protocol

The Safe and Sound Protocol (SSP) was developed by Dr. Stephen Porges. It is an intervention designed to reduce stress and auditory sensitivity while enhancing social engagement and resilience. By calming the behavioural and physiological state, further therapy is enhanced or even accelerated. The SSP is based on the polyvagal theory which was developed by Dr. Stephen Porges (see video below for more information).

The intervention involves listening to music that has been specifically processed so that the middle ear muscles are trained and exercised to focus on the frequency range of the human voice. The individual listens to a total of 5 hours of music over a period of time determined appropriate for the individual client.

The SSP targets specific features such as:

  • auditory hypersensitivity
  • difficulties with auditory processing
  • behavioural outbursts
  • inability to focus or sit still
  • anxiety in social situations

Bright Horizons OT utilizes the Safe and Sound Protocol as one part of our treatment with children who have a variety of needs. Please contact us for more information or to book an appointment.

For more information see the iLs website. There is also a facebook group that has testimonials and more information on the Safe & Sound Protocol.

SSP Summary from Dr. Stephen Porges

Dr. Stephen Porges: What is the Polyvagal Theory

SSP Parent Testimonial

Therapeutic Listening

Therapeutic Listening is an evidence-based auditory intervention intended to support individuals who experience challenges with sensory processing dysfunction, listening, attention and communication. Therapeutic Listening activates listening which is the process of detecting sound, organizing it and integrating it for use with information from other senses.

Therapeutic Listening involves listening to modulated music through specialized headphones twice a day for 30 minutes. The headphones are open air meaning the child can also hear others around them and can talk to others while listening to the music. The child can go about their daily activities while listening to the music (except for watching TV, playing video games and other similar activities). The time period between listening sessions must be at least 3 hours apart.

Therapeutic Listening is not a specific protocol but rather a dynamic process in which a trained therapist chooses modulated music specific to the child’s needs. The child will listen to each music album for a period of two weeks. After two weeks is up the child will be reassessed by a therapist and a new album will be recommended. There is no specific time frame for Therapeutic Listening, some children will benefit from listening to the music for twelve weeks and others will listen for 6 months plus.

Therapeutic Listening has been used to address:

  • poor attention
  • difficulties with social interaction and play skills
  • abnormal responses to various sensory stimuli (e.g. sounds, touch, taste, pain)
  • poor timing and sequencing of motor skills
  • challenges perceiving and navigating space
  • struggles with sleep, bowel and bladder control, and eating
  • difficulty communicating (both verbal and non-verbal)
  • challenges with transitions or changes in routine

Here is a short video explaining more about Therapeutic Listening – Therapeutic Listening

Here are a few testimonials from parents that have used Therapeutic Listening – Therapeutic Listening for Parents

Here is some more information on the science behind Therapeutic Listening – Science Behind Therapeutic Listening

Therapeutic Listening is used along with many different OT activities to help children in these areas. Please contact me if you have any questions or would like to start exploring Therapeutic Listening for your child!

References: Therapeutic Listening – Listening with the Whole Body

Tips for Left Handed Writers

  • As with all writing/desktop activities make sure the child is sitting in a well supported position
    • Feet are well supported
    • Hips and knees are at 90 degrees
    • Back is well supported
  • Have the child angle their paper clockwise about 30 degrees to the left (the bottom of the paper moves towards the left and the left top corner is pointing upwards)
  • Can place tape on the desk around the paper to form an outline to remind the child of the ideal paper position (a taped outline of one corner works well)
  • Encourage the child to move their grasp up the pencil about 1 – 1.5” so they are able to see their writing and avoid smudging
  • Can place a sticker on the pencil as a visual cue as to where they should have their fingers
  • Instruct the child to keep their hand underneath the line they are writing on
  • Rather than having the paper in the center of their body have the child move their paper to the left of their body so their eyes can see the writing as they move across the paper
  • Make sure they are using their right hand as their “helper hand” to hold the paper in place
  • Try writing on a slant board to help position their wrist appropriately and to help make the writing more visible
  • When using spiral notebooks flip the notebook around so that the spiral is on the right instead of the left
  • When using scissors make sure to use left handed ones

Tactile Defensiveness

Tactile defensiveness is the hypersensitivity to touch. Children with tactile defensiveness notice touch more than others. They react negatively to unexpected, light touch and even to the anticipation of light touch. The child may react with a fight or flight response by being hostile to those around them or by fleeing from contact with people, finger paints, playdough, etc. Some children will withdraw passively by avoiding the object and people that cause distress. The receptors of the tactile system are in our skin so therefore it is not just our hands that can be hypersensitive to touch but our whole body.

When our tactile system is functioning well we are able to filter out which tactile information is important and which is not. Those with tactile defensiveness have difficulty ignoring input that is not important (e.g. the way their shirt feels, the light breeze on their face, etc.) and may appear distracted. Many children who do not enjoy light touch may actually enjoy deep pressure touch, like bear hugs or heavy blankets.

Signs of tactile defensiveness:

  • Dislike brushing teeth or going to the dentist
  • Dislike getting hair washed or cut
  • Dislike wearing clothing or certain types of clothing, may prefer really tight clothing or baggier clothing
  • Withdraw from being kissed or from a light touch
  • Avoid playing with playdough, finger paints, etc.
  • Immediately want to wipe hands when they get dirty
  • Avoid playing in the dirt, mud, sand, grass, etc.
  • Picky eater

Suggestions when working with children who have tactile defensiveness:

  • Don’t approach or touch the child from behind
  • Avoid light touch
  • Use firm pressure when touching the child
  • Allow the child to have their own space during circle time (sit on their own piece of carpet or on a bean bag chair, rocking chair, etc.)
  • Have the child stand at the front or back of the line to minimize unexpected touch
  • Create a “quiet corner” (bean bag chair, tent, teepee or blanket draped over table) in the classroom or in another supervised room where the child can go if they are starting to feel upset or over-stimulated
  • Provide the child with deep pressure activities/movement breaks throughout the day (easiest to incorporate into daily class schedule as it is valuable for the whole class)
  • Weighted items such as a weighted lap pad or a weighted snake around the shoulders can be used to provide that calming deep pressure touch
  • Encourage the child to participate in sensory play activities
    • It is important to encourage the child to participate but do not force them into doing anything they don’t want to do, we want to gradually incorporate some challenging textures/touch while keeping it fun and enjoyable
    • The child may need to begin by just watching others take part in the activity, then move onto using a utensil (knife, paintbrush, rolling pin, cookie cutters) to play with the substance (fingerpaint, playdough, shaving cream, flubber etc.) and then finally to using their hands to play in it
    • Subtle, gradual exposure is the key to successful sensory play


Core Strengthening Activities

Here are some suggestions for activities that will engage a child’s core muscles (back and front). Make sure the child is breathing and not holding their breath during these activities. Focus on good quality exercises rather than quantity. Be silly and make sure it is fun for the child! If the activity is too hard for the child think of a way to adapt it or find another activity that is the “just right challenge” for them.


  • Laying on stomach, lift legs and arms off the ground and hold that position


  • Laying on back, bring knees up to 90 degrees and lift upper body off the ground with arms across chest and hold that position until someone says “pop” and the egg breaks open


  • Laying on stomach, push up onto forearms or hands while keeping the body straight and hold
  • To make it easier go on knees, to make it harder go on toes


  • Keeping their shoulders and head on the ground, knees bent and feet on the ground the child will bring their bottom up and hold that position

Snake Curl Ups

  • Have the child lie on their back with knees bent
  • Pretend to play a magic flute or play some snake charmer music on YouTube and have them sit up until their hands are on top of their knees
  • Stop the music and start over
  • Hold their feet down if they are having difficulty

Crawling Through a Tunnel

  • Any crawling activity is great for engaging the core

Inchworm Walk

  • Start with hands and feet touching the ground with bottom up (legs and arms straight)
  • Walk hands forward until the body is in a plank position
  • Then walk feet up to hands and start over

Crab Walk

  • On hands and feet with bottom lifted off the ground walk around sideways


  • Most yoga poses are great for engaging the core, some ideas include boat pose, happy baby pose, downward dog, 3 legged dog, dolphin pose
  • Cosmic Kids Yoga on YouTube is great for kids


  • Child lays on their stomach and adult lifts up their feet
  • Child pushes up onto straight arms and walks around on hands
  • Make sure the child keeps their body as straight as possible
  • To make it easier, the adult can hold onto the child’s legs closer to their hips

Visual Schedules

Many children benefit from routine in their daily lives. A visual schedule is an easy way to provide a child with a visual reminder of what they can expect for their day. Many children experience less anxiety when they know what to expect before something happens. It is easy to find pictures to make your own visual schedule by searching Google. You can make very specific visual schedules (for example: getting dressed – put on underwear, put on pants, put on socks, put on shirt, put on sweater) or a more general schedule (for example a daily routine – get out of bed, eat breakfast, go to school, eat lunch, TV time, homework, supper, play time, bed time). Print the visual schedule you make and hang it close to where they will use it.

Some ideas to try:

  • Give the child a new paper with their visual schedule on it every time so they can check off the steps as they complete them
  • Laminate pictures of each of the steps and create a schedule with two columns (one column is ‘to do’ and the other is ‘done’), attach velcro to both sides and have child move the picture from the ‘to do’ column to the ‘done’ column when they have completed it

Here is an example of a visual schedule:

Morning Routine

Eat breakfast

Get dressed

Brush teeth

Brush hair

Put on coat

Put on shoes

Put on backpack

Activities That Help Develop A Pincer Grasp

A pincer grasp is when you use your thumb and the tip of your index finger to pick up an object. As children develop they move from a gross raking grasp involving their whole hand to a more refined pincer grasp as seen in the picture below.

A pincer grasp is important for many functional activities such as zipping a zipper, picking up small objects, using a key, etc. Here are some activity ideas to help develop a pincer grasp:

  • Use tongs to pick up items
  • Set out a muffin pan and give the child small items to sort and place into the cups
  • Stickers – any activity that involves stickers helps practice the pincer grasp
    • Bigger stickers will be easier and small stickers will be more challenging
  • Hide small coins, beads, etc. in playdough and have the child get them out
  • String beads on a pipe cleaner
  • Any game involving clothespins
  • The Sneaky, Snacky Squirrel Game
  • Lite Brite
  • Mr. Ball

There are many different activities that work on the pincer grasp. Be creative and have fun!

Heavy Work Activities

Heavy work activities are activities that involve the big muscles and joints of the body (pushing, pulling, carrying, etc.). Heavy work activities help release a neurotransmitter called serotonin that helps calm and organize our brain and bodies. Below are some examples of heavy work activities:

  • Carrying heavy books from one room to another at school
  • Playing tug of war with a rope
  • Crawling through a tunnel
  • Pushing themselves around on a scooter board
  • Pulling another student that is holding a hula hoop and sitting on a scooter board
  • Pulling another child around on a sheet or blanket
  • Pushing the cart while grocery shopping
  • Doing animal walks (crab, bear, bunny, kangaroo, elephant, etc.)
  • Wall push ups – stand up with hands against the wall and do a push up
  • Popcorn – sitting in a chair push up on hands so bottom is off the seat, keep popping up and down like popcorn

There are so many activities that would be considered heavy work activities. Any activity that involves the large muscles of the body are great for organizing the brain to help the child be ready to learn. Use these activities throughout the day to help children stay on task and provide them with the movement their bodies crave!

What is the Vestibular System?

The human body has 8 sensory systems which give us information about the environment and our place within the environment. 

The 5 most commonly known sensory systems include:

  • Tactile – the sense of touch
  • Visual – the sense of sight
  • Auditory – the sense of hearing
  • Gustatory – the sense of taste
  • Olfactory – the sense of smell

The 3 less commonly known sensory systems include:

  • Vestibular – the sense of our head position in space
  • Proprioception – the sense of knowing where our body is in space, this information comes from our muscles, joints, tendons and ligaments
  • Interoception – the sense of the physiological condition of the body (hunger, thirst, pain, temperature, the need to go to the bathroom, etc.)

Today we are going to talk more about the vestibular system. The vestibular receptors are located in our inner ear. The receptors include the 3 semicircular canals (anterior, lateral and posterior) and the otoliths (utricle and saccule). The semicircular canals pick up rotary movement and the otoliths pick up linear movement.

The vestibular system answers 2 basic life questions:

  • Which way is up?
  • Where am I going?

Any movement of the head in any direction (up and down, forward and back, side to side, diagonal and rotary) activates the vestibular system. 25% of the vestibular information received goes directly to the cerebellum which is responsible for balance and posture. The other 75% of vestibular information goes to the brainstem via the vestibular nuclei which then connects to many other parts of the brain including:

  • Reticular formation – arousal, orientation, regulation & attention
  • Spinal cord – postural alignment and control
  • Oculomotor nuclei – head orientation & stability for oculomotor (eye) control
  • Autonomic centers – gravitational impact on cardiovascular, visceral & respiratory control
  • Cerebral cortex – spatial orientation & body movement

Since the vestibular system has so many connections in the brain it is very important that the vestibular system is functioning well. In many of the children that we see in Occupational Therapy their vestibular systems are not functioning optimally. Many children have an under-responsive system or an over-responsive system. A child with an under-responsive system may be able to spin for hours without getting dizzy or sick. A child with an over-responsive system may get dizzy or sick with even the slightest movement.

In Occupational Therapy one of the goals is to help the vestibular system work optimally so that sensory information is processed correctly in the brain to allow the eyes to work well, the ears to work well as well as the many other areas that have been discussed above.

References: From Eyesight to Insight: Visual & Vestibular Assessment & Treatment