Yes. I did indeed say, “Vibrating Pool Noodle”.
Occupational therapists that treat sensory processing disorders frequently see hypoarousal in our clients.
But low somatic awareness and hypoarousal happens with mental health issues too. They can be just as disabling as hyperarousal. It is also harder to treat if you don’t understand the nervous system well. Fortunately, some OTs are very well trained in treating hypoarousal and providing strategies to their clients of all ages.
Other team members don’t perceive people with hypoarousal as struggling. Psychotherapists think they are calm. They are nothing of the sort. People with hypoarousal are not aggressive, not loud, not complaining or avoiding much of anything. But a good OT knows that this isn’t adaptive. This isn’t a state in which someone can engage and feel connected to their body and to the world around them. And to serve the needs of any person, at any age, in any situation, our sensory system needs to be adaptive.
What is “adaptive”, and why is hypoarousal not adaptive?
My new car has adaptive headlights. They follow the road and give me a better view of what is coming up in front of me, even around a curve. They switch to high beams when other cars are far away, and turn them off when streetlights or oncoming traffic is sensed. It isn’t adaptive to blind other drivers or pedestrians. My headlights can sense change and they respond efficiently to help me see what is coming. They are in-the-moment and can respond. THAT is adaptive.
Clients displaying hypoarousal symptoms aren’t actively overwhelmed by sensory input. There is no crying, shouting, or running. They are either flooded with emotional and sensory input and have gone somewhat … numb. Under-responsive, blank, quiet, with little interest in communicating or exploring their environment. They aren’t calm, at all. They are the opposite of calm. They cannot react in an effective manner to the sensory, motor, communication, and social demands in front of them.
OR…..
They are under-stimulated. Kids whose brains need more juice to become alert and responsive. This is more commonly seen with a child that has global developmental delay, but it can also be seen with kids whose nervous system is poor at registering sensory input. They don’t feel your foot as they step on it. They break their crayons, even the colors they hoard. These kids need more sensory input, not less.
Why would a vibrating pool noodle be a good idea?
Because the fastest way to bring someone into a more adaptive state is to engage the part of their nervous system that can bring them into more vagal activation while stimulating the parts of the brain that support sensing the body. And that would be the reticular activating system and the insula. Vibration can do that, particularly if it is placed on or near the body’s core, where mechanoreceptors for this particular sensation reside in large numbers.
I use a vibrating padded foam core that could be placed on any body part, but is flexible enough to wrap around the waist. It has a soft washable cover and a variety of vibration patterns. The strong alternating vibration pattern is a fave for my most “frozen” clients of all ages.
Who should not use vibration? I would want a physician’s approval for anyone with a seizure disorder before I would trial these tools. I wouldn’t use it without medical clearance for anyone with a pacemaker or a cardiac diagnosis. Vibrating objects are not used near the front of the neck or pressing firmly on the gut. The risks are not worth it. I wouldn’t give a vibrating tool to someone who would bite it or who would take out the batteries unless I know they have direct constant supervision.
This is a brief targeted treatment. It is intended to support someone dysregulated to shift states and improve their functioning. It won’t be as effective if the situations that cause low somatic tolerance don’t get direct treatment, but it can speed up responsiveness. It can’t be the only treatment for someone who is regularly in a hypoaroused state. They need a well-crafted therapy program.
