Sensory Modulation Resource Manual

Universal Design for Uniforms

Schools and Workplaces can adopt Universal Design principles by offering sensory-friendly uniform options as part of the standard uniform range.

This benefits students/employees who are Autistic or ADHDers or people who have sensory processing differences, eczema, chronic pain, fibromyalgia, hypermobility, or other conditions that make certain clothing uncomfortable.

The goal is for students/employees to spend their energy on learning and participating, not on coping with uncomfortable clothing.

Sensory Friendly clothing can include:
* Tag-free (printed labels instead of sewn-in tags)
* Flat or flatlock seams
* Minimal internal stitching
* Covered elastic waistbands
* Soft waistbands
* stretch
* minimal polyester
* Easy-to-use zips
* Large buttons or magnetic fastenings (where appropriate)
* Minimal buckles
* No stiff collars unless optional
* Choice of relaxed or fitted styles
* Multiple length options
* Clothing that allows freedom of movement
* Soft socks with flat toe seams
* Comfortable jumpers without itchy wool
* Comfortable shoes
* Hats with soft internal bands

The most important feature is choice. Students/employees should be able to wear the uniform option that best meets their sensory needs while still meeting the dress requirements.

People with sensory processing differences are not going to “get used” to seams and tags etc and their attention will be continually drawn to the discomfort.

Chapter 6 of ‘Sensory Approaches to Mental Health Practice’ was written by Sensory Modulation Brisbane.

This chapter ‘Sensory modulation interventions in practice when working with trauma’ explains trauma and trauma informed care, the role of sensory modulation when working with trauma and outlines a model and strategies for using sensory modulation as an intervention in this space.

Sensory Modulation Brisbane offers comprehensive on demand training on trauma and sensory modulation – designed as a lunchbox series (where individual training topics can be purchased separately or all together as a comprehensive course).

Link to a free introduction to the on demand training series -
https://sensorymodulationbrisbane.ticketspice.com/free-introduction-to-trauma-and-sensory-modulation-lunchbox-webinar-series?fbclid=IwY2xjawNX8E5leHRuA2FlbQIxMAABHg6WLuEVw_4eJ8d_SXCu4B5QuOHwwcdh3HX3KrSBJ4D5KfQMG_Krno1Hj2MV_aem_r2WfB2J4VOsAx3mD2524ow

Link to the introductory session for the on demand training series -
https://sensorymodulationbrisbane.ticketspice.com/sensory-modulation-and-sensory-processing-introduction-on-demand-lunchbox-series

Link to the session on frameworks for working with trauma -
https://sensorymodulationbrisbane.ticketspice.com/sensory-modulation-frameworks-for-trauma-on-demand-lunchbox-series

Link to session on sensory modulation interventions for trauma -
https://sensorymodulationbrisbane.ticketspice.com/sensory-modulation-interventions-for-trauma

Link to session on anxiety, panic & breathing -
https://sensorymodulationbrisbane.ticketspice.com/anxiety-panic-and-breathing-trauma-sensory-modulation-lunch-box-series

Link to session on sensory spaces and equipment -
https://sensorymodulationbrisbane.ticketspice.com/sensory-spaces-and-sensory-equipment

Sensory Spaces and Sensory Equipment Get tickets online for Sensory Spaces and Sensory Equipment here.

Misophonia – more than just dislike of sounds and how OTs can help

Most people can relate to the experience of certain noises or sensations as being really unpleasant. For example, the thought of nails scratching down a blackboard can make the hairs on your arms to stand up, your teeth feel ‘on edge’ and the strong impulse to quickly cover your ears to stop the noise!

The term “misophonia” (hatred of sound) was first used in the early 2000’s to characterise the experience of an extreme emotional and physical response to certain ordinary, often repetitive, day to day sensory input. It is reported to occur in up to 20% of the population and equally in men and women. The input that evokes the most intense responses tends to be human created orofacial noises like breathing, swallowing, chewing, sniffing, throat clearing and lip smacking. Noises such as tapping and pen clicking have also been reported to be problematic. For people with misophonia, these experiences can evoke intense responses that may not seem in keeping with the circumstance such as disgust, irritation, anxiety, distress, anger and an overwhelming desire to remove themselves or remove the input from their environment.

Is Misophonia a hearing problem?
Rather than misophonia being a hearing problem, it is now proposed to stem from attentional or emotional processing issues later in the brain’s auditory system. In examining brain activity while listening to a variety of sounds (including neutral, unpleasant and known misophonia triggers) Kumar et al (2017) found the following:

· the misophonia group rated the trigger sounds as more distressing than the other sounds.

· the research control group rated trigger and unpleasant sounds as similarly annoying.

These results support the theory that people with misophonia experience selective intolerance for trigger sounds (Kumar et al, 2017).

Misophonia research
When hearing trigger sounds, Kumar also found people with misophonia demonstrate increased insula activation compared to controls, with higher levels of insula activity being correlated with greater reports of distress. The experience of trigger sounds for misophonics showed altered functional connectivity between the insula and other brain regions for attention and emotion. Given the insula plays an important role in internal awareness of body and emotional states, these findings suggest people with misophonia experience altered activation of interoceptive brain networks. Further, it has been proposed that this altered brain connectivity may have similarities to that which occurs in conditions like synesthesia, which is the experience of sensory crossovers (Edelstein et al, 2013)

A study by Kaufman et al (2022) showed people with misophonia have increased sensory responsiveness in the areas of adversive, hedonic, auditory and smell subscales. However they were not identified to have a sensory over-responsiveness type of sensory modulation dysfunction, which suggests that misophonia and SOR, while having some similarities, are actually separate conditions.

The intense adverse response to mouth noises (like chewing) are proposed to be due to heightened sensitivity in the connections between the auditory cortex and orofacial motor control areas. However a research study by Hansen et al (2022) has demonstrated strong connections also between brain regions associated with finger movement & sensation (ie tapping) and the insula.

Further research by Kumar et al in 2021 found that misophonics show increased activity between the auditory cortex and motor control areas related to the face, mouth and throat. Motor regions were not only strongly activated by trigger sounds (not other sounds), but also between visual and motor regions. These findings suggest that discrete visual cues/sensory input can also trigger misophonic responses, possibly due to an involuntary overactivation of the brain’s mirror system resulting in a perception that external trigger sounds are impacting on our bodies without our control.

Samermit et al (2022) investigated whether pairing of different visual stimuli with orofacial sounds (eg a visual of paper tearing paired with the sound of chewing) could alter the misophonic adverse response. Results indicated that this pairing increased the pleasantness of the sound, with the degree of pleasantness further improved if this pairing was presented first. This may indicate that the belief/prior about the sound source might impact on the level of adverse response. Kumar (2021) also suggests that some people can lessen symptom intensity by mimicking the action that generates the trigger sound, possibly by providing the brain with a prediction cue thus reducing novelty and increasing a sense of control.

This research further reflects the complexity of misophonia, including range of triggers and neurological pathways and networks involved, symptoms and functional implications.

How does misophonia impact?
The impact of misophonia can be widespread and result in people experiencing many challenges with a range of occupational and functional roles, for example:

· Eating meals with family & in public dining spaces (food courts, restaurants, hospital dining rooms)

· Studying in libraries and open classrooms

· Participating in examination conditions with a group of people

· Shared sleeping arrangements

· Using public transport

· Busy public entertainment venues (cinemas, theatres, concerts)

· Being around others in cold and flu season or being in a health clinic waiting rooms

What strategies can assist with misophonia?
Continued research and the findings discovered can help us better understand the mechanisms of misophonia and provide clues and recommendations to help in its management.

OTs can offer a range of different tools and strategies to assist people to better understand and manage their unique experience of misophonia, including:

· Education and support to increase people’s understanding and awareness of their experience of misophonia, including –

o specific sensory triggers

o resultant emotional and body responses

o the role that heightened interoceptive (internal body sensory) signals play in misophonia

o the impact of sensory overload on functioning and the importance of energy conservation principles including pacing, taking regular rest breaks, task modification & adaptation to reduce adverse sensory input.

Sensory modulation strategies for misophonia
· Sensory modulation strategies to help eliminate or dampen down the experience of the sensory trigger, such as –

o Earplugs such as ear defenders or ear loops

o Modify distance from/ proximity to the trigger (eg – position self further away)

o Adapt the task to alter engagement with the trigger (eg – sit somewhere else or an adjoining room to eat meals, consider a different activity for family connection time like an outdoor walk or board game instead of combined evening meal)

o Strategies to compete with the sensory trigger (use of masking sounds like music, nature sounds or white noise)

o Blue tooth headband for sleep

· Tailored sensory modulation strategies to help reduce stress and manage the emotion dysregulation that can be caused by the experience of misophonia, for example –

o Preferred sensory input

o Sensory routines embedded in day to day activities

Address/update the brain’s prediction of the sensory input using an intervention combining sensory modulation, predictive processing strategies and sensory health principles

Information on relevant courses and references are available in the blog at Sensory Modulation Brisbane

Tinnitus and the Default Mode Network

Thanks to the supporter who shared this article with us.

Ear Ringing and the Residual Self Changes in the brain networks responsible for identity, self-awareness, and the residual self help explain how chronic tinnitus becomes an entrenched condition in some people.

Sensory Modulation Brisbane was proud to contribute Chapter 6 ‘Sensory modulation interventions in practice when working with trauma’ to the book ‘Sensory Approaches to Mental Health Practice’, published in March 2026.

The chapter offers a comprehensive outline of –

· Trauma and trauma informed care

· Features of trauma and the impact on occupational functioning

· The neuroscience of trauma

· The role of sensory modulation interventions when working with people with trauma

· A model for using sensory modulation as an intervention and its application when working with people with trauma

· Sensory modulation interventions with respect to the person, the environment and activities of choice with respect to working with trauma

The book and the chapter can be purchased using the following link –

https://www.sciencedirect.com/science/chapter/edited-volume/abs/pii/B9780443405969000166

This blog has very useful instructions for the beginner !

I am hoping that this will be an activity in mental health units ( but without the glass ! The the if this article advised -There are plastics designed for fermentation (or similar). Just don't use recycled plastics that might not stand up to the acidity and salinity. )

This new study examined the sensory role of cutlery in eating disorder (ED) treatment—an often-overlooked aspect of the mealtime environment.

Using a mixed-methods sensory object elicitation workshop with adults receiving intensive ED treatment within an autism-friendly service, the researchers found that cutlery acts as an active sensory interface. Preferences were shaped by embodied sensory experiences of weight, balance, texture, material, and mouth fit. While metal cutlery was consistently preferred over wooden, plastic, paper-based, and hybrid alternatives, individual sensory preferences remained highly variable.

These findings demonstrate the value of sensory-informed environmental adaptations and highlight how seemingly small design choices can support more neurodivergent-affirming, person-centred ED care.

https://doi.org/10.3389/fpsyt.2026.1827308

Follow us to keep up to date on the latest research in Sensory Integration and Neurodiversity.

To learn more about supporting individuals with sensory differences across the lifespan see the link below:
https://www.sensoryintegrationeducation.com/bundles/Sensory-Inclusion-Facilitator-Certificate-B

Sensory Modulation Brisbane is so pleased to have contributed Chapter 6 to ‘Sensory Approaches to Mental Health Practice’, published in March 2026.
As per the book description –
‘Sensory Approaches to Mental Health Practice’ presents the latest research on the relationship between sensory processing and a range of mental health conditions, along with coverage of relevant sensory-based programs. This book includes real life case studies to support practical and clinical application. Organised into sections on theory, specific diagnoses, clinical settings, interventions, and tools to practice, it explores key topics such as sensory processing, sensory integration, sensory modulation, and the intersection of these with recovery-oriented and trauma-informed care, in mental health practice. This comprehensive resource equips readers with the knowledge, practical skills, and tools to apply sensory approaches effectively and in a recovery-focused manner across diverse client needs and settings.

More information on the chapters and purchase via the following link –

https://lnkd.in/gUy_AGGj