The Neurodiversity Voices Podcast

Guest: Cynthia Miller-Lautman – Occupational Therapist, Educator, and Host of Swinging Upside Down

In this episode of The Neurodiversity Voices Podcast, host Paul Cruz sits down with occupational therapist Cynthia Miller-Lautman, whose work bridges sensory science and neurodiversity-affirming practice.

Cynthia shares how early clinical experiences, parenthood, and work in diverse communities taught her to “watch the person” and see so-called “behaviours” as signals of dysregulation, not defiance.

Together, Paul and Cynthia explore the eight senses (including vestibular, proprioception, and interoception), what “just right” regulation actually feels like, and how to design sensory-safe micro-spaces in schools, homes, clinics, dental offices, and workplaces—without needing huge budgets or perfect setups.

You’ll walk away with a minimum viable plan to support sensory regulation, plus a new lens on “behaviour” that centres safety, consent, and dignity for neurodivergent children and adults.

Key Takeaways
  • The 8 Senses, Not 5
    Cynthia explains touch, vestibular, proprioception, taste, smell, hearing, vision, and interoception, and why the first three are the foundation for regulation.
  • “Just Right” vs On High vs On Low
    Instead of pathologizing, Cynthia uses “just right,” “on high,” and “on low” to help families and educators understand sensory needs in plain language.
  • Behaviour as Communication, Not Defiance
    Rocking, leaving the room, refusing to eat, or “not listening” are reframed as clues to sensory overload or underload, not bad choices.
  • Sensory Is a Human Need, Not a Reward
    Sensory tools (movement, weight, deep pressure, safe spaces) should not be “earned”—they’re supports that make learning, therapy, and daily life possible.
  • How to Build a Micro Sensory-Safe Space
    With low-cost items (pillows, old sheets, beanbags, rocking/office chairs, simple weighted or vibrating tools), you can set up sensory corners in:
    • Classrooms
    • Homes and small apartments
    • Therapy, medical, and dental offices
  • Consent and Safety with Tools
    Cynthia shares practical guidelines for things like weighted tools (never more than ~10% of body weight), watching eyes and body language for consent, and avoiding forced touch.
  • Sensory Needs Across the Lifespan
    Sensory regulation isn’t “just for kids.” It matters in:
    • Dental and medical procedures
    • Waiting rooms
    • Workplaces and therapy offices
    • Aging, dementia, and hospitalizations
  • Becoming a Sensory Detective
    The most powerful shift: adults becoming curious detectives instead of judges—asking “What is this person trying to get to feel just right?” instead of “Why are they being difficult?”
Key Quotes
  • “Sensory is not a reward. Sensory is a human need.” – Cynthia Miller-Lautman
  • “Behaviours are often signals—our detective work is figuring out what’s really going on.”
  • “Parents, teachers, and therapists must become sensory detectives to help kids (and adults) find ‘just right.’”
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Creators and Guests

Guest
Cynthia Miller-Lautman
She is an Occupational Therapist, Educator, and Host of Swinging Upside Down.

What is The Neurodiversity Voices Podcast?

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Beginning December 2025, all future episodes of The Neurodiversity Voices Podcast will be available as full video experiences. Watch along on our YouTube channel (@neurodiversityvoicespodcast) or on Spotify, and connect with our conversations in a whole new way.

I’m Paul, the host of The Neurodiversity Voices Podcast.

I’m not a clinician, researcher, or professional expert — and that’s intentional.

I come to this work as a neurodivergent individual with lived experience. I know what it feels like to navigate systems that weren’t designed for how your mind works, to question your own capacity because of labels, and to search for language that actually reflects who you are, not just how you’re measured.
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This podcast exists because too many conversations about neurodiversity happen about us, rather than with us.

How This Podcast Is Different
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Unlike many podcasts in this space, The Neurodiversity Voices Podcast isn’t built on credentials or clinical authority. It’s built on listening, reflection, and shared humanity.
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I don’t position myself as an expert with answers. I show up as a facilitator of stories — asking curious, grounded questions from the perspective of someone who lives this reality every day.
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That means:

Conversations aren’t rushed or overly polished
Guests aren’t reduced to diagnoses or achievements
Complexity, contradiction, and uncertainty are welcome
Lived experience is treated as valid knowledge

​Whether I’m speaking with educators, parents, authors, creatives, researchers, or other neurodivergent individuals, the focus is always the same: seeing the person before the label.
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​Why Lived Experience Matters Here
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Being neurodivergent shapes how I listen, how I notice patterns, and how I hold space. It allows me to ask questions that come from recognition rather than assumption — and to create conversations that feel safer, slower, and more honest.
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This isn’t a podcast about fixing people.
It’s a podcast about understanding ourselves, our systems, and each other more clearly. If you’re looking for expert opinions, you’ll find many excellent shows.

If you’re looking for real conversations, grounded in lived experience and mutual respect, you’re in the right place.
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Paul Cruz:

Hello and welcome to the Neurodiversity Voices Podcast. I'm your host, Paul Cruz, and I'm thrilled to have you join me on this journey of exploration, advocacy, and celebration of neurodiversity. Together, we'll have meaningful conversations, share inspiring stories, and challenge misconceptions about neurodiversity. This podcast is for everyone, whether you're neurodivergent yourself, an educator, a parent, or just someone curious to learn more. My goal is to amplify voices, foster understanding, and spark change in the way we view and support neurodiversity.

Paul Cruz:

I'm so excited to have you as we celebrate the beauty of diverse minds and work toward a more inclusive future. So sit back, relax, and let's get started. Welcome to the Neurodiversity Voices Podcast. You're listening to the Neurodiversity Voices Podcast. I'm Paul Cruz, proud advocator with lives in the balance, where together we're building a world of compassion, collaboration, and hope for every child.

Paul Cruz:

Today's guest is Cynthia Miller Lotman, an occupational therapist whose work bridges sensory science and neurodiversity affirming practice. From her formative years at Summit School to training with the Cree Board of Health, she's learned to watch the person and to build sensory safe spaces that turn so called behaviors into signals we can support. We'll unpack the eight senses, show how to set up a microsensory safe spot at school or home, and talk about changes clinics and classrooms can make sensory regulation today?

Cynthia Miller-Lautman:

Oh, Kate, thank you. Yes. When I think back to my earliest days, I realized that I didn't learn a lot of what I know now in my schooling. So I really needed to learn on the job. So I had my first stag, sorry, my last stag as an occupational therapist at a special needs school.

Cynthia Miller-Lautman:

And it was there that I met an occupational therapist who was my mentor. And I still credit her for how she taught me how to think about sensory. I was getting lost in all the assessments and the tools and all the lingo. And as you say, like the science part of it. And I was having trouble of how to communicate it in a report to a teacher.

Cynthia Miller-Lautman:

And so my first alone client, I was working with a young student who was autistic and he was non speaking and he had very, very limited eye contact. And so he would kind of do his own thing until we got into the sensory room. And that's where I learned to be an occupational therapist who does sensory activities. Because I would roll him, bounce him on a ball, give him vibration, give him a massage, and he would like come alive. He would start making eye contact and actually communicating with small words.

Cynthia Miller-Lautman:

He would smile and giggle and actually have lots of circles of communication. So I learned really early that by doing sensory activities, it can really help someone communicate and form bonds and relationships. And so that was really that stuck with me, that first client that I worked with. And later on, I moved on and had my own children. And that was probably the next experience that really taught me.

Cynthia Miller-Lautman:

I had first a very colicky first born baby and I had no idea what I was doing. And I started to learn how just typically developing what we thought typically developing children can have sensory issues from birth. They need to be rocked and cuddled and bounced and soothed. So that taught me again and my brain was going and I was thinking so much about that. And comes to my third daughter and my third child.

Cynthia Miller-Lautman:

And when she was born, she developed meningitis. She was five days old and she spent a lot of time in the hospital. And any parent that has had a premature baby or a child that gets sick can know the impact of all those tubes and things on their children and how much that can create a mini sensory trauma for them. And that's where I started to learn how hospitalizations and dental offices and all of that can shape how people respond to the world and sensory world. So that was another learning.

Cynthia Miller-Lautman:

And then my last story, really sticks with me, and this was really ten years into my practice, but again, I was still learning. I had a mom come who desperately wanted to be part of all the therapy sessions. And I loved it because to me, the parents are hand in hand. It's not me just doing the therapy outside and the parents watch. They're part of it.

Cynthia Miller-Lautman:

And she and her son taught me that sometimes the first words can take place during a sensory activity. So after eighteen weeks of working together, her goal was her son to talk, but we did that through sensory experiences. And I'll never forget, she was sitting in the swing with him in my office with a cushion on him and swinging back and forth. And he said his first words and the tears of joy. I learned how important it is to involve the parents.

Cynthia Miller-Lautman:

It's not remove the child and do the therapy. It to me, it's really a family process. And I spent equal time working with mom as I did with a child, because it's both. As parents, we don't know this journey and it's new and we don't have a roadmap for our neuro diverse children. So it's really important that we work hand in hand and there's equal time for the parents.

Cynthia Miller-Lautman:

So that's my last story that I think really shaped me.

Paul Cruz:

You often say, watch the person. What does that look like in real time when you are meeting someone for the first session?

Cynthia Miller-Lautman:

So I'm always observing. That was one thing I learned as an OT is that all these tests are important, but your observation skills are even more. So when I say watch a person, I mean, I'd actually ask the person if they can speak, I would ask them. If it's a little child, what do you want to try first? What do you like?

Cynthia Miller-Lautman:

And I would ask. If they cannot speak, I would ask their caregiver, their parent accompanying them. If it's someone older, I would ask the parent if it's for a child, or I would ask the children if it's for their parent to tell me a little bit about. But then the watching what's really the watching is what do they go to in my sensory room? Do they go to the mats?

Cynthia Miller-Lautman:

Do they go to the bean bag? Do they go try to swing on that swing right away? And I would be watching these things for clues. Are they a little clumsy? Are they bumping into things?

Cynthia Miller-Lautman:

Can they not actually take off their jacket because they can't really feel where their body is? Can they not untake off their shoes or take off their coat? All of that I'd be watching and with a little sensory lens to, to say, so it's not like they can't take off, but why can't they take off their coat? Why are they going towards the swing? I'm starting to form questions and a hypothesis on the person, but watching is the most important.

Cynthia Miller-Lautman:

That's why I need to spend time with the clients. And you can't do that in a short period of time. You need to see them also on different days so you can know, what they're like. And that's why I love it. Parents and teachers know the most because they're with them all the time.

Cynthia Miller-Lautman:

And I see a tiny snapshot.

Paul Cruz:

Let's ground the science without the jargon. How do you explain the eight senses, especially touch, vestibular and proprioception as the base for regulation?

Cynthia Miller-Lautman:

Yeah. When I give my course to people, I always marvel. Even the professionals, we're not sure. It's all these terms and jargon in our head. So I love that because the senses we learn in kindergarten, most of them, not all of them.

Cynthia Miller-Lautman:

And there's eight of them. And I will go through them all if that's okay. And I'll tell you a little bit about each one. And I'm going to start with the three main ones. So there's the touch vestibular and proprioceptive senses.

Cynthia Miller-Lautman:

So the touch sense you've learned about in kindergarten, you know that that is how you feel touch, but did you know there's light touch and deep touch? And people respond differently to both of those senses. Someone could be craving deep touch to help them calm down, but could not stand the light feeling of a scratchy shirt on their sleeve. Or if someone is approached with light touch, they might hit you if they're in high stress level, but they might really be craving that deep touch of like something weighted or cozy blanket around them. So that's the touch system in a nutshell.

Cynthia Miller-Lautman:

It's developing in utero when babies are developing and it can be immediately affected when children have had hospitalizations. When adults are hospitalized, our touch system needs to be activated. We need to be touched to have it working on just right. So when there are situations that make it unsafe or you feel threatened that can affect your touch system in a nutshell. The second most important sense is, and they're equally important, is your vestibular sense.

Cynthia Miller-Lautman:

So this sense is really like two little inner ear circular canals that sit like this in your inner ear. And they sense they're super sensitive to sense movement. If you're off balance, your head is tipped, if you need to re correct. But unfortunately, some people do not feel just right on their vestibular system. So two ways they could feel too much or too little.

Cynthia Miller-Lautman:

So a too much vestibular system would be they cannot tolerate the car or spinning or their parents bouncing them up and down. They feel sick, they cry, they don't want it. So that is either they could feel on high to linear, so back and forth like a swing or rotational, which a lot of people can get sick quite easily from. So that's the vestibular system in a nutshell. But in a sense, what I look for is are people feeling too much or too little?

Cynthia Miller-Lautman:

If they're feeling too much, they feel sick usually and will refuse to do something. But if they feel too little, they might go out looking for vestibular. So there'll be swinging and getting out of their chair and running and spinning, or maybe subtly keeping moving their head and rocking in their chair. So that's already telling me that their vestibular system might not be on just right. And they're trying to get there.

Cynthia Miller-Lautman:

The third most important sense. And again, a sense you probably didn't learn about in kindergarten is the proprioceptive sense. And this is the sense that you can feel where your body is in space with your eyes closed. So I could touch my nose with my eyes closed and not miss it. I could get to my nose.

Cynthia Miller-Lautman:

And this sense is working in the background. So most people do not know it's there, but when it's not working on just right, you know, and you know it because you're uncoordinated. You can't quite feel where your body is. You may then develop messy writing because you can't feel your hand. It might be a bit clumsy at sports because your body just doesn't sense exactly where that racket is or where that ball is.

Cynthia Miller-Lautman:

And so it's really working in the background, but it can cause a whole bunch of havoc in a kid that doesn't feel enough. So you may have someone that doesn't feel enough of their proprioceptive system. So some of them go out to get it. So they'll be leaning on things and they'll be reaching for things and looking for deep pressure because it actually gets them to just write. And someone who is really good with their purpose, they feel a lot.

Cynthia Miller-Lautman:

These are the kids and adults that are really good at sports. They are hyper athletes and they can do perform really well because they have a really good tuned sense of that. So that's in a really small nutshell, the proprioceptive system. And then we have the five other senses, which I'll go through just a little quicker, but you probably know most of them. The first is the taste system and any parent or someone that knows someone that is a picky eater, as we might say, which I feel is a bit more of a negative term, but selective eaters, the way we like to say it now is that they are sensitive sometimes to taste and it affects them so much.

Cynthia Miller-Lautman:

They don't want to take touch a new food and they don't want to eat certain foods. They're really go after predictable foods because they it feels too much in their mouth. So that's the taste system in a nutshell. But the taste system is really, really, really closely affected by the touch system. So usually when someone is having a taste difficulty, there's something going on in their touch system.

Cynthia Miller-Lautman:

The next sense is the sense of smell, which we all, again, all know, but it's also directly related to taste. When you smell something that's not good, it's human nature and it's a protective mechanism to not eat it. Right? We don't eat garbage. We don't eat food that's spoiled, but some people feel too much on the sense and their sense of smell is so strong.

Cynthia Miller-Lautman:

They can't walk into a room with certain kinds of smells. And this makes it hard. This makes it hard to be in a typical world with smells and different experiences. Again, when there's a smell sensitivity, I'm usually seeing another regulation problem in the touch vestibular and proprioceptive sense. Usually something also a clue there that something's not on just right.

Cynthia Miller-Lautman:

Then there's the auditory sense. And anyone who has been sensitive to noise or has trouble sleeping when there's noise will know this sense. When something is too loud or hurts your ears, you don't want to be there and you cover it and you move away. And this is really, really disruptive and can be really hard for someone who is feeling too much on this system to stay in a crowded place, to go to the movies, to go to the grocery store. But again, there's a clue there.

Cynthia Miller-Lautman:

When the auditory system is not on just right and responding too much on high, what might happen is one, the person might plug their ears and make their own noises so that they can block out the other noises. So it looks like they're seeking auditory, but they are, but they are comfort zone of auditory. And the second thing they might do is run away and leave the environment. And yet we say that's a behavior. Often they're just trying to get what they need, But that auditory system is an indicative that something's going on most likely in the touch vestibular and proprioceptive sense.

Cynthia Miller-Lautman:

The next sense that's again important is, but also not as important as those three main senses, is your visual sense. And this is where you might see someone who is very overwhelmed by visual experiences. So you might say, okay, they can watch a video game and play it and play it. By the end of that video game, they're vibrating. It's like it was too much for them.

Cynthia Miller-Lautman:

The other thing could be in classroom or a doctor's office. So the lights, those neon lights that are so bright take a toll on all of us. But someone who is feeling too much to their visual system might really have a lot of trouble concentrating because of that bright light. Distracting walls, busy walls, flashing lights. All of these things can be really hard, especially for someone autistic individuals talk about this a lot.

Cynthia Miller-Lautman:

That their peripheral vision is really, really, really strong. So they look to the side and they see all of those signs that you and I might be able to ignore and say, Hey, it's a behavior, just pay attention. But that's not so easy for someone who has a really strong peripheral vision. So you can see that it can look like a behavior, but really their visual system is not on just right. Again, the clue is in the touch vestibular and perpoceptive sense.

Cynthia Miller-Lautman:

Also probably dysregulation going on there. And the last sense, which is not new, but newer on the field of science in the senses is the interoceptic system. And I have learned a lot in the last little while about that system, but it's everything to do with your internal body senses. So are you hungry, thirsty, tired? Are you feeling stressed?

Cynthia Miller-Lautman:

Is your heart beating? Do you have to go to the bathroom? So to me, this is like a whole bunch of senses all in one, but I'm learning a lot about the interoceptive and there's people doing some great work on that. And again, if the interoceptive system is not on just right, I'd be looking at the touch vestibular and proprioceptive systems to increase activity there to help regulate those senses, to help them be even able to feel an internal body cue. So if you don't feel good in your touch and your vestibular and your perceptive system, there's like very little chance you're going to be able to feel all those internal body cues, which is why you see some neurodiverse people running out of the room quickly to go to the bathroom or someone with ADHD is not learning, has not learned to feel that cue of I've got to go to bathroom.

Cynthia Miller-Lautman:

So it happens at the last second or oops, I forgot to eat because I didn't have that internal hunger cue. And so suddenly I'm ravenous or now I'm really in a bad mood. So in a nutshell, that is the eight senses.

Paul Cruz:

Families need usable, not perfect. When translating complex sensory science, what do you keep and what do you leave out so it stays actionable?

Cynthia Miller-Lautman:

Right. I think I already kind of use some of the lingo, but I myself had to clarify how do you say it and explain it to parents and therapists, even a psychologist, a social worker, the teacher working with the child. And I really like to use the just right language theory. It's like, if you are just right on your senses, that's just right. You're able to participate.

Cynthia Miller-Lautman:

You're able to do the classroom activity. You're able to do the work. You're able to eat your meal without disruptions, but that is just right. Anything on high would be feeling like on overload to that sense. So I really explained the senses as I did in kind of, are you just right?

Cynthia Miller-Lautman:

Are you feeling too much on high or are you feeling too little? Are you on low? Do you need more of it because you can't go get it yourself? So you need help getting enough or maybe you can go get it yourself. So you're seeking a lot of movement because you're trying to get to just right.

Cynthia Miller-Lautman:

So basically, that's the language I use. And when I think about things, I'm like, what is the person trying to get? Are they trying to get to just right? And are they going about it the right way? Or is it really disruptive and hurtful sometimes to them?

Cynthia Miller-Lautman:

So that's the theory in general. There is a lot more complexity when you go into therapy world and assessments. There's really a lot of nuances. And that is a time when you're with a therapist and occupational therapist, especially who knows sensory, they would work on much more fine tuning of those skills. But in general, when we're trying to help our families and our teachers and our therapists have a safer sensory environment, we need to think about just right and how do we get there.

Paul Cruz:

If we walked into a space you helped set up, what would we see and why?

Cynthia Miller-Lautman:

I like to talk about the three different spaces I would set up because there's the classroom, there's a home, and then there's a therapy office or dental or medical office. But in a classroom, when I walked into a classroom, I would want to see a space in a corner or in one part of the room that is sensory safe. And by what I mean by that, I would mean that the lights are dimmer or there's a sheet over a table or there's a tent. There's something really comfortable to sit on, a beanbag chair, a mat, a pillow. I would want to make sure that in that space there was access to something touch vestibular and proprioception.

Cynthia Miller-Lautman:

So could there be a little rocking chair or an office chair if you don't have access to a rocking chair? Could there be a weighted lap pillow or a weighted animal if it's littler kids that is give something weighted that we know activates the proprioceptive and the touch system? Is there something vibration that you can have? Like we have vibrating snakes and little sensory tubes that they can have access to, which can really help get their system to just right. So I'd really want to see a sensory safe corner.

Cynthia Miller-Lautman:

It doesn't have to be expensive. You can buy the vibration handheld tools at the pharmacist, at the drugstores and the weighted things I've made them before. I take a sock and I fill it with beans and I sew the end shot in dried beans and you can, they can wear that on them. So it can be simple. It can be inexpensive and you can do it with an old couch cushion and an old curtain that you put over a table or an old sheet.

Cynthia Miller-Lautman:

So that would be a classroom. If I could, if it was ideal, I would stack when I walked into that classroom, there would be the sensory corner. And then there would be at least one wall when the children had to focus that had nothing on it, that just had the essentials on it. Maybe the SMART Board where they have to focus, but there would not be artwork all around that. So someone with a very strong peripheral sense of vision would not be looking at all of that.

Cynthia Miller-Lautman:

So I would have at least one wall where they could turn when there's a test or when they need to focus to look at. So that's a nutshell in a classroom. I would also have though the light covers, the neon light covers. So you didn't have that strong neon light all day and I would hope to have nice open windows. At home, there's two different ways.

Cynthia Miller-Lautman:

Some people live in a small apartment and they don't have a lot of space. So say they might need a removable sensory space. I still encourage that at home, there's a space somewhere that a child or adult who's feeling too much has a space to go that is sensory safe. Again, mimicking that classroom setup. Something on the floor where you can get down to the floor and feel comfortable, maybe a rocking chair or an office chair that you can get some vestibular, something weighted, something vibration, maybe noise canceling headphones.

Cynthia Miller-Lautman:

If you need to tune out the noisy family around you, But it needs to have a space that they can go to and it's not a punishment and it's not a reward. It's somewhere they can go when they need to regulate. Same thing in a therapist's office. When we bring our children or when we ourselves go to a doctor or a therapist, it's usually stressful, especially if you're talking psychology, social work, speech therapy. There's a lot of demands on the kids or the adults that are going there and emotional demands, and that can trigger stress.

Cynthia Miller-Lautman:

So again, I really like to see an office and it's not traditional. I haven't seen many people do it, but people are starting. That is not just you sitting in an office chair, that there is a place on the floor with a match or a bean bag. And all the things I talked about, a weighted lap pillow. So that person can feel grounded while they're talking to you or doing these hard therapy.

Cynthia Miller-Lautman:

So the same concepts, but. And people say, but have a small office. I've done it in super small offices. I've redesigned with a social worker recently and we redesigned our office. We turned off the upper lights.

Cynthia Miller-Lautman:

We brought in a lamp and she could turn on that light and she had the corner with her bean bag and her sensory tools. It just changed the dynamic of her office and the feeling when you walked in, it became a really welcoming space.

Paul Cruz:

And how we use tool matters. How do you coach staff to shift from earn a break to supports to do the work?

Cynthia Miller-Lautman:

Well, one of them logo, the mottos I say is sensory is not a reward. Sensory is a human need. We would not not give someone their medication because they were good or bad. We would give it because they need it. We give glasses to people who need glasses.

Cynthia Miller-Lautman:

We need to have sensory regulation opportunities for everyone in our classrooms, in our therapy offices, in our homes, because we may need it at different times. So that mindset has to shift. You don't get to go to the sensory corner because you've been good or you did your work. You get to go to the sensory corner so you can do your work. So you can be the best part of you at school, home or therapy.

Cynthia Miller-Lautman:

And what do I do to teach it? I often reframe. So if I hear a teacher, therapist, parents say they're being bad or it's a behavior and they're just so they're trying to get me mad. I'll reframe. I'll literally say the words, you know what?

Cynthia Miller-Lautman:

It might feel that way, but they're actually telling you something. They're actually communicating something to you. If they're showing you that they're upset and they're leaving the room or your classroom, they're telling you it's too much. Now it's your detective work to learn what is too much in that classroom. And I keep saying it again.

Cynthia Miller-Lautman:

I really find that we all need more and more reminders to change how we think about certain things. So I do that a lot and I give trainings. I find that trainings really, really help. When we speak to a group, it's like people are open to listening. And one of my favorite things I do in my course is I teach what it feels like to be sensory overwhelmed.

Cynthia Miller-Lautman:

So I do a sensory activity that makes the entire audience feel overwhelmed sensory wise with their touch vestibular and proprioceptive system. And by doing that, that's when I get people believing, because when we can really feel what it's like to be dysregulated sensory wise, we're much more empathetic and we're much more attuned to the students and people we work with.

Paul Cruz:

Let's talk about what gets labeled as behavior. How do you help adults see defiance or inattention as signals of dysregulation instead?

Cynthia Miller-Lautman:

Well, again, I refrain when, and I teach the detective kind of patterns. So if someone, for example, would say a student's rocking in their chair all the time and they're falling off their chair. I would say, woah, they're rocking in their chair because they're telling you they need to rock in their chair. What is rocking? Linear vestibular back and forth.

Cynthia Miller-Lautman:

So maybe we need to provide them with an office chair or a rocking chair that they can work at, or they have rocking stools and they call them T stools. There's tons of different seating opportunities for kids and adults too, to wiggle while they learn. So that would be one, it's again, reframing why it's happening. And often when we are frustrated as an adult and don't know why something's happening, we tend to blame. Whereas if we can learn to ask a question, why I do feel we can change that negativity.

Cynthia Miller-Lautman:

Another really common one I see is they keep getting out of their chair. They're always moving. They're disrupting everyone in the classroom. And I see this a lot in the littler grades when they're learning to sit and stay still and really a four year old can sit about five or ten minutes. So that's not long.

Cynthia Miller-Lautman:

So sometimes I see circle times that last thirty minutes. Well, of course they're going to get up. And remember that is the average child that would sit for five to ten minutes. So then you have a child that has needs more vestibular and more movement and more touch. So they're going to get up in that circle time and move around and maybe come up to you and touch you.

Cynthia Miller-Lautman:

And that seems annoying, but they need it. I'm going to remember the age we're working with. And if it is someone older, what is their developmental age? Then their attention and sitting ability is that age. So that's another common one I see.

Cynthia Miller-Lautman:

And I'm just saying, well, why don't we get the whole group up and move? We can all do this standing up and we can rock while we're learning about frogs and science and whatever you're learning about. I see another one that I hear they're refusing to eat. This is common at lunchtime, sometimes at schools when kids are staying for lunch and you have the lunch monitors, or parents that are really worried about their kid not eating. And I reframe that with saying it's not refusing to eat.

Cynthia Miller-Lautman:

It's maybe they're really sensitive to their taste system. Maybe they're a super taster and they really taste the pepper in that food. Maybe they, their sense of smell is on high and they feel too much. They really can't stand that strong smell of fish or whatever that is. So again, it's a reframing so we can get away from forcing eating because that does a whole other, bout of damage and trauma to someone who has to eat that food before they get to go out for recess.

Paul Cruz:

Support also means safety and consent. With items like weighted tools or movement activities, how do you handle dosage, consent, and group safety?

Cynthia Miller-Lautman:

Right. The big safety concern I have is with weighted equipment. I love weighted equipment. However, there is rules and you can never put 10, more than 10% of body weight, of weight on a child or adult. Especially if they are low muscle tone, you know, they have trouble moving.

Cynthia Miller-Lautman:

So like an elderly person, for example, or a child who has motor problems, but it doesn't mean it's not good for them, but just never go up past that 10%. So with weighted stuff, that's really clear. And I don't leave them unattended, especially if we're using it in a group, in a school, you really need to be attentive. You don't just go off somewhere else while they're wrapped in a big weighted blanket and walk away because that's when problems can happen and they could get scared one thing, or if they're low muscle tone or have a breathing difficulty, it could be dangerous. But the other thing I really have to be careful with, and this is consent and everyone's like, well, how do you get consent if someone's non speaking?

Cynthia Miller-Lautman:

And what I love and what I learned early on is that most people can tell you. I remember my grandmother in the late stages of dementia and she couldn't speak anymore because she could barely move. But boy, did her eyes tell me what she liked and what she didn't. And she could turn her head and she could look at me and she could tell me she wanted that touch and that head rub or that massage to continue. So just because someone's non speaking or can't move very well, doesn't mean they can't tell you.

Cynthia Miller-Lautman:

So you really want to watch the eyes. The eyes that people have said are the windows to the soul. And I do believe they tell you a lot. They tell you when someone's scared, eye contact and eye expression can really give you a lot of feedback. So I'm always watching.

Cynthia Miller-Lautman:

I put something weighted on someone and they push it away, I take it off. It's not my, it's, I'm not there to force. I'm there to expose and teach and try and let's be a detective. I would never force weighted equipment on someone, but it doesn't mean that cause they try it once. I don't try it again because just because maybe the first time they felt that weighted lizard or animal on them, they felt that light touch of the scratchy material and they couldn't tolerate it, but they really need it.

Cynthia Miller-Lautman:

So the next time we try it, they're wearing a blanket on top of them. Then we put the weighted thing and guess what? Like it. So you keep trying, you keep being a detective. And honestly, I don't always know.

Cynthia Miller-Lautman:

I have to try with the kids. The other thing is that when someone pulls away at all, so they jerk away, that is telling you something. That is consent to say, I don't like this. And it's important to respect that. And I see, unfortunately, a lot of in adult child relationships that are not the parent that there's, you know, touch by instinct, we want to touch someone to help them calm down, but that's not always the place to start.

Cynthia Miller-Lautman:

And you really need to be in a trusting relationship because anyone who is defensive, especially to touch will react to that. And you could traumatize them and delay all the work you do. So really important to look at the eye contact, look at the body language when you're working with someone and being that detective.

Paul Cruz:

Sensory needs aren't just for kids. What does sensory safe design look like in dental or medical offices, waiting rooms or workplaces?

Cynthia Miller-Lautman:

Right. You know, we talk about sensory in terms of kids and that is an absolute myth. It is in everyone, in all age populations, in many different diagnoses and many different typical developing people have different experiences of sensory. So yes, it's not just for kids. It's all through the ages and through many different individual diagnoses.

Cynthia Miller-Lautman:

So one of the common things that is very difficult for someone with sensory difficulties, especially if they have taste and sensitivities, is going to the dentist. These kids, adults often need to be put under general anesthetic to get basic treatments like maybe a tooth pulled because they are so fearful and they feel so much. So they are rightfully scared because they are feeling a lot more pain or anxiety compared to someone who doesn't feel that. So that waiting room is a stressful place for a kid that knows or an adult that knows they have to do something stressful. So that waiting room should be just like that classroom.

Cynthia Miller-Lautman:

Is there a sensory safe spot that someone can go to? And there is dental. If you Google it, you can see dental offices, especially India. They're doing a lot of this that are sensory safe. You can look at images of it, but is there a rocking chair, an office chair?

Cynthia Miller-Lautman:

You know, you go to an office and you're sitting side by side with people stuck like this really close contact. Is there a space they can have to relax and feel just right before they go in? Because if they're not on it just right before you go in, good luck in the procedure. So again, it would be a space with maybe a mat, a washable bean bag. Cause I know for men, for hygiene reasons, it can't be just material.

Cynthia Miller-Lautman:

It might need to be like a plasticized material, but you can get those rocking chair, office chair, just so that there's movement. Maybe if you're willing to get some of the vibration tubes and a vibrating mat, they have waterproof covers for them. Someone could go lie on it before their session. And that is sensory safe. And it's happening.

Cynthia Miller-Lautman:

I was in the chair in a dental office or especially a dental office, let's say they use weight by, because they have to, when they're taking an x-ray, they put a weighted pad over you to take that x-ray to protect you. But it feels so good if you've ever had it. You're like, this is great because it's providing a proprioceptive feedback. You feel grounded. And when we're stressed that proprioceptive feedback helps us calm down and get to just right.

Cynthia Miller-Lautman:

So I would wear that. I would have someone wear that the whole time. If I knew that they were sensory dysregulated in the dental office, that would stay on them. So that's not something new they need to buy that would be on them. I would also possibly even have vibration tools that the person could have while they're doing, because if instead of focusing here, they could be holding that vibration tool in their hand and getting the vibration to their hand.

Cynthia Miller-Lautman:

So you know that when we have pain, we often grab something and hold it. So it would be that same kind of theory as giving them what they need so that they can cope with that stressful situation. In a medical office, it would look quite similar. I wish in most pediatric offices, waiting rooms, that's sometimes you're waiting a long time. And if you have a child that is neurodiverse and sensory dysregulated, that is very hard.

Cynthia Miller-Lautman:

So again, I would have the sensory set of space in all of these. I would have mats on the floor. I would maybe have a sensory tent that a child could go in that is calming without the bright lights of the office. And you need to have to have safe tools. I wouldn't probably have the vibration tools and everything there because kids can take them apart and get into trouble if they're not watched.

Cynthia Miller-Lautman:

But I would have a sensory safe space they could escape to so they could get to just right. And when you were in the office, how many times are parents listening and while their neurodiverse child who is sensory dysregulated is running and they can't listen. So the doctor's giving them important information, but they can't listen because their child is running or crying or moving. So again, I would have a little corner with a mat, maybe a little sensory tent right in the office. I know they're small, but I've seen it done.

Cynthia Miller-Lautman:

And in that place, might have a weighted lap pad that the child could sit on them, maybe earphones, noise cancelings, they could put them on. I would have some of those options. So it's safer for parents too, so they can be regulated themselves when they're listening to important medical information.

Paul Cruz:

Words shape care. How do you keep practicing neurodiversity affirming inside medical systems that can pathologize?

Cynthia Miller-Lautman:

Right. I've learned a lot about this and I'm continuing to learn. I know my colleagues and I practice regularly talking and learning and reading about the new neuro affirming tools and terms to use. And one of them that I'm really using, and I think you've heard me say here, I don't say they're non communicative because everyone's communicating. I say non speaking because that's very different than communicating because if we can blink, we're communicating.

Cynthia Miller-Lautman:

But non speaking is not using words to speak. So that is an example of one that we're really trying to use a lot more.

Paul Cruz:

Many listeners are juggling limited time and energy. What's your minimum viable plan to stabilize regulation at home or school?

Cynthia Miller-Lautman:

Right. So there's no cookie cutter plan and that would be unsafe to do. If you were a parent or teacher trying to make something tomorrow, set up a sensory corner, set up a little sheet over a couch or over a table and see. Put something comfy, put a cushion inside. That's where I would start.

Cynthia Miller-Lautman:

But you wanna also think about what's going on in the touch vestibular and proprioceptive sense. Are you providing activities to your child that are vestibular and proprioceptive? So touch, we know that might be massage. That might be weighted equipment, which is also the proprioceptive sense. When we put weights on ourselves and move through that, we can activate.

Cynthia Miller-Lautman:

So like a weighted hand weight, you can move through that. So think about weights, never more than 10% of the body weight. And then with vestibular, when our child is not listening and mealtime was a mess, did they move enough before dinner so that they have the ability to sit and eat their dinner? Maybe not. Well, you try again next time.

Cynthia Miller-Lautman:

Okay. Maybe they need to run outside for a few minutes before, or maybe we need to spin them in an office chair for a little bit. Maybe they need to do a little jump on a trampoline, an inside one or an outside one, or little jump on your couch, maybe holding your hands. But these activities can help regulate to just write so that remember we talked about those other senses can be activated, like eating and smelling and tasting and all of those other senses that are important at home.

Paul Cruz:

Let's end with what's next and something listeners can try. Which frontier, like interoception or stress literacy, are you most excited to develop? And what would you ask listeners to try this week?

Cynthia Miller-Lautman:

So for myself, I'm really interested in the interoceptive system. I'm trying to understand how we can help it more and how we can teach the attunement. So I'm working with a psychologist to learn more about that and how she's implying that into her practice with her clients. And I'm also developing a talk on how stress affects sensory regulation and vice versa. How, when you're not sensory regulated, it can increase your stress level.

Cynthia Miller-Lautman:

And so we say we're stressed, but maybe we're not sensory regulated or we've something stressful has happened and suddenly we're not sensory regulated. So that is what I'm excited about. But for the parents, like what can you try tomorrow? If you're a teacher listening to therapist, become a sensory detective, be that person that can help the person you love or are caring for or teaching, figure out how to get to just right. Become that detective and don't give up because you didn't figure it out.

Cynthia Miller-Lautman:

Try again. The tool you tried today might not work and actually it might work today and not work tomorrow, but be that detective. That is the one best thing you can give someone who is not able to get to just write on their own.

Paul Cruz:

Cynthia, where can we find your work or resources? And do you have any upcoming talks, trainings or guides?

Cynthia Miller-Lautman:

Yes. So I just recorded a four hour live webinar, which is on demand, and you can find that at courses.cynthiamillerlauban.com. And I'm really excited for anyone in Montreal, Quebec. I'm giving this talk at the Teachers' Convention in Montreal in November, November 6 at the Bonaventure Hotel. So I'm very excited for that because I love doing that to educators.

Cynthia Miller-Lautman:

You can also, I have a podcast called Swinging Upside Down where I record every one episode a year when it's meaningful. You can find stuff there. And I'm, you can also look for me, Cynthia Miller Lawton dot com on social media.

Paul Cruz:

Doctor. Cynthia, thank you. Links are in the show notes, so thank you for coming.

Cynthia Miller-Lautman:

Doctor. Jose: Thank you.

Paul Cruz:

To our listeners, if this conversation resonated with you, please share this episode. Don't forget to subscribe to the Neurodiversity Voices podcast wherever you get your podcasts and even rate our podcast on your favorite podcast app. If you have any questions, ideas, or stories you'd like to share, please feel free to write us or sign up to be a guest on our podcast website at www.neurodiversityvoices.com. We'd love to hear from you. Until next time, take care, stay curious, and keep celebrating the beauty of diverse minds.

Paul Cruz:

Thanks for listening to the Neurodiversity Voices Podcast