Sensory Modulation Resource Manual

Julie and Carolyn have developed a course based on years of clinical experience in working with people who found bathing really challenging.

* The person who hears voices when they try to shower
* The person who experienced trauma in the bathroom and hates being in there
* the autistic child with sensory and anxiety challenges
* People who feel that a shower needs to be done in a certain way and does not have the energy for that.

Julie and Carolyn provide practical guidance and solutions to suit most challenges in bathing!



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Clinicians working in mental health need a broad toolbox including grounding skills.

This webinar provides a deep dive into grounding skills and content includes:
Brief description of Dissociation, Panic, Disconnection and Flashbacks
Pickle juice, vinegar, mustard as strategies including
why it works.
Other Sensory Modulation strategies that are grounding
This 2 hour 30 minute pre-recorded webinar series and powerpoint presentation focuses on grounding strategies .
The videos are divided up into 9 smaller videos.

Throughout each webinar, participants will be invited to pause the recording for the opportunities to reflect on content or engage in an activity to help consolidate learning.
A 31 page workbook is also accessible for participant use.

Grounding strategies for Dissociation, disconection and flashbacks Grounding Strategies for Dissociation, Panic, Disconnection and Flashbacks This webinar provides a range of Grounding strategies for you to try. Content includes: Brief description of Dissociation, Panic, Disconnection and Flashbacks Grounding Strategies Workbook

Are you interested in assistive technology and autism?

Do you want to increase understanding of neuroaffirming approaches to AT assessment & prescription for autistic people? The next ARATAaus webinar (available real time and on-demand via recording) is being delivered on Wednesday 19th August 2026 at 4pmAEST by Carolyn Fitzgibbon (Sensory Modulation Brisbane and OTSi).

Details and registrations via link in comments

Ruth Lanius article includes predictive processing and an understanding of why trauma may result in someone not feeling safe in the current moment

Why Traumatic Memories Feel Like They’re Happening Right Now These findings help explain why the brain continues predicting danger after trauma — and could reshape how we understand and treat PTSD.

New Research - Exploring sensory aspects of cutlery in neurodivergent-informed eating disorder care

Sensory sensitivities are common in individuals with eating disorders (ED) & this research focused on the sensory preferences of the cutlery.

*Chubinidze D, Meyer A, Makin L, Sterling K and Tchanturia K (2026) Exploring sensory aspects of cutlery in neurodivergent-informed eating disorder care. Front. Psychiatry 17:1827308. doi: 10.3389/fpsyt.2026.1827308

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.