Sensory Processing, Meltdowns, and Better Transitions with Dr. Kristen Pfeil

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In this episode, Dr. Phil Boucher is joined by pediatric occupational therapist Dr. Kristen Pfeil, OTD, ​​OTR/L to unpack what’s really going on beneath common childhood “behaviors.” They discuss how sensory processing shapes regulation, why some kids seem constantly overwhelmed or “too much,” and what parents can do to better support their child (and themselves).

Sensory Processing 101: Kids don’t just have five senses, they have eight. In addition to sight, sound, touch, taste, and smell, there are internal systems like movement (vestibular), body awareness (proprioception), and interoception (internal body signals like hunger or anxiety). When these systems are out of sync, it can look like “behavior” but it’s often a nervous system trying to cope.

Sensory Seeking vs. Sensitive Kids: Some children crave more input (movement, touch, chewing), while others get overwhelmed quickly (noise, crowds, textures). Most kids are a mix and mismatches between a child’s needs and their environment (or even their parent’s sensory style) can lead to frustration and disconnection.

Meltdowns Aren’t Just Behavior: Many “problem behaviors” are actually signs of dysregulation. A loud classroom, too much sitting, or unexpected transitions can overload a child’s nervous system, leading to hitting, yelling, or shutting down. The key is looking at what happened before the behavior.

Helping Kids Regulate: Regulation looks like calm, connection, and a body that feels “just right.” Supporting this might mean movement breaks, deep pressure (“heavy work”), or simply giving a child space to reset. Just as important: parents staying regulated themselves and practicing co-regulation.

Transitions Without Meltdowns: Moving from preferred to non-preferred activities is hard, especially under age five. Tools like visual timers, giving limited choices (“10 or 15 seconds?”), and setting expectations ahead of time can dramatically reduce conflict.

Public Meltdowns & Boundaries: When things fall apart in public, consistency matters more than convenience. Holding boundaries (even when it’s uncomfortable) helps kids feel safe and learn expectations. Gentle parenting still includes clear limits, and those boundaries are what create security and freedom.

Timestamps

00:01 What Sensory Processing Really Means (Beyond the “5 Senses”)03:00 The 3 Hidden Senses: Movement, Body Awareness, Interoception06:00 Sensory Seeking vs. Sensory Sensitive Kids10:00 “Behavior” vs. Nervous System Overload14:00 Why Kids Get Kicked Out of Daycare (and What’s Underneath It)17:00 How OT Helps: Heavy Work, Awareness, and Regulation23:30 What a Regulated vs. Dysregulated Child Looks Like26:00 What to Do in the Middle of a Meltdown30:00 Transitions: Timers, Choices, and Reducing Power Struggles33:30 Public Meltdowns: What Actually Works38:00 Boundaries, Gentle Parenting, and Why Kids Need Limits42:00 When to Consider Occupational Therapy

Resources & Links

Connect Pediatric Therapy → connectpediatrictherapy.com

Book: The Out-of-Sync Child by Carol Kranowitz

Sponsor: Skylight Calendar — Use code DRBOUCHER for 15% off

Questions? Submit at dearparents.substack.com