This is one example of a sensory diet/modulation form created by occupational therapists to assist the consumer with the identification of the types of things available in each setting, to be used preventatively and/or during crisis states. These handouts should include a variety of options, which can be made available for use.  This particular form was developed for a specific adult acute care inpatient psychiatric setting, where most of the listed options have been made readily available. A "sensory diet" may be created and utilized in treatment, with or without a sensory room, and is very appropriate in occupational therapy practice with clients of all ages.  Such handouts are often useful for facilitating an increased awareness regarding what things tend to influence one's system and how, and for information gathering prior to attempting to help an individual create a sensory diet.

Sensory Modulation: An Essential Element of Occupation by Tina Champagne, M.Ed., OTR/L offers information on sensory approaches, sensory room development and a host of practical ideas and handouts for practice, which are appropriate for use among adolescent, adult and geriatric populations.