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Markus, a lifelong skateboarder, surfer, and devout meditation practitioner, deeply understands a range of sensory profiles, from the on-the-go thrill-seeking to the calm and regulated. And having dealt with social anxiety much of his life, he also empathizes with the emotional challenges and withdrawal many kids experience with verbal interactions, earning him the nickname "the baby whisperer." He has an uncanny ability for understanding a child’s sensory and emotional differences, meeting them where they are, and guiding them to where they want to go.
As a musician, Markus tends to approach therapy with an artist's touch, often using music, singing and rhythms to creatively craft sessions to each child’s individual differences. His unique approach to occupational therapy is fun and it is effective.
Markus' love for travel, culture, and photography led him to International Therapy Intensives across several continents and in turn, Sensory Gym design. When some overseas clients lacked nearby therapy clinics, Markus began designing sensory gyms in their homes. This allowed him to meet children's sensory-motor needs and train families in effective home routines. Realizing the value of in-home treatment spaces, Markus expanded his efforts and began creating custom Sensory Gyms here in the US as well. His work combines insight, creativity, and craftsmanship to support children from the Ground upP.
Markus Jarrow, a lifelong skateboarder, surfer, and devout meditation practitioner, deeply understands a range of sensory experiences, from thrill-seeking to calm regulation. Having dealt with social anxiety, he empathizes with the emotional challenges and sensory overstimulation many kids experience with verbal interactions, earning him the nickname "the baby whisperer." He has a unique ability to relate to a child’s sensory and emotional differences and meet them where they are in order to support them to where they need to go.
As a musician, Markus tends to approach therapy with an artist's touch, often using music, singing and rhythms to creatively guide sessions. His unique, unconventional approach to occupational therapy is both fun and effective, helping children reach new levels of development.
Markus's love for travel, culture, and photography led him to International Therapy Intensives and in turn, Sensory Gym Design. When some overseas clients lacked nearby therapy clinics, Markus began designing sensory gyms and therapeutic play spaces in their homes. This allowed him to meet children's sensory-motor needs and train families in effective home routines. Realizing the value of in-home treatment spaces, Markus expanded his efforts and began creating custom Sensory Gyms not just for families abroad but here in the US as well. His work combines insight, creativity, and craftsmanship to support children along their unique developmental journeys.
Integrating a comprehensive clinical approach that supports the whole child
Tailoring a therapeutic approach to each child's unique developmental journey
Ground upP brings together SI, NDT, and DIR/Floortime with a twist, into a hands-on, bottom-up approach that truly incompasses all aspects of a child’s development. By respecting each child and their unique developmental journeys, we build empowering relationships that become the vehicle for meaningful change. Recognizing the deep interconnection between regulation, social-emotional development, sensory processing, movement patterns, language and learning, we treat the child as a whole, supporting sustainable progress across all areas.
It’s our responsibility to dive deep beyond surface symptoms to support each child’s growth from the bottom up. As clinicians and caregivers, we have to move beyond traditional power dynamics, building rich, meaningful relationships rooted in respect and playfulness. Rather than simply instructing and telling kids what to do, we should become partners and co-pilots in their journeys, honoring their passions to fuel positive change through play.
Ground upP is a holistic approach that evolved organically throughout my career, rooted in SI, NDT, and DIR/Floortime. It’s not as much of a new intervention as it is an integrated blend of these existing methods with a twist. Though child-led, affect-based and often playfully silly on the surface, it’s a carefully calculated and forensic approach behind the scenes.
Early in my career, I realized that working without a comprehensive clinical scope was like cooking without all the ingredients. This led me to spend the next 20 years deepening my knowledge in SI, NDT, and DIR/Floortime. As I saw the potential for these approaches to seamlessly integrate, I noticed that clinicians and therapeutic organizations tended to focus on one. SI lacked the in-depth body and movement pattern components and NDT missed the depth of the sensory piece. But how can you address regulation and the sensory systems without supporting alignment and movement patterns? And vice versa? And with children on the spectrum, how do you address either without navigating the nuanced layers of the social-emotional system? DIR/Floortime then becomes the glue that guides your every interaction.
Over time, I discovered that a strong understanding of these clinical models provides the framework to not only support every child, but support the whole child: mind, body and spirit. This isn’t about managing symptoms or behaviors but treating the root systemic causes - the social-emotional, neuro-motor, and sensory processing. Each child presents with a unique mix of strengths and challenges. It’s our responsibility to dive deep below the symptoms, be playful, fun and respectful, and support each child’s growth from the Ground upP.
Sensory integration (SI) therapy is a play-based approach aimed at helping children of all ages with sensory processing difficulties to better perceive, interpret, and respond to sensory information from their environment. This primarily includes touch, movement, sound, and vision. Each sensory system can present with heightened sensitivity (resulting in anxious avoidance), under sensitivity (resulting in seeking of more of that input) or a mix of the two. Many of the sensory systems work together in various subgroups to support different areas of function and therefore are highly interconnected and dependent on each other. Common issues include: sensory seeking behaviors, always “on-the-go”, balance and coordination challenges, motor difficulties, anxiety and withdrawal, and challenging, oppositional behaviors.
SI therapy aims to normalize any heightened or under sensitive systems and restore the collaborative functions in order to improve developmental areas, including motor skills, attention, and emotional regulation. Children learn to respond appropriately to sensory experiences, thus reducing anxiety, improving focus, and enhancing social interactions. Sensory integration is particularly beneficial for children with neuro-divergences such as ADHD, behavioral and learning challenges, autism spectrum disorder and sensory processing disorder.
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Ground upP is a hands-on, affect-based and relationship-centered approach that supports the whole child from the bottom up. What does "whole child" mean? By integrating SI, NDT, and DIR/Floortime with a unique twist, this approach comprehensively addresses all aspects of a child’s Development. DIR/Floortime enriches the social-emotional piece, NDT refines the physical body, and SI organizes the sensory systems.
In short, Ground up goes beyond surface-level issues to establish and strengthen the foundational building blocks that support development, adaptation, and generalization across all areas of a child’s growth.
Give a kid a sandwich, and they eat for a day
Teach a kid to make a sandwich, and they’ll eat when there’s bread and peanut butter
Empower a kid to think and problem solve, and they’ll adapt to any situation and thrive for a lifetime
Most early skills develop naturally through play to solve problems, driven by thought, reason, and intrinsic motivation. This rich emotional process connects our ideas, experiences, and skills, enabling us to learn, adapt, and apply ourselves to novel situations. It’s the essence of early learning and play.
However, when this natural process is disrupted for a neurodivergent child and skills are then arbitrarily taught through a top-down, behavioral approach, they often become isolated “splinter skills” that don’t generalize beyond the context in which they were introduced.
While skills are important, they’re only as effective as the social-emotional, motivational, and experiential richness in which they are learned. This richness creates the gray area that supports thinking, problem-solving, emotional range, and promotes integration and generalization.
However, when a neurodivergent child’s natural learning process is disrupted and skills are arbitrarily taught using a top-down, behavioral approach, they often become isolated “splinter skills” that fail to generalize beyond the context in which they were introduced. While skills are important, their effectiveness depends on the social-emotional, motivational, and experiential richness in which they are learned. This richness serves as the glue that supports thinking, problem-solving, emotional depth, and promotes integration and generalization.
While limit setting and imposed structure can be necessary at times, it is our duty as clinicians and caregivers to move beyond traditional power dynamics and build rich, meaningful relationships with our kids. Instead of simply instructing them and telling them what to do, we need to playfully support them as partners and co-pilots in their passions and journeys… play, get creative, try and fail, think and experiment together, laugh and cry, encounter and adapt to problems, and let learning unfold naturally and together. And most importantly, have fun!
Yes, for children who naturally adapt through trial and error, using feedback to learn and refine. However, for neurodivergent children with differences in strength, coordination, sensory processing, etc. the process can be very different. They may not benefit from the same reliable feedback to support learning and adaptation and instead develop compensations and maladaptive habits. In these cases, routine practice doesn’t make perfect - it simply reinforces those compensatory patterns.
Humans are resilient and will find a way to adapt. Children without arms have learned to play piano with their feet. This is truly remarkable. However, when resilience intersects with neurodivergence, it often leads to maladaptive habits that create a compromised foundation and limit further development. That’s why it’s essential for a child to establish the fundamental early building blocks, ensuring a strong foundation that not only supports skill development but also adaptation and generalization. It is our duty to assess and address the root causes rather than just the surface level symptoms and behaviors. There is always more to the story.
When a neurodivergent child struggles with a skill, it’s often a sign of an underlying issue that requires a deeper look. The challenges we see in motor skills, behavior, attention, etc. are usually just surface level symptoms of a more complex issue. Like fixing a leak in a dam, we don’t simply patch the hole – we address the root cause to resolve it and prevent future issues.
In therapy, this means not focusing immediately on the specific skill the child is struggling with. Instead, we need to step back and assess the foundational roots that support the skills such as regulation, strength, alignment, vision, coordination, etc. These almost always play a significant role in the child’s challenges and must be addressed first.
Through strategic treatment, we can target these foundational areas while making the process playful and meaningful for the child. Improvements in these areas often lead to the skills of concern developing more naturally, without the need for repetitive drills. For example, if a child struggles with catching a ball or sitting upright in class, we don’t simply practice those actions; we focus on the underlying challenges, such as visual processing, trunk stability, proprioception, etc. As the supportive foundation develops, refinement of the skills can then be more strategically practiced if needed.
How can we tap into a child’s sensory and emotional systems to best prepare them to rise up and reach their ultimate potential in therapy? How can we maximize gains during sessions and in home programs, thus creating fundamental shifts and strengthening those critical foundational areas? Whether dampening hyper-sensitive systems or activating under-reactive ones, the sequencing of our sessions is critical and how we address the relevant sensory and emotional systems to set up a child to optimally perform is key. Here’s a hypothetical case study to help paint a picture:
Background Information
You begin working with a 5-year-old boy whose teacher and parents are concerned about his slouched posture when seated at the table. Improving his sitting posture is an OT goal. He presents with decreased global muscle tone and core strength, often sitting with a posterior pelvic tilt, but has no mobility issues or restrictions. He presents with an under-responsive vestibular system and lights up during movement activities but his system tends to slow significantly when stationary and he can become lethargic. His tactile and proprioceptive systems are hypo-responsive as well resulting in decreased body awareness, which paired with the low muscle tone, does not provide adequate feedback for refined movement, postural alignment and sustained arousal level. He enjoys baseball and sports, being silly, and high energy environments.
Think Sensory Systems!
By strategically activating all relevant sensory and emotional systems in a deliberate sequence, we maximized his potential for optimal performance. Each new gain in alignment, strength and endurance, as well as sense of pride and accomplishment, becomes embedded in motor and emotional memory, laying the groundwork for even greater success in future sessions and beyond! Ground upP.
Over the years, I’ve met incredible people in the field, many of whom have become dear friends. This space is a shout-out to those colleagues and friends, as well as the esteemed mentors who have shared their priceless knowledge and wisdom with me. Having people to brainstorm and problem solve with is invaluable. Whether facilitating the learning or being the recipient of it, that collaborative clinical reasoning process is essential for growth and I’m always grateful for the opportunity.
