Sensory AND Behavior: Addressing Difficult Behaviors from Both Perspectives

A seven year-old who insists on wearing the same outfit everyday. A five year-old boy who frequently hits and kicks his parents during hair and teeth-brushing. A tween with autism who becomes aggressive during transitions at school. Should these actions be treated as sensory problems or as behavioral issues?

Sensory or Behavioral?
My answer to this common question is typically that it is both – a sensory issue as well as a behavioral one. Through behavior analysis, we can often see that problems like these are rooted in a sensory need but they become behavioral. The child who insists on wearing the same outfit everyday is probably over-responsive to tactile input and she has learned that her fits about clothing are effective in getting her parents to back down on the issue. The child who hits and kicks during tooth-brushing probably is seeking proprioceptive (heavy work) input to help him tolerate the task but he still needs to learn that aggression is unacceptable no matter what. The tween who becomes aggressive during transitions is probably overwhelmed by the auditory and visual input inherent in transition time but he has also learned that aggression ends with him getting wrapped up in weighted blanket, which is soothing to him.

Tips for Handling Sensory Needs
Here are my recommendations on how to handle problems like these:

  1. Consult an occupational therapist for help on figuring out what the behaviors are telling you about the child’s sensory needs. Hitting and kicking may indicate the child is seeking proprioceptive input. Meltdowns may indicate the child is in sensory overload.
  2. Be PROactive in meeting the child’s sensory needs. If the child is a hitter and a kicker, make sure to allow him the chance to get “heavy work” type of sensory input BEFORE the problem time (like tooth-brushing). For example, ask him to crab-walk to the bathroom. The tween who becomes aggressive during transitions should be offered the weighted blanket BEFORE transition time so he doesn’t have to resort to aggression to get the input he is seeking.
  3. Be REactive using typical behavior strategies. Think through rewards and consequences and be prepared to implement these strategies if the child kicks during tooth-brushing.

Send the Message, “I Believe in You”
I know that as parents, we are often hesitant to use typical behavioral strategies to address issues that seem to be outside of our kids’ control due to sensory processing problems. But if we continue to allow them to wear only one outfit everyday or overlook being kicked during tooth-brushing, they will never be motivated to use the sensory strategies available to them to learn to cope with their sensory issues. Furthermore, by allowing behaviors like these, we are sending them the message that we don’t believe they can do any better. However, by using sensory strategies PROactively and using rewards and consequences RE-actively, we are letting them know that we believe in them and we are raising the bar for their development. We are showing them that they CAN learn to self-modulate and that even beyond that – we expect them to simply because it’s the right thing to do.

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Gwen Wild, OTR/L About Gwen Wild, OTR/L

Gwen Wild is the owner of Sensational Brain Co. She is also on the faculty of Summit Professional Education and travels nationwide speaking on the topic of “Creating and Implementing Effective Sensory Diets for Children and Teens.”