By: Anna Cole McTish OTD, OTR/L
It is sensory? Is it behavior? Or is it both? This is the age old question that pediatric therapists and parents ask themselves time and time again. We have all had experiences where children with behavior problems also exhibit sensory concerns. On the other hand, we have all had experiences where children with sensory concerns also exhibit behavioral problems. The truth is…it is hard to have one without the other. If this is the case, how do we make our treatment beneficial for the child that exhibits sensory and behavioral concerns? How can we help parents manage behavioral tantrums and sensory meltdowns?
This article will discuss the definitions of sensory and behavior. It will also provide some tips for how to tell the difference between sensory and behavioral concerns and provide the most well-rounded treatment for your patients and tips for parents.
First some definitions:
Merriam-Webster dictionary defines “Sensation” as “a mental process (such as seeing, hearing, or smelling) resulting from the immediate external stimulation of a sense organ often as distinguished from a conscious awareness of the sensory process”.
Merriam-Webster dictionary defines “Sensory” as “of or relating to sensation or to the senses”.
Merriam-Webster dictionary defines “Behavior” as “anything that an organism does involving actions and a response to stimulation” and “the way in which someone conducts oneself or behaves”.
From the definitions above, it seems as if it is difficult to have sensation without behavior and difficult to have behavior without sensation. Sensation results from an external stimulus and behavior results in a response to stimulation. How do we know which type of reaction we are getting from a child?
A few things to keep in mind:
1. Negative behaviors tend to quickly escalate from “0-60” and can sometimes be easily extinguished with a redirection or alternative. Negative behaviors often spawn from difficulty communicating wants/needs, seeking attention, avoiding fearful stimuli, or attempting to obtain an object or activity of choice. For a behavioral example, a child immediately throws a tantrum after being told that he or she cannot have a toy in a store. The child is in control of his actions and is extremely upset (crying, throwing themselves on the ground, etc.) but is also easily redirected when Mom says that there is a treat waiting for them in the car. A response that is led by something a child wants or does not want and can be easily changed or redirected is most likely a behavioral response.
2. Typically, a sensory reaction might come out of nowhere but is not easily extinguished with a redirection. For example, another child is in the same store and experiencing a plethora of different sensory stimuli. They are already overwhelmed and overstimulated. When Mom states that the child cannot have the toy that they ask for in the store, the child escalates quickly and the situation ends in a meltdown. The child becomes extremely upset but is not in control of his actions/response. A response that is not extinguished when the child gets what he or she wants and cannot be easily changed or redirected with an alternative option is most likely a sensory response.
**Disclaimer: Sometimes a child exhibits learned negative behaviors due to the continuous presentation of a non-preferred stimulus. For example, if a child does not like loud noises and is continuously presented with these loud noises (without techniques to cope with or tolerate the noises), the child might start exhibiting negative behaviors. These negative behaviors spawn from the child believing they are in a situation where they will encounter the non-preferred noise.
Tips for determining the difference between a sensory meltdown and a behavioral tantrum in session:
Sensory Meltdown:
1. The child is not looking for a reaction from the parent or the therapist.
2. The child does not seem to care what the parent or therapist is doing during their meltdown.
3. The meltdown continues despite the parent or therapist giving in to the initial request.
Behavior Tantrum:
1. The child might look to the parent or the therapist for a reaction during their tantrum.
2. The child has been trying to communicate a want, need, or fear and you have accidently missed their cues.
3. The child has been exhibiting typical behavior until something does not go his/her way.
4. The tantrum immediately dissipates when the child is given what they have asked for prior to the tantrum.
What can I do when a sensory meltdown occurs?
- Look for specific triggers that always cause the child to become upset (Is it a loud noise? Is it snack time? Is it too much clutter in their environment? Have they had a very busy or overstimulating day?) This will help in the future. When you know the negative stimulus will be present, you can start to be proactive by providing deep pressure, heavy work activities, or adaptive tools (headphones) prior to the stimulus occurring. If the child allows, you can provide deep pressure to arms and legs to help calm as well.
- Understand that the child is not purposefully acting out…do not treat the meltdown like it is a negative behavior.
- Provide warning cues to prepare the child when something non-preferred or overstimulating might occur. “When we go into the store it will be loud and bright. What can you do to keep your body calm while we are in the store?”
- Keep additional sensory stimuli to a minimum in order to provide a calm environment.
- Give the child a safe place where they can rest and calm with different sensory tools present.
- Keep your verbalizations to a minimum and try not to talk through the problem at first…this can be overwhelming and cause the meltdown to worsen
- When the child is calm, offer a snack. Hunger might be a catalyst. Snacks can also be distracting and provide deep pressure orally (crunchy, chewy, strong tastes, etc.). Chewy: gummies, cheese, gum, granola bars, raw bagels. Crunchy: crackers, nuts, raw veggies, popcorn, pretzels. Sour: sour candies, lemon candies.
What can I do when a behavioral tantrum occurs?
- First, remember the child is experiencing the fight, flight, or fright response and is not in a position to reason with you regarding the situation.
- Stay calm and provide a model for calm behavior. Your calm behavior will help the child get to a place where they can reason through the situation.
- Keep language simple and to a minimum.
- Keep your voice low and calm and possibly state, “when your voice is calm like mine; you can tell me how you are feeling”. Repeat this phrase as many times as necessary.
- Acknowledge that the child is upset stating “this is hard for you, and you are mad/sad/frustrated.”
- Give the child space and do not provide extra attention to the tantrum. If you are able, allow the child to retreat to a calming spot. You can state, “your body needs a break, when you are calm, we can talk.”
- When the child is calm, offer a snack. Hunger might be a catalyst. Snacks can also be distracting and provide deep pressure orally (crunchy, chewy, strong tastes, etc.). In order to make sure the snack is a tool and not a reward, you can say “that was exhausting, let’s give your body some energy.”
- When the child is calm, you can then talk about the situation. For example, “you are frustrated that you can’t have this toy. It is such a cool toy. When we get home would you like to write it on your wish list/birthday list/Christmas list?”
- Be prepared with a toolbox of strategies and distractions for these situations! What works today will not always work tomorrow.
References and Resources:
Kaylene. (2017). 4 Simple Ways to Tell a Tantrum from a Sensory Meltdown. Retrieved July 26, 2017,
from http://thisoutnumberedmama.com/tantrum-sensory-meltdown/
Merriam-Webster Dictionary. (2017). Definition of BEHAVIOR. Retrieved July 26, 2017, from
https://www.merriam-webster.com/dictionary/behavior
Merriam-Webster Dictionary. (2017). Definition of SENSORY. Retrieved July 26, 2017, from
https://www.merriam-webster.com/dictionary/sensory
Merriam-Webster Dictionary. (2017). Definition of SENSATION. Retrieved July 26, 2017, from
https://www.merriam-webster.com/dictionary/sensation
Murray-Slutsky, C., & Paris, B. A. (2005). Is it sensory or is it behavior?: behavior problem
identification, assessment, and intervention. San Antonio, TX: PsychCorp, a brand of Harcourt Assessment.
Voss, A. (2017). A Sensory Life – Sensory Meltdowns. Retrieved July 26, 2017, from
http://asensorylife.com/sensory-meltdowns.html