Is it Sensory or is it Behavior? How to Differentiate
By: Tricia Kernan, MOTR/L
As an Occupational Therapist (OT) who provides assessments and interventions to children via telepractice, I get a lot of questions regarding how I can accomplish this with students who have a sensory processing disorder. When parents and teachers report student concerns such as: “squirming in their seat, squealing, flapping, being aggressive, wiggling and decreased focus”, the task becomes to differentiate between attention, behavior, and sensory needs. OTs can address these concerns through teletherapy so that these students can succeed both academically and in their daily life skills.
Differentiating Sensory from Behavior
It’s not always simple to determine if a child’s behavior is due to sensory processing disorder or a behavioral issue. Below are some of the key differences between attributes related to behavior and sensory needs.
A behavioral reaction based on the child not getting something they want. It can look like this:
• The child is seeking attention or a specific reaction.
• The child asked for or demanded something prior to their reaction.
• The child is still aware of their surroundings and others.
• The behavior may end abruptly, particularly if the child gets the outcome they desired.
• The behavior is a choice, purposeful and meant to influence the situation or person.
A sensory response or meltdown is a biological reaction to feeling overwhelmed by a situation, environment, or sensory input. It can look like this:
• The child is not concerned about your reaction to the behavior.
• The child is usually not asking for or demanding anything before the reaction.
• The child is not in control and does not appear to be aware of their surroundings or others.
• Meltdowns can last longer and the child can need more time to fully recover afterward.
• A meltdown is not a choice, it is considered a biological response. (Fight, flight or freeze)
How Does Occupational Therapy Help with Sensory Processing Disorder & Behavioral Reactions?
Through sensory assessments, observation, and parent interviews it is often easy to differentiate the two. The OT can accomplish these via video conference platforms and telepractice. OTs typically start by discussing the differences between sensory responses and behavior characteristics with parents and educators. Once it is established that it is a sensory response, OTs then move to educate the student, teacher, and parent about sensory vocabulary to describe what the student’s body is feeling and why it feels the way it does.
The next step would be to provide strategies to the student, teacher, and parent so that the student has a toolbox of strategies to pull from prior to having a sensory response. Giving the student the vocabulary to express their emotions and alternate ways to respond, gives them the ability to communicate their needs without an adverse reaction such as hitting, yelling, or self-injurious behaviors. As part of an OT session, the OT and student can role-play different emotions and problem-solve different responses in order to support carry over and generalization in different environments. Telepractice can open the opportunity to school-based OTs to access environments that otherwise would not be possible.
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