Friday, April 17, 2015

OCCUPATIONAL THERAPY: It's the Little Things that Make Life BIG!

Photo Credit: thanunkorm
Thanks to Cara Koscinski, MOT, OTR/L (The Pocket Occupational Therapist) for this informative "OT Month" guest post!
Is it Sensory or is it Behavior?

A child screams, yells, and hits other classmates at school.

Your daughter refuses to get her hair washed.

People stare at you because your son has thrown himself on the ground and has a tantrum-right in the middle of the mall!

The scenarios above occur daily in some of our lives. Our children have difficulty processing sensory input, making transitions, expressing their feelings, and controlling behavior. People often stare and offer suggestions about discipline, which we know won’t work for our kids. This situation is not only frustrating for the child, but leads many parents to believe that they are failing. So, the question remains….how much is behavior and how much is a sensory processing difficulty? Occupational therapists can help parents to determine the answers and provide strategies to help your child. Behavioral therapists may imply that the child is looking for attention. Each discipline has their theory as to what underlying issues are. Often, parents argue among themselves whether the child is ‘acting out’ or having a response to sensory stimuli. The entire situation becomes frustrating and overwhelming for everyone. As a result, cooperation from the entire team is a must!

Sensory processing and integration is our ability to take in information and make sense of it. Our brain compares the information with our previous experiences in order to determine what is dangerous to us and what/how we should respond. Children who have mature sensory processing systems are able to effectively take in and process the information and form an appropriate response. For example, a child is at school and the fire alarm sounds. He quickly raises from his desk, gets into line, and exits the building. However, a child who has sensory processing difficulty hears the fire alarm and screams in absolute panic, next he runs for the hallway in attempt to escape. He is unable to organize himself to finish his day and is sent to the counselor’s office. He is labeled a ‘difficult child’ because he often exhibits aggressive behavior in response to something that others consider harmless.

Determining sensory verses behavior requires some detective work. In my book, The Pocket Occupational Therapist for Families of Children with Special Needs, I encourage families to take a step back and analyze a child’s behavior by asking some key questions. What is the environment in which the behavior occurs? What happened before the child began the behavior? What was the child’s response? How did the adult respond to the child’s behavior? How did the child recover from the episode? If the behavior was prompted by a sensory experience then talk with your child to determine how he/she felt during the experience.

The old saying is true, “An ounce of prevention is worth a pound of cure.” Talk with the teacher to make a plan for the next fire drill (of course, there may be unplanned alarms). Involve your child in the process. Create a social story book and review it on a regular basis. Use actual pictures whenever possible. So, take a picture of the actual fire alarm at school. Consider purchase of noise-cancelling headphones or earplugs that your child has quick access to.

Working as a team to help a child is always best. Keep a journal of your child’s outbursts and tantrums. You might see a pattern. As a parent, make sure to get support from a friend or loved one. Always remember that you’re not alone and millions of others (parents and professionals) are trying to determine the question: Is it sensory or is it behavior.

Cara Koscinski is a long-time pediatric occupational therapist, speaker, and author of the Pocket Occupational Therapist book series. She is the mother to two sons with autism. Her books include, The Pocket Occupational Therapist for Caregivers of Children with Special Needs and the Special Needs SCHOOL Survival Guide for Autism, ADHD, learning disabilities, and More! For more information, visit her website at

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1 comment:

  1. I appreciate your post on determining if actions are behavioral or sensory in nature. I find that this is often hard to determine and can be a cause of frustration for most families. Your suggestions for noise cancelling headphones, social stories, and pictures of the fire alarm are all great ideas that can help to decrease behaviors associated with sensory dysfunction. I would also like to suggest using video modeling as a technique for visualizing the appropriate ways to respond to situations. This method has been researched and proven to be more effective than picture schedules.
    Your post provided clear ways to begin assessing client’s behaviors and strategies that can help to manage those. Thank you so much for your post.
    Tara Thompson, MS, OTR/L