Last weekend, I stopped at my local grocery store to buy some needed items for dinner. As I was checking out, I noticed a boy crying in a grocery cart. He appeared quite upset as he screamed and hit the cart with his hands. As I finished my shopping and headed home, I thought about a question I hear frequently – was it simply his behavior or did he have a sensory issue?
In order to answer this boy’s situation (and others like them), let’s start with a basic question:
What is behavior?
Behavior is anything that we do that involves an action and is made in response to something in our environment. Everything we do is behavior. Behavior can be innate (i.e., behaviors we are born with that are linked to survival) or learned through repetition, observation and reasoning skills.
So I see a behavior from my child that I do not like, such as the boy who was upset in the grocery store. Is my child behaving this way on purpose? Is my child trying to avoid a task?
Well, that depends. He/she may be behaving a certain way in order to get out of a task or demand. But if we assume that most children will behave if they can, then we first need to ask, Why is my child behaving this way?
Therapists at the STAR Institute for Sensory Processing Disorder use a strategy called A SECRET to help problem solve through behavioral challenges in children with sensory processing issues. This strategy provides structure, rather than a rigid routine, for solving problems. The program examines possible solutions for behaviors by considering the following :
(A)ttention: Where is the child’s attention focused? What can I do to change their focus? Is this child’s attention on anxiety? How can I redirect their attention? Is the child motivated to complete the task?
(S)ensation: Is there sensory input that is overwhelming or alarming this child? Can I change their environment to reduce their input/stress? Can I use sensory input to change their response?
(E)motional Regulation: What emotion are they experiencing? Is this emotion appropriate for the situation? Is the child experiencing a fight, flight, or fright response? How can I model emotional control? How can I support emotional control in the future?
(C)ulture: What part of the routine can be changed to help this child? Can my habits be changed to support this child? Can our family culture be changed to help my child? Are my expectations appropriate for this child? Can I change my expectations? Can I improve my child’s understanding of the expectations?
(R)elationships: Is my relationship with this child affecting the situation? Am I respecting his needs? Does this child trust me? Am I projecting my own fears, anxieties, stress onto the situation? Are my preconceived ideas influencing the situation?
(E)nvironment: What in the immediate environment is causing a problem for this child? Can I change anything in the environment? Can the activity be moved to a different environment?
(T)ask: Does the child have all the necessary skills to complete this task? Is this task too difficult or too easy? Is this task necessary? How can I assist with this task? Can I modify this task to make a “just right challenge?” Can accommodations help with the task?
Let’s return to the boy who was screaming and crying in the grocery store. We need to look at the possible reasons he may have been screaming.
- He may have been screaming for a piece of candy that he saw at checkout.
- He may have been overstimulated by the lights in the grocery store and all of the people moving around him.
- He may have been tired as their shopping trip took longer than planned and his nap was late.
- He may have heard a loud unexpected noise in the store and was suddenly very scared.
- The parent may have expected too much of him during the shopping trip, such as walking and not touching items on the shelf.
So if we think of his behavior as a type of communication, let’s consider what he could be saying to us. I can’t do what you are asking me because…
- I am tired
- I am overwhelmed with all the noises and lights around me
- I am scared
- I don’t understand all the words you are saying
- I can’t make my arms and fingers work like they should
- This task is too hard for me
- This task has too many steps for me to do
We must be ready to listen to our kids and hear their message, then we can problem-solve and think about ideas to help. Options could include:
- Use picture cards to help communication
- Go to the grocery store at a different time
- Give him a treat to eat while we are shopping
- Shop only for a couple of items at one time
- Give him picture cards to hold for items we are buying
- Provide a video for him to watch at checkout time to distract him
So can my child just be misbehaving and testing me?
Yes! Tantrums or “acting out” behaviors are natural during early childhood development, because children have a normal and natural tendency to assert their independence as they learn. While all children will have tantrums, behavior of children with sensory processing issues may escalate quickly into meltdowns. A meltdown is an out-of-control emotional response to being overwhelmed, and tends to occur in children who lack skills and coping strategies. Meltdowns are an emotional reaction to an internal state (hunger, sensory overload) and are NOT developmentally appropriate.
When our children experience meltdowns, we struggle. Not only are we unsure of what to do, but the problem is compounded when other people look at us and expect us to resolve the situation quickly. Remember: your child is out of control during a meltdown. Your normal strategies will not work. Your occupational therapist can help by providing suggestions about what and what not to do.
So what about children with special needs?
Children with special needs often display challenging behaviors because of skill deficits. These children lag behind their peers in their physical skills, language, emotional control, social skills, and cognitive skills. We also need to remember that children with special needs demonstrate other special challenges that may affect their ability to behave. These include:
- Learning and attention disorders
- Decreased social emotional skills
- Hearing and vision issues
- Strong-willed personality
- Health or medical issues
- Poor sleep or nutrition
- Uneven skill development (common in gifted children)
- Sensory processing issues
So is it behavior? Or is it sensory?
It is both! And probably more… But remember that children will behave if they can, and try using the following toolkit the next time your child has a meltdown.
Jill Ronske, BS, OTR/L