Sensory Issues and Challenging Behaviors

1. Sensory Issues and Challenging Behaviors

2. Assess your own sensory sensitivities. What stimuli do you dislike, and often try to avoid or escape ? • Visual • Auditory • Olfactory • Touch • Oral • Temperature

3. And what kinds of sensory stimulation do you love, and seek out? • Visual • Auditory • Olfactory • Touch • Oral • Temperature

4. My Assumptions Regarding Sensory Issues • We all have idiosyncratic sensory needs and sensitivities • Some of us have relatively strong sensory needs and sensitivities • The strength of the needs and sensitivities varies by the day, or even by the hour and within the span of an hour • We naturally seek a state of homeostasis, or equilibrium…a comfort zone. • When seeking sensory equilibrium our students can be impulsive, rude, defiant, self-injurious, or aggressive. • These behaviors may also have no sensory basis at all. • The following is based on this behavior analyst’s view of sensory integration, and may not reflect the position of an OT.

5. Sensory Integration • Neurological organization of sensations and environmental stimuli making it possible to use our bodies effectively. • SI involves processing multiple sensory modality inputs. • SI is an occupational therapy specialty • The use of SI to successfully treat challenging behaviors is not supported by sufficient research to be considered an evidence based approach. • If a child seems to have exceptional sensory issues, a formal evaluation by an OT may be in order.

6. Examples of possible behavioral manifestations of sensory needs.All of these behaviors may well have other functions or antecedents, and may not even be sensory based.

7. 1. Self-stimulation: body rocking, spinning/twirling, repetitive vocalizations, waving hand in front of face, tapping or rubbing objects, etc. Suggests hypo-arousal (sensory deprivation) Possible sensory exercises: Swinging, merry-go-round, music w/ ear buds, kaleidoscope, finger paint, working w/ clay.

8. 2. Fidgeting: excessive movement in seat, fiddling w/ objects, standing by desk to work, kneeling on seat, frequently changing positions, out-of-seat to wander. • Suggests hypo-arousal • Possible sensory exercises: gel seat, sitting on therapy ball, squeeze ball, short breaks to walk around, yoga, short work sessions interspersed w/ movement breaks.

9. 3. Compression seeking: student seems to enjoy protective restraint, bumping, jumping, climbing, running, kicking, hitting, stomping. • Suggests hypo-arousal • Possible sensory work: crashing, climbing, running, kicking in a structured and safe setting. Under or between bean bags or gym mats, body sock, lycra swing or hammock, compression vest, weighted vest.

10. Confusion, agitation, or escape/avoidance behaviors in environments that have may high visual and/or auditory stimulation (cafeteria, fire drills, long work sheets, playground, unstructured time in classroom, auditorium, school assemblies, school bus, concerts, etc.). May include running away, crawling under desks or tables, covering ears, defiance, disruptive behaviors, yelling. Suggests hyper stimulation (over stimulation) Possible sensory alternatives: headphones w/ music, hearing protectors, partitions, seating changes, visually chunking work, having a plan for escape, eating lunch in the class room, hand held video devices.

11. Additional Guidelines for using Sensory Strategies in Behavior Support • Integrate into self-regulation strategies (e.g., with calming breaks). • Schedule sensory sessions as part of the daily schedule. • Plan for a sensory session right before an activity that has generated sensory issues. • Sensory strategies can be ONE element of our support strategies with SOME children. • Offer sensory exercises as an option for calming techniques. Never insist. • Use functional behavior assessment to try to determine the type of sensory issues, when and where they might occur. • Review data regularly. • Use behavioral procedures (contingent reinforcers, high interest materials and activities, shaping, fading) to increase tolerance for uncomfortable levels of stimulation.