Originally Presented by Joani Richardson, OTR/L and Edited by Alexa Moses, OTR/L
Picture this: A child with ASD accompanies his mother to the grocery store. In the frozen foods aisle, the child suddenly becomes visibly upset while his mother is shopping. The mother in this scenario now must become a good detective to discern why the child is acting this way. Is it because he is bothered by the temperature in this aisle? Is it because he wants the toy that he saw in the shopping cart next to him? As parents and caretakers for #childrenwithASD, we often have difficulty discerning between a #sensory processing need and a #behavior. Let’s take a closer look at what each one is and learn to understand how to best address those needs when they arise.
What is Sensory Processing?
#SensoryProcessing is how the nervous system receives sensory messages and
responds to them. Most of us receive sensory messages and organize them effortlessly into appropriate responses. Responses can result in behavioral, emotional, attention-related, motor, and organizational outcomes. Some children with ASD, however, may find it much more difficult to process those sensory messages, resulting in a Sensory Processing Disorder. When sensitivities to sensory input become chronic, interfere with daily living and the ability to function, they become SPDs.
We organize and filter sensory info and control our internal environment naturally. The dual ability to take a real interest in the world—sights, sounds, sensations, to make sense of those and to adjust our internal environment to the just-right level is called self-regulation; it is the neurological basis for motor control and influences all behavior. We expect children to regulate their internal environment much earlier than they are able to; most children under the age of 8 or those that are struggling with sensory differences rely on adults to supervise their regulation.
We are familiar with the five senses, but there are three lesser-known movement senses: proprioception, which is the sense of self-movement and body position, or where we physically are in space; the vestibular system, a sensory system that provides the leading contribution to balance and spatial orientation for the purpose of coordinating movement with balance; interoception, the sense of the internal state of the body (like hunger, or the need to use the bathroom). Children with ASD may not be able to process any of these sensory signals well.
What Impacts Behavior?
According to BF Skinner, a renowned psychologist and behaviorist, human action depends on consequence of previous actions; what we do is based on what happened before, which means we are capable of learning. Biologists define behavior as our reaction to internal or external stimuli. Everything we do is behavior, even doing nothing. We don’t eliminate behaviors, but rather aim to shape or replace them.
What is Problem Behavior Theory?
Problem behavior is behavior that is socially defined as a problem, as a source of concern or as undesirable by the social and/or legal norms of conventional society and its institutions of authority, according to Richard Jessor, a distinguished professor at the Institute of Behavioral Sciences, University of Colorado Boulder.
Society has defined behaviors that everyone agrees are not ok, like committing a crime, for instance. Behavior becomes a problem when it impacts function of the setting one is in, takes away from others, or puts the child at risk for later issues. Tantrums and meltdowns are common examples of problem behaviors with children with ASD, and often look the same although they are not.
When asking, is something a #sensoryneed or a #behavior, the answer is BOTH. We cannot turn off our nervous system, and behave, or react, all the time. A caretaker will determine where on this sliding scale a situation is more heavily stemming from, a behavioral or #sensoryprocessingneed.
How do you Manage Tantrums?
1. Speak in a calm, quiet voice. Emotions naturally match others' emotions.
2. Make it clear that you understand what the child is after. Be clear, firm and consistent (“it’s ok that you’re upset”)
3. Visually ignore what the child wants without giving in. Tell them how to get what they want; Use redirection.
4. Try distraction.
5. Teach skills to avoid future tantrums, but not during one.
How do you deal with a Meltdown?
1. Help the child find a safe, quiet place to de-escalate.
2. Provide a calm presence without talking to the child too much.
3. Avoid future meltdowns: predict and plan ahead.
4. Approach from the side and whisper
5. Firm hugs or deep pressure
6. Lower lighting and noise levels
Tantrums are a part of typical development; most kids go through the tantrum phase. They usually begin at 12-18 months, get worse between ages 2-3, and then rapidly decrease until age 4. After age 4, they should rarely occur. Tantrums help children learn boundaries, test limits, and exert control, and usually have a purpose.
Meltdowns are an emotional reaction to something, typically to feeling overwhelmed, and are usually beyond the child’s control. They occur in children who lack abilities, skills or coping strategies, and serve no purpose. Meltdowns are not likely to stop, even when the child gets what they want, and sometimes the child may not know what they want altogether. They can be an escalation of tantrums but can also occur all on their own.