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Sensory and Behavior

Is it sensory or behavior? If there were a clear cut answer to this question, your job as a parent and mine as an occupational therapist would be much easier.

The sensory/behavior pendulum is a dynamic and complex process. It takes patience, data analysis, and intuition to delve into the depths of a child's behaviors. Often, children habituate to certain behaviors due to initial sensory concerns. For example: a child may initially hate a swing because it makes them dizzy. They cry. The parent stops swinging them. The sensory concern may continue because their system does not get used to swinging (sensory). Or, the child's system may naturally mature and tolerate the swing just fine, but they have gotten used to crying whenever they see a swing because they still think it will be unpleasant (behavior).

Various professions assess and treat behavior issues: behavioral psychologists,professions that analyze the sensory components of the behavior. Some professions (example, ABA therapists) may treat the sensory needs too, but it is important to ensure that their training in sensory integration is strong and that they are utilizing evaluation tools to understand the child's issues before prescribing sensory strategies. Sensory dysfunction is a key element of many dysfunctional behaviors and is a necessary piece of the puzzle in extinguishing poor behaviors. Effectively analyzing the child's sensory system requires training and a strong understanding of the various kinds of sensory dysfunction sensory modulation, praxis.

Here is another example of how sensory and behavior dysfunction work together. A child may have developed a behavior of shoving and being too rough with his sibling. A behavioral approach may identify the source of the behavior (example: attention seeking), and provide strategies to decrease the behavior, such as setting up a token system.

Some occupational therapists also incorporate a behavioral approach. In addition, we incorporate the sensory components. By analyzing the child with a sensory lens, the OT identifies that the child is shoving his sister because his sensory system is under aroused and is seeking heavy input. He isn't just shoving his sister, he is also jumping into the couch cushions, asking to be hugged frequently, hiding under heavy blankets, slamming doors, and has a preference for crunchy foods. These examples highlight sensory seeking and suggest the need for a "sensory diet" with more appropriate heavy work activities. Occupational therapists will incorporate replacement strategies for the attention seeking behavior. In addition to the behavior program we may include a crash cushion area in the corner of the house and we will teach the sibling and child to appropriately play with the crash cushions. This replacement activity "feeds" the sensory seeking behavior which will help to decrease the inappropriate shoving behavior, along with the behavior- based interventions.

So, in answer to the question, "Is it sensory or behavior", my answer is most often, "It is sensory AND behavior."

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