Parent Literature: Is it Sensory or is it Behavior
Rita Arpino Patterson, Executive Director, OT/L
Rita’s Commitment to Practice:
As a licensed occupational therapists, Rita and her staff are committed to providing the optimal level of quality care while facilitating the highest level of function and learning. Rita and her staff are committed to making a positive difference in every child’s life.
A Model for Viewing child or infant’s behavior from a Sensory Integrative Perspective
Self-regulation refers to the child’s ability to maintain regulated states of arousal (being able to respond effectively) in the face of changing environmental demands and challenges.
In a noisy room, for example, a tired child with “adequate” self-regulation might turn his head or move away from a crowd, or an infant may begin to suck vigorously on a pacifier, in an attempt to maintain regulation during this sensory experience. A child with poor self-regulation might become over stimulated and disorganized, start biting or chewing on his sleeve or act out with any kind of challenging behavior.
A child’s behavior may be a demonstration of his state of responsivity (to sensory input from environment) and his ability regulate the sensations in his body from this input. IN this way, Sensory responsivity and self-regulation are interrelated. Any breakdown of sensory processing, whether it be intrinsic or extrinsic, creates an inability to modulate sensory stimuli, this includes inconsistent environmental supports, can disrupt important social, affective, and neurophysiological processes and result in behaviors reflecting panic fright, fight, flight responses, as well as anxiety. Any breakdown in the sensory feedback loop or sensory processing or in extrinsic supports; can trigger changes in physiological states, thus creating behavioral challenges.
Sensory Integration theory (Sensory Processing) is a framework for understanding sensory processing and gives us a method for structuring observations of children’s’ behaviors and capabilities, and interpreting their implications. It helps us in trying to understand the underlying causes or reasons behind a child’s behavior.Using this framework, a child’s behavior is based on both intrinsic (state of their CNS) and extrinsic (environmental) factors.
A child’s responsivity (threshold for tolerance and ability to process in coming sensory input) to his environment and his capability to process incoming sensory input is an intrinsic factor that influences the following 4 A’s (below). The 4 A’s are influenced by a child’s sensory responsivity, and in reverse, “sensory responsivity” is influenced by the 4 A’s. It is an interrelationship that goes back and forth.
Intrinsic factors consist of the 4 A’S:
Arousal: Crying or Calm state, adequate arousal for learning or hyperarousal as in a state of anxiety
Attention: Organized or disorganized, focused or highly distracted, ability to focus on desired stimulus
Affect: Negative mood, receptive mood, defiant mode, crying versus as in an infant suckling to self-calm. The emotional component, not only affective response to the sensory stimulus, but also experiencing and interpreting socially based emotions and relatedness to others.
Action: Being able to move competently, in an infant bringing hands to mouth for sucking, in an older child completing the task. It is the ability to engage in goal directed behavior. Includes motor planning, ideation (the idea), motor planning/ sequencing, knowing body in space and cognitive steps to complete the task, and lastly, execution and implementation, taking the physical steps carrying out the planned steps. According to this model, a child’s “ability” to process sensory input and respond to it is a “core intrinsic factor” and therefore is central to understanding of and in the evaluation of the child’s behavior and with providing intervention.
Extrinsic factors include the social and physical environment and goodness of fit. “Goodness of fit” between child and environment. GOF refers to the match between the child’s needs and abilities and the environmental demands and supports. Extrinsic factors determine the challenges and supports available to the child as he or she develops sensory integrative competence, the ability to respond effectively and in healthy manner to its environment that allows for optimal learning and growth.
Taken in whole, this model demonstrates that the child’s behavior is in a complex interplay of intrinsic and extrinsic factors that affect behavioral expressions resultant and interactions, with the main focus being the child’s ability to ‘process’ sensory input.
Using this model, a therapist can understand a child’s behavior more accurately and thereby plan a more meaningful intervention.
In the same fashion, a parent/ guardian can understand a child’s behavior to plan for structuring a home environment that offers a better “goodness of fit” to include with adaptations and accommodations to help foster improved sensory processing, with resultant improved behavior and provide opportunities for a larger window of optimal learning.
Home adaptations and accommodations may include:
More handouts are available upon request, as well as list of Parent resources book recommendations
Opportunities for oral motor stimulation that help calming and reduce hyper states of arousal
Opportunities for movement experiences or sensory input that helps a child to better self-regulate (rocking chair, dizzy disc, tent, etc)
Increase space and opportunities to meet physical/physiological needs (tent for quiet time, trampoline or ball for vestibular input
The goal of therapy is to help the child achieve an ‘optimal zone of arousal’ or experience just the ‘right challenge”. Caregivers and therapists must provide optimal experiences that ‘extends’ the limit of the child’s potential without exceeding his or her tolerance for learning at that moment and time.
The Magic: Encouraging and creating opportunities for ‘just right challenge’ or ‘zone of proximal/ optimal development’ is where the challenge meets opportunity to extend child’s (developmental and neurological) competence, where the child is able to succeed, and experience a sense of wellbeing. During these periods, or challenges, the process of providing sensory input to help with integration of the input, the organization of sensory information for child’s use, takes place.
*Taken from: Sensory Integration with Diverse Populations, Roley, Blanche, Schaaff, (Chapter 14)
