Why Sensory vs. Behavioral Is Not Actually a Thing

A few days ago, a client asked me a question I've heard at least once a week for the past year. Her three-year-old daughter, who is currently in occupational therapy for issues around sensory processing, has started to have epic tantrums when she needs to put on her shoes. "How can I tell," this mother asked, "if she is having a sensory problem or if it’s just behavioral?"

Knowing that so many parents are posing the exact same question about their children's emotional and behavioral reactions, I reached out to my friend and colleague, occupational therapist Becky Lewin, and asked whether she'd consider penning a guest post for this blog. Below are her (wise and so very helpful) words.

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Becky Lewin, occupational therapist.

Source: Becky Lewin

When I started working with children as an occupational therapist 10 years ago, I asked this same question. However, I’ve come to learn through my practice, and as a parent myself, that this is actually not the question to ask. Perhaps a better question is, "How can we use what we know about sensory processing to better understand our child’s behavior?"

So, what is sensory processing?

Our body has eight sensory systems. These include the visual, auditory, tactile, smell, taste, proprioceptive, vestibular, and interoceptive systems. Working together, these systems lay the foundation for how we perceive the world. In addition, we all have our own sensory preferences, or a unique sensory profile. These preferences guide many of our day-to-day choices, like the clothes we wear, the food we eat, the music we enjoy, and the recreational activities to which we gravitate.

We also all have sensory input that we don’t particularly like. When our body receives input that doesn’t feel good or that we can’t make sense of, our internal alarm system goes off and we automatically seek to solve the problem. But what if your child isn't able to resolve the situation for themselves? This can cause a prolonged state of stress, resulting in a host of different behaviors, including tantrums, meltdowns, refusal to engage, rigidity, difficulty with transitions, aggression, and even complete withdrawal.

How do we figure out our child’s sensory preferences?

I suggest starting with an exploration into your child’s sensory "likes" and "dislikes."

1. “Sensory Likes”: The forms of sensory input that your child enjoys or is drawn to. There are online surveys that can help you determine your child’s “sensory likes,” or you can start a list yourself. Think about an activity your child loves to do, or a time when they're really at the top of their game. Now, think about that activity and figure out its different sensory components. For example, when I did this exercise with a father recently, he immediately pinpointed bath time. We explored what it was about bath time that was appealing to his son, and he came to realize that the bathtub packs a big sensory punch! There is the tactile input from the water, the proprioceptive input from moving his body, the vestibular input as he flips from his stomach to his back, and then back up to sitting, and even the scent of the body wash and shampoo. The bathtub also provides a "container" of sorts for his son's body, providing built-in structure to his movements and play. Lastly, bath time is a predictable activity, occurring at the same time each evening with little variation.
2. “Sensory Dislikes”: The forms of sensory input that your child doesn’t particularly like. Think of a time when your child is fragile, difficult to soothe, or “on edge," then consider the sensory components of this moment. Let’s revisit the bathtub. I recently spoke with a couple whose little girl refused to take a bath. She hated the feeling of sitting in water and despised having her hair washed. Even when the bath finally ended, the saga continued, as she hated the feel of putting her pajamas on against her wet skin.

Source: Stux/Pixabay

Then what?

Exploring sensory likes and dislikes is just the first step. Once we have the information, we can begin to problem solve—and make everyone's lives easier! In the case of the little girl who hated bath time, understanding her sensory likes and dislikes led to a range of adjustments. For starters, she did better in a shower, standing up, and using a removable shower head that she could control. Control is a key element with many sensory sensitivities! Next, her parents got some loose-fitting nightgowns, instead of her usual snug pajama sets.

Was this family's bathing problem solved completely? Of course not. Did bathing continue to be hard for this little girl? At times, yes. However, understanding their daughter's sensory likes and dislikes allowed her parents to find a way to make bathing more comfortable and tolerable. As a bonus, they modeled for their daughter that we have the ability to solve tough problems. Her parents didn’t cave and give up on bathing entirely (clearly not really an option), nor did they ignore her behavior, which was clearly her attempt to communicate just how hard bath time was for her. Using knowledge of their daughter’s sensory profile, compromise, and a bit of trial and error, everyone’s needs were better met.

If my child has strong sensory likes and dislikes, does that mean they have a sensory processing disorder?

No. A child does not need to have this—or any other—diagnosis to benefit from a parenting approach that appreciates their unique sensory preferences. While it is crucial to identify and provide treatment for individuals who do meet the criteria for the diagnosis, it is equally important to recognize that we all use sensory information to understand our internal and external worlds.

Sensory Processing Disorder Essential Reads

It’s Not Autism, It’s Sensory Processing Disorder

Sensations: Too Much, Too Confusing, or Not Enough?

The point of my suggestions is not to make sure every moment of our child’s day is a perfect sensory fit. It certainly isn’t for my own children! Rather, the point is to familiarize yourself with what sets your child up for success, and to think about the sensory components that are part of that success. Because bringing curiosity, wonder, and compassion to the sensory components of your child’s life will help guide their choices, impact their behavior, and support their relationships. Isn't that what all parents want most?