Children's Behavior- Sensory Processing & Sensory Regulation, A Different Perspective
Problem behaviors in children can be due to sensory regulation problems. Understanding sensory processing can help parents and teachers be more patient and tolerant in dealing with children with these issues.
How Adults Use Self Regulation
To better understand the problems children have paying attention, think about things we do as adults to help us focus our attention. Some people doodle, rock their leg, or chew on a pencil during meetings. Many of us would never make a morning meeting without our coffee! Some people suck on hard candy or chew gum in church. Some of us listen to music while we work. Others would never work with music. There are many inconspicuous, socially acceptable things that we can do to help us pay attention or stay awake.
There are other times when we have too much stimulation, and can’t concentrate because we are over-aroused. We may try to minimize the noise, activity or other factors that have overwhelmed us. We may need to escape the overly stimulating environment.
Not only have we found ways to help us attain and maintain that “just right” level of attention and arousal, we have developed strategies to help us act appropriately in a variety of situations. We may exercise regularly to help control stress. We may take a few seconds to breathe deeply and relax, several times throughout the day. Said another way, we have found ways of coping with life’s demands. We have learned self regulation.
Just as we sometimes have difficulty with self regulation, so do children. It is perfectly normal for any of us to be better at self regulation on some days or in some situations more than others. How then can we use the concept of self regulation to help us recognize and better understand behaviors in children?
The Impact of Self Regulation on the Daily Lives of Children
Children exercise different levels of self regulation throughout the day, every day. When children are unable to find a successful strategy to increase their arousal level, they may be considered to be inattentive. Often children find a way to help them pay attention better, but others find these strategies distracting. The strategy the child chooses for self regulation may be perceived by adults as deliberate misbehavior. Strategies that may be distracting to others include drumming on the desk, making noises with the mouth, and repeatedly tossing something in the air. Children and adults who become distracted by these strategies then have self regulatory problems of their own!
Obviously the needs of the many outweigh the needs of the one. Rather than eliminating the behavior however, we need to assist the child in finding a more acceptable alternative.
RESOURCES AND REFERENCES FOR FAMILIES
The Out-of-Sync Child: Recognizing and Coping with Sensory Processing Disorder, Revised Edition by Carol Stock Kranowitz and Lucy Jane Miller, April 2006.
Sensory defensiveness is a concept that can help us better understand self regulation. Each of us deals with multitudes of sensations throughout the day. Sensations include things we see, hear, and smell. Sensations also include things we feel, including touch and movement. Many people have a few sensations to which their systems over-react. That is, they are hypersensitive to certain stimuli. For example some people do not like loud noise or loud music. Many people do not like scratchy wool sweaters. Sensations that we find unpleasant, but that do not bother the general population, could be areas of sensory defensiveness.
Now let us look at sensory defensive behaviors in children. A child who has auditory sensory defensiveness, or defensiveness related to sound, may cover his/her ears when he/she hears a vacuum cleaner, an airplane, or other loud sounds. A child who is sensitive to movement may not enjoy playground activities, or may only swing or ride the merry-go-round if their feet can be in constant contact with the ground.
Probably the most common form of sensory defensiveness is tactile defensiveness, which refers to sensitivity to touch sensations. A child may not like to get his/her hands messy, such as with finger-paint, sand or lotion. The child may have many clothing likes and dislikes. Labels in clothing may be annoying. Soft clothes, like sweats and tee shirts may be preferred. Many children with tactile defensiveness prefer baths to showers, use their hand rather than a washcloth, and do not like their hair washed or combed.
Most children and adults have a few of these “quirks”. We learn to deal with them, but some days our “normal” sensory defensiveness may be easier to deal with than others. We may feel jittery if we consume too much caffeine. Subsequently we may be more sensitive, or over-stimulated by normal daily sensations. We may feel a cumulative effect. If bombarded with the sensations we don’t like throughout the day, we may feel over-stimulated and irritable. When this cumulative effect happens to children, they may not be able to regulate this overload of sensation, and may have an explosive outburst that we perceive as “bad behavior for no reason.”
Some children have more pronounced sensory defensiveness. Instead of a few tactile sensitivities, they have many. Some children may have multiple sensitivities in several areas, such as touch, movement, seeing and hearing.
Tactile defensiveness has been associated with distractibility, poor attention, and increased activity. Many children with mild attention problems, as well as children with attention deficit disorder (ADD or ADHD), have a higher level of sensory defensiveness, particularly tactile defensiveness, than the few “quirks” that most people have. These children are hypersensitive to sensations most people ignore, such as the feel of clothing on our bodies. When more prominent sensory defensiveness is present, children are bombarded by annoying sensation. This bombardment may result in distractibility, irritability, restlessness, or excessive movement. With a higher level of sensory defensiveness, children are trying to process these numerous pieces of sensory information. They can’t seem to filter out “background” noises, sights and other stimulation that is unnecessary for the task they are trying to attend to. Imagine trying to do math when you had 12 cups of coffee, or a medication that made you feel wired! Children with ADHD, with this level of distractibility, are often given medication such as Ritalin, which may help them filter out unnecessary information.
A very common event is for children with more pronounced tactile defensiveness to get in trouble while waiting in line with their class. If they are inadvertently touched by a classmate, before they can think, SMACK! Eventually, after getting in trouble a number of times for hitting a classmate “for no reason,” the child may learn to control that reaction. Learned control however does not mean the sensation no longer bothers the child.
Another common occurrence is for young children to say “ouch” when touched. The touch, though light, may feel painful to the child, or the child may not have the understanding to say, “I didn’t like the way that felt.” Sometimes children say nothing, but “brush off” where they have been touched.
Other Issues of Registration
Also associated with attentional problems is under-registration of sensory information. Some children may perceive a much smaller amount of stimulation than they actually received. For example, they may receive a “gallon” of touch sensation, but perceive a “pint”. Therefore, the child may not receive enough stimulation to maintain a good attention level for school work. The child may be “stimulation seeking”, looking for additional touch, movement, or other sensation to attain a better attention and arousal level.
What About Really Extreme Levels of Sensory Defensiveness or Under-Registration?
Some children exhibit extreme levels of sensory defensiveness and/or sensory under-registration. A child may have so many sensory defensive behaviors that he/she is unable to develop strategies to cope. The child’s sensitivities may be disruptive to family life or prevent successful interactions with other children. Children with severe under-registration problems may be at constant risk for injury due to poor safety awareness.
Children with autism exhibit extremes of sensory defensiveness and/or sensory under-registration. Some children may be incorrectly diagnosed with autism because they have severe sensory regulation problems. While the doctor recognizes these “odd” and disruptive behaviors, which are common in autism, he or she may not realize a child might have a Sensory Regulation or Sensory Processing Disorder.
The child may benefit from a referral to an occupational therapist specializing in sensory integration or sensory processing problems. You may need to discuss a referral with your child’s pediatrician. Although your child may need a sensory integration therapist, most healthcare plans will not pay for sensory integration therapy. If the child has fine motor or dexterity problems that have a negative impact on handwriting or self care, then your doctor should write an occupational therapy consult for these problems. Then shop for an OT that has certification or experience with sensory integration.
What is Sensory Processing Disorder?
MORE RESOURCES AND REFERENCES FOR FAMILIES
Rynaski, H. (1994, November 24). How Does Your Engine Run? OT Week.
Trott, M.C., Laurel, M.K. & Windeck, S.L. (1993). SenseAbilities: Understanding Sensory Integration. Tucson, AZ: Therapy Skill Builders. 1-800-211-8378.
Wilbarger, P. & Wilbarger, J.L. (1991). Sensory Defensiveness in Children aged 2-12. Santa Barbara, CA: Avanti Educational Programs.
Zero to Three. (1994). Diagnostic Classification of Mental Health and Ddevelopmental Disorders of Infancy and Early Childhood. Arlington, VA: National Center for Clinical Infant Programs.
SOURCES FOR THIS HUB:
Koomar, J.A. & Bundy, A.C. (1991). The art and science of creating direct intervention from theory. In A.G. Fisher, E.A. Murray, & A.C. Bundy (eds.) Sensory integration: Theory and practice. Philadelphia: F.A. Davis Company.
Lashno, M. (personal communication, 29 April 1998). Occupational Therapy, Kennedy-Krieger Institute, Baltimore, MD.
Royeen, C.B. & Lane, S.J. (1991). Tactile processing and sensory defensiveness. In A.G. Fisher, E.A. Murray, & A.C. Bundy (eds.) Sensory integration: Theory and practice. Philadelphia: F.A. Davis Company.
Trott, M.C., Laurel, M.K. & Windeck, S.L. (1993). SenseAbilities: Understanding sensory integration. Tuscon, AZ: Therapy Skill Builders. 1-800-211-8378.
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