Dig a Little Deeper: Using Knowledge of Sensory Processing to
Respond to Challenging Behaviors Heather Kennell OTR/L & Amy
Russell Yun, OTD, MS, OTR/L
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You cant make children grow faster by pushing them, just as you
cant make flowers grow faster by pulling them -Otto Weininger
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Sometimes behavior is just the tip of the iceberg Are we
missing the remaining 90%?
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It may reflect many things Poor quality of life Little control
in life Illness/Pain Few choices Impairments in social skills or
communication skills STRESS
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Factors that Affect Behavior External Influences Family
transitions Death of a family member/loss of a pet Chronic or
serious illness Moving Unreasonable expectations Heavy academic
demands Inappropriate educational placement Abuse Internal
Influences Stress Illness/injury Unreasonable expectations
Cognitive functioning Developmental profile Communication
difficulties Temperament Emotional problems Learning
difficulties
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Tips for Enhancing Self Regulation Work on YOUR OWN capacity
for self-regulation Be attuned to child & childs needs ANS
signs check to ensure accurate behavior interpretation Start with
proximal strategies for regulation & move to distal ones
Provide structure & predictability (helps child develop
internal structure." Too flexible -likely to see uncontrolled
behaviors to seek structure. Anticipate transitions & prepare
child for them in advance Timers-one more minute-songs
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Strategies for Teaching Get caregivers to regulate selves!!!
Focus!!! Target specific areas for growth & specific strategies
to address them Motivation matters! Use materials & activities
of interest Work to broaden interests Keep it light! Be positive
& have FUN Encourage flexibility. Context Start with what is
needed & desired (social routines) Practice Reinforce learning
Generalize to different people, settings, & materials Structure
& routine add predictability & comfort Visual environment
is important Placement of objects Visual schedule Social scripts
can be a building block
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Coping Things people do to avoid being harmed by life strain
(Pearlin & Schooler, 1982, p. 109) Patterns of coping responses
Change the stressful experience Control the meaning Manage stress
Problem focused coping Attempts to Deal with reality &
consequences of crisis Create a better situation Appraisal-focused
coping Efforts to understand & find meaning in a crisis
Emotion-focused coping Handling feelings provoked by the crisis
Moos & Billings (1982)
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Attacking the Problem Change situations -that cause stressful
experiences To do this Situation must be amenable to change Person
must 1.Recognize the situation which is causing stress Difficult to
do 2.Know to change the situation directly Often changing one
situation leads to different additional stressors Making careful
observations of the sensory environment can help avoid un-needed
stressful situations
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Think about the Sensory Contributions to the Environment What
type of sensory information is present? Visually Auditory
Vestibular Proprioceptive Tactile Olfactory Gustatory Consider the
following for each Intensity-strength or power Duration of the
stimulation Location Predictability
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Emotion, learning & memory NONASSOCIATIVE LEARNING
HABITUATION: repeated presentation of the same stimulus produces a
progressively smaller response SENSITIZATION: a strong stimulus
results in an exaggerated response to all subsequent stimuli
Managing the Stress Control stress after it emerges (Pearlin
& Schooler, 1982, p. 115) Focus on managing stress resulting
from stressors
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Attunement Mutual Eye Contact Baby smiles Mother responds-
usually by smiling Right Brain Attunement
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Joint Attention Process of sharing ones experience of observing
an object or event, by following gaze or pointing gestures.
Critical for social development, language acquisition, cognitive
development Pre-linguistic communication skills that are used to
initiate or maintain turn-taking routines & used to request or
obtain help in obtaining objects or events. Joint attention is used
to direct attention in order to share the experience of an object
or event with another person
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Strategies to Build Joint Attention Observe child Watch for
alternating his/her eye gaze between an object & person.
Playfully try to get child to make eye contact Go to childs level
to make gaze shifts from object to face easier Play with toys that
draw the childs attention to your face. (bubbles, pinwheels,
balloons) Hold onto objects you are giving child until he looks at
you & bring it to eye level. Follow child imitate his actions
with an identical toy/object Play with toys Draw attention to
adults actions. (that make noise /need to be activated, musical
toys) Facilitate reciprocal interaction (balls, blocks in a form
box, a train, puppets, telephone) Facilitate requests for help (a
jar that is too hard to open, an favorite object out of reach,
wind-up toys that are too hard to turn)
Slide 80
Evidence for SMD is Growing Davies & Gavin (2007) Ability
to habituate typically develops over time Children identified as
having SMD demonstrate difficulties habituating to neurological
stimuli compared with controls Difficulties increase with time
& exposure to stimuli Schaaf, Miller, Seawall, & OKeefe
(2003) Children with SMD demonstrate vagal tone (PNS) Children with
SMD do not habituate to repeated stimuli Do not shut off SNS
McIntosh, Miller, Shyu, & Hagerman, (1999). Electrodermal
responses high amplitude orienting is associated with poorer
performance on the SSP
Slide 81
Early Brain Development Concepts Children learn best through
hands-on experiences which require problem solving
