Sensory Detective

During my book signing a few weeks ago, I was asked by a mom how you can tell the difference between sensory problems and behavior problems.  It made me smile.  Why?  Because in my experience, this is hands down the number one parenting concern for those raising a child with Sensory Processing Disorder.  It always has been and I suspect it always will be.   

And since getting a diagnosis of SPD is becoming more common at an earlier age – (you can’t say enough things about the value of early intervention, can you?) -- we as parents have an even harder time telling the two a part.

A 2 year old with sensory issues is a tantrum throwing machine. Been there. Done that.  And it sure doesn't end at 2, does it?!  Some days I feel like my nearly-nine year old isn't any better!

So, I figured I would give my take on this -- but please remember, this is my non-doctor, non-therapist, non-medical professional of any kind, advice, and in no way shape or form should you consider it medical advice or substitute it for your own good judgement.  Deal?

In a nutshell, my advice is the same advice that Dr. Ostovar gave in her interview last month, “Be a detective, and try and determine what caused the reaction.”  But, I am going to give you some specific examples that will hopefully help pave the way for your own clue-finding.

And with a wave of my magic wand:  You are a sensory detective.

By default, we should start with the theory that whatever is bothering our child is sensory related – or caused by some inability to react appropriately. Why? Because I much prefer to go with Dr. Ross Greene’s theory that children do well if they can (as opposed to the theory that children do well if they want to). If your child could react adaptively, I believe he/she would.

So, let’s assume that the tantrum isn’t just willful disobedience by an over-spoiled and over-coddled child. You don’t buy into the idea that your child is “just spirited” do you? I didn’t think so.

Before we begin sensory vs. behavior, let’s talk about the difference between a tantrum and a meltdown.

A tantrum is a manipulative fit (crying, screaming, throwing themselves on the floor, etc.) aimed at the child getting what they want from you – example being, “I want ice cream!”

A meltdown is an emotional response (crying, screaming, throwing themselves on the floor) to the child not getting what they need – example being “I want ice cream!”

Confused?

Sure you are.

Children don't always have the vocabulary to explain their motivation to you in the moment (if at all). So, often the words they use don't give us a clear enough picture of what the problem is, or more importantly how to solve it.  That is why you have to be a detective!

Although both the tantrum and the meltdown sound the same, and include some of the same behaviors, they are not the same: determining why the challenging behavior is occurring is where the answer lies. If your child is upset because they lack the skill to deal with the situation, it is a meltdown – which by definition means that ignoring it won’t make it go away, and punishing it sure won't help either.  If they have the skills to deal with the problem, then it *could* be a tantrum – but those are MUCH more rare than you think.

As parents we, for some reason, seem to gravitate towards the idea that our kids are attention seeking or manipulative, and that therefore all meltdowns are tantrums.  The reason I believe we do this is because if our children are misbehaving due to those reasons, it requires less of us to fix it. Conventional wisdom would suggest we could ignore the problematic behavior, and it would go away – or even better – we could punish it away. I don’t know about your house, but mine doesn’t work that way. If I could time-out-away the problematic behaviors for ANY of my kids, my life would be ridiculously easy. But, alas, it’s not. : )

So let’s talk about how to play detective – sensory detective and skill deficit detective.

First skill deficit detective – detective hats on.

Scenario #1 – Suzie was with you when you bought ice cream at the store and she really wants some. As soon as you get in the door she is yelling. “I want some ice cream!” And when you say she has to wait until after dinner, she is in full flip out.  Is that a tantrum or meltdown? Could be a tantrum – could be a meltdown. Does little Suzie have the skills required to wait? Or is waiting hard for her?

In our house, Matthew is awful at waiting. He gets an agenda in his head and by god there is no turning that child around. So, we have set it up to not push his waiting skills further than he can handle, or he is going to have a meltdown. For example, if you see us at McDonald’s, and we have agreed ahead of time (key here) that he can have ice cream, it is ordered with the chicken nuggets (mind you, we request a smaller than normal cone). He can eat both at the same time. At home, he knows that the routine is dessert (if any) will be after dinner. But his ability to access those skills at McDonald's is greatly diminished due to other factors (tired, hungry, overwhelmed, excited, etc.) so I don't test his waiting skills when he is less likely to succeed.  You know your child best; did little Suzie use up all of her waiting skills getting from the moment you put the ice cream in the basket to the time you walked in the door?  Maybe that was good waiting for her and she deserves the reward. 

Scenario #2 – Little Suzie is playing in the cul-de-sac, and along comes the ice cream man. The kids come running to the street from houses away to greet the truck, and Suzie runs with them. But wait. You don’t buy ice cream from the ice cream truck – because it is filled with more chemicals than milk – and this is just something that is an existing rule for you – and Suzie knows it. So, when all of the other kids run to the street for ice cream, you offer Suzie a juice bar from the house like usual, but this time since you are outside, she begins to lose it. Screaming, yelling, demanding ice cream. Is this a tantrum? I would say this one is more black and white – and it is a meltdown.

Why? My interpretation is there is a good chance she is having an emotional reaction to the feeling of being left out, not just wanting ice cream. This isn’t about what is better, a juice bar or an ice cream, or whether she knows it or not, it is about everyone else in the cul-de-sac getting to do something that she can’t – and wants to. Having the skills to handle feeling that left out, is out of Suzie’s developmental ability.

Now let’s talk more about how to tell when it is specifically a sensory issue. Detective hats on.

What we know about Little Tommy: Tommy is a sensory seeker; he craves deep pressure touch, and can be very busy at times. He likes things to go his way, and can be a ‘black and white’ thinker.

Scenario #1 – Little Tommy is playing on the floor in the family room. He has cars out, and he is pretending that they are having a race. His brother, John, walks up and lays down next to him. At first they seem to be playing fine, but then all of a sudden, out of nowhere, Tommy starts to yell, and punches John over and over. Why did this happen?

Knowing the very little that I do about Tommy, I am going to guess one of two things happened: either his brother John happened to touch Tommy, perhaps too lightly, and that sent him into a sensory-meltdown (fight or flight). Or perhaps, his brother John may have broken an implied rule of the game – perhaps in Tommy’s mind the red car ALWAYS wins, and John made the green car win.

Needless to say, in both cases, it appears as though Tommy doesn’t have the skills necessary to respond adaptively, so he acted badly. The important part here is to recognize what the problem is, and address that – not just the reaction.  Note to self -- this cannot be 'punished' away.  All the time outs in the world won't change Tommy's mind about the NEED for the red car to win!  You knew that, right?

Scenario #2 – Little Tommy has played hard all day, first at home with his mom, and then at developmental preschool all afternoon. Mom picks him up from school at 3:30pm and needs to go grocery shopping with him and his baby sister. Once in the grocery store, Little Tommy can’t keep his hands to himself, he is buggin the baby, can’t stop touching things in the store, and goes so far as to knock something off the shelves. Mom is feeling frustrated. By the time they get to the checkout counter, the overhead speaker comes on, “We have a special on crab legs today….” As soon as it starts, Little Tommy starts yelling and having a meltdown. Tommy isn’t usually sensitive to sound, so why is this happening?

Given how long Tommy’s day has been, the grocery store only made things worse. All of the lights, sounds, visual stimuli and people – that has Tommy on sensory overload – even if he is a seeker. How do I know? By the fact that he has had a long day – with new skills being taught and practiced at school, and by the way he was acting in the store – that behavior is caused by his sensory issues. And when that person came over the speaker, it may not have been louder than usual, but that was more than Tommy could handle – enter meltdown (not tantrum, because Tommy does NOT have the skills to deal with the grocery store after school -- plain and simple).

How are those detective hats fitting?  Are you getting the hang of this? 

Determining the answer to "Is it sensory or is it behavior?" is a really complex issue -- that said, you know your child better than anyone else – you are the expert!

Take the time to think about what is going on, because when you begin to recognize where the problems start, and why they did, the problematic behavior is avoidable -- and doesn't require you to punish more.  This is 2010 and we should all have evolved past the "time out" strategy -- special needs or not! 

Have a question for me?  Leave your most challenging sensory vs. behavior question below and see if you can stump me!
H

27 comments:

Jaimee said...

Thank you so much for this post. It gave me some insight to have a comparison between a "tantrum" and a "meltdown." We are currently struggling with teasing out which are sensory issues and which are behavior issues....I think asking, "Is this a tantrum or a meltdown?" will help!

Martianne said...

What a great post! We just had an incident with our son at my mom's house where he was pitching a fit becasue my niece got out of the wagon he was pulling her in in order to run the newspaper they had collected from the front yard into Grampy. Well, Grammy asked my niece to come back out, so my son could finish pulling her to the back steps. She happily complied, but my son kept crying, sitting on the gorund saying "I can't! I can't!" when we told him his cousin was back in the wagon and he could pull her now. Finally, he sobbed, "the newspaper", at which point we realized he had it in his mind that he had to pull her AND the newspaper to the back porch to complete his task of delivering the paper to Grampy. Easy enough. His cousin ran in and got the newspaper from grampy, my son pulled them both to the steps. She ran abck in to redleiver the nespaper and we were all happier for it.

Tantrum? Meltdown? Not sure, but I am sure my son's brain is wired differently than some and he needed to - at the moment - complete his task as he saw it. Thankfully, his cousin is a very easy going gal!

SensoryMommy said...

I LOVE this post. I have this discussion with my husband all the time. I operate under a lot of the same assumptions that you do, where as he has a tendency to lean the other way. Even though that is my husbands natural instinct, he is also learning to become a "detective" and look further at the behaviors than what appears on the surface. This is a wonderful article!

Stacey,momof 2 said...

This post was timely for us also.
At our house we usually see a change in how Shane is acting when it's sensory- he will not look us in the eye, and he will stop making full sentences. Recently we have started using thumbs up if you heard me-- and that is often enough to get him to give thumbs up-- sometimes he will continue to not make eye contact-- but as long as he is following directions I don't worry about the eye contact. It's hard to explain by writing it out ... maybe one day I'll video what we do....???

Heather B said...

I'm asking you now if I could use some of that material! Not only am I a mom of a kiddo with SPD, but I also am a developmental specialist. At work I teach an inservice on 1-2-3 Magic and that question ALWAYS comes up because the parents attending the inservice have children in our early intervention program and many of them have sensory needs. We've been looking for a way to sum up what they are trying to find. You have said it beautifully. So, I vow to site you appropriately, but will be using or sumarizing some of what you said to help out the parents that I work with:) Thanks for posting!

Anonymous said...

I enjoyed your post, as a parent and a pediatric SLP. I only wish those friends and family members that know nothing about SPD could begin to understand.

Careen said...

We are dealing with a lot of change over here lately and our little SPD kiddo doesn't do so well with change. He got so frustrated trying to communicate tonight that he hit himself and called himself bad! My heart just broke:( I just held him. I've never seen him do this before! Suggestions??

Hartley said...

Jaimee, Martianne, SensoryMomma, Stacey: I am happy this post was timely for you all! Hopefully it will help at home in a practical way. :)

Heather B: You are welcome to use my post, but do realize it is all copyrighted, so please do cite it appropriately. :) Also, 3-2-1 Magic isn't something I suggest or use because it does't tend to lend itself well to kiddos with skill deficits. Good luck!

Careen: My suggestion is to use a visual card where he can point to what he needs (a generic one that shows "I need help" and other suggestions that he can use when he is in the moment). I also say to my kids all the time, "I am listening. You don't have to hurry." And show them this is true by sitting down with them the moment they try to tell me something -- especially in the middle of a problem. Assuring them I am there to listen is the first step -- not trying to fix the problem, that is step 3. :)

Let me know if you need more suggestions!
Hartley

Careen said...

Thanks. Hartley! I haven't been a good listener lately. You reminded me of the book "Explosive Child." I really need to refer back to it more often! I too struggle with is it a choice to tantrum or not?? We go weeks with no problems and then "BAM" constant struggle after struggle. I told myself I'm lucky b/c I get to forget his has SPD sometimes! I will use the picture cards and let you know. Do you keep them all over or what? I was thinking where I should place them! I don't know where the struggle might happen, so do we carry them around with us or what? Is it kind of like the PEC System? Thanks, again! I love reading your blog, it gets me through on the rough days!

Hartley said...

Morning Careen,

When Gabe was younger we had picture cards on 3x5 index cards bound together at the corner with a metal ring; they could go in my purse, his pocket or backpack -- really whatever works best for you. Otherwise, keep a set in the main living area (or wherever more problems happen - in the car if necessary!).

I hate to admit it, but the one thing Gabriel still yells at me when he is angry is "YOU'RE NOT LISTENING TO ME!" Which is true -- I am so busy telling him to stop flipping out and help me solve the problem that I don't even listen to his perspective on the problem itself. I don't blame him for being frustrated. :)

Good luck!
Hartley

Caitlin Wray said...

I'm glad you mentioned the problem with 123 Magic, Hartley, I was thinking the same thing. I just don't think it's a healthy fit with sensory kids.

Caitlin
www.welcome-to-normal.com

K- floortime lite mama said...

OMG i LOVE this post
Another important thing is to be able to keep your sensory detective hat on
Its so easy to get frustrated or embaressed if we are in public
But I always repeat to myself
"WHat is in R's best interest" and it gets me out of the kid mode myself and into a more higher order emotional mode

Sensory Solutions, Inc. said...

I have an article about this same issue on my blog. You might find the information helpful. You can find the article at
http://sensorysolutionsinc.blogspot.com/search/label/sensory%2Fbehavior

Making Sense of the Senses said...

If you could tell I was on this post for hours; it's because I kepted running around the house with my SPD kiddo while trying to determine tantrum or meltdown? Your posts have become my go to quick guide.

thanks

Jenna said...

My son is 3.5 and very advanced verbally. I was getting SO TIRED of being told he will stop misbehaving, melting down, hitting and being otherwise exhausting once he is able to better communicate. We now have a fresh diagnosis and a stck of SPD books by the bed. This post sums it up so well: If my son could do better, he would! I will bookmark this post to use when the time comes to explain this to the relatives... Thank you!!

PS. As for 1-2-3 Magic... my son screams at me, "Stop counting!!!" ;) We've stopped counting.

Christine Marlow said...

Thank you for taking the time to address this very important issue. I myself have been dealing with this exat problem with my 6 year old in school. He has a one one aide and is fully included in a typical classroom but has had problems transitioning from a classroom of 18 and a half day pre-school class to a all day Kindergarten program with 26 kids. Jack has been melting down over things he has never had problems with before in school. I have been trying to troubleshoot with his IEP team but have felt the class size is the biggest problem. Unfortunately the Least Restrictive Environment Law takes precidence and over rides everything so the fact he has a large class does not factor into the equation. We basically will have to go through the failure method while they implement Functional Behavior Analysis and Behavior implementation plans. Everything possible needs to be tried before they will even look at the idea of a smaller class. I'm very frustrated.

We finally were able to get private school placment for our oldest who has Aspergers/Bipolar/ADHD & ODD. It took years and thousands of dollars for attys and advocates to finally get the school to conceed he needed private school with a therapeutic environment.

I want my youngest son to be successful in the regular classroom environment because he models up so well to typical developing children. He just really needs a smaller class, with adaptive sensory supports in place.

I would love feedback from anyone with ideas that could make this happen.

Thanks so much!

Cari said...

Thanks so much for the post! I've changed how I handle meltdowns because ignoring them just wasn't working. The family and friends still don't get it, but my son is happier so who cares what they think? Some deep pressure and bear hugs go a long way when he's in sensory overload.

Sarah said...

Nice blog. I liked your comment that kids do well when they can & if they have the skills. If you haven't already, I would encourage you to research PANDAS: Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcus. You can find much info by Googling PANDAS and strep. Basically, it's a physical illness with mental illness symptoms including emotional lability/meltdowns, OCD, tics, age regressing, sensory seeking behavior, tantrums, ODD, fears, anxiety, ADHD, and MORE! It can stand alone or have comorbidity with ASD. Strep in the body becomes confused and actually attacks the brain/basal ganglia. But once PANDAS is in place, any infection can trigger an autoimmune response & symptoms. My son suffers from this disorder, & we are currently treating him for it. Best wishes in your parenting adventures!

tara said...

The part about Tommy and the cars is my just 4 year old to a T. We have been talking to our doctor and though he's not sure it's sensory related,I'm becoming more and more convinced it is.
Thanks for this article

Skillful Squad Seraphs, Inc said...

Your posts are always insightful and packed with knowledge...thank you.

www.skillfulsquad.net
www.skillfulsquad.blogspot.com

Lauren Morris said...

Hartley, I think you read my mind. It is so refreshing to see this when for the past little bit I have been asking myself the same question. I get told he isn't disciplined enough and not told "No" enough. I say, how do I know when he is just acting out and when or what he really has an issue with. "A" is 2 so the terrible 2's are upon us as well. Keep it coming. I have finally found a place that I can call home with you. Thank you!

Itsy Bitsy Spider said...

I've always assumed that Kaia's explosions were meltdowns rather than tantrums, but no matter how you name them, there are times when I just can deal with them.

Case in point, Kaia has problems with biting (see "This Bites" ==> http://helloworlditskaia.blogspot.com/2011/01/this-bites.html)

Sometimes it's just a sensory exploration and we understand that. We offer her an alternative to biting people and *hopefully* she accepts it.

But sometimes it IS an attention-seeking behavior. We have tried to teach Kaia that there are better alternatives to biting to get people's attention, but it feels like it's just not sinking in.

My question for you, Hartley, is: you have repeatedly demonstrated and even seen your child demonstrate the tools for dealing with a situation. You have also modified the environment to limit exposure to the situation that sets your child off. In a nutshell, you've done a LOT of work to help your child avoid the situation and/or deal with it when it does arise. Yet, s/he is still melting down.

How do YOU deal with he frustration? How do you keep from losing your own cool and making a bad situation worse?

Thomas said...

I love this post. Some times when I read your blog, I laugh out loud. Not at funny parts either. I just feel like you must have been in my house. Thank you for taking the time to understand your children. It is fun to commiserate, even if just via blog browsing. How are your kiddos with SPD adjusting to the new school year? It seems to get better each year with mine. Good luck and keep up the detective work!

robin said...

Love your blog. It helps me to see what has worked and not worked for you with SPD. I have a question I hope you can address. My 2 1/2 year old son is in daycare full time. He has SDP and Fragile X and recently he has started pushing his classmates A LOT. He does a relaxed sensory diet during the day. It is hard to ask the teacher to give him all the input he needs throughout the day. Luckily he has several hours of therapy each day so that helps give him the one on one dedicated input his body craves. I wanted to see if you could give me any advice about how to discourage this behavior. The only option at school is to place him in time out to be consistent with the other kids who are bad but I know that is not what Sam needs because of SPD. I welcome any advice you have. I know I need to be more structured with his sensory diet and social story and I know that will help.

mariner2mother said...

Fantastic post! My son just turned 9 and I'm still being a detective. School has been an absolute nightmare for him, and I know that a component of this is sensory based. For that reason, we are revisiting therapy in January. It's been a long time since he's had therapy to do with sensory issues. Most recently, it was vision therapy; and his PT will be working on his vision as well as sensory issues.

When he was about 14 mos. old, I discovered Positive Discipline. It is fantastic! But, if the behavior is sensory driven, I first have to deal with that. Then, apply PD principles (that are absolutely non punitive).

JenBen said...

i have definitely noticed time-out doesn't work with my son. he can't even sit still. i have to physically hold him down, which is ridiculous. but, even the OT suggested that half his problems or sensory and half behavior and i need to create serious consequences, demand respect, etc. i have no idea what to do! i have tried ross greene's method with little success so far, and the supernanny's tactics don't work either. i don't know if it's my fault that i am not 100% consistent 24/7, particularly in public when chaos ensues. everyone "blames" me, in the end. but how can i help him be able to react properly? how can i change his mind about the right car winning? (stuff like that is big here!) 18 months of OT hasn't helped. those are the questions i want answered. if anyone knows, please tell me. :) thank you for the post!

Alex Bond said...

Very cool article.

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