Sensory or Behavior?

This is one of the popular and everlasting discussions among the professionals in sensory integration / child development field. When a child is having e.g. a tantrum, how do you know if it’s sensory or behavior? This is a very important question because it defines our reactions towards the child in that moment. And our reactions are there to help the child either by calming him down or by teaching him some boundary.

There is a consensus about a couple of things:

  • every child needs good* boundaries
  • every child needs good* structure

*not necessarily strict or harsh
While reading other people’s opinions on sensory or behavior question, one interesting answer pops up: it is sensory and behavior, and not sensory or behavior. It is very hard to define a behavior and not take the sensory factor into the consideration. If your child doesn’t want to eat something and is crying and jumping in their feeding chair, take a look at the food you gave them: is it too hot or too cold or perhaps too chewy? Children who have low muscle tone in the oral area will most likely find difficult to chew and will thus most likely refuse to eat e.g. some meats or bread crust. Those same kids, on the other hand, will want to get the stimuli the easy way and you might see them asking you for crunchy foods that are easy to chew through e.g. chips, salty sticks, rice cereals etc. Food temperature is also very important to sensory kids. Just try to make them get used to it step by step. Forcing  them to eat something, whether of the “wrong” temperature or texture is only going to make them refuse it, even if they would initially want to taste it.

So, how come a lot of the times we get the report from the preschool teacher that the child ate everything and is eating nicely in the preschool and makes such a drama at home? Well, the answer may as well be – the structure. Don’t confuse this with boundaries. Parents may be very clear on the boundaries, but the structure is what is missing at home. Usually preschools organize time and setup for meals where all children eat together at a table at the same time. So, this structure and predictability helps a lot of the sensory kids in their organization and regulation. If they do not have to think about what’s coming next and how they will manage themselves in the new situation, but they know that at this time, kids will start getting together at the table and food will be served, those sensory kids can be at peace and they can participate in an adequate way. To go back to the structure vs boundaries – sometimes what happens is that parents put stricter boundaries or let’s say, stricter parenting to compensate for lack of structure. Perhaps this is a good question to analyze in one of the future posts.

Another question to be asked here is how to know whether your child’s current behavior is purely sensory or behavioral, though I said that usually it’s both? Well, The Anonymous OT gives a good point in his “Is it Sensory, Behavior or Both?” blog post.

This is where I tell my parents to be incredibly attentive to the subtle signs from their child. With any behavior analysis, there is an “antecedent,” or something that happens before the behavior. This is where the parent has to look for the clues. What was the root cause of the outburst?

I agree with this statement and have been recommending the parents I work with to do so – to try and figure out what happened right before some good or bad behavior. Important thing to know and remember is that kids are not bad, they do not want to act badly. Children actually want to please their parents. If a child is behaving “badly”, it is up to us to figure out why and help them.

P.S. I like this document!

Posted on by lina. 4 comments

Aktivnosti u shopping centru

click here for English version

Najprije, kako izgleda promjena aktivnosti ili mjesta kod Vašeg djeteta, pogotovo u veliki, blješteći, glasni i napućeni trgovački centar? Potrči li Vaše dijete unutra ili se počne ritati i bacakati još u autu čim ste skrenuli na parkiralište od tog centra? Neka Vam Vaš odgovor bude polazište za ovo iskustvo.

Ako Vaše dijete ne voli ići po trgovačkim centrima, ne morate to izbjegavati. Učinite to postepeno prateći djetetove reakcije. Ako se Vaše dijete počne derati već na parkiralištu, neka vam onda to bude i cilj – sigurno parkiranje auta, ali ne i izlazak iz njega. Idući put probajte izaći iz auta, ali ne i otići u centar, možda svega do ulaznih vrata. Ono što je tu bitno je da uvijek kažete djetetu mirnim glasom (šapčući ako je dijete preosjetljivo na zvuk) koji je Vaš plan. Želite da Vaše dijete i dalje ima kontrolu nad situacijom koja mu se očito ne sviđa. Kada dijete uvidi da kontrolira situacijom, stvari će teći glađe. Ako im se čini da se situacija odvija prebrzo, da gube tu kontrolu postat će nervozni i možda će nastupiti tantrum i bacanje po podu. Dakle, samo glasno komentirajte svoj plan bez obzira koliko je Vaše dijete staro i bez obzira na to što možda mislite da Vas ono ne razumije; “sada ćemo se sparkirati ovdje lijevo i onda će mama ugasiti auto. Vidi, gasim! 1…2…3.. auto je ugašen”. Možete koristiti jednostavnije ili kraće rečenice ako je Vaše dijete manje ili ako je veće ili verbalno, možete unijeti još detalja i dapače uključiti ih u brojanje ili dati im izbor gdje da parkirate auto. Uključivanje djeteta u ovakve aktivnosti daje im pouzdanje i kontrolu koja im je vrlo potrebna.

Kada dođete unutar trgovačkog centra, uzmite vremena da svom nervoznom djetetu obratite pozornost na to što je oko njega, ono će se tako opet osjećati bolje i imat će kontrolu. Ako je Vaše dijete malo, možete ga podići i komentirati što sve vidite; svijetla, kafiće, ukrase, čujete glazbu u pozadini, vidite dućane, kolica, ljude itd. Dajte mu minutu, dvije da spozna te stvari oko sebe. Kada vidite da je u redu, nastavite sa svojim planom. Vjerojatno idući put nećete morati prolaziti kroz ovu situaciju, ali ako ćete morati i to je u redu. Samo dajte djetetu vremena. Ako niste u mogućnosti izdvojiti to vrijeme ili krenuti u centar ranije, a budimo realni, često smo u velikoj gužvi, radije ostavite dijete s nekim drugim nego da ga bespotrebno “vučete” na mjesto gdje se ono ne osjeća ugodno.

Danas većinom svi trgovački centri imaju dječje igraonice gdje se djeca mogu igrati dok odrasli obavljaju svoje kupovine. Neke imaju pravila o ostavljanju djeteta samim u igraonici, neke se plaćaju, neke su besplatne, ali su svakako odličan izvor senzornih podražaja. Veće igraonice imaju i sprave za penjanje, bazene s lopticama, tobogane i tunele. Iskoristite to! Provjerite najprije je li Vaše dijete preosjetljivo na zvukove. Ako je, izaberite trenutak kada je u igraonici manje glasne djece. Jednako vrijedi i za djecu koja su prekomjerno vizualno osjetljiva na micajuće podražaje. Ako mnogo djece trči oko Vašeg djeteta, ono se može “zalediti” i ne uživati na ovako zabavnom mjestu. Ja bih najprije izabrala sprave i aktivnosti koje dijete poznaje dok ne spozna prostor, ljude oko sebe i svoje mogućnosti u tom prostoru. Kada Vam se čini da je dijete u redu, možete predložiti nove aktivnosti s kojima inaće ne bi bilo oduševljeno. Polako i postepeno. Najbolje je dati djetetu da odluči i napravi aktivnost prvo koristeći svoju kreativnost i motoričko planiranje, ali ako Vaše dijete treba dodatni poticaj, možete i Vi to učiniti prvi.

Girl in a tunnel. Permission acquired from the parents.
Girl in a tunnel. Permission acquired from the parents.

Ako nemate vremena za igraonicu ili ju Vaš trgovački centar ne nudi, pokušajte uključiti svoje dijete u poslove koje morate obaviti. Djeca koja trebaju dodatni ravnotežni podražaj će se voliti voziti u shopping kolicima u dućanu i na taj način može stavljati namirnice i proizvode u kolica. Dajte djetetu da izabere između dva ili tri proizvoda koja se tiću njega: koji sok ili koje pahuljice kupiti. Ali, ograničite izbor na dva ili tri artikla pogotovo za manju djecu ili ona koja još nisu verbalna.

Ako Vaše dijete voli brzo izmijenjivati aktivnosti, pokušajte brže završiti Vašu kupovinu da ne podražujete dijete prekomjerno. Ne morate odmah napustiti dućan, možete malo pokušati produljiti vrijeme izlaganju, ali nemojte pretjerivati. Vidjet ćete znakove na djetetu kada mu je dosta; odbija suradnju, izgleda kao da mu je dosadno ili da je umorno, vuče se po podu, moli vas da odete doma pa sve do bacanja po podu dućana. Neka djeca pređu ovaj spektar znakova vrlo brzo, dok neka odmah pređu na plakanje. Sigurna sam da poznavajući vlastito dijete znate što je najbolje za napraviti u toj situaciji, otići ili ostati u dućnu – ali ispravnu stvar nije uvijek lako i moguće napraviti, znam!

Posted on by lina. 4 comments

Activities in a shopping center

verzija na hrvatskom jeziku (in Croatian language)

First of all, how does an entrance to a new place, especially a big, shiny, loud, crowded place such as a shopping center affect your child? Does your child rush into it or has a meltdown as soon as your car makes a turn to the shopping center’s parking lot? Take your answer to this question as a guide to your shopping center experience.

If your child does not like going into the malls, you don’t have to avoid it. Do it gradually and observing child’s reactions. If your child starts screaming at the parking lot, try making that your goal – safely parking the car, but not exiting from it. Next time, try exiting the car but not going inside the mall, but perhaps until the main entrance. What is important is that you always tell your child in a calm voice (whisper to those overly stimulated to sounds) what is your agenda. You want your child to be in a control over the situation. When the child feels they are in control, things will get a lot easier. If they feel activities are too fast for them, if they are loosing that control, they will become upset, anxious and perhaps even have a tantrum. So, just comment on your plan to your child no matter how old they are and no matter how much you think they can comprehend; “we will park in the spot right here on the left and then mommy will turn off the car. I’m doing it, look, 1…2…3… car is off”. You can use simpler sentences, or break it apart in more smaller ones or if your child is bigger, you can add more details. If your child is verbal, you can have them count or choose the parking spot. Engaging your child in these simple activities gives them confidence and control they badly need to stay regulated.

Once you slowly get inside the mall, take a moment to see what is around you to make your anxious child feel better and back in control. You can take your child in your arms if they are small and tell them what you see around them; lights, coffee places, ornaments, music playing in the background, shops, carts, people, etc. Give a minute or two to your child to comprehend what is going on around them. When you see the moment is right, continue to your chores. Most likely next time you will not have to go through this process again. If you do, that’s ok, too. Give your child the time they need. If you are not able to take those few minutes extra, or start early, and let’s be realistic, we are sometimes on a very tight schedule, rather leave your child with somebody else and not “drag” them into a place  where they will feel uncomfortable.

Nowadays, most of the larger malls have some sort of playground for children to play at while parents are doing their shopping. Some have rules about leaving your child unattended, some are paid, some are free but most of them are a good source of sensory input. Larger playgrounds have all kinds of climbing equipment, ball pits, slides and tunnels. Use it! See if your child is overly sensitive to sounds. If it is, then choose a moment when there are less loud children around. Same goes with children who are overly sensitive to moving visual stimuli. If there is a lot of running children around, your child might freeze and not enjoy this fun playground. At first, I would choose some activities there that your child is familiar with, just to get some confidence in the space and its own possibilities. Once you feel your child is ok with the environment, you can propose going to an activity your child is not very thrilled about. Slowly and gradually. It’s always good to leave it up to your child to do it first so they use their own creativity and motor planning on how to achieve the goal of that activity, but if you see your child needs some encouragement, you can do it yourself first.

Girl in a tunnel. Permission acquired from the parents.
Girl in a tunnel. Permission acquired from the parents.

If you have no time for the playground or there isn’t one at your mall, try engaging your child in the chores you need to do. Children who need vestibular input can enjoy a ride in the shopping cart plus they can easily put the groceries into the cart itself. Let them choose out of the two products that are relevant to them; e.g. which juice or cereals to buy. However, limit your options to two or three to choose from for smaller children, especially those that do not use verbal language.

If your child likes changing activities very often, try to do your shopping chores quickly because we don’t want to overstimulate the child. You do not have to leave the store right away, try prolonging the period for one activity, but do not go overboard. You will see the signs from your child: not engaging in your activities anymore (“getting bored”), looking tired, dragging themselves on the floor, asking you to leave, “nagging” and everything else up to a tantrum. Sometimes children go through the spectrum of signs very quickly, and some children skip to crying right away. I’m sure knowing your child, you will instinctively know what is the right thing to do in that moment; leaving or staying – but the right thing is not always easy or possible, I know.

Posted on by lina. 4 comments