Having Trouble Understanding Your Child’s Challenging Behaviors? His Sensory Processing System May Provide Important Clues

“I always thought Samantha was just more ‘intense’ than other children. Her reactions to nearly everything were incredibly strong. She threw massive tantrums at least 5-10 times per day over things such as having to sit in her car seat or accidentally getting water in her eyes during bath time. People would tell me tantrums were “normal,” but I felt it wasn’t normal to be having such intense tantrums so many times each day. She was incredibly impulsive and constantly reached out to touch interesting things she saw, regardless of the appropriateness (such as clothing on someone’s body) or the danger (such as a burning candle). She also seemed to both seek physical input (for example, by climbing on others) while also protesting intensely to any physical touch that she didn’t like (for example, an adult restraining her from an unsafe situation). She would melt down if someone else did something she wanted to do like flush the toilet, push a button, or turn on the faucet to wash hands, and she often didn’t “recover” for several minutes, even an hour at times. She also had a hard time listening to and following directions, so things like getting her dressed were often very difficult. I felt completely overwhelmed and lost.”

— Samantha's mom

About 10 years ago, I was feeling increasingly frustrated with the limited progress many children I was working with—such as two-year-old, Samantha—were making using the typical tools of my trade. Trained as a clinical social worker, my focus was on helping parents understand their children’s emotions and providing them with strategies to help their children learn to manage their feelings so they could behave in constructive, “pro-social” ways. No matter how tuned in, loving, and empathetic parents were, and how clearly and consistently they were setting limits and boundaries, their children continued to struggle with typical challenging behaviors such as: biting/hitting/kicking, defiance, extreme fearfulness/anxiety, impulsivity, or an overall lack of self-regulation.   

Around this time, a friend was telling me about problems she was having with her then 3-year-old, “Ruben”. He was very impulsive, aggressive, defiant, and wasn’t tuning in to others—all behaviors very typical of the kids I was having the hardest time helping.  She told me that after trying many different failed behavioral interventions, they were referred to an occupational therapist (OT) who identified underlying sensory processing challenges that were at the root of many of the problematic behaviors Ruben was exhibiting. Further, she explained how the therapy Ruben was doing with the OT was yielding very positive results for the first time. I am embarrassed to admit that at that time I was mostly ignorant about OT for kids. I thought of it as an intervention for adults with carpal tunnel syndrome or who had been injured on the job. What could the “occupation” of a child possibly be? So, I asked my friend for permission to observe a few sessions of her son’s OT.  

That experience proved to be a watershed moment: I saw first-hand how many challenging behaviors children exhibit are rooted in problems in their sensory processing systems and that this was a critical piece of the puzzle that I was missing as I tried to make sense of the meaning of children’s behaviors. For example, some of Ruben’s challenges were the result of a low threshold for tactile input. When people got too close to him, he pushed them away—by biting, hitting, kicking—to protect himself. Through targeted activities, the OT incrementally exposed Ruben to tactile experiences to help his system better detect, regulate, and interpret these sensations and respond to them more appropriately. In effect, OTs help children do their most important “jobs”, which include the ability to: manage their bodies and feelings, learn, play, get along with others, and work well in groups—pretty much everything that enables children to function effectively in the world!