Key definitions
These words still echo around my head, words overheard during a placement assessment at a school.
The misconception was that this child's 'misbehaviour' was because he was being ‘naughty’, and not that he was trying to regulate himself so that he didn't have a total meltdown. The difficulty is, how can we tell the difference between ‘naughtiness’ and sensory need?
For a child with sensory processing disorder (SPD), sensory information goes into the brain but becomes mixed up and the resulting responses are not always socially acceptable.
One way of understanding the wiring in the brain is to think of a new ball of wool, with the threads neatly lined up. If these were neurons the messages would pass along easily, with responses being well learnt and appropriate.
The key to understanding whether a behaviour is a learnt behaviour or a sensory processing need is to assume that it is sensory
A child with SPD (and frequently autism) has a brain where the ball of wool has become tangled and twisted and the paths for the messages can no longer be easily traced. Messages struggle to pass along, resulting in mixed messages and muddled responses. The sensory input then becomes misinterpreted and the child’s body goes into a ‘fight’ or ‘flight’ reaction.
The resulting behaviours can act as a self-regulating response. They may be deemed inappropriate within society but to the child the behaviour has prevented their total meltdown. Stopping this sensory need behaviour without meeting its purpose can easily result in more challenging behaviours being displayed.
| Sensory system | What it controls | Behaviours that show dysfunction within the system |
| Vestibular | Co-ordinating movements, balance, eye movement and spatial orientation. | Rocking, jumping, teeth grinding, pacing, throwing self onto the floor, spinning, head banging, ear flicking, humming. |
| Proprioceptive | Body’s ability to know its own position in space, e.g. knowing that your feet are touching the grass. | Running, jumping, throwing self onto the floor, head banging, shaking fingers, hitting self, pinching, biting, over focusing with their eyes. Watching hands or feet as they move them. |
|
Somatosensory (tactile proprioceptive) |
The ability to interpret bodily sensation. Sensation takes several forms, including touch, pressure, vibration, temperature, itch and pain. | Biting, mouthing objects, pica, picking skin or eyelashes, need for constant touching, crashing into things. Dislikes wearing shoes or clothes. |
| Gustatory | Taste | Picky eater, difficulty eating mixture of textures, flavours or colours. Wanting food very hot or cold. Frequent drooling, dislikes brushing their teeth. Licks, chews, or mouths inedible objects frequently. |
| Auditory | Sound | Shrieking, tooth grinding, vocal play, ear flicking and humming. |
| Visual | Sight | Love of bright or moving lights and colours. Watching moving pictures. Wanting to wear sunglasses. Hiding their eyes. |
| Olfactory | Smell | Sniffing things, greeting people by sniffing them. |
Each child is an individual and with each sense the child could be hypersensitive or hyposensitive.
The warning signs of each sensory processing need can overlap, making clear identification even more difficult. A child could also be both hypersensitive to one sense while being hyposensitive to another.
Added to the behaviours linked to their sensory processing system they will also have learnt behaviours being displayed. Unpicking all these behaviours can appear impossible.
At The Loddon School, we assume that:
In response to these two assumptions we offer:
When assessing a child, one restrictive behaviour is identified and focused upon.
The chart below shows the structure of the observation and monitoring period. Discussions with key members of staff provide the required information.
Case study example
Recommendations
Each child has a timetable built around their preferred learning and their sensory diet.
The symbols within each time slot emphasises the sensory diet aspect that needs to be met either by the major learning activity or with an additional sensory activity input provided. This could be that the child walks via the swings to their next activity and stops for a five-minute swing – a routine which will mean that the child can finish the activity knowing the regularity of these sensory inputs.
Careful hourly monitoring of behaviour and sensory input patterns will show staff the difference between behaviours when the sensory need has been met and those that are sensory led. Having a school structure that places sensory awareness as a consistent focus for all staff and having a good understanding of the behaviour profiles moves practice forward rapidly.
Key takeaways
