Is it Sensory or Is it Behavior?
I See Your Frustration and I’m Here For You.
Guest Blog Contributed By: Dr. Angie Harisiadis, OTD, OTR/L Owner and Executive Director of In2Great! Therapy and Dr. Melissa Donegan, OTD, OTR/L, Director of PR & Marketing
As an occupational therapist, I’ve spent decades studying and applying what I’ve learned in pediatric based practice, having evolved my skills and knowledge into building a private pediatric outpatient clinic. It doesn’t matter the space or place, parents continue to come to me in tears, struggling to understand why their child can never seem to sit still, why they cry over the smallest bumps or bruises, and why they are just not developing at the same rate as other children their age. These are the families that receive numerous angry calls from their teachers that their child continues to run in circles around the room when they should be sitting down and doing their work. The teacher says it needs to stop. Parents try all the tools in their toolkit, but they come up empty. I hear you. It’s not easy being a parent. It’s not easy understanding your child’s every action and reaction. Enter: Angie.
The System: Failing
As a western society, there’s not much grace given to a child that doesn’t fit the mold or act like the ‘normal’ student. When a child is repeatedly sent to the principal's office, given a red card, and sent home because of bad ‘behavior’, as a society, the child is failing. Society thinks the child is the problem. I argue it’s not the child, it’s the system. Society needs to support our children to a greater extent.
Decoding The Reason Behind the Action and Reaction
After spending decades learning and studying the sensory system as an occupational therapist and then building a pediatric clinic to support clients with sensory processing disorders, I think I’ve cracked a good amount of the code.
Background: I am an occupational therapist. An occupational therapist is a healthcare provider that looks at the science of occupation, which means we support the occupations that are the most meaningful activities that a person wants to do, needs to do, or is expected to do. For an adult, it could be home maintenance, functional mobility, financial management, community participation, or sleep hygiene. For a child though, it’s more foundational. It’s the most basic activities of living like toileting, dressing, eating, and sleeping. But the most important occupation for a child is play. At the core, play needs to be interwoven in every single step of a child.
From birth to adulthood, growth and skill development happens when play is taking place. However, play is pretty much dependent on one singular thing: the child and their sensory system.
In grade school, our children learn that there are 5 senses that make up our sensory system such as sight, hearing, touch, smell, and taste. But how do you know you’re hungry or in pain? We can’t see or touch either of those internal feelings. Well that’s what your interoceptive system is for. But how do you keep from falling over just when walking in a straight line? Well that’s your vestibular system doing its job and our proprioception system responding correctly. The way we respond to our environment goes beyond that of just the 5 senses that we’ve grown up to know. I want you to walk away from this article understanding that all 8 sensations intertwined together is what makes each human incredibly unique and our sensory profile determines how we act and react to the things, people, and environment that surrounds us. Taking the time to understand our children’s sensory profiles means that we can begin to learn why our children act and react to certain situations and environments in a way unique from that of their peer counterparts.
IEP and 504: Important Letters and Numbers
Your child gets in trouble for hitting, biting, not sitting still, difficulty keeping their hands to themselves, for “NOT LISTENING,” for yelling, for frequent meltdowns and you’re at a loss. Tired. Defeated. The school argues this is “behavioral.” But what about their unique sensory profile? What if your child’s actions and reactions are caused by an environmental mismatch. A mismatch between their sensory needs and what their school is giving them.
I argue that there could be MANY sensory underpinnings that contribute to your child’s challenges at school. You got a “hitter” on your hands? I would look to see if that child needs more proprioceptive input to stay organized and regulated. You have a child that bites? Well, I know our oral motor sensory system is our body’s #1 regulator, and when a child reverts to using their mouth to make a point, it means they are dysregulated and oral input can help them. You have a child that “just won't sit still?” Well, I would like to see if that child’s vestibular system may be set to “high” and unless we give them the input they need, they won't be able to sit still.
I promise. It’s not that kids don't want to sit still, for kids with vestibular challenges, they legitimately CAN’T sit still. For all these examples and more, I frequently get called into children’s classrooms by families searching for answers. I am a specialist in advocating for children in their schools. I go into their classroom, observe, and take the time to understand their children. The process of observing a child in the classroom, in addition to gathering information from families, is incredibly important to understanding a child's sensory needs. Afterwards, I’ll meet with families and school staff collaboratively, either in a stand-alone meeting or actually participating in a child’s Individualized Educational Plan (IEP) or 504 meetings, in an effort to change school staffs’ perspectives on who these children truly are, and WHY they “behave” the way they do at school. It is important to have solid IEP/504 plans in place for our children that are true depictions of who they are, and that we leave no stone unturned in educating their educators on how to best support them.
When I opened In2Great’s doors in 2012, I envisioned a pediatric clinic where families can come to get all their services under one roof. I envisioned a clinic that was client centered and felt more like “home” than a sterile office space. My dreams have turned into a reality, as In2Great! offers almost every therapeutic discipline in a most collaborative, compassionate and state of the art facility.
As I continue to advocate for children within the school system, I developed a clinic focused on therapeutically treating children needing specialized care for their sensory needs. All therapists at my clinic come to their families with the skilled expertise of the sensory system in hopes that they may help their families answer the question: Is it sensory or is it behavior? I strive to give you that answer.
C.I.T.Y. of Support is grateful to Dr. Angie Harisiadis and her clinic for their participation in our organization as one of its Premier Sponsors; however, the information and opinions presented here are specifically hers/theirs. Please note, that the purpose of C.I.T.Y. of Support's collaborative blog is to help connect families and professionals to different community resources, and we do not specifically endorse any particular recommendations provided herein.