Author: Rebecca O'Callaghan, M.S., OTRL, SWC

Is it Sensory or Behavior?

Let’s face it … life can be hard. We’ve all been there in those moments, feeling on the verge of overwhelm, frustration, or even hopelessness. It’s not a pleasant feeling. For our kids, life can be hard too. Changes in routine, transitioning from one thing to the next, and unexpected challenges can test both children and their parents. Children thrive on the consistency of everyday patterns and routines. Usually, children can participate in and cope well with activities they can anticipate and are used to as part of day-to-day life.

Our sensory processing systems also benefit from everyday patterns and routines. It is one of the many ways that our brain organizes sensory information. When we can organize and use sensory information, it helps us maintain self-regulation. When we maintain self-regulation, we can cope with unexpected changes, challenges, or the new demands of a situation.

But these changes, challenges, and demands also bring in new sensory information, and that requires time to process and organize. Sometimes we can process and adapt quickly. Other times, we might need a break to process the information and come back to it later, particularly if we are experiencing feelings of overwhelm, frustration, or even hopelessness. For many children, processing sensory information quickly to adapt or taking a break to sort out emotions around a particular situation can be very difficult. The result often rests along the continuum from a simple tantrum to a full sensory meltdown.

You may be asking, but is there even a difference between the two? Aren’t tantrums and meltdowns the same thing? No, they are quite different. The triggering circumstances and the emotional distress that follows each are characteristically different from the other. A tantrum is a behavior, while a meltdown stems from sensory responses that involve environmental demands.  I want to help you understand the differences between these two and give you strategies to help you manage situations when your child’s frustrations come up in daily life.

What is a Tantrum?

A tantrum occurs when a child becomes angry or frustrated with a challenge that results in an expression of frustration, anger, or similar emotion. It is typically an outburst of emotion that is brief in nature. When a child has a tantrum, he/she can often be redirected, ignored, or comforted and the situation will resolve quickly.  

What is a Meltdown?

A meltdown occurs because of sensory overload and results in intense reactions, deep emotional distress, and has continuous or cyclical pattern of recurrence across time. A meltdown builds from one sensory trigger to the next, occurring over an extended period of time, that results in sensory overload. Once a child reaches sensory overload, the body is triggered into an anxious or high arousal state of flight, fight, or freeze. Meltdowns can be characterized as seemingly inconsolable distress (crying), intense and disruptive vocalizations (screaming/yelling), non-verbal behaviors (hitting, biting, slapping, scratching, kicking, head banging, or self-injurious behaviors, etc.), complete loss of attention to the activity, and/or extreme shutdown or disengagement. In occupational therapy, a meltdown is also known to be an episode of extreme dysregulation. It is difficult for children who experience extreme dysregulation to calm down quickly. Sometimes, it can take hours or even days for a child to get back into a more well-regulated state, where they no longer feel the need to stay on alert. But if another trigger comes up before the body can calm fully; it can quickly send a child back up into another episode of extreme dysregulation. This is why meltdowns are often cyclical in nature. 

Can I Anticipate a Tantrum or Meltdown?

I’ll be honest, the answer here … yes but not always. Life is certainly unpredictable, so being able to anticipate a tantrum or meltdown relies on your own ability to recognize the sensory cues and signs of distress that your child experiences before he/she has a tantrum or meltdown. Every person is unique so the sensory cues and signs of distress that result from sensory overload and lead to emotional distress are not the same for every child. It is important to take the time to observe your child and learn your child’s own individual sensory cues and signs of distress so that you can respond in a way that is proactive. It is better for us to be proactive rather than reactive. To better help you understand sensory cues and emotional distress responses, look at our list. Then take the time to observe your child and add your own signals too. Every child gives us signals, and we must be prepared to see them and respond accordingly.

Sensory Cues or Signs of Distress...What Do I Look For?

• Heart Rate Changes
• Respiratory Changes
• Color Changes – flushed or pale
• Temperature Changes – clammy, sweaty, or cold
• Aversion Responses (i.e. facial grimacing, gagging, or finger splaying, etc.)
• Avoidance Behaviors – turning away or moving away from the activity
• Startled Response
• Prolonged holding of bowel and bladder
• Repeated Yawning
• Repeated Sighing
• Hiccupping
• Irregular sleep patterns, difficultly falling asleep, or difficulty staying asleep
• Irregular eating patterns
• Sudden sleepiness or falls asleep (shut down) during an activity
• Irritability or fussiness
• Emotional distress (i.e. crying, tantrum, emotional distress that is recurring, etc.)
• High guard arm position – often seen with infants and toddlers in feeding
• Repetitive Movement Behaviors
• Frenetic Motor Activity – disorganized motor activity
• Attempts at disengagement or elopement
• Visual scanning of the environment (as if “looking out” for something)
• Visual gaze is avoided
• Visual gaze may be fixed (as if to stare or “tune out” the environment)
• Quieting of communication, limited vocalizations, or verbalizations of what is less than usual for the child
• “Build-up” of arousal state – usually high arousal state can build quickly to flight/fight/freeze response

Being Prepared...What Do I Do?

When possible, have a predictable and consistent routine in place for everyday tasks and routines.

Before making any changes to a routine or going somewhere new, consider where your child’s current regulation state is at today. Are you seeing any irritability, fussiness, crying or tantrums today? Did your child get enough sleep last night to prepare him/her for a new challenge today? Have they had enough to eat? Are you going out in between meals? If so, bring a snack. Have they gone to the bathroom recently? If not use the restroom before you leave the house and have a plan for using the public restroom, diaper changes, etc. while you are out.

Before going somewhere that you know will be new or may be challenging for your child, take time to consider ways to minimize the potential sensory triggers within the environment. If your child takes time to “warm-up” to new or group situations, hold your child (or hold their hand) and keep them at a distance to let him/her observe the situation before going further. Control greetings from others, loved-ones, friends, and strangers. If your child doesn’t like being touched kisses, hugs, and pats on the head from loved ones can be too much. Be an advocate for your child, and help family and friends choose to wave “hi” or “high-five” instead.  Meeting someone new for the first time? Have the person wait outside your child’s personal space and allow your child enough time to observe them before making an introduction. Better yet, give lots of time and allow your child to go to the person when he/she is ready.

Provide sensory supports that help to activate calming sensory sensations and prevent overload. Try a compression vest or weighted vest.  Is your child sensitive to noise? Try noise-cancelling headphones. Is your child sensitive to bright light? Wear sunglasses even inside.

Provide sensory toys that help to keep your child calm or decrease his/her anxiety while in the environment. Consider fidget toys (there are TONS to choose from!), squeeze balls, pull tubes, pop-it toys, or stretchy noodles.

Help your child understand that there will be a limit to sensory exposures. Set a visual timer and watch it run out on the clock. Listen to a playlist of music or sing a song, and when the playlist or song is over, we are done. Let’s count to 10, 20, … 100!

Provide your child with items that help him/her to stay calm. These are not “sensory toys”. Bring a favorite toy or object from home to keep in the car, shopping cart, or stroller (just don’t forget it or lose it!). Bring your favorite blanket, wear your favorite hat, or a book to look at or read.

Not sure how to prepare for a particular situation, ask your child’s occupational therapist for ideas on how to be ready!

A Meltdown Happened...How Can I Help?

Safety first! – Ensure the environment is safe so that the meltdown can occur. Watch for non-verbal behaviors (hitting, biting, slapping, scratching, kicking, head banging, self-injurious behaviors, etc.) and quickly create a space that your child can meltdown safely. Do not leave your child alone to ensure his/her physical safety. If your child moves to another room, move with them, and continue to monitor for potential dangers.

Give them a hug or give them space. – Some children want comfort when sensory overload occurs, and others do not. If your child is not reaching for your or indicating he/she wants you in his/her personal space, and it is safe to do so, give them space.

Give them some time. –  It can take a while to recover from sensory meltdown. Don’t expect for things to resolve quickly.  Remember, it can sometimes take hours or even days for a child to get back into a more well-regulated state, where they no longer feel the need to stay on alert.

Return to a predictable and consistent routine.  – Remember children thrive on consistency of everyday patterns and routines. It is important for children to have a predictable and consistent routine.

DO NOT try to reason, argue, threaten, discipline, or bargain with your child if a meltdown has already begun. – Your child is not in a place to hear you and he/she cannot connect with these ideas in the moment. In addition, you as a parent must think if these are the best ways to communicate with your child. Children need boundaries and structure. Set these in place before or after a meltdown occurs, not during. Did you prepare as best you could? Did you prepare your child? Remember to be proactive, not reactive! Many times, reasoning, arguing, threatening, disciplining, or attempting to bargain only make your child feel ignored and can escalate the situation.

Let your child know you are listening. – Validate your child’s feeling and emotions during, and after the meltdown, “I understand you are mad…frustrated…angry.” Even if your child is not able to express their feelings and emotions verbally, helping to label them in the moment or even after the meltdown episode can demonstrate your understanding. Express your understanding using communication through non-verbal means as well. Think about things like eye contact, physical touch, or personal space. Many times, you will be ready to re-engage in interaction long before your child is ready. Also try to keep your body relaxed and not tensed.

Ask others for support. – Sensory meltdowns are tough for everyone involved. Ask your child’s occupational therapist or other professionals that work with your child on ways to support your child. Talk to your spouse, significant other, trusted friend, parent group, or psychologist if you feel overwhelmed. Ignore comments, advice, and suggestions of those not educated or trained in responding to sensory meltdowns.