Photo source: www.forbes.com, www.rompa.com
If
you have spent any time with ABA people you may have picked up on the fact that
we're all about data. We collect data, analyze data to make decisions, and look for the evidence, or data, behind strategies or techniques before we implement them.
So
where do we stand on the issue of “sensory diets/sensory protocols/sensory
interventions”? Well, many items or activities often included in a “sensory
intervention” (I
keep placing that in quotation marks because one of the problems is there is no
set definition of this term. It means many things, to many different people), such as
koosh balls, massage, tickles, dark lighting, aromatherapy, scented oils,
pillows, etc., are quite enjoyable and can be very reinforcing.
Did you catch
that?
Okay,
I’ll say it again: Many items or activities often included in a “sensory
intervention” such as koosh balls, massage, tickles, dark lighting,
aromatherapy, scented oils, pillows, etc., are quite enjoyable and can be very
reinforcing.
And
there is the problem. “Sensory protocols” are often implemented as a response
to problem behavior, in order to quickly remove the agitated child, let them de-stress,
and to give them a quiet and relaxing space to gradually de-escalate. So what
happens if you apply an enjoyable and possibly reinforcing activity after
problem behavior has occurred? You inadvertently reinforce, or strengthen, that problem behavior.
Many
center programs or schools are now setting up separate cool down areas where
some type of “sensory protocol” is applied, such as the child sits on a beanbag
and listens to soft music while a teacher or aide gives them deep pressure and
firm touch.
These
professionals often are unaware that the very protocol designed to reduce or
prevent problem behavior is actually causing problem behavior to increase. Here’s
a sample scenario to show you what I mean:
Child in math class.....hates math class.....child throws book across room, yells, and stands on desk...immediately removed from math class (yay!)...taken to the cool down room...now laying on a soft blanket, sipping water, and
holding a koosh ball...awesome!
For
all the parents and educators: there is NOTHING wrong with using preferred
items to bring about behavior change. Just pay attention to WHEN you present
these items/activities.
Preferred, enjoyable items and activities should be
presented when desired behaviors occur and not when problem behaviors occur.
When problem behaviors repeatedly occur, your best plan of action is to conduct a FBA, and create a Behavior Plan.
So
why do “sensory protocols” or other interventions without empirical support persist,
or even gain traction among professionals and educators? What is the lure? Well, Lilienfield et al (2015) provide
a few answers to that question:
- Parents are often desperate for Autism treatment options
- Behaviors often wax and wane naturally as children age and mature, so it can seem that sudden short term improvements are due to a particular treatment or intervention
- The internet and technology brings a mass of information to people quickly, and most people would rather read something online than in a research article
- At a psychological level, once someone believes in something it can be quite difficult to convince them otherwise
I absolutely agree that fad treatments can be very alluring. It’s like that
fast food place that you know you shouldn’t eat at, but the food is cheap, fast, and convenient.
Based
on my experiences with this issue, here are the main captivating lures I see
when it comes to “sensory protocols”:
The Lure
|
The Truth
|
Typically
easy or quick to come up with, can be implemented or created by anyone
|
Most
quality, evidence based interventions require the use of credentialed or licensed
professionals who have specific expertise
|
Materials/objects
are often cheap and readily available, some can even be made
|
Gather
together all of these cheap and readily accessible items and use them as reinforcers,
not as a “treat” that only comes out after the child has aggressed at someone.
If the only time the child can access all these amazing items is after they
have become severely disruptive, then Houston, we have a problem
|
Can
appear to have an immediate effect, or in the short term can appear to be
working
|
Especially
for an escape maintained child, yes….these types of interventions will
appear to work like magic! Unfortunately, that is only until the child gets
sent back to class or a high demand situation. What I typically see is a high
cycle of: behavior, calm down room, behavior, calm down room, etc. Another
important point to consider is do you plan to create a sensory room in all environments?
No? Then what happens when problem behaviors occur at the beach, the post
office, or at Grandma's house?
|
A
“sensory room”, particularly in a school, can serve as negative reinforcement
for the teacher (escalated and disruptive student is quickly removed from their classroom)
|
If
at all possible, it’s best not to
remove the child from the location where problem behavior began, or for
another educator/professional to come to the “rescue” and remove the student.
This sends a message to the child you don't want to send: that you cannot
handle the child’s behaviors, and if they want to quickly leave a certain
setting all they have to do is exhibit significant problem behavior
|
If
the child enjoys it, what’s the harm?
|
Lemon treatments waste money, time, efforts, and energy that could be directed at
effective interventions based on data. They can also shape up problem
behaviors and make them far worse, or more entrenched over time. Lastly, during the time the child was engaged in the sensory intervention and removed from the learning setting, effective instruction was paused or delayed.
|
Reference:
The persistence of fad interventions in the face of negative scientific
evidence: Facilitated communication for autism as a case example
Lilienfeld
SO, Marshalla J, Todd JT, Shane HC (2015) Evidence-Based
Communication Assessment and Intervention
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