by Patricia S. Lemer, M. Ed., NCC, Chairman of the Board, Epidemic Answers
Mental health professionals and schools often depend on a behavioral model to address emotional and learning issues. Programs such as 1-2-3 Magic, discrete trial training, time out and even tutoring reward positive behaviors and attempt to extinguish less desirable ones.
An alternative way to approach problematic behaviors is to look for the underlying needs that drive them. Let’s visit a third grade class, where I observed Emily, a mainstreamed nine year old with PDD-NOS.
Emily wiggled and squirmed, walked to the water fountain, took a long drink, sharpened her pencil and sat down. She tucked her foot under her leg, which dangled above the floor, chewed on her pencil, tapped it on the desk, and twirled it in her hair. She stared hard at the visitor. “Teacher, teacher!” she called. No answer. Emily glared again, and then tried to make an arithmetic sentence using 8, 3 and 5.
“Ooo…ww,” she wailed suddenly. Her classmates rolled their eyes. The teacher stared. “Ooo…ww,” Emily cried louder. Finally, she jumped from her seat. “OOO…WWW,” she screamed.
I couldn’t help thinking of psychologist Abraham Maslow’s hierarchy of human needs. Obviously, Emily’s basic needs for water and recognition were competing with her teacher’s need for her to learn mathematics. Are there any solutions, I wondered, that meet both Emily’s and her teacher’s needs?
Coincidentally, the same day I discovered the book, “The Irreducible Needs of Children”, by Drs. T. Berry Brazelton and Stanley I. Greenspan. Each of the needs they describe applies to Emily. Four needs are analogous to Maslow’s.
Maslow Brazelton & Greenspan
Biological Experiences tailored to individual differences
Safety Physical protection, safety and regulation
Security Ongoing, nurturing relationships
Knowledge Developmentally appropriate experiences
Maslow believed that only after children’s most primitive biological needs are met should adults address the higher level needs for safety, security and knowledge. Unfortunately, in today’s schools, many teachers put acquisition of knowledge first. Emily and others have basic biological, safety and security needs that must take precedence. Her behavior shows us what these needs are.
Biological Needs: Water Nourishes the Brain; the Mouth Organizes it
Emily’s brain, like everyone’s, needs water to function. According to Carla Hannaford, author of “Smart Moves: Why Learning Is Not All in Your Head”, optimal hydration enhances the brain’s ability to process information efficiently. The mouth is also key to a well-organized brain. Both sipping water and chewing on a pencil are calming. Emily unconsciously did both to get focused.
Ideas: Provide everyone with a water bottle. String plastic tubing on a cord for chewing. Hydration and oral-motor work will increase focus for all students.
Safety Needs: Children Struggle to Look/Listen When Underlying Senses Are Inefficient
Feeling “safe” means more than being out of range of gunfire. Emily has sensory processing and regulatory problems that cause her much anxiety. When children fear unexpected movement, touch and sounds, they become hyper-vigilant, as Emily’s staring suggests. Emily simply cannot pay attention to staying seated and do her math problem simultaneously.
Ideas: Provide Emily with occupational therapy to normalize her regulatory and sensory processing dysfunction. Put a fidget toy in her pocket to provide appropriate touch and pressure as needed. Do Brain Gym activities before lessons. Allow movement breaks at least every 20 minutes.
Security Needs: Ignored Needs Don’t Go Away; They Become Stronger and Undermine Nurturing Relationships.
Being posturally/gravitationally secure helps a child to feel emotionally secure. Emily’s desk and chair are ill-fitting, and her dangling feet, disconcerting. Emily tucks her leg to feel more secure, but the total sensory experience of two ungrounded legs puts her “over the edge.” Her teacher ignores her, hoping to extinguish her outbursts, but Emily’s need to be heard overtakes her need to learn.
Ideas: Provide Emily with a footstool, a cushion or seat wedge and a chair with arms. Pair her with another student, so that they can work together and Emily has someone who might listen.
Knowledge Needs: Children Learn and Remember Lessons When They Are Developmentally Ready.
Emily’s math lesson makes no sense to her. She cannot make number families because she still doesn’t know that eight is more than five.
Ideas: Use manipulative materials and story problems to give the mathematics lesson some meaning. Have Emily use the manipulatives while her partner makes the number sentences.
A combination of behavioral therapies and sensory-based, developmentally appropriate activities are best for young children with autism, PDD-NOS, ADHD, Sensory Processing Disorder and developmental delays.