FAB Sensory Matching Strategy

Sensory matching is an evidence-based strategy for replacing repetitive self-injurious behavior with an alternative activity that provides similar sensory input. Sensory matching is consistent with the evidence-based behavioral intervention of (NMS) non-contingent matched stimulation (Davis et al. 2013). Behavioral and sensory modulation theories are integrated in the sensory matching strategy to functionally replace repetitive self-injurious behavior with desirable sensory activities embedded into daily home and school routines. Before using the sensory matching strategy it is important to assure that the function of problematic repetitive behavior is non-social (e.g., sensory) reinforcement.

In treatment planning for a non-verbal 3-year old with intellectual disabilities demonstrating repetitive finger sucking that caused skin breakdown I began by using the (QABF) Questions About Behavior Function. Through understanding the function of his problematic behavior using the QABF the sensory matching strategy can improve self-injurious behavior engaged in for sensory (e.g., non-social, automatic) reinforcement. Replacing self-injurious behavior with safe, equivalent sensory stimulation activities, referred to as matched sensory input, is a proven strategy for improving self-injurious behavior (Davis et al., 2013). I also took a baseline on the frequency of the problematic finger sucking behavior so I could objectively assess the efficacy of intervention (Mays et al., 2011).

 

His QABF results indicated that the primary function of his finger sucking behavior is non-social (e.g., sensory, automatic) reinforcement.

QABF3yr.Old

Since he often did finger sucking as a form of self-stimulation and if he thinks no one is in the room (see items 3 & 8), it suggests that finger sucking was primarily done for sensory input, as seen in non-social being the highest total score. Since the behavior is being done primarily for non-social reasons, sensory processing theory is used to assess the sensory stimulation achieved through finger sucking and how it can be met safely.

From a sensory integration perspective repetitive self-injurious behavior is viewed as “a short circuit”, in which harmful repetitive behavior such as hand sucking does not provide the desired sensory input. Applying sensory processing theory assumes that finger wetness and touch inside his mouth are the primary sensory inputs received from finger mouthing (Dunn et al., 2016). The Sensory Profile (Dunn, 2014) and Trigger & Coping forms were administered.

The Sensory Profile results showed a definite difference in sensory seeking, while his mother chose on the coping forms water play and a chewey as his favorite coping strategies. Using a preference assessment showed that his favorite activities providing finger wetness and touch input in his mouth were water table play and mouthing a chewey, respectfully. Consistent with a sensory integration approach these activities were embedded in his daily home and school routines so they could best be integrated in his day (Murray-Slutsky & Paris, 2014; Mays et al., 2011).

Water play and chewey use were embedded in the daily routine whenever he wanted them, providing (NMS) non-contingent matched stimulation. In addition, if he demonstrated reduced finger sucking he was given a favorite toy (e.g., a contingent reinforcer). After two weeks of consistent treatment finger mouthing was significantly decreased compared to baseline. This combination of behavioral and sensory strategies enables the sensory matching strategy to guide therapists in replacing problematic behavior.

 References:

Davis, TN, Dacus, S, Strickland, E, Machalicek, W, Coviello, L, 2013. Reduction of automatically maintained self-injurious behavior utilizing noncontingent matched stimuli. Developmental neurorehabilitation,16(3), pp.166-171.

Dunn, W, Little L, Dean E, Robertson S, Evans B. The state of the science on sensory factors and their impact on daily life for children: A scoping review. OTJR (Thorofare NJ). 2016;36(2_Suppl):3S-26S.

Dunn, W. Sensory Profile 2: Users Manual. Psych Corporation; 2014.

Matson, JL, Vollmer TR. User’s guide: Questions About Behavioral Function (QABF). Baton Rouge, LA: Scientific Publishers.

Mays NM, Beal-Alvarez J, Jolivette K. Using movement-based sensory interventions to address self-stimulatory behaviors in students with autism. Teaching Exceptional Children. 2011 Jul;43(6):46-52.

Murray-Slutsky C, Paris BA. Autism interventions: Exploring the spectrum of Autism. Hammill Institute; 2014.

More information on the Sensory Matching Strategy is given in my new book FAB Functionally Alert Behavior Strategies

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