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Q&A: What Behavior Needs OT Evaluation/Qualification?


I have a 5-year-old young man that is very intelligent. Though he is sometimes aggressive, likes to ram and jam, and is stimulated very easily in noisy, exciting areas. He will create a fight to get stimulation (so it appears). He gets angry easily and can be somewhat controlling and bossy. He likes things loud and desires high-stimulous activites. He gets overactive in the cafeteria  and sometimes doesn’t eat beacuse he is distracted, etc. 

His mother has a difficult time keeping him calm when she takes him to the  day care where there is noise and a lot of action.

He has somewhat of a difficult time calming and regulating himself.  He told me once when he got angry with his brother that “he could  twirl.”

He loves to give me what I call “Power Hugs,” where he squeezes me really hard and tight. I made this up to give him some help for his needs to be strong. I have rolled a ball on him as he lays on the floor and he
really enjoys this. 

He is really a great kid and doesn’t do these things all of the time, but enough to be somewhat concerned.  He has gotten better but not completely rid of these behaviors. 

My question is this: Can I do anything else to help and is this enough to require and OT eval? His teacher said it is not affecting his school work, and he is at the top of his class academically; however, it
does affect his social time and play.

Thank you for any suggestions you may have.


You are right to be concerned but since he is still little and very smart, I am confident that he can learn to self-modulate before his sensory needs become a lifelong problem for him.

Obviously, I’m a big believer in OT, so I definitely think an eval would be helpful. But even if he doesn’t qualify, a sensory diet would be a great way for him to learn self-modulation and to take some ownership of his sensory needs.

To get started, I recommend filling out the Sensory Symptoms Checklist you can print off my website. Go to and click on the FORMS tab to get it. Based on your description of his behavior, I suspect you will find out that he is UNDER-responsive to vestibular and proprioceptive input and OVER-responsive to auditory and visual input. But in spite of his OVER-responsive issues, I would primarily treat him as a SENSORY SEEKER due to his intense need for movement. Therefore, most of
the time, his engine will be on GREEN and he should be encouraged to choose GREEN arrow activities to “burn off his extra gasoline!”

In general, he should be allowed a 10–20 minute sensory break every 1 ½ hours or so, due to his young age, and a lot of movement should be worked into the rest of his schedule as well—as much as possible. Try to be preemptive: When you can see he is escalating, pull out the BrainWorks tool and encourage him to make sensory choices before he gets in trouble.

After engaging in sensory activities, refer him back to the tachometer and hopefully he will be able to see that now his sensory engine is on YELLOW—just right and in control.

You may be able to suggest that his parents read The Out of Sync Child or Raising a Sensory Smart Child. Both of these are great books that would give them an idea of why it’s important to meet his sensory needs.

On a side note, we have a new BrainWorks app that will be released any day now from iTunes. This would be a nice portable way for him to choose sensory activities if his parents have iPhones or iPads. 🙂

I hope this helps!  Please let me know if I can be of further assistance.

Best Wishes,