I am asked this question frequently as a pediatric OT, by teachers, parents, and colleagues. It’s a tough one but here is my best answer: “Behavior” and “sensory” are not mutually exclusive states of being. Rather, the former follows the latter. Sometimes sensory issues are so prominent in certain situations that kids know no other way to handle what they feel is noxious sensory input other than to act out behaviorally in order to avoid or escape what they feel is a noxious stimulus. This is when you might see some negative behaviors. When a child is already in the throes of a “sensory meltdown” it is not the right time for applying “sensory strategies”. I would suggest “preemptive” or preventive strategies (think sensory diet prescribed by your OT!) so that kids are in a comfortable sensory state at least most of the time. Frequently check the child’s “sensory state”, and if it is not optimal, you can help them get there before there is a problem of behavior associated with it. However that won’t always happen in an imperfect world so if you find yourself confronted with negative behavior and you suspect the behavior has surfaced due to a sensory issue that is or was occurring, you can still address it behaviorally since it is still a behavior. We always need to shape all childrens’ behavior via positive behavior support and other strategies that work and we must also do this with children who have sensory differences. But for these kids, try to remember: “if sensory diets go on all day, bad behavior stays away”. Behaviors will still happen though and should be addressed accordingly, not rewarded with a preferred sensory activity after the fact. Constructive feedback is welcome here!