Behavior Support

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Challenging behaviors occur at a much higher rate among children and adults with SMS than they do in people with other types of developmental disabilities. Common behavioral differences in individuals with SMS include:

  • Attention-seeking
  • Self-injury, including: head banging; hand biting; picking at skin, sores and nails; pulling off finger- and toenails; inserting foreign objects into ears, nose, or other body orifices
  • Attention deficits, with or without hyperactivity
  • Explosive outbursts
  • Prolonged tantrums
  • Destructive and aggressive behavior

The reason for these behaviors is unclear, although they appear to be related to underlying physical and developmental differences associated with SMS. Outbursts often result from frustration over communication difficulties, fine motor deficits, or changes in routine. Many people with SMS crave interaction with adults and react negatively if attention is withdrawn or directed toward others. People with SMS frequently have rigid ideas about their world; a prolonged tantrum may result if things do not go exactly as expected or envisioned. Some of these behavioral issues may be related to an underlying developmental asynchrony in which emotional growth progresses more slowly than other areas of development. Not surprisingly, sleep disturbance is also known to be a significant contributor to negative behaviors in people with SMS.

It is important to balance the description of challenging behaviors in people with SMS with a recognition of their many positive attributes. Many people with SMS have an engaging and endearing personality along with a well-developed sense of humor. Although they crave attention, they are generally appreciative when attention is given and eager to please parents and teachers. Students with SMS are often popular with their peers. Despite the behavioral challenges they can pose, they seem to endear themselves to those around them because of their affectionate natures and happy outbursts of excitability, often accompanied by the SMS “self-hug!”

Additional resources regarding behavior support for people with SMS can be found on the SMS Toolkit page.