This comparison draws in part from “I Can Do It With a Broken Heart: Promoting Participation through Interoception” by Abigail Hamilton, MS, OTR/L (BehaviorLive), and extends it with peer-reviewed research from our library of 27,900+ ABA research articles. The decision framework, BACB ethics code references, and cross-links below are synthesized by Behaviorist Book Club.
View the original presentation →When a pediatric client presents with behavioral challenges that appear to be driven by sensory or interoceptive variables, behavior analysts and occupational therapists may approach the problem through different conceptual lenses. The behavior-analytic framework emphasizes functional relationships — identifying the antecedents, motivating operations, and consequences maintaining the behavior — and designs intervention around environmental manipulation and skill teaching. The sensory integration framework, developed within occupational therapy, emphasizes the neurological processing of sensory information and designs intervention around activities that support sensory modulation and interoceptive awareness development. These frameworks are not incompatible, but they differ in focus, assessment methods, and intervention priorities. BCBAs working in collaborative, interdisciplinary settings benefit from understanding both frameworks and their respective contributions to integrated treatment planning for clients with interoceptive challenges.
| Factor | Evidence-Based Approach | Traditional Approach |
|---|---|---|
| Assessment Approach | Behavior-Analytic: Functional behavior assessment (FBA), systematic manipulation of physiological state conditions, behavioral data collection across varied antecedent contexts | Sensory Integration (OT): Standardized sensory processing assessments, clinical observation of sensory responses, structured sensory history interviews with caregivers |
| Understanding of Behavior | Behavior-Analytic: Behavior is a function of its antecedents and consequences; internal states are operationalized as motivating operations that influence behavior probability | Sensory Integration: Behavior reflects the nervous system's attempts to regulate sensory input; dysregulation signals that the sensory system is over- or under-responsive |
| Primary Intervention Target | Behavior-Analytic: Environmental antecedents, reinforcement contingencies, skill building for self-management and communication about internal states | Sensory Integration: Sensory diet activities, interoceptive awareness exercises, graduated exposure to sensory experiences that support nervous system regulation |
| Evidence Base | Behavior-Analytic: Strong empirical support from single-case experimental designs in JABA and related journals; MO-based intervention well-supported | Sensory Integration: Growing body of research in OT journals; evidence base for sensory integration therapy is mixed; interoception-specific interventions have emerging support |
| Generalization Planning | Behavior-Analytic: Multiple exemplar training, training across settings and partners, explicit programming for transfer from clinic to natural environment | Sensory Integration: Sensory activities embedded in daily routines; caregiver training in sensory diet implementation; OT consultation for environmental modifications |
| Scope and Collaboration | Behavior-Analytic: BCBA addresses functional behavior, communication, and skill building; refers to OT for specialized sensory assessment and intervention beyond scope | Sensory Integration: OT addresses sensory processing and interoception; refers to BCBA for behavioral programming when behavior is not addressed by sensory intervention alone |
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Use this framework when approaching i can do it with a broken heart: promoting participation through interoception in your practice:
Does the data support a need for intervention? Is there a meaningful impact on the individual's quality of life, safety, or access to reinforcement?
YES → Proceed to assessment NO → Document reasoning, monitor
A functional assessment should guide intervention selection. Avoid defaulting to standard protocols without individual analysis. Consider environmental variables, setting events, and private events.
YES → Select evidence-based approach matched to function NO → Complete assessment first
Goals should be co-developed. Assent and informed consent are ethical requirements. The individual's preferences and values matter in selecting both goals and methods.
YES → Proceed with collaborative plan NO → Engage in shared decision-making
This course covers the clinical and ethical dimensions in detail with structured learning objectives and CEU credit.
I Can Do It With a Broken Heart: Promoting Participation through Interoception — Abigail Hamilton · 0 BACB General CEUs · $0
Take This Course →We extended this decision guide with research from our library — dig into the peer-reviewed studies behind each approach, in plain-English summaries written for BCBAs.
280 research articles with practitioner takeaways
279 research articles with practitioner takeaways
231 research articles with practitioner takeaways
BACB General CEUs · $0 · BehaviorLive
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All behavior-analytic intervention is individualized. The information on this page is for educational purposes and does not constitute clinical advice. Treatment decisions should be informed by the best available published research, individualized assessment, and obtained with the informed consent of the client or their legal guardian. Behavior analysts are responsible for practicing within the boundaries of their competence and adhering to the BACB Ethics Code for Behavior Analysts.