Dr. Sarah (00:02):

Ever wonder what psychologists moms talk about when we get together, whether we’re consulting one another about a challenging case or one of our own kids, or just leaning on each other when parenting feels hard, because trust me, even when we do this for a living, it’s still hard. Joining me each week in these special Thursday shows are two of my closest friends, both moms, both psychologists, they’re the people I call when I need a sounding board. These are our unfiltered answers to your parenting questions. We’re letting you in on the conversations the three of us usually have behind closed doors. This is Securely Attached: Beyond the Sessions.

Dr. Rebecca (00:45):

Hi everyone, I am Dr. Rebecca Hershberg and Dr. Sarah Bren has graciously allowed me to be the guest intro for this episode of Beyond the Sessions, Emily. Ups sure couldn’t make it today, but Sarah and I are delighted to be here to answer your questions. We love that you’ve been sending them in and listening and we get so excited when we see your dms. And so here we are. Let’s go. Good morning, Sarah.

Dr. Sarah (01:14):

Good morning. So that was amazing. Thank you for intro-ing that off. Yes. Do you want to read the question?

Dr. Rebecca (01:23):

Oh my gosh. Can I do that too, please? Sure. So we got a question. I believe this one came to Sarah, to Dr. Bren. It says, hi, our 4-year-old has a hard time with personal space boundaries and always touching her baby brother who’s almost one. Could this be a sensory related or possibly a delayed jealousy response? Thanks.

Dr. Sarah (01:51):

So this is a good one. I feel like I get questions like this a lot. Do you feel these questions a lot?

Dr. Rebecca (01:57):

Yeah, I do get these questions a lot. I think having siblings, frankly, having two or more kids is really hard and parents are often really looking at the dynamic and trying to kind of figure it out. And I also think that sensory challenges have gotten a lot of press and sort of air recently, and that’s good. I think it’s important, but I do think sometimes there’s a lens through which we see typical development as though it might be a sensory issue. I mean, the first thing that I read in this is, yeah, you’ve got to two kids and your four year old can’t keep his hands off his one year old. And that’s sort of the most common thing in the world and it’s a drag. You have to watch it and come up with some guidelines. But this wonderful listener is in the weeds, right, with the four-year-old and the one-year-old and noticing that the four-year-old, I mean if you think about it, the one-year-old is the most fun interesting toy that the four year old has. And so that’s what I hear, and we can certainly speak a little bit more about what would potentially be a cue that it might be a sensory issue. But from the way the question is phrased, it’s one of these rare moments where I can answer in a fairly straightforward one word way. No, not a sensory issue.

Dr. Sarah (03:17):

Yeah, not necessarily based off of just this information, I’m not necessarily inclined to say we should really explore sensory challenges, although you brought up a really good point, which is can we look at something through a lens and see it as pathology or as something that is developmentally atypical versus can we look at something through a lens and see it as well, this is all things are sensory related, but does that mean it’s a sensory disorder.

Dr. Rebecca (03:58):

Issue or problem, right. Well, I think what’s so wonderful about working with kids this age, and I say this probably three times a day to different clients, is that you will know, let’s say if you have a four year old now you will know in three or four years if it turns out this was a sensory thing or was ADHD or was anxiety or what you will know. And the really good news is that the recommendations of how to handle it now would be the same. So in some ways you can sort of be a little bit less concerned that, oh my gosh, what if it’s a sensory thing, what would we do differently? Probably at this age, not that much other than potentially get an OT evaluation. But if you’re on the fence about that and if you’re pretty sure it’s within the realm of typical developmentally appropriate behavior, then there’s no need to rush to do that.

Dr. Sarah (04:54):

Right. And is I think the point that I think could be helpful is you’re saying in a couple years you might know definitively if something that you’re seeing when they’re four could be explained by a sensory processing disorder or an anxiety disorder or ADHD. But the point is the reason why at four we wouldn’t necessarily be able to make that distinction is because the behaviors that we see at four that are related to sensory sensitivity or difficulty paying attention or sitting still or difficulty inhibiting impulses not touching your baby brother, even though you’ve probably been reminded a thousand times what the rules are, that at four we wouldn’t look at that as developmentally atypical because at four it’s appropriate to have trouble inhibiting impulses. It’s appropriate to have a really strong inclination to engage in sensory seeking behavior. So it’s still in that developmental typical behavior range. And it’s not until you get outside of that age. And if those behaviors are persisting in a way that’s getting in the way of functioning at a level of seven or eight years old that we would expect to see, then we can say, oh, these paths diverged. We are on a normal trajectory and we moved off of it, but at four you just can’t know. Is it because they are a four year old or is it because there is some sensory sensitivity or some other regulatory inhibition challenge?

Dr. Rebecca (06:50):

And you use the word path, which is the word that I always use with parents. I think of when kids are younger, let’s say starting infancy, they’re on this hugely wide path. There’s a huge spectrum of what we consider normative and and then the path actually gets narrower as you get older and there’s fewer behaviors on that path that are considered within the normal range. And so are you off the path perhaps at seven when you weren’t at four? And I think what I hear parents say with their nine-year-olds, 10 year olds, let’s say, who have a reason diagnosis of a sensory processing disorder or of ADHD, they might say, we saw this coming even when he was two. When he was two, we saw this coming. And if they describe what they saw, you could easily imagine another scenario where they wouldn’t have seen this coming because that kid would’ve grown out of it. And so again, your frame, your lens is really important to consider when you’re asking these questions about your kids.

Dr. Sarah (07:54):

And I’m going back to what you had said earlier, Rebecca, about how we would do the same things for all of these potential diagnoses if it’s ADHD or if it is sensory processing disorder or an anxiety disorder and what doesn’t matter as much because the interventions might be the same. I’m thinking what that really looks like is whether it’s skill building, so whether the skills are necessary to build because they’re just developmentally not there yet, or the skills are necessary to build because there’s a gap or a deficit because of a sensory processing disorder or a other developmental disorder like ADHD or an anxiety, whatever it is, we’re still going to, at the end of the day, what we would do to treat that is fill the gap of the skill deficit by practicing skills. And so that’s really kind of what we’re talking about at the end of the day.


So yeah, I obviously think if you are worried about a child’s sort of functioning, there really is something that doesn’t feel like it’s going. Your kid trust yourself. If you’re feeling like you want to get a professional assessment on it, you can go to an occupational therapist or you can go to a psychologist or someone who works with children professionally in that way and get that evaluation for sure. But at the end of the day, how we treat, it’s going to look relatively similar, especially at four. It’s going to be about building skills. And the other thing that I think is really important is, and she kind of asked this when she says, could it possibly be a delayed jealousy response? And I am more inclined to look at perhaps that, although even that is almost saying we need to explain this behavior with some sort of label. And I think that’s actually not a terrible label to use because I think it’s more about that’s more descriptive than, it’s not a noun, it’s emotion.

Dr. Rebecca (10:00):

What feelings might he be having, which is sort of what we encourage parents, what if you kind of pan out and you look at your kid and you try to put yourself in their shoes, how might he be feeling? And so I think there’s less of a label and more of an attempt at reflective functioning. I’ve also seen that a lot to be fair, which is jealousy that happens as younger siblings get older because then younger siblings can do more stuff and they can get in your toys and get in your way and truly take mommy or daddy’s attention. And so jealousy I have found really does, it’s not so much a delayed, but it actually kind of kicks in around this age. And I would also really look at how much engagement and attention this older sibling is getting when he touches his younger sibling and what’s happening before he touches his sibling.


So before he touches his sibling, are you trying to get something done? You’re in the kitchen and then he touches a sibling and you come running out to address that. And it’s sort of the chain analysis, what’s the antecedent, the behavior and the consequence. And certainly we’ve talked a lot about the limitations of behaviorism on this podcast, but this is an example where I do think it’s really important to look at what happens when he does touch his sibling that may actually be reinforcing his doing that again and again and again, even when you’ve asked him not to in addition to the normal difficulty inhibiting impulses and everything else we’ve talked about.

Dr. Sarah (11:39):

Yeah, yeah, I mean I think that’s a really important point, and I think it’s helpful for us to start with the after, right? To your point, if every time he touches his baby brother, I give him attention. It might be negative attention, it might be reprimanding him or getting upset with him. It might be gentle, but firm, oh, I’m not going to let you do that. You could do this or something else. But I’m still giving him a lot of attention, and I’m not suggesting that you don’t, but it might be that we’re reinforcing the kind of tail end of something. I actually think it’s much more useful to go to the front end, the antecedent and say perhaps there is someplace before he touches the brother that he might be needing a little bit more attention. And is, I always think this is so important.


I’m not saying that we have to give our children undivided attention all the time in order to prevent bad behavior or problematic behavior. You can’t shadow your kid all the time. And I am going to assume that this parent probably, if they’re paying this close attention, taking the time to write a question out to get the help, this is someone who’s paying attention to their kids. She’s super observant. And so I don’t want this advice to sound like the implication is you’re not filling up your kid enough. Because I think that gets thrown about a lot. Like, oh, just give them more undivided attention. And it’s like most parents say to me, but I do.

Dr. Rebecca (13:20):

Right? I pay attention to my kid all the time. I think where again, I go to a very behavioral place in this to CBT and PCIT training and I go to specific praise. If we are really looking for him to give his brother a personal space, let’s say framed in a positive way, it’s not just about don’t touch your brother, it’s about let’s keep our hands on our own bodies, or let’s give everybody personal space. Can you find different ways to praise that and give high fives for that and smile at that and wink for that or whatever it is throughout the day, check you out. You just walked by your baby brother and gave him so much space as you did. Give me a high five. You are deliberately paying extra attention, not just in a general way, but to the specific behavior that you want to see rather than criticizing even in the most gentle way, the behavior that you don’t want to see. And that I have found, I mean, that is such a powerful tool.

Dr. Sarah (14:33):

Another one is preparation too to that same point when you see the behavior that you want to see more of to really acknowledge it, but also if there are certain times where it’s more often to occur. If you’ve identified a pattern, I would help prep a kid in advance, Hey, when I’m making dinner and we’re all hanging out in the kitchen, you often really want to get up in your brother’s space. So what can we do instead? We’re about to go into the kitchen, I’m going to make dinner. Do you want to help me? Do you want to help me mix the marinade for the chicken, whatever, but can you give them something else to do? Remind them what the expectation is. We got to give your little brother some personal space, but maybe if you stood next to me, that would be easier. So you’re kind of like preemptively anticipating something and helping them cope ahead, troubleshoot ahead, have a plan, give them a specific target too. I always think that’s very helpful, especially a four year old. The younger they are, the more specific and concrete we want that target to be. So it’s very, and again, this is more work upfront. I recognize that, but the payoff comes when you don’t have to be hovering around your kid, getting up in their brother’s face while you’re trying to cook dinner or do whatever. But just helping a kid anticipate and then giving them something very specific to do instead.

Dr. Rebecca (16:12):

I mean, and you can make something up. I mean, there are so many times that I would say to my, can you find five things in this room that are red? I’m really in the mood to look at red things while I’m can you. Or I used to put a whole bunch of hair things scattered in my bag and be like, Ooh. Because then there was a task whenever I needed it. Like, Ooh, I just remember I need a hair thing. But you put a word in there, Sarah, just sort of offhandedly that I think is really important to emphasize. You said you were roleplaying with the kid and you said perhaps it would be easier for you if you stand next to me. And I think that frame is so important that this is a hard task for him. This is about building a skill.


I go back to Ross Green’s lens of there may be an unmet need, let’s say for parent attention or a lagging skill. He may not know how to not touch his brother when his brother is sitting there with his nice chubby cheeks. And so what you’re saying, if you say, Hey, why don’t you stand next to me? It might make it easier for you to give your brother. Personal space is such a beautiful example of being on your kid’s team and saying, I get that this is challenging for you and I’m here to help you out, as opposed to I’m going to keep giving you this task that’s challenging from a developmental perspective and then chastising you again, even in the most gentle way when you can’t quite get it.

Dr. Sarah (17:46):

And that’s such a powerful reframe. So I’m so grateful that you pointed that out. When we can look at the problem, my kid is touching his brother’s face and that he won’t stop, even though I tell him not to as something outside of our child that the two of us can come together and tackle together, it really moves us out of looking at our child or their behavior as the adversary, even unconsciously, I don’t think parents consciously are like, it’s me against my kid. But it’s like we feel that in the moment. And so just that visual of being like, let me stand next to you. And together we look at this challenge and say, what’s our strategy together to try not to do this thing today or to try to do this thing instead? To your point, framing it in the positive, how are we going to keep our personal space today? I love that. I think, and that could be used in so many different places. That’s a really transferable strategy for parents. Really kind of no matter what the challenge.

Dr. Rebecca (18:58):

I mean I’ve talked a lot to parents about it’s you and your kid against the problem of how annoying it is to have to take a bath. It’s not you versus your kid. It’s you and your kid against the messiness in their room. And the fact that no one is in the mood to clean it up.

Dr. Sarah (19:17):

Which I find invites some incredibly creative problem solving from the kids because visually the way kids solve problems is so much more fun than the way we solve problems. And if they offer a solution that’s playful and fun and we join in that, oh my gosh, is that going to have a massive impact in that skill development? It’s going to land. They’re going to want to practice it. Gamifying things with kids is a very underrated thing.

Dr. Rebecca (19:49):

Absolutely. No, this kid, if you said, what do we think we should do to make it easier for you not to touch your brother’s face? This kid might say, let’s make up a song. How about I do a thing where I take four giant steps and you tell me what? Then you’re like, great, I’m in. Let’s give it a shot. And then there you are both sort of laughing and having fun to your point.

Dr. Sarah (20:10):

So if I’m going to prescribe anything to anyone ever, it’s probably going to be find a way to have fun with your kid and make it playful. So I feel like that’s probably where I go. And you know what the reality is? It is really stressful to have a four-year old and an almost one-year old. And to feel like…

Dr. Rebecca (20:31):

You can’t take your eyes off them.

Dr. Sarah (20:32):

Full stop, period. It’s stressful. You are also postpartum still. You’re managing two kids with very different needs, but both are incredibly high demand. So I say this, not like, oh, add more to your plate. Be more fun. Why don’t you play with your kids? But when we authentically can find a way to find the joy and the playfulness with our kids, it’s actually a legit stress reducer for us. It is more fun if parenting is always this slog of a stressful, I’ve got to make everything a teachable moment, and my kid is supposed to be well-behaved at all times. And if they’re not, I’m clearly failing, then ugh, that’s not fun. It’s stressful.

Dr. Rebecca (21:21):

Yep. Nothing to add there. I agree. We’ve all been there rut. It’s like you’re stuck in a rutt with like, oh my gosh. Every word I say is No, don’t stop. And that’s when it’s sort of like, okay, break out the popcorn and have a dance party or just do something. But we could have a whole episode on that. So perhaps next time on popcorn and dance parties.

Dr. Sarah (21:45):

Yes, I love a good dance party.

Dr. Rebecca (21:47):

All right. Should I close this out?

Dr. Sarah (21:48):

Close us out, take it home.

Dr. Rebecca (21:50):

Oh, it’s my day. Thank you so much everyone for joining us today. It’s always a pleasure. We love answering your questions. Please keep them coming. They are so important. And if you have the question, chances are so many other parents do, this is not easy. And we are delighted to have these conversations. We hope you’ve enjoyed. Have a great rest of your day.

Dr. Sarah (22:11):


Dr. Rebecca (22:13):


Dr. Sarah (22:15):Thank you so much for listening. As you can hear, parenting is not one size fits all. It’s nuanced and it’s complicated. So I really hope that this series where we’re answering your questions really helps you to cut through some of the noise and find out what works best for you and your unique child. If you have a burning parenting question, something you’re struggling to navigate or a topic you really want us to shed light on or share research about, we want to know, go to drsarahbren.com/question to send in anything that you want, Rebecca, Emily, and me to answer in this new series Securely Attached: Beyond the Sessions. That’s drsarahbren.com/question. And check back for a brand new securely attached next Tuesday. And until then, don’t be a stranger.

✨We want to hear from you! Go to https://drsarahbren.com/question to send us a question or a topic you want to hear us answer on Securely Attached – Beyond the Sessions! ✨

151. BTS: My 4-year-old can’t keep his hands to himself, could that be a sensory issue?