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Behavior & Sensory Support

What you need to know

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Children who have Williams syndrome tend to have unique personalities. They may be overfriendly, empathetic, or have generalized anxiety, or anticipation anxiety vs. social anxiety.  They may worry and have anxiety about themselves and others. This may lead to problems with toileting, eating, and sleeping.

School age children who have WS are often outgoing, sociable, and articulate.  Many love talking with adults and can be very helpful. Being overly friendly to adults may make it hard to make and keep friends.

Children who have WS are usually cooperative and eager to please. They can be highly sensitive to emotions of others and may cry tears of empathy. They may be sensitive to mood changes in adults and sensitive to criticism. They may be very sensitive to their own feelings of frustration and have temper outbursts. They may have trouble interpreting words or facial expressions.

Some of the personality and behavioral issues may include:

Attention deficit hyperactivity disorder
  • 50-90% of adolescents and adults meet Diagnostic and Statistical Manual of Mental Disorders, fourth edition (known as DSM-4) criteria for anxiety disorder, phobic disorder, Attention Deficit Hyperactivity Disorder (ADHD), or a combination.
  • 65% of adolescents meet criteria for ADHD and about 1/2 of that group meet criteria for specific phobia. 
  • Can be challenging to sit still and concentrate on tasks for length of time
Sensory defensiveness

Auditory system challenges

  • Very sensitive to sounds such as loud bangs, clapping, and laughter
  • May become tense and fearful when hearing or anticipating sounds

Tactile system challenges

  • May be sensitive to different textures
  • Sensitivity can include textures in foods and may cause gagging. 
Perseveration
  • Preoccupation and fascination with objects and topics
  • Unusual or restricted interests
Sleep difficulties

Individuals with Williams syndrome often have significant sleep disturbance, including:

  • sleep anxiety
  • bedtime resistance
  • increased sleep latency
  • frequent night walking

This may lead to daytime sleepiness. It may be helpful to incorporate a nap or rest time in their schedule. 

Specific phobias

Phobias are common, especially those involving loud or sudden noises.

Other phobias may include:

  • thunderstorms
  • high places
  • animals
  • escalators

What you can do

Supports for children who have WS in dealing with their anxiety and social challenges
  • Occupational therapy, cognitive, and behavioral approaches can address anxiety.
  • Individuals with strong verbal skills may benefit from counseling (relaxation, rehearsal)
    • Medication may be considered
Supporting children who have behavioral challenges
  • Use Positive Behavioral Interventions and Supports including Applied Behavior Analysis (ABA), functional behavioral assessments, and person-centered planning.
Working on social skills development

Improve conversation skills

  • How to make appropriate physical contact
  • How and when to interrupt

Practice cooperative play skills

  • Taking turns

Support development of friendships

  • Inclusion in typical classrooms
  • Respecting personal boundaries
  • Peer supports
  • Small group work to help support friendships
  • Social coaching from adults

Support development of emotional skills

  • Recognize feelings of self and others
  • Recognize nonverbal cues

Teach safety with strangers

Improving adaptive behavior

Strengths in tasks with verbal skills

  • Social interaction
  • Communication
Challenges in skills depending on visual motor or spatial skills
  • Self help
  • Community living skills