Biobehavioral States

A typical nervous system exhibits a range of levels of arousal. All humans have  a structure in the brain stem that controls levels of arousal, what we call biobehavioral states. Biobehavorial states are defined as a series of behavioral and physiological conditions that range from sleeping to awake and crying. (Wolff 1959) (Guess 1989)

Biobehavioral States chart moving from top to bottom: quiet sleep, active sleep (REM), drowsy, quiet alert, active alert, crying.
Biobehavioral States chart moving from top to bottom: quiet sleep, active sleep (REM), drowsy, quiet alert, active alert, crying.

Definition of States

Each of these states have behavioral features we can observe.

Quiet Sleep

In a quiet sleep state the individual is generally unresponsive with regular breathing patterns. Though the person may occasionally startle, there is an overall lack of facile, eye or body activity.

Active Sleep

During active sleep, what is referred to as REM sleep, an individual exhibits more body activity and irregular respiration. They are also more responsive to their environment and exhibit movements of the eyes and face.


When we are drowsy, we are fluctuating between sleep and awake states. Think of that feeling you get when sitting in a meeting or class after lunch; you almost fall asleep then startle into an awake state as your head begins to drop. 

Quiet Alert

In quiet alert we are still with regular breathing patterns. We are attentive to what is going on around us and have a bright, shiny expression on our faces. Think of a baby who has wakened from a peaceful nap and is being held by a parent. They feel safe and enjoy looking at what is going on around them though they may not be ready to fully participate.

Active Alert

In an active alert state, the best state for learning new information, the individual exhibits a lot of movement, breathing patterns shift with the intensity of the activity, and they exhibit an array of facial features. They engage in what is happening around them to some degree. They communicate their preferences and reject what does not interest or appeal.


When a learner becomes overly stressed or excited their breathing becomes irregular. The learner may grimace or show changes in color, and becomes very sensitive to stimuli and cries.


If our nervous systems are in the normal range, we spend our day shifting across the states in a typical manner. In order to be able to learn new information we need to achieve and maintain an alert state.

Children with additional disabilities may not exhibit the typical range of states. This is a characteristic of a number of students who are deafblind. We often see children who cry or fuss incessantly and others that seem to sleep continually. These children need intervention to move from one state to another at times. Many of these children may have brief cyclical periods of alertness, but seem unable to maintain this state long enough for typical instructional activities. This is especially true when any slight over-stimulation can cause the child to “shut down” to a sleep state or become extremely distressed. Our goal is to help the child be able to achieve a quiet alert or active alert state for longer periods of time so they can engage in learning.

Assessment Questions

The questions related to biobehavioral states that should be answered during assessments are:

    • What are the range of states the child exhibits across the day or week?
    • What are the child’s most common states?
    • Is this child able to reach the quiet alert or active alert state?
    • Can he/she maintain it?
    • What problems does the child have in shifting and maintaining states?
    • What variables appear to effect state in the child (especially attending)?

Additional Tools and Resources

Here are two additional tools related to assessing the biobehavioral states in children:

Assessment of Biobehavioral States: Supporting Availability for Learning for Students with Multiple Disabilities including Deafblindness & Profound Intellectual & Multiple Disabilities, 2020. Chris Russell, MS. Ed., TVI, Project Coordinator, New York Deaf-Blind Collaborative,

Assessment of Biobehavioral States and Analysis of Related Influences, 1997. Millie Smith and Stacy Shafer, Texas School for the Blind & Visually Impaired, Austin, TX.