Sensory Processing and Autism: A Piece of the Puzzle

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Question: I’ve read that Autism Spectrum Disorder and Sensory Processing Disorder are two distinct conditions. With that said, why do my child’s therapists and teachers keep talking about his sensory processing problems when he is diagnosed as having Autism?

Answer: With at least three quarters of children with Autism Spectrum Disorder (ASD) showing signs of Sensory Processing Disorder, (SPD) your child is not alone! Interestingly, the reverse is not so – most children with SPD do not have ASD, according to research conducted or compiled by the STAR Institute (SPDStar.org).

While diagnosis is important, one of the essential matters here is the processing of sensation, the basis for our understanding of ourselves and our world, and for our everyday interactions with the people, objects and surroundings of our lives. The bottom line – while there are many factors that could contribute to behavior that is well suited to life’s occurrences, the more accurately and efficiently we’re able to pick up on, and understand sensory information relevant to our daily lives, the better equipped we are to respond. Unreliable and/or insufficient sensory processing is often a foundation of inappropriate or less-than-desirable behavior. It can contribute to limited tolerance for everyday situations, outbursts & tantrums, repetitive actions, inflexibility or rigidity related to environmental characteristics, an inability to fit in or “sync up” with others and/or the pace of daily events, difficulty figuring out how to do things, difficulty acquiring and applying skills, and so much more. Disordered sensory processing also can affect sleep/rest, nutritious eating and movement, the mainstays of our wellbeing.

Since both Autism and Sensory Processing Disorder both involve differences in patterns of responsiveness to sensation, when it comes to planning how we can help with change it seems easiest and most logical to think sensory. Over responsiveness to sensory input, such as certain sounds and touch, as well as light, movement (including dynamically moving surroundings such as a crowded place or a playground) is very common. People with over responsiveness are extra sensitive to, cannot filter, and are often uncomfortable with or frightened by stimulation that neurotypical people may not even notice. Their heightened sensitivity is apt to interfere with their ability to engage and discriminate because they move into a state of heightened arousal often associated with “fight, flight, fright or freeze”. On the other hand, those who are under responsive generally need a good deal of stimulation, beyond what is provided in so-called typical daily life, in order to be alert, discriminative and active. Under responsiveness is also prevalent. Often people who are under responsive seek the sensation they need; craving and seeking of movement, deep pressure, and sensations gained through intense physical effort are most common. Many people with sensory processing differences present both under responsiveness and over responsiveness; day-to-day variability is also frequently noted. While standardized testing (such as the Sensory Integration and Praxis Tests administered by certified professionals) is helpful in diagnosing and understanding sensory issues, observation and careful consideration of a child’s behavior in home, school/daycare and community settings by an OT trained in sensory integration assessment and methodology often proves to be most useful, particularly in cases of more severe sensitivity, behavioral challenges and inattentiveness or age. Assessing and treating disordered sensory processing involves both the individual and the environment.

The good news – decades worth of neuroplasticity research supports the basic premise of treatment of sensory problems – experience can bring about change, or, in other words what we sense and how we respond to it is transformational! Opportunities for participation and adaptation, created with priority given to the nature of the stimulation provided and individuals’ characteristic patterns of responsiveness, can nourish change in central nervous system structure and/or function, and change in our abilities through our lifespan. While those of us experienced in serving people with sensory differences know this because we see it, most people within the general public have come to realize for themselves that, somehow, what we experience shapes who we are and how we function. The other news – there’s still an inconceivable amount of information to be learned about sensory processing. Your child’s therapists and teachers know and respect this! Likely they are continuously bringing up his/her sensory processing because they believe it is at the foundation of his/her performance, from his/her ability to control himself in varied situations, to his/her ability to successfully interact interpersonally and form relationships and his/her ability to experience the success and fun that helps bring about brain and functional change.

To finish up, here are a few suggestions to get started thinking and working “sensory” with your child’s therapists and teachers:
• If you haven’t done so already, ask your OT about both you and your child’s teachers completing either the Sensory Profile or the Sensory Processing Measure (both are checklists), and arranging a meeting to discuss patterns and/or dissimilarities that emerge. Both provide nice structure to help frame, interpret and understand observations.
• Consider both sensory-based assets & liabilities, and recognize both preferences & aversions.
• Get to know more about your therapists’ and teachers’ frames-of-reference and approaches to sensory processing.
• With your OT or team, make a list of specific desired home and school behaviors, discuss sensory contributions to those behaviors (or current less-than-desirable behaviors)/functional skills, and develop a few sensory strategies that can be implemented consistently at home and school. Make sure to consider what is done proactively and what is done in response to your child’s actions, as well as how desired behaviors will be acknowledged.
• Stimulation your child loves is so important! Be mindful of how/when it’s provided, and make sure you get involved and share his/her joy!

-Sheila Allen, MA OT

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