Sensory Issues with the child
with an Autism Spectrum
Disorder
Why so many kids with Autism?
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Possible causes can include:
Pruning during normal development
Cell migration
Brain stem structures
Abnormal cerebellum, faulty volume control
Hypothalamus issues related to body
temperature, hunger, thirst, circadian rhythms
and hormone regulation.
Causes
• Neurotransmitters play a role in sensory
issues. Dopamine, norepinephrine and
serotonin affect CNS and impact arousal,
sleep, attention and motivation.
• Recent studies have shown that children
with Sensory Processing Problems have
nervous system disturbances.
Other Contributing Factors:
• Genetics
• Prematurity
• Birth Trauma and Hospitalization
• Adopted Children
• Heavy Metals Ingested during Pregnancy
Wake Up your senses!
• Fast moving activity!
• Activity analysis, what did we just do?
• How fast our brains worked to make this
happen?
• Rapid firing neurotransmission taking
place and of course we saw it as being fun
because we were moving and thinking!
Every Child with Autism Is Unique
• ASD casts a wide net
• What people on the spectrum do have in
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common is that they almost always have
significant sensory problems.
Geneva Centre for Autism study in Toronto
found 8 out of 10 were hypersensitive to touch
and sound and had vision problems and nearly
1/3 had taste or smell sensitivities.
Stanley Greenspan Study
• 200 children with ASD 94% had sensory issues
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including:
39% were underreactive( 28% did not respond to
sensory stimuli while 11% engaged in sensory seeking
behaviors)
19% were oversensitive
36 % both over AND undersensitive
100% had auditory processing dysfunction
100% had motor planning dysfunction ( 48 % with
severe motor planning problems and 17% with low
muscle tone and related problems)
Significant Sensory Differences
• Tactile Sensitivity
• Taste/Smell Sensitivity
• Movement Sensitivity
• Under responsive/Seeks Sensation
• Auditory Filtering
• Low Energy/weak
• Visual/Auditory Sensitivity
Tactile Sensitivity
• Would rather touch others than be touched by
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others
Fuss or resist hair washing/cutting/nail trims
clothing changes/tags/labels/seams
Crowds or body space/being bumped into
Dirty or messy hands
May seem unnecessarily rough
Bump or crash into things seeking sensation or
seem under responsive to certain sensations or
pain
Fun or yuck?
Taste/Smell Sensitivity
• Smell is primitive, we smell danger
• Smell travels thru the Limbic system,
which is the center of our emotions,
memory, pleasure, and learning.
• No other sense taps into our emotions like
our sense of smell
• Senses of taste and smell are intimately
connected
Common signs of Taste and Smell
Sensitivity
• Avoids most foods children their age enjoy
• Have limited repertoire of accepted foods
• Crave or become upset by certain smells
or tastes
• Hold their nostrils closed even when
nothing smells bad to you
• Gag, nauseated and even vomit at the
sight of the food
And this is just a typically
developing child
Oral Defensiveness
• Avoid placing toys in their mouth
• Refuse bottles or breast
• Resulting in poor weight gain, use of g-
tubes and long term feeding problems if
gone un detected
It starts even before this first
spoonful
Motor Homunculus
Movement Sensitivity
• Postural Insecurity this is the fear and
avoidance of certain movement activities
due to poor postural mechanisms.
Gravitational Insecurity
• Irrational fear of change of position or
movement. These children are often
fearful of having their feet leave the
ground, or having their heads tipped
backwards.
Auditory Defensiveness
• This reflects an over sensitivity to certain
sounds and may involve irritable or fearful
responses to noises like vacuum cleaners,
motors, fire alarms, blow dryers.
• Sometimes children may noise to block
out these sounds and their attention can
be disrupted because of these noises.
It hurts my ears
Visual Defensiveness
• This may involve an oversensitivity to light
and visual distractibility.
• They may avoid going outside in certain
light and may need sunglasses and hats to
block out the light
• They may startle more easily and appear
to avoid eye contact.
Identify the purpose of Self
stimulating behaviors and how to
address them
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Coping Mechanisms
Some more socially acceptable might include:
Rationalization
Ex: Creating a logical justification for an action. Buying a new outfit when
you are broke to help you find a better job.
Idealization
Ex: Overestimating the positive qualities of someone/something while
underestimating the negatives. She is so beautiful and successful but
always manages to forget her wallet when it is time to pay the bill.
Sublimation
Ex: Channeling unwanted impulses into something more constructive.
Ex: Cleaning the house when you are anxious or upset is sublimation.
Coping Mechanisms
These coping mechanisms we all use are worth
learning about and help us to deepen our self
understanding of ourselves.
Children with Autism can demonstrate three key
forms listed below. These we consider
unacceptable and wish to reduce and fade over
time and eventually extinguish.
Maslow’s Hierarchy
Self Stimulatory Behaviors
• Tuning Out
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He may want to hear you but his sensory issues
are so intense , that he may feel he has to block
out external input by shutting down and
becoming completely self absorbed. Maslow’s
Hierarchy, Safety needs.
Acting Out
Becoming loud and aggressive. He may be in a
panic mode not thinking of the consequences of
biting etc. He is trying to protect himself. Safety
needs
Engaging in Self stimulating
Behaviors
• Why they do this?
• They help block out the world and its overwhelming demands. Too
much sound, too much visual, I hate your patterns on your shirt! It
is all just too much!
• Stimulation can regulate a poorly functioning CNS. What we might
do, wiggle your ankles, pump your legs, chew gum, these all help us
keep our arousal in check and socially acceptable . Ex: Lining up
trains might give the child more organization and control in what
she experiences as a chaotic world.
• Lastly, Gym Euphoria versus natural high that occurs with self
stimming they trigger the body’s natural painkillers “ endogenous
opioids” which include endorphins and enkephalins.
Common Stim Behaviors
• Visual- flicking fingers, lining up toys spinning
• Vestibular-rocking, spinning, pacing
• Auditory- humming, singing, unusual
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vocalizations
Tactile- touching, rubbing, scratching, chewing
nails
Proprioceptive-tooth grinding, biting, chewing,
body slamming, crashing.
Taste and Smell- licking or smelling objects,
others or their own body parts.
Questions to ask about self
Stimulatory Behaviors.
• In what situations and under what
circumstances does the child stim?
• What does the child get out of the
behavior?
• What sensory system is most involved?
• Is there and underlying Medical Issue?
• What would help?
Optimal Level of Arousal
Moderate anxiety produces optimal
performance
The Human Function Curve , Nixon
1979
Identify resources available to
develop a sensory diet, improve
sleep, enhance self regulation and
improve social skills.
• Weighted blankets and lap pads
• Activities to help sleep readiness
• Temperature and smells to prepare for the
evening
• Social stories and routine
• ROUTINE is so important
Keeping Therapy Practical and
Concrete
• Use of idioms versus concrete statements
• Just a little bit or a whole lot, what do
they mean to our children with Autism?
• Use of a 1-5 rating scale maybe more
useful. 1 being a minor annoyance and 5
being unbearably uncomfortable.
Parenting the Child who has Autism
and Sensory Issues
The Need for Physical Activity and
Sensory Diets
Heavy work
Changes in Routines and
Interactions
• Routine
• New classroom and teacher
• Moving houses, starting a new school,
moving into a new room or bed.
Adapting the Environment
Thanks to Dr. A Jean Ayres
Thanks to Temple Grandin
Patricia Wilbarger