How might sensory experience differ for those with ASDs from those without? What use
can educators make of this information to improve the educational experience of
children with ASDs?
Introduction
In describing the sensory experience differences of those with Autistic Spectrum
Disorders (ASDs) and those without, an overview is presented of diagnostic criteria and
probable reasons for the non-inclusion of sensory perception issues. The seven
sensory systems are described together with summary of the sensory integration
process. A definition of dysfunction in sensory integration is presented with a synopsis of
profiles illustrated by examples from the published literature. The value of dysfunction in
sensory integration is then discussed and the impact of sensory perceptual differences
on behaviour summarised. Sensory Profiling techniques are outlined and evaluated
followed by a discussion of intervention strategies. Finally, two checklists together with
observations of my 4 ½ year old son diagnosed with autism are used to develop his
sensory profile, identify associated behaviours and document intervention strategies for
use in his primary school setting.
All names of individuals with the exception of my son, Dylan, have been omitted to
protect confidentiality. The term ‘individual with autism’ has been used to ensure the
focus remains on the person and not the diagnosis. It is assumed the reader has an
understanding of Autistic Spectrum Disorders and in particular diagnostic criteria and
Wing’s Triad of Impairments.
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Autistic Spectrum Disorder Diagnostic Criteria and Sensory Perceptual Issues
Autism as a disorder was not formally documented until 1943. (Wing,1995). By
coincidence Hans Asperger was conducting research into a similar group of children at
approximately the same time as Kanner (Wing, 1995). The work completed by Kanner
and Asperger in the 1940’s laid the foundations for the definition of an autistic spectrum
ie within the three areas of communication, socialisation and imagination (Wings triad of
impairments, Wing 1996) the degree to which an individual is affected is infinitely
variable.
According to Smith Myles (2000) Asperger did document sensory perceptual differences
in the children he observed. However, for some reason further research and discussion
largely ignored these observations. It was not until Delacato (1974) began to work with
individuals with autism that sensory perceptual issues were given serious consideration
by academia and the medical world. The reason for this may be as stated by Delacato
(1974, p5) that ‘the mild injuries were the most difficult to detect’. He goes on to state
(p5):
the most common factor in mild brain injury proved to be perceptual problems:
There was apparent difficulty in the way a child took in the world through his eyes,
ears and/or skin.
Current diagnostic criteria used by the American Psychiatric Association (APA) and the
World Health Organisation (WHO) continue to exclude reference to sensory perceptual
issues. This may be due to the fact that such issues are also associated with other
disorders. Cribbin, Lynch, Bagshawe et al (2003) identify sensory perceptual issues
being observed with a number of conditions such as Attention Deficit Hyperactivity
Disorder, Learning Disability, Cerebal Palsy, Development Co-ordination Disorder,
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Specific Learning Difficulties and Autistic Spectrum Disorder. Baranek (2002) states
‘these types of behaviour appear neither universal nor specific to the disorder of autism’.
In addition, not all individuals with autism may display sensory perceptual differences.
(Baranek, 2002) reviewed the published literature and identified unusual sensory
responses being recorded in a number of studies ranging from 42 to 88% of older
children with autism. Delacato (1974) recorded taste and smell problems in only 2428% of the autistic children studied whilst tactile problems were observed in all
individuals with autism.
Therefore sensory perceptual differences are experienced differently, are not unique to
and may not be experienced by all individuals with autism.
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Sensory Systems
A description of sensory systems can be found in numerous publications. For example,
Cribbin, Lynch, Bagshawe et al (2003), Kranowitz (2003) and Smith Myles, Tapscott
Cook, Miller et al (2000).
Delacto (1974, p52) initially identified five sensory systems – ‘seeing, hearing, tasting,
smelling and feeling through the skin.’ He did in-fact identify six sensory systems
although the proprioceptive system was classified under tactility (1974, p88). As
summarised by Bogdashina (2003, p30-31) there are seven sensory systems:

Visual – the ability to see;

Auditory – the perception of sounds;

Vestibular – the detection of movement and head position within the inner ear
(balance);

Olfactory – a sense of smell;

Gustatory – a sense of taste;

Tactile – the ability to perceive touch, pressure, pain and temperature;

Proprioceptive – the faculty of perceiving stimuli produced within an organism,
especially related to the position and movement of the body.
All seven systems interact with each other and affect the other(s). These individual
sensory systems providing the starting point for delivering messages to the central
nervous system. Our senses enable individuals to absorb information about the world
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around us, process this information and initiate a response which dependent on an
individuals sensory processing capacity, may or may not be appropriate or expected.
5
Sensory Integration and Dysfunction in Sensory Integration
The sensory integration process has been described by a number of authors. For
example, Anzalone and Gordon Williams (2000, p145) summarise the work completed
by Lester, Freier and LaGasse (1995) on the four “A”s – arousal, attention, affect and
action. As summarised by Smith Myles, Tapscott Cook, Miller et al (2000) sensory
integration must successfully occur for our sensory experiences to be meaningful.
Integration is a five fold process which involves the following:

Registration – a person becomes aware of a sensation such as a taste, smell or
touch. The quantity of sensory input required varies between individuals and
depends on our emotional state, stress levels and general well being;

Orientation – a person focuses on the sensation. This may mean that our
orientation to other sensory stimuli present at the same time is reduced;

Interpretation – a person then relates what they are experiencing to past
experiences. For example, a certain smell may remind a person of a pleasant
experience of walking in a park whereas a cry of a child in distress may be linked to
a previous accident;

Organisation – a person then decides whether a response is necessary and what
response to make. For example deciding to run to a crying child to determine if they
are hurt or to remove your hand from a very hot object;
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
Execution of a Response – this involves displaying an emotion or carrying out an
action or a response. eg the actual act of running to a crying child or removing your
hand from a hot object.
In reality these five steps often occur very quickly without a person even knowing they
have done so. The act of modulation then allows an individual to facilitate a response or
disregard or inhibit a response. Successful modulation in the brain maintains a sense of
harmony and balance. eg an appropriate response is given to a particular stimuli.
An individual with autism may exhibit ineffective sensory processing. ie one of the five
key steps from Registration to Execution of a Response is impaired or modulation
occurs inappropriately. This is known as dysfunction in sensory integration.
Effective sensory processing also contributes to motor planning abilities which enables
an individual to undertake appropriate body actions. For motor planning, input from the
tactile, vestibular and proprioceptive systems is considered to have the greatest
influence on performance. (Smith Myles et al, 2000). Some individuals with autism may
therefore be unable to execute every day tasks that his or her neuro-typical peers take
for granted. Dawson and Watling (2000, p420) report that ‘evidence suggests that
regions of the brain mediating sensory arousal and motor functions are dysfunctional in
autism.’
Authors with autism often report dysfunction in sensory integration. For example Grandin
(1996, p185) states ‘reports from people with autism clearly show that sights, sounds
and sensations that do not bother normal people may be painful and confusing’’.
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Profiles of Dysfunction in Sensory Integration
There are a number of profiles of dysfunction in sensory integration. It should be noted
that an individual with autism may experience a combination of these profiles in the
same or different sensory systems, their profile may differ from day to day, may change
with age, stress levels, emotional state or the environment in which it is experienced.
Delacato (1974) was the first to present three possible patterns of dysfunction in sensory
integration – hyper and hypo sensitivity (see 1. below) and white noise ‘a sensory
system that operated so inefficiently that its own operation created an interference or
noise in the system’. Delacato (1974, p71-72). Delacato’s work has been reviewed and
developed over the last 30 years. As a result approximately twenty different profiles of
dysfunction in sensory integration have been identified. These are summarised by
Bogdashina (2001, p13-61) and briefly discussed below.
1. Intensity of the Senses. Hypersensitivity results in an individual with autism being
over sensitive to stimuli. For example, background noise may be distracting or painful. In
contrast hyposensitive individuals have a high sensory threshold. ie they require a much
greater level of stimulation from the environment to initiate a response. These
individuals may therefore appear not to hear what is said to them or may not register
that they have experienced anything.
2. Inconsistency of Perception. Fluctuations in hyper and hypo sensitivity to particular
stimuli. For example lights that appear to be to bright one day and dim the next.
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3. Mono-Processing. The inability to use the senses simultaneously. For example, the
inability to hear what is said when looking at the speaker.
4. Fragmented Perception. The inability to perceive objects, people and surroundings
as a whole. For example, an individual with autism may be able to see the furniture in a
room but not the door.
5. Distorted Perception. Objects are perceived as being smaller or larger than they
really are. Sounds may appear ‘echoed’ or syllables perceived as being shorter or longer
than they are.
6. Peripheral Perception. Objects are viewed from the side as this is where the vision
is most developed with the central part of the eye being hyposensitive to visual stimuli.
7. Inability to Distinguish between Foreground and Background. Objects appear to
have no depth or position in relation to each other and may appear two dimensional.
8. Sensitivity to Certain Stimuli. A given stimuli eg bright lights or shrill or sudden
sounds consistently result in hypersensitivity.
9. Fascination with Certain Stimuli. A given stimuli eg a smell or a texture consistently
results in an unusually high level of enjoyment.
10. Resonance. The ability to loose oneself in a sensory stimuli. Eg looking or smelling
a particular object.
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11. Daydreaming. The ability to see, hear or feel etc events experienced by other
people.
12. Delayed Perception. A stimuli results in a response but with a considerable time
delay between the event and response occurring.
13. Vulnerability to Sensory Overload. Every day situations appear overwhelming as
an individual with autism may either try to process to much background sensory
information, may experience delayed processing or any other of the profiles described
here.
14.System Shutdowns. Sensory overload may result in the person being unable to
process any sensory information and can be viewed as the most extreme form of
dysfunction in sensory integration. ie no integration of any sensory information is
possible.
15.Sensory Agnosia. The interpretation of one or a number of senses is lost. ie blind
while seeing or deaf while hearing. This profile has also been described as ‘meaning
blind or deaf’. Topographical Agnosia may occur which results in the inability to find your
way around places visited on a daily basis or to recognise landmarks.
16. Compensation. If one sense proves unreliable or does not provide the correct
amount of information to enable a reliable interpretation of the environment other senses
may be utilised. For example, sniffing food before it is eaten, licking or tapping objects.
10
17. Synaesthesia. The stimulation of one sensory modality triggers a perception in
another. For example in two sensory synaesthesia a sound may trigger the perception
of colour. In multiple sensory synaesthesia when letters are heard or read they may be
experienced as colours.
18. Perceptual Memory. Events are remembered in much greater detail than in neurotypical peers. Memories are not just visual but may include sounds heard or smells
experienced at a particular time. Experiencing these sounds or smells again may result
in the same response as the original event regardless of context.
19. Serial Memory. Memories which are triggered by certain smells, colours, objects or
patterns.
20. Perceptual Thinking. The ability to think in pictures or video which can include
mathematical, gustatory or olfactory images.
Other profiles include Allochiria where stimuli presented to one side of the body is
responded to as if is presented to the other.
Evidence of these profiles in dysfunction in sensory integration is presented by
published accounts in the literature. A number of individuals with autism are published
authors and most recount with clarity dysfunction in sensory integration. For example,
O’Neill (1999, p23) states ‘the sensory experiences of an autistic person play a huge
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role in the condition’. This author then goes on to state (p24) ‘I am both hyper emotional
and hyper sensory. All of my senses are finely tuned’.
Williams (1992, p59) writes of her school days:
I would wander through the school, watching the various colours which
disappeared under my feet, and I would stop sometimes and stare at something
for the entire break, like the polished floor of the gym or the reflection in the
curved tinted-glass window.
Lawson (2000, p3) states ‘I find colour simply fascinating and it stirs all sorts of feelings
in me. The stronger and brighter the colour the more stirred up I become’. Lawson (2000
p4) goes on to describe hyper sensitivity in terms of her auditor sense ‘…certain noises
and the pitch of some sounds cause me a lot of discomfort . The buzzer on the
microwave oven, children’s voices, car horns…’. Grandin (1995, p19) explains her
perceptual thinking as ‘when somebody speaks to me, his words are instantly translated
into pictures.’ She then goes on to explain how her mind works like a computer graphics
programme and describes her ‘video library’ of imagination.
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The Value of Dysfunction in Sensory Integration
Authors describing dysfunction in sensory integration often use negative terminology.
For example, the use of terms such as sensory disturbances, deficits, problems,
distortions etc (Anzalone and Gordon Williamson (2000)). This implies that the correct
way to experience the world is through a neuro-typical sensory integration process and
that any dysfunction is undesirable and requires correction.
This view is not held by a number of authors with autism. They clearly state that such
differences in sensory processing should not be regarded negatively but should be
valued and viewed as an opportunity to appreciate how the world can be experienced
from a different perspective. For example, O’Neill (1999, p23) states ‘….it is exciting and
a thing of beauty to be gifted with unusual sensory opportunities.’
Lawson (2000, p7) writes:
I have often wondered if Asperger people are able to appreciate colour, taste,
sound and texture to a higher degree than non-Asperger people? Perhaps there
is a way such talents or heightened senses can be harnessed? Of course
Asperger people are already benefiting from these gifts because they know such
joys to be treasures, but their joy can easily be turned into frustration and anger
or sadness and fear by the words of others who do not understand.
Lawson (2000) also goes on to describe the enjoyment she gained from playing with the
round dots in front of her eyes that appeared as a result of her squint and long vision.
Other observations made by Lawson (2000) include the superiority she felt due to her
ability to hear noises before her neuro-typical peers did.
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Personal observation of pre-school children with autism confirms that dysfunction in
sensory integration is not necessarily an undesirable or unpleasant experience. If an
individual with autism can gain pleasure by continually spinning a coin or a plate or
enjoyment from focusing on an insignificant detail in a picture there would seem no
reason in theory to prevent them from undertaking such activities. However, when
dysfunction in sensory integration results in traumatic emotional experiences or results
in unsocial behaviour these need to be addressed for the well being of the individual with
autism.
14
The Impact of Sensory Perceptual Differences on Behaviour
Delacato (1974, p77-79) summarises how dysfunction in sensory integration can have a
significant impact on behaviour. He regarded autism as a ‘brain injury’ which results in
dysfunction in sensory integration. Some of the behaviours exhibited by individuals with
autism may therefore be an attempt at self-regulation ie to normalise their sensory input.
Other researchers have also identified the impact of dysfunction in sensory integration
on behaviour. O’Neill and Jones (1997, p283) concluded that ‘unusual sensory
responses are present in a majority of autistic children, that they are manifested in very
early development, and that they may be linked with other aspects of autistic behaviour.’
As every individual with autism is unique so is their dysfunction in sensory integration
and the impact on behaviour. Examples of behaviour that may occur due to dysfunction
in sensory integration in one of the seven senses are given below:

Visual – waving of hands or flicking of fingers, unable to tolerate bright lights;

Auditory – great distress shown at every day noises such as washing machines and
vacuum cleaners, doesn’t respond when name is called;

Tactility – overly sensitive to touch and withdraws, craves physical contact;

Proprioception – rigid body tone, unable to maintain posture;

Vestibular – is constantly on the move, has poor co-ordination;

Olfactory – experiences the world by smelling everything, repelled by innocuous
odours;
15

Gustatory – unable to tolerate many foods or eats odd combinations of foodstuffs
such as sweet and sour.
Individuals that have modulation issues may avoid eye contact, have a weak grasp or
may seem accident prone. In addition, they may respond to a visual or auditory stimulus
that their neuro-typical peers ignore. For example, showing great distress at noise
generated by every day household objects such as washing machines and vacuum
cleaners. Individuals with motor planning issues may find it difficult or impossible to walk
downstairs, ride a bicycle or use a knife and fork to eat with.
In comparison to their neuro-typical peers, the behaviour of individuals with autism may
be described as uncooperative, difficult to engage, inattentive and easily distracted.
Such individuals may find it difficult to focus on the key sensation in any given situation
which leads to poor understanding of what is expected of them and an inability to
complete given tasks.
However it is not just individuals with autism whose dysfunction in sensory integration
impacts their behaviour. Delecato (1974) visited a number of schools for deaf and blind
children. He states (1974, p9) after visiting a school for the blind ‘Many of the children
were rocking in their chairs, waving their hands in front of their faces, tapping their eyes
!’ After visiting a school for the deaf Delecato (1974, p50) states ‘I saw heads bobbing,
gently hitting the chair in front of them. I saw children gently, or not so gently, hitting
themselves on the ear. I heard strange rhythmic vocal noises.’ These behaviours were
known as ‘blindisms’ and ‘deafisms’ respectively. Delacato renamed these observed
behaviours of individuals with autism sensoryisms.
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Assessing Sensory Perceptual Differences
An evaluation of dysfunction in sensory integration primarily needs to be conducted by a
qualified occupational therapist, physiotherapist or speech and language therapist who
ideally has had additional training in sensory integration. Due to the diversity and
variability of dysfunction in sensory integration that an individual with autism may exhibit,
each child needs to be assessed separately, in a range of environments and over an
extended period of time. In addition, sensory profiles need to be reviewed on a regular
basis to identify any changes in dysfunction in sensory integration. Assessments may
take the form of standardised tests, parent/carer checklists, observations in a range of
environments or discussions with those involved in the care and treatment of the
individual with autism.
Delacato (1974) used an approach based on observation of a child with autism by a
number of members of staff, a staff conference and the production of a home
programme for implementation by the parents. He also recommended making a ‘list of
the channels affected and the isms under each’. (1974, p113).
Bogdashina (2003) lists a number of standardised tests as Sensory Integration and
Praxis Tests (SIPT) developed by Ayres and the DeGangi-Berk Test for Sensory
Integration. These standardised tests are reported to have various drawbacks such as
the use of an artificial environment and the lack of compliance or understanding of an
individual with autism that would prevent the test from being successfully completed.
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Although subjective in nature, the completion of checklists or questionnaires by
individuals very familiar with the child with autism is likely to be produce a reasonably
accurate outcome. Examples include the Bogdashina (2003) Sensory Profile ChecklistRevised, the Sensory Profile (Dunn 1999) and the Short Sensory Profile (Dunn, 1999).
However, due to the variability of dysfunction in sensory integration between individuals
it is unlikely that any one questionnaire will provide enough detail to identify all sensory
processing differences.
If observation is the sensory profiling technique of choice, given the variability of
dysfunction in sensory integration known to be exhibited by an individual with autism,
observations needs to be conducted over a relatively extended period of time and at a
number of locations. This will ensure that as many dysfunctions in sensory processing
are identified as possible. Observation as a sensory profiling technique is therefore time
consuming and labour intensive.
Discussions with carers and professionals very familiar with the individual with autism
will provide detailed information about the individual with autisms sensory profile.
However, this will be subjective and rely on the facilitator asking questions in a
consistent manner relating to all seven senses.
As all approaches to assessing dysfunction in sensory integration have benefits and
drawbacks a more accurate sensory profile may be produced by adopting a combination
of assessment techniques, for example a checklist , observation of the individual with
autism in a number of environments and discussions with familiar carers and
professionals.
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It should also be remembered that subject to adequate communication skills, whether
verbally or through some other medium such as the Picture Exchange Communication
System (PECs), the individual with autism may be able to provide valuable information
relating to their sensory profile.
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Intervention Strategies
As stated by Cribbin, Lynch, Bagshawe et al (2003, p19), ‘sensory integration therapy is
child-centred and works from what the child needs or likes to do’. Therefore whatever
intervention activity is utilised it needs to be enjoyed by the child and enable the
individual with autism to readily achieve success. In addition, as no two individuals with
autism will present with the same sensory profile intervention strategies will need to be
specific to each individual with autism. Thomasgard states (2003, p202) ‘Differences in
sensory processing, such as having a low versus high sensory threshold, yield very
different interventions that emphasize a decreased or increased input respectively’.
Involvement of the parents or primary carers of the individual with autism is critical to the
success of any intervention strategy utilised. Delecato (1974, p116) states ‘I found that
when the parents were involved in the evaluation of the behaviour, when the parents
understood the theory, a big step towards survival was taken’.
Recognised intervention strategies are as summarised by Bogdashina (2003, p143159):

Auditory Integration Training - either the Tomatis or Bradit methods;

Irlen Method – for the visual sense and utilises coloured overlays and tinted glasses
to improve reading and visual perceptions respectively of the environment;

Behavioural Optometry – aimed at improving visual processing;

Holding Therapy – to reduce hypersensitivity to tactile stimuli and in particular close
physical contact with other human beings;
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
Hug/Squeeze Machine – the application of deep pressure to reduce hypersensitivity
to touch and the anxiety it generates (as described by Temple Grandin (1996, p62);

Sensory Integration Therapy – aimed at facilitating the development of the nervous
system to process sensory input in a neuro-typical way;

Aromatherapy - aimed at stimulating the olfactory, tactility and proprioceptive
senses.
In addition, to those listed above a number of more recent publications such as those by
Smith Myles,Tapscott Cook, Miller et al (2000) and Kranowitz (2003) provide practical
intervention strategies that are easy to implement at home, school and in other
environments. Smith Myles,Tapscott Cook, Miller et al (2000) group commonly observed
behaviours under incident headings and link each to an interpretation and intervention.
For example, under the Incident Heading of ‘Emotions/Feelings/Relationships’ (p81) an
observed behaviour is cited as ‘appears to like fathers touch better than mothers’. A
number of reasons or interpretations are given for this including ‘mothers touch may be
too light’ and this is support by a number of suggested interventions including ‘make the
child aware that touch is coming’.
Kranowitz (2003) has under each sensory system provided a list of SAFE (Sensory
Motor, Appropriate, Fun and Easy) activities aimed at increasing sensory integration. For
example, for the tactile sense activities such as Messing Around with Un-Paint, Shaving
Cream Car Wash and Slimy Shapes are presented to reduce tactile
defensiveness.(Kranowtiz 2003, p26-28).
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For parents or carers that do not have access to formal sensory profiling techniques, or
access to specialist intervention resources, these publications provide a practical
starting point for addressing dysfunction in sensory integration and subsequent
behaviours. As stated by Grandin (1996, p185):
A better understanding of sensory problems will lead to more effective treatments.
Research in this area will explain why an intensive behaviour programme, such
as that proposed by Lovaas, will work with one child but fail with another.
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Compilation of a Sensory Profile for an Individual with Autism
A combination of sensory profiling techniques will probably result in the most accurate
sensory profile for an individual with autism. Therefore for the chosen individual, my son,
Dylan, aged 4 ½ years old a combination of a checklist approach and observation has
been utilised to generate his sensory profile – Bogdashina (2003, p184-199) Sensory
Profile Checklist – Revised (SPCR), Dunn, Saiter and Rinners (2002) Conceptual Model
and observations of behaviour made by immediate family members and Dylan’s
Learning Support Assistant at nursery. Personal observations of the impact on his
behaviour are used to illustrate the findings of the two checklists and are drawn from a
number of environments - home, nursery, park, children’s farm, visiting family and
friends etc over a period of approximately 12 months.
Bogdashina’s SPCR. The checklist was completed by myself and the SPCR, table and
Rainbow are included in Appendix A.
Completing the checklist and producing “The Rainbow” confirmed my observations of
my son in terms of dysfunction in sensory integration and the impact on his behaviour.
Dylan’s vision is hyposensitive in some instances. This results in a fascination with bright
and colourful lights and objects. For example, his fascination with the ‘disco ball’ at a
family wedding and with the different coloured lights at a theatre. Conversely, his visual
sense is also hypersensitive to the presence of small objects and he frequently spots a
plane or helicopter in the sky before anyone else has seen or heard it. As a toddler
Dylan enjoyed spinning the wheels on toy cars and this may be another example of his
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hyper vision as recorded by Delacato (1984, p109). Lawson (2000, p2) also recalls the
visual stimulus gained from this activity:
I turned my new bicycle upside down and spun the wheels round and round and
round. The light gleaming from the silver mudguards seemed to go on forever. It
was so intoxicating and I felt so alive.
Dylan’s hearing is at times hyposensitive. He has always enjoyed noisy environments
such as kitchens and making a lot of noise either from household objects or from
musical toys. This behaviour was observed by Delacato (1974, p103-104) in hypoauditory individuals with autism. At nursery he is reported to enjoy singing and can often
be heard doing so very loudly around the house. As a small child barking dogs
appeared enjoyable rather than upsetting. He enjoys hoovering and helping to mow the
lawn. When noise levels are too high to engage in conversation he often sings.
As with his visual sense, Dylan’s hearing is on occasions hypersensitive as well. One of
the questions he often asks is ‘What’s that sound?’ This can be in response to a chiming
clock, passing traffic or a door opening or closing. At nursery he is reported to find the
sound of a humming computer in the background distracting. As observed by Delacato
(1974, p102) ‘haircuts are a special terror to hyperauditory children’. Dylan appears
terrified when having his haircut.
Dylan’s sense of smell and taste are both hypersensitive to food. He is a very fussy
eater and many of the foodstuffs he does eat are very bland in nature both in terms of
smell and taste eg bread, rice, pasta and fish. Dylan often refuses to taste new foods.
Lawson (2000, p56) offers an explanation for this ‘To make a decision about what to eat
for lunch was too difficult and I was afraid of attempting new tastes that looked, smelt
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and were different.” Dylan does not eat sweets and it may be that the reason for this is
his hypersensitivity to taste. (Delacato, 1974, p106).
From being able to move off the spot at about 5 ½ months Dylan has always wanted to
explore every inch of his environment as quickly as possible regardless of safety. The
Rainbow identified my son as being hypo sensitive in terms of his vestibular sense. This
would seem to explain his lack of fear of heights, his desire to run everywhere and climb
everything regardless of the potential consequences. Lawson (2000, p6) attempts to
offer some explanation for this behaviour:
But autistic children do not have any sense of danger when it comes to roads,
oceans, rooftops or cliffs. They seem constant and non-threatening, offering
quietness, calm and reassuring space – a place without interruptions and
abundant with activities to occupy and satisfy the autistic child’s need for
sameness and repetition.
At nursery he is reported to engage in physical activities such as football with great
vigour and expel a much greater degree of effort and persistence than his neuro-typical
contemporaries.
In completing the Rainbow, hypersensitivity was observed for touch in terms of his
relatively high pain and temperature tolerance. For example, Dylan likes hot water in his
bath and rarely cries when he injures himself. Dylan seldom recognises the need to
urinate and it may be that his tactility is hypo sensitive in some instances. Hyper
sensitivity in terms of the tactile sense was not recorded by the Rainbow. This confirms
our observation of Dylan as a very tactile child who enjoys physical contact.
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Dysfunction in sensory integration was not detected in terms of the proprioceptive
senses. This is supported by observation of Dylan as a well co-ordinated child with the
same flexibility, fluidity of movement and body control as his neuro-typical peers.
Dunn’s Sensory Profile. Dunn, Saiter and Rinner (2002) have proposed an alternative
model for sensory processing ‘based on a person’s neurological thresholds and self
regulation strategies’ (p173). The Psychological Corporation only allows those with a
professional qualification to purchase their documents. Therefore the questionnaire
could not be accessed. Instead, personal observation by myself, close family members
and Dylan’s Learning Support Assistant have been utilised to assess his pattern of
sensory processing using this conceptual model. In terms of the four basic patterns of
sensory processing – Low Registration, Sensation Seeking, Sensory Sensitivity and
Sensation Avoidance, Dylan would appear to be mainly in the Sensation Seeking
category as observed by the following behaviour response and self regulation strategies
identified by Dunn, Saiter and Rinner (Figure 1, p175):

High Ability to Generate Ideas and Responses – Dylan talks all the time and is
always asking to do new things eg ‘Can I go waterskiing/skating/ride?’ ‘Can I make a
train/bus/boat out of the piece of cushions?’ ‘Can I have that toy?’ He always
responds enthusiastically, positively or negatively, to any question or idea to do
something or go somewhere. For example, ‘Come on, come on hurry’, ‘I can’t go
there anymore’, in a very loud voice;

Notices and Enjoys all the activity in the Environment – my son continually says
‘Look it’s a tractor/train/bus’. This is rapidly followed by ‘Can I ride the
tractor/train/bus?’. Other statements frequently made are ‘Look it’s a
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flower/windy/yellow etc’. At times it appears he cannot satisfy his need for visual,
auditory and vestibular sensory experiences or assimilate them fast enough;

Always Active, Continuously Engaging – Dylan never sits still and runs
everywhere. His favourite activities involve running, jumping, riding, swimming and
climbing;

Fidgety and Excitable – Dylan finds it difficult to sit still. For example when
watching TV he is continually jumping and climbing on the furniture. If there is a wall
or a fallen log or tree he has to walk in it. He often gets very excited by children’s TV
programmes eg someone falling down or dropping something.
Dunn, Saiter and Rinner (2000, p174) go on to state ‘speech and language issues also
have a sensory-seeking quality’. Dylan often asks the same question over and over
again. This may be because he enjoys the sensation of articulating the words or enjoys
the sensation he feels when he is given the answer. For example, ‘I wish to go home
’answered by ‘we are going home ‘ or ‘You are at home!’ either calms him down or
makes him feel happy.
However, Dylan also appears to share some characteristics of the Sensory Sensitivity
pattern. As described by Dunn, Saiter and Rinner (2000, p176) ‘they are distractible,
hyperactive and can be complainers. They notice many more sensory events than do
others and comment on them with regularity’. At times Dylan will complain very loudly
about the slightest thing eg being asked to hang up his coat and will protest about
visiting places he enjoys eg visiting the farm or the park. As already noted Dylan is a
very active child and finds it difficult to concentrate on one task for more than a few
minutes at a time eg playing with toys, play-dough or painting. This combination of the
27
two profiles is acknowledge by Dunn, Saiter and Rinner (2000, p176 ‘ it is important to
remember that children do not have a single sensory processing pattern but rather have
several patterns in several repertoires’. Therefore in terms of the Conceptual Model
proposed by Dunn, Saiter and Rinner (2002) Dylan would be described as primarily
Sensation Seeking whilst exhibiting some aspects of the Sensory Sensitivity pattern.
Although documented by Bogdashina (2003) other profiles of dysfunction in sensory
integration exhibited by Dylan have not been identified through completion of the
Rainbow or Conceptual Model. For example, his ability for perceptual thinking. At age 4
years he was asked to describe his new bedroom spaceman curtains. He replied ‘Milky
Way, Rocks, Purple Planet’ whilst swaying from side to side. This was followed by the
question ‘What TV programme have you got that from?’ Dylan replied ‘Dora the
Explorer’. He has given me the same answer and explanation on a number of
occasions! In addition, he has described babies using descriptions learnt from children’s
stories and often uses the phrase ‘It’s just right’ when I believe he is recalling the story of
“Goldilocks and the Three Bears”. Dylan’s perceptual thinking may also explain the great
success of PECS in stimulating him to speak. We were at last ‘talking his language!’
Dylan frequently links the presence of individuals or objects with a return visit to an
environment which he has previously experienced with that individual. For example, a
particular house is remembered not for the people who live in it but by a specific toy
such as Thunderbirds or a Bouncy Castle. Alternatively he will expect the same friends
to be at a particular park or children’s farm who were there on a previous visit. These
may be examples of serial thinking.
28
When tasting a new food he often says ‘It smells horrible’. Dylan also uses the phrase ‘It
smells delicious’ when describing food that he likes whilst he is tasting it. This may
therefore be an example of synaesthesia. ie taste stimulating the olfactory sense.
In summary, Dylan’s sensory profile is hyper and hyposensitive in terms of the visual
and auditory senses, he demonstrates hypersensitivity to taste and smell and is
hyposensitive to vestibular and tactile stimuli. Dylan is a Sensation Seeker but with
some residual Sensory Sensitivity. He demonstrates synaesthesia in the gustatory and
olfactory senses and is a perceptual and to a lesser extent serial thinker.
29
Intervention Planning in a Primary School Context
The Local Education Authority has an Autism Outreach Service which is being used to
support Dylan during his transition from nursery to primary school. As part of the service
they have developed a “Passport to School” which includes information on his family, his
interests, things that upset him and those he enjoys. The “Passport to School” has been
used to provide information as to how Dylan is affected in terms of the Triad of
Impairments (Wing, 1996), to explain his dysfunction in sensory integration and its
impact on his behaviour. Suggestions in terms of intervention planning to minimise the
negative behavioural impact of dysfunction in sensory integration are presented in the
table contained in Appendix 1 in terms of the Bogdashina (2003) Rainbow, Dunn, Saiter
and Rinner (2002) Conceptual Model and observations.
It is planned to review Dylan’s progress at school on a termly basis through the
completion of an Individual Education Plan (IEP). This will allow all interventions
including those implemented to address dysfunction in sensory integration to be
monitored and evaluated with changes made as appropriate.
In addition, a “Daily Diary” will be completed both at home and at school which will
record activities Dylan has successfully completed, those he has found stressful and
those that have been too difficult to complete. This will allow any changes in Dylan’s
Sensory Profile to be identified and the continuing review of intervention strategies to
address his dysfunction in sensory integration.
30
Conclusion
Sensory experiences for those with autistic spectrum disorders compared to
those without may in someway differ dependent on the sense or senses
subject to dysfunction in sensory integration. This may result in to much, to
little or incorrect sensory input and processing.
The exclusion of dysfunction in sensory integration from diagnostic criteria for
autistic spectrum disorders does not infer it should be overlooked as a reason
for observed behaviours. The completion of a sensory profile can only provide
valuable information with which to assess an individual with autism and
identify appropriate intervention strategies to manage behaviours.
The value of dysfunction in sensory integration should not be dismissed.
Many individuals with autism gain great enjoyment from the sensory world
they experience. Only when dysfunction in sensory integration results in great
emotional distress, inappropriate behaviours or the inability of the individual
with autism to successfully undertake daily activities are intervention
strategies to improve sensory integration generally required.
Educators can make essential use of the information gleaned from the
completion of a sensory profile by ensuring the environment and the
behaviour of others is modified for the individual with autism to allow
dysfunction in sensory integration and undesirable behaviours to be
minimised as much as possible. This will assist the individual with autism in
accessing learning and reaching their full potential.
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References
Anzalone, M.E. and Gordon Williamson, G. (2000) Sensory Processing and
Motor Performance in Autism Spectrum Disorders in Autism Spectrum
Disorders, A Transactional Developmental Perspective, Baltimore: Paul H
Brookes Publishing Co.
Baranek, G.T (2002) Efficacy of Sensory and Motor Interventions for Children
with Autism, Journal of Autism and Developmental Disorders, 32 (5) p397422.
Bogdashina, O. (2001) A Reconstruction of the Sensory World of Autism,
Sheffield: Sheffield Hallam University Press.
Bogdashina, O. (2003) Sensory Perceptual Issues in Autism and Asperger
Syndrome. Different Sensory Experiences, Different Perceptual Worlds, 1st
Edition, Jessica Kingsley Publishers.
Cribbin, V. Lynch, H. Bagshawe, B. and Chadwick, K. (2003) Sensory
Integration Information Booklet. A Resource for Parents and Therapists, 1st
Edition, Ireland: Published by the Sensory Integration Network.
Dawson, G. and Watling, R. (2000) Interventions to Facilitate Auditory, Visual
and Motor Integration in Autism: A Review of the Evidence, Journal of
Autism and Developmental Disorders, 30, (5), p415-421.
32
Delacato, C.H. (1974) The Ultimate Stranger, The Autistic Child, 1st Edition,
Northumberland: Ann Arbour Publishers Ltd.
Dunn, W. Saiter, J. and Rinner, L. (2002). Asperger Syndrome and Sensory
Processing: A Conceptual Model and Guidance for Intervention Planning.
Focus on Autism and Other Developmental Disabilities, 17 (3) p172-185.
Grandin, T. (1996) Brief Report: Response to National Institutes of Health
Report, Journal of Autism and Developmental Disorders, 26 (2) p185-187.
Grandin, T. (1996) Thinking in Pictures and Other Reports from my Life with
Autism, New York: Vintage Books.
Lawson, W. (2000) Life Behind Glass A Personal Account of Autism Spectrum
Disorder, London: Jessica Kingsley Publishers.
O’Neill, M. and Jones, R.S.P. (1997). Sensory Perceptual Abnormalities in
Autism: A Case for More Research, Journal of Autism and Developmental
Disorders, 27 (3) p283-293.
Kranowitz, C.S. (2003) The Out-of-Sync Child has Fun. Activities for Kids with
Sensory Integration Dysfunction, New York: The Berkley Publishing Group.
O’Neill, J. L. (1999). Through the Eyes of Aliens. A Book About Autistic
People., Jessica Kingsley Publishers.
33
Smith Myles, B. Tapscott Cook, K. Miller, N. Rinner, L. and Robbins, L. (2000)
Asperger Syndrome and Sensory Issues. Practical Solutions for Making
Sense of the World, 1st Ed., Autism, Asperger Publishing Company.
Thomasgard, M. (2003). Working with Challenging Young Children: Relations
between Child Temprament, Response to Novelty and Sensory Processing,
Clinical Peadiatrics, 42 p197-204.
Williams, D. (1992) Nobody Nowhere, London: Jessica Kingsley Publishers.
Wing, L. (1995). Autistic Spectrum Disorders: An Aid to Diagnosis. 3rd Edition,
Norwich: The National Autistic Society.
Wing, L. (1996). The Autistic Spectrum A Guide for Parents and
Professionals, London: Constable and Company Ltd.
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Appendix
Completed Sensory Profile Checklist (Bogdashina, 2003) – Revised, for
Dylan George Harries aged 4 ½ years.
Dylan George Harries - Suggested Intervention Strategies to Manage
Behaviour in a Primary School Setting.
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Dylan Harries - Suggested Intervention Strategies to Manage Behaviour in a Primary School Setting
Dysfunction in
Sensory Integration
Rainbow
Sensory
Sense
Pattern
Behaviour
Intervention
Anticipated Outcome
Gustatory/
Olfactory
(Hyper)
Sensory
Sensitivity
Only eats a few
foodstuffs and becomes
easily distressed if
pressure is applied to
eat others.
If Dylan does not want to try something new to
eat or says it ‘smells horrible’ he is to be given
something to eat that he does like.
Dylan will have eaten enough to
allow him to focus on activities in
the afternoon. Dylan will not
worry or become anxious about
lunchtime at school.
Visual
(Hyper)
Sensory
Sensitivity
Easily distracted during
‘quiet times’ by the sight
of people, passing traffic
aeroplanes etc.
Dylan needs to be sat with his back to the door
and facing away from windows.
A reduction in the number of
distractions and enhancement of
concentration enabling the task
to be completed.
Visual
(Hypo)
Sensation
Seeking
Easily bored by every
day activities and finds it
difficult to maintain
concentration.
Use visual aids to explain concepts and
activities. For example, colourful and vivid
pictorial representations, videos and computer
programmes.
Provides a sufficient level of
visual sensory input to maintain
Dylan’s interest enabling the task
to be completed.
Auditory
(Hyper)
Sensory
Sensitivity
Easily distracted during
‘quiet times’ by
background noise.
During times when Dylan is required to sit
quietly and listen to instructions, external doors
are to be shut, computers switched off and
visitors to the classroom to be minimised.
A reduction in the number of
distractions and enhancement of
concentration enabling the task
to be completed.
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Dylan Harries - Suggested Intervention Strategies to Manage Behaviour in a Primary School Setting (cont)
Dysfunction in
Sensory Integration
Rainbow
Sensory
Sense
Pattern
Behaviour
Intervention
Anticipated Outcome
Auditory
(Hypo)
Sensation
Seeking
Unable to maintain focus on
activities that do not
generate a sufficient level of
noise.
Design activities and explain concepts
which allow the classroom to maintain
a reasonable noise level.
Provides a sufficient level of auditory
input to maintain Dylan’s interest
enabling the task to be completed.
Tactility
(Hypo)
Sensation
Seeking
1) Has a higher than normal
pain threshold.
1) Ensure Dylan is checked by an
adult should he be involved in an
accident regardless of his emotional
response.
1) Dylan receives the appropriate
medical treatment for any injury
sustained.
2) Ensure Dylan is regularly reminded
to use the toilet.
2) Dylan is able to remain focused on
the given task.
1) During PE and out door play Dylan
needs to be closely observed to
ensure he does not attempt activities
that he is not physically capable of or
that could be dangerous.
1) Ensures Dylan is able to safely
complete activities.
2) Does not recognise the
need to use the toilet
Vestibular
(Hypo)
Sensation
Seeking
1) Attempts activities that
are far beyond his physical
capacity to safely complete
or are dangerous.
2) Requires a greater
degree of movement and
interaction with the physical
environment to maintain
interest in a given task.
2) Design activities and explain
concepts through the movement of
objects or use of materials eg sand,
water, sticking and building.
2) Provides a sufficient level of
vestibular sensory input to maintain
Dylan’s interest enabling the task to
be completed.
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