Sensory integration issues and ASD
Information Booklet and strategies
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Sensory integration is a neurological process that occurs in the brain, it’s an unconscious
automatic process, to give us meaning, allows us to respond in a purposeful way, and
forms the foundation for learning and behaviour.
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Our 7 senses are: vision, hearing, touch, smell, taste, and then we have the sense of
movement (the vestibular system) and the positional sense (proprioception system).
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Sensations flow into the brain like traffic, the brain locates sorts and orders these
sensations, when sensations flow in a well organised manner the brain can use these
sensations to form perceptions, behaviour and learning.
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People with ASD process and respond to sensory stimuli in a much different way and
they have a different physiological response to sensory stimuli than typically developing
people (tone and tactile - lower). Difficult to work out exactly what the sensory issues are
as each is unique and affected by other issues e.g. illness, mood.
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80-90% of individuals with ASD experience atypical sensory responsiveness that affects
their ability to take part in daily life.
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Sensory processing disorder is like a computer breaking, incorrect information is put in,
it’s not been made sense of and the response is inappropriate. This changes how a
person will respond to changes in their own body, the environment and how they interact
with it and others around them.
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Sensory needs are becoming more recognised in ASD. The DSM V states “Hyper-or
hypo-reactivity to sensory input or unusual interest in sensory aspects of environment;
(such as apparent indifference to pain/heat/cold, adverse response to specific sounds or
textures, excessive smelling or touching of objects, fascination with lights or spinning
objects)” as part of the diagnostic criteria.
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Brain gut connection – After a painful event a much smaller event may trigger a painful
reaction. E.g. if a child eats lots of cold food when young and gets severe pain, a small
amount later on can cause major pain as a pain message has been stored – the same
can be said for smells, lights etc . (Dr Wendy Lawson – Sensory Issues in Autism).
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Some autistic individuals can see the flicker of florescent lights. (Lawson, 2001) Coleman
et al (1976) found that florescent lights increased repetitive behavior in some children
with autism. (Dr Wendy Lawson – Sensory Issues in Autism).
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What we know about ASD is that we use single attention. If attention is all in one
place then sensory issues will take precedence when they exist. I won’t have spare
attention for learning, my senses are occupied! (Dr Wendy Lawson – Sensory Issues
in Autism).
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Please note it can be difficult to work out exactly what a person’s sensory issues are
because each person will experience things differently and respond in different ways.
Everyone’s tolerance levels are affected by their well being so if tired, ill, stressed etc we
might not be as tolerant of sensory stimuli as when we are feeling good.
Type of
sensory need
What’s happening
Hypersensitive Meaning brain channel is too
open and as a result too much
information passes into the brain
to handle.
Signs/Symptoms
 Dislike to dark / bright lights
 Notices minute detail
 Covers ears
 Resists touch
 Runs from smells
 Moves from people
 Uses Tip of tongue for tasting
 Craves certain food
 Places body in strange positions.
 Turns whole body to look
 Difficulty walking on uneven surfaces.
Hyposensitive
Meaning brain channel not fully  Moves fingers or objects in front of eyes
open and brain is deprived of  Fascination with bright/coloured objects /
information.
reflections
 Makes loud noises (can be rhythmic)
 Likes vibration, pressure, tight clothes
 Enjoys rough and tumble play
 Smells things (including self and people) and
seeks strong smells
 Puts objects in mouth, licks things
 Eats anything
 Rocking and Spins/runs round and round
 Lack of body awareness / Bumps into things
Sensory
Overload
Meaning too much information all
at once. Trying to process
everything at once. Needs to be in
control of environment.




Sudden outbursts of self injury or distress
Tires easily in stimulating places (noises).
Nausea/vomiting from lots of movement
Withdrawal
Might see certain
behaviours to calm down
or stop pain
This might work
because…
- Rocking,
- swinging,
- flapping
- spinning,
- hit or press against myself
These cause sensations
to help my brain block
things out.
- Banging,
- Seeking of noises
- Tight clothes
- Self injures
- Smearing
These
causes
sensations which help
my brain get more
information
in
from
outside (get the nervous
system working more).
Use one sense at a time,
avoid direct involvement with
stimulus, remove self or
withdraws,
engages
in
rituals and routines.
This may reduce the
feeling
of
being
overloaded and cut out
some sources, allowing
recovery.
Type of
sensory need
What’s happening
Signs/Symptoms
Might see certain
behaviours to calm down
or stop pain
Gestalt
Perception
Meaning
difficulties
filtering
background
and
foreground
information so everything is seen
as a whole (this can happen in
any sense). This may mean that if
a picture is hanging at an angle
this will change the whole scene
and environment will become
unfamiliar. Can impact if routine is
changed.
- Fear
 Notices every tiny change in environment
 Easily frustrated if trying to work in noisy - Stress
- Frustration
crowded room
 Clumsy – stiff movement
 Does not follow instructions with more than
one person talking
Fragmented
Perception
Difficulty seeing things as a
whole/processing all relevant
parts of something at once e.g. a
person might appear as lots of
unconnected parts – each being
unpredictable due to movement of
them – processing them bit by bit
- but can see a whole person.
-
Delayed
Processing
Meaning a delay in the time taken
to process information that is
coming in.
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This might work
because…
Can complicate interpretation of facial
expressions and body language.
Very narrow focusing of attention
Resists change
Gets lost easily
Difficulty recognising people in unfamiliar
clothes
Hears few words of a sentence
Complains about some parts of clothes,
smells etc
Attention for minor parts of scene
Complain about body parts
Focus on one thing e.g.
own breathing, arranging
furniture, tearing paper,
rubbing fingers / hands,
Delayed responses
Poor at sport
Oblivious to risks
Experiences perceived as new despite
number of times they have already
experienced it.
Confusion, having to break Need time to process the
down the process each time language / object etc to
to understand what it is and make sense of it.
what it can be used for (e.g.
for known objects etc).
Physical
activities
running, bouncing.
Concentrating on one
thing cuts down amount
of processing my brain
has to do,
e.g. Increase endorphins in
brain which help calm
down
the
over
stimulation.
Get away from the issue Avoiding
can
help
e.g. block ears, shut eyes, recover and prevent
leave room.
escalation.
Unable to transfer skill to a
different area / situation.
Type of
sensory need
Distorted
perception
What’s happening
Meaning brain may misinterpret or
change what it can really see,
hear, touch, smell or taste. This
gets worse in state of sensory
overload.
Signs/Symptoms
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Sensory
shutdown
Compensation
Might see certain
behaviours to calm down
or stop pain
Fears heights and stairs
Difficulty catching balls
Spaces expand or decrease
Cant associates the location form and
texture of objects
Double vision
Seeing things in 2D only
Poor awareness of own body.
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Startled
approached
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Compulsive
repetitive
body movements
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Hits eyes, ears, nose.
Shut down one or more This
may
reduce
sensory channel
incoming information to
Withdraws
cope better.
Avoids
Engage in routine/rituals
Happen when they can’t deal with
all the information coming in e.g. if
overload occurs. Can occur if one
or more senses cannot cope.
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May not react to any stimuli
Appears to not know how to move own body
Disorientated in noisy/bright places
Rocks unconsciously whilst doing other
activities.
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Due to the above sensory
sensitivities
a
person
may
compensate through other more
reliable senses to build a better
understanding of the environment.
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Investigate objects
Look for sound source
Inspect food before eating
Watches feet while walking, watch hands
when doing things
Avoids walking on uneven ground.
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This might work
because…
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-
-
when
Smell, lick, touch or tap Uses
other
sensory
objects,
systems to give reliable
information so I can
Looking at hands and make sense of it.
feet when in action,
Refusal to walk
certain flooring.
on
Simple Strategies
Ways to help: sight
Hypo (under-sensitive)
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Increase the use of visual supports.
Hyper (over-sensitive)
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Reduce fluorescent lighting - use deep-coloured light bulbs instead.
Wear sunglasses.
Create a workstation in the classroom: a space or desk with high walls or divides on both sides to
block out visual distractions.
Use blackout curtains.
Ways to help: sound
Hypo
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Use visual support to back up verbal information.
Hyper
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Shut doors and windows to reduce external sounds.
Prepare a person before going to noisy or crowded places.
Wear ear plugs.
Listen to music.
Create a workstation.
Ways to help: touch
Hypo
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Use weighted blankets or sleeping bags.
Hyper
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Warn a person if you are about to touch him or her; always approach him or her from the front.
Remember that a hug may be painful rather than comforting.
Gradually introduce different textures - have a box of materials available.
Allow a person to complete activities themselves (e.g. hair brushing / washing) so that they can do
what is comfortable for them.
Ways to help: taste
Some people with an ASD are hyper- or hyposensitive to taste, and may limit themselves to bland foods or
crave very strong-tasting food. As long as someone eats a bit of a varied diet, this isn't necessarily a
problem. For more information about ASD and restricted diets, visit www.autism.org.uk/restricteddiet
Ways to help: smell
Hypo

Hyper
Use strong-smelling products as rewards and to distract people from inappropriate strong-smelling
stimuli (like faeces).
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Use unscented detergents or shampoos, avoid wearing perfume, and make the environment as
fragrance-free as possible.
Ways to help: balance
Hypo
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Encourage activities that help to develop the vestibular system. For children this could include
using rocking horses, swings, roundabouts and seesaws, try games like catching a ball or practise
walking smoothly up steps or curbs.
Hyper
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Break down activities into small, more easily manageable steps; use visual cues such as a finish
line.
Ways to help: body awareness
Hypo
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
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Position furniture around the edge of a room to make navigation easier.
Put coloured tape on the floor to indicate boundaries.
Use the 'arm's-length rule' to judge personal space. This means standing an arm's length away from
other people.
Hyper
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Do 'fine motor' activities like lacing boards, pin boards, finger painting, Lego play etc.
Ways to help: picky eaters
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Possible reasons: sensitive to taste or texture, or unable to feel food around the mouth.
Possible solutions: change the texture of food, for example purée it. Slowly introduce different
textures around the person's mouth, such as a flannel, a toothbrush and some different foods.
Encourage activities that involve the mouth, such as whistles or bubble wands.
Ways to help: a child that chews on everything, including clothing and objects
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Possible reasons: may find this relaxing, or enjoy the sensation of chewing on the item.
Possible solutions: offer latex-free tubes, straws or hard sweets (chill in the fridge).
Ways to help: smearing
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Possible reasons: may like the texture of faeces or not be very sensitive to smells.
Possible solutions: try and introduce things like jelly, or corn flour and water to handle instead;
introduce alternative strong-smelling items.
Ways to help: children that refuse to wear certain clothes
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Possible reasons: may dislike the texture or pressure of clothes on their skin.
Possible solutions: turn clothes inside out so there is no seam; remove any tags or labels, allows the
person to wear clothes they're comfortable in.
Ways to help: children who find it difficult getting to sleep
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Possible reasons: may have difficulty shutting down their senses, in particular sight and hearing.
Possible solutions: use blackout curtains or weighted blankets; listen to music to cut out external
sounds.
School strategies
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How we can help – consider tone of voice, what we wear (clothes and jewellery) our movements and
actions, perfumes and deodorants, proximity and eye contact, make up etc can affect the child.
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De-clutter classroom or the working space – have organised work spaces – adopt the TEACCH
classroom layout / visual timetables (clear start and end to task) / timers, work trays etc.
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Have clear boundaries for them e.g. privacy boards / pop up partitions, quiet area and hide outs.
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Sensory diets – sensory enriched activities - regular access to movement opportunities to provide
children’s sensory system with the input they require to achieve a calm alert state – 2-3 minutes of
movement can increase concentration for 15-20 minutes (do 3 times a day) e.g. raise hands, clap,
wriggle toes, bend wrists, open and close your hands, flex your feet, bend your neck, make a funny
face. Schedule movement breaks at least 3 times daily for the whole class i.e. morning, mid
morning, mid afternoon.
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Heavy work activities (heavy muscle work for proprioception or linear/ rotary movement’s for
vestibular) – complete twice a day, 15 minutes of activities can increase attention for up to 2 hours
e.g. whole body movements e.g. push ups, hula hoops, star jumps etc. (Linear movements e.g. lying
on a gym ball, jumping on a tapeline, and Rotary movements e.g. swing round on a tyre swing)
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Seating positions – therapy balls, wobbly cushions, Rocking chairs, busylegz, and ball chairs.
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Visual means for the child to show its getting too much e.g. stress thermometer, traffic lights have an
agreed exit strategy.
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Time out in dark areas, quiet areas, enclosed areas, tents.
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Music – for calming and regulating (Mozart), attention (Vivaldi) or arousal and co-ordination (clear
rhythm and beat).
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Weighted products (lap pads, blankets, jackets) – provide pressure that helps them to relax.
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Oral motor strategies e.g. chewing, sucking, crunching, blowing.
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Sensory tool kit – individual to each child – e.g. iPods, ear defenders, headphones etc., sunglasses,
jumpers with hoods, heavy coat, miracle belt, backpack, finger fidgets (pushing, pulling, squeezing
massaging), stress balls, lycra undergarments etc.
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Teach child to self-regulate by identifying the signs (alert program – how does your engine run).
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Therapy is undertaken by OT e.g. SITS, sensory diets, alert program, and deep pressure techniques.
References
http://www.autism.org.uk/living-with-autism/understanding-behaviour/the-sensory-world-of-autism.aspx
Information taken from: Sensory Issues in Autism by East Sussex County Council. Eastsussex.gov.uk
Autism and Sensory processing in every day life (NAS Course)