Sensory Challenges in Children With Autism Fasten your seat belts! We are going to spend some time discussing the sensory world for those on the spectrum. Sensory differences vary greatly for people on the spectrum; however, most of them experience the sensory world much differently than us neurotypical people. People on the spectrum frequently have difficulty in all areas of registering, integrating, and processing sensory experiences. For some these sensory issues dominate everything they do. When the outside world is constantly assaulting their nervous system, they are on high alert and always anxious. First it is important for us to gain an understanding of the different types of sensory issues that can be affected. Although there are many shades to sensory vulnerabilities, the several listed below are the main ones. It is important to be aware of how the child processes sensory information, what sensory preferences they are attracted to, and what sensory sensitivities they avoid. Knowing how your child experiences the world will allow you to modify his environment to minimize sensory overload, change your interaction style to foster engagement, and build learning opportunities around his sensory preferences. You can use the child’s sensory preferences to sooth and calm him when overwhelmed, and arouse him when slow and sluggish. Parents, caregivers, and teachers need to be aware that sensory processing issues can be one of the biggest challenges people on the spectrum experience. The more we understand how the person experiences his sensations, the better we are in accommodating and compensating for these vulnerabilities. Common Sensory Issues 1. Fragmented or distorted sensations 2. Problems integrating/processing multi-senses 3. Sensory defensiveness (hyper-sensitive) 4. Hypo-sensitivity 5. Sensory overload 6. Modulating stimulation (arousal) People with autism spectrum disorder can experience a variety of sensory issues. The most common, and the ones people recognize the most, are sensory defensiveness (hypersensitive to stimulation) or sensory overload (when too much stimulation is bombarding the child). In addition, problems can occur in the actual registering of stimulation, integrating the various senses together, and regulating the amount and intensity of stimulation provided to the brain. We will look briefly at a few of these problems. Fragmented or Distorted Perception Fragmented perception is common in autism. The neurotypical (NT) brain automatically takes in and organizes all incoming information (sensations) into one overall perception. We integrate all of our senses smoothly with little conscious awareness of this process. We take in what we see, hear, smell, taste and feel and smoothly integrate all this information into one flowing perception. Our ongoing experiences consists of a dynamic flow of sensory information continually integrating and assimilating to keep a steady stream of experience that allows us to interact with, and adapt to, the world around us. However, for some individuals on the spectrum, they have fragmented perception. They only perceive parts or fragments of the perceptual field at one time. For example, people typically can look at a face and see the overall face in one perception. Integrating the shape of the head, eyes, nose, ears, hair, mouth, and etc. all into one perception of a face that we recognize. For people with fragmented perception, they may only be able to discriminate parts of the face (eyes, nose, mouth, etc.) at one time, and have to piece together each part sequentially, like a puzzle. Some have “face blindness” where they do not recognize faces at all. For many, they will pick one aspect of the face, like your hair or your glasses to remember you by. Consequently, if you cut your hair or use a different perfume they may not recognize you. For people with fragmented or distorted senses, their perceptions do not come in overall smooth patterns. Instead of the brain integrating all the details into a whole picture, they are overwhelmed by a sea of details that often seem to conflict with each other. In a steady stream of mass confusing stimuli, they pick up on bits and pieces, without perceiving all the information. This can cause faulty perception by not gaining the whole picture. At best it can result in delayed processing, since the bits and pieces have to be put together sequentially, like a puzzle, instead of simultaneously. Of course, we can imagine how stressful that could be, especially when the stimulation is fleeting (changes quickly) or the situation demands quick responding. Much of our daily experiences require us to rapidly process dynamically changing information. It requires our brains to rapidly process multiple stimulation simultaneously. For those with fragmented perception, piecing together the fragments might not give the whole complete picture, rendering their responses out-of-sync with what is required. Children with these difficulties will usually categorize things by one or two fragments, rather than the whole picture. They may remember a person only by their hair, a room by a certain piece of furniture, or an object by its shape, color, or feel, but not all three. This can make the world more fragile for the child. When the one characteristic they recognize changes (person cuts her hair, or furniture is moved from the room, etc.) this can throw the person’s sense of security out of whack! Less common, but more troublesome is distorted perceptions. For individuals with this problem the distortions can vary across a variety of dimensions (size, shape, depth, movement, etc.). Objects shake, distort in size, or move and stretch. Since these distortions may not stay consistent, the person’s field of vision or hearing can fluctuate, making judgment very difficult. You might see delayed processing, plus hesitation is responding with these children. They may have problems navigating objects around them or feel that everything is moving. They have to proceed slowly, sometimes freeze, or shut down completely. Again their ability to process stimulation will be weakened under periods of stress, fatigue, illness, or hunger; rendering their perceptions unreliable. Hyper or Hypo-Sensitivity Heightened acuity or hyper-sensitivity is very common. For these individuals, they can register stimulation at a much greater sensitivity. They can hear frequencies and intensities of sound that most people cannot register, see minuet particles or distinct details, sense smells that others cannot pick up on, and feel the slightest stimulation to their bodies. This can be distracting and overwhelming, and at times painful. Their brains may not be able to filter out background noise, and get so distracted by meaningless details that they miss the important elements. Imagine seeing the flickering of fluorescent lights, feeling the magnetic and electromagnetic waves of refrigerators and microwaves, or hearing people breathing that are near you. This heightened acuity, or hyper-sensitivity, can be a strength (jobs requiring observation of detail) but more often is a distracting nuisance. It can be overwhelming and make concentrating very difficult. Some individuals can be hyper-sensitive in one sense, and hypo-sensitive (poor awareness) in another. With hypo-sensitivity the person does not register normal levels of stimulation, and often does not feel, hear, see, or smell common sensations unless they are intensified. This is the child who stumbles around because his body does not “sense” the contact with the floor and objects around it. He may be really rough with things because he does not sense how firmly he is being. In addition, this person may not feel pain at normal levels, and be prone to injuries (broken bones, cuts, etc.) without awareness of the injury. Sensory Defensiveness Often occurring with hypersensitivity is sensory defensiveness. With this condition the child may be over-sensitive in one or more senses, often causing uncomfortable and sometime painful sensations. For them, soft touch can feel like pins and needles, certain frequencies and intensities of sounds can be amplified numerous times. The buzzer at school may be tormenting, or the phone ringing can shock their nervous systems. Typical smells can make them nauseous, and common lighting can be overwhelming. Their nervous system is constantly anxious and on high alert. They panic easily. This child will often try and escape or avoid common sights, sounds, tastes, and touch that may put his nervous system in a frenzy. These children are often on “high alert”, anxious, and oppositional, because they are on guard for possible threatening stimulation. They need to control everything that occurs around them to control the level of stimulation. Imagine sitting in a classroom where the hard seat is painful, your clothes are uncomfortable, the fluorescent lights overwhelm you, you can hear the person behind you breathing heavily, the smell of the markers and paste make you nauseated, and the scratching sounds of all the pencils irritate your ears. Then try and concentrate on what the teacher is discussing! Problems integrating multiple senses For some on the spectrum, they may register each sense adequately but have problems integrating all their senses into one overall perception. Whereas our brains take in multiple senses (seeing, hearing, feeling, smelling, etc.) and integrate them together simultaneously, people with integration difficulties are bombarded by competing sensations that do not get integrated effectively. For them all the sounds, smells, sights, etc. compete with one another and do not get integrated simultaneously. They often need to block out one sense in order to focus on another. For these individuals our normal stimulating world can be very overwhelming. Often they need to process each sense sequentially, one at a time, and then piece all the information together. As can be expected, this would be very draining. Mono (single channel) processing For those who have a hard time integrating their senses together, they often have a dominate sense that they use to interpret their world. They may need to touch and manipulate everything they are processing, or need to smell everything first before eating or engaging with it, or explore things visually before engaging with it. For them their other senses are too competing for them so they may try and block out the other senses, so they can concentrate on their dominate sense. So, for the child who is a visual processor, he may frequently cover his ears to block out noise so he can focus on his vision. We need to identify what sense (vision, hearing, or touching/manipulating) the child primarily uses to explore his world, and then use that sense to tailor learning to. Delayed Processing and Sensory Overload As you can imagine, if you cannot filter out background noise, have fragmented or distorted sensations, or cannot integrate all your senses simultaneously, your sensory processing will be delayed. While sorting through all the jumbled sensations and piecing together all the details, the child’s processing is delayed and often overwhelming. When you are hypersensitive to stimulation and cannot adequately integrate your competing sensations, the brain becomes overwhelmed and panics easily. The person is always on “high alert”, anxious and insecure. This child can appear resistant and oppositional, and have a high need to control everything around him. When the brain starts to become overloaded, it may start to shutdown, blocking out stimulation to avoid being overwhelmed. The child may become glassy eyed or close his eyes and lie his head down. However, if the stimulation is coming in too much, and too fast, the child may meltdown (act out). Modulating Arousal Level Lastly, many children with sensory processing difficulties have trouble modulating their sensory input to stay aroused. They are either over-aroused and overwhelmed easily, or under-aroused and bouncing off the walls to increase stimulation to stay alert. They either filter out too much stimulation to stay alert (the hyperactive child), or not filter out enough stimulation and become overwhelmed by the stimulation coming in. For these children staying calm, organized, and alert is a difficult task for them. They may either be slow and sluggish, or fidgeting and moving constantly to stay alert. These children are often labeled hyperactive and have trouble concentrating. These individuals benefit from a sensory diet (discussed later in this chapter) to provide them “alerting” stimulation when under-aroused, and calming stimulation when over-aroused. An occupational therapist that specializes in sensory processing disorders will develop a list of sensory strategies for the child to engage in throughout the day, to keep him calm and organized. As you can see here, sensory processing issues can dominate the lives of many people on the spectrum. These issues can make the world chaotic, confusing, and very overwhelming. These differences can lead to a host of challenging behaviors (acting out, compulsive behaviors, self stimulation, oppositional/resistance, rigid inflexibility, etc.). These difficulties can be very overwhelming and taxing to the brain, living it drained and irritable. We need to be very aware and respectful of the individual’s sensory needs. This series on “sensory issues” can be found in the blue book, “Autism Discussion Page on the Core Challenges of Autism”.
Posted on: Sat, 17 Jan 2015 12:13:04 +0000
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