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Told from the STAR Perspective

Lisa M. Porter, OTD, OTR/L STAR Institute for Sensory Processing Disorder Faculty Owner & Director Sensory KIDS

Individual Differences in Autism:

Summary of a Scientific Revolution

Virginia Spielmann, MS OT Executive Director, STAR Institute for Sensory Processing Disorder DIR/Floortime Expert

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Foreword: Brief History of SPD Research

& Key Characters

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Chapter 1: Questions ASD & SPD

What is the Relationship?

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What is the relationship? • Two distinct disorders?

ASD SPD

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ASD SPD

What is the relationship? • Are the two disorders equivalent?

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Baranek, et al., 2006 Tomchek & Dunn, 2007 Schoen, et al., 2009

Sensory Processing

Dysfunction

Autism Spectrum Disorder

What is the relationship? • Do the majority of individuals with ASD have sensory processing differences?

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Sensory Processing

Dysfunction

Autism Spectrum Disorder • Sensory Modulation

• Sensory Over-responsivity • Proprioceptive Processing • Vestibular Processing • Interoceptive Processing • Motor Abnormalities • Visual Processing Chang, et al., 2014; Doumas,

McKenna, & Murphy, 2016; Garfinkel, 2016; Schaaf & Lane, 2014; Smith-Roley, Maillox, Parham, Schaaf, Lane, & Cermak, 2014; Stins & Emck, 2018

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Autism Spectrum Disorder

• Persistent deficits in social communication and social interactions

• Restricted, repetitive patterns of behavior, interests or activities (2 of following):

• Stereotyped repetitive motor movements • Insistence on sameness (inflexible routines) • Restricted interests with strong preoccupations with objects • Hyper- or hypo- reactivity to sensory input or unusual interest in

sensory aspects of the environment e.g., • indifference to pain/temperature • adverse response to specific sounds or textures • excessive smelling or touching of objects • visual fascination with lights or movements

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Chapter 2: ASD & SPD

Biological & Neurological Differences & Similarities

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The Sensory Challenge Protocol: A Laboratory Paradigm for Objective Measurement

• To assist in recruiting a homogenous sample • To evaluate differences between groups • Outcome measure?

2009

14

SPD Highest Reactivity: Baseline Arousal Significantly Decreased in ASD

SMD Highest Reactivity: Orienting Response

15

Schoen, et. al. 2009

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Schaaf, et al., 2010

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(Tavassoli, et al., 2018)

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SPD ASD

Empathy

Systemizing

Tavassoli, et al, 2018

Relation Between SPD and ASD

Higher empathy related to fewer sensory challenges

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Neurological Outcomes

2013

2014

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Owen, et al., NeuroImage: Clinical, 2013 Chang, et. al. Plos One, 2014

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A proposed visualization of Ayres Sensory Integration Hypothesis in autism spectrum disorders

Ayres Theories of Autism and Sensory Integration Revisited: What Contemporary Neuroscience Has to Say, Kilroy, E., Aziz-Zadeh, L. & Cermak, S. (2019)

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Ayres Theories of Autism and Sensory Integration Revisited: What Contemporary Neuroscience Has to Say, Kilroy, E., Aziz-Zadeh, L. & Cermak, S. (2019) • Sensory heterogeneity Current neuroscience evidence regarding: • Sensory registration • Sensory modulation • Motivation

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The Central challenge of autism research: What neurobiological alterations might affect social cognition and sensory perception?

● Sensory processing has recently been added as a core feature of the diagnostic criteria for autism12

● Atypical sensory experience is estimated to occur in as many as 90% of autistic individuals and to affect every sensory modality: taste, touch, audition, smell and vision3-11

● Should these sensory sensitivities be considered primary phenotypic markers? Or are they secondary consequences of domain-general neural mechanisms that affect both social processing and sensory processing?

Sensory Perception in Autism Robertson, C. & Baron-Cohen, S. (2017)

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Sensory Perception in Autism Robertson, C. & Baron-Cohen, S. (2017)

“Posits that sensory symptoms are core, primary characteristics of the neurobiology of autism. Specifically, sensory processing differences in autism are visible in early development, as early as infancy, and are predictive of diagnostic status later in childhood. … This conclusion marks a revolutionary shift in our conception of autism from its early diagnostic characterizations and calls into question modern ‘social brain’ theories, in which sensory defecits are hypothesized to be ephphenomenal to core defecits in social processing. Moving forward, neurobiological theories of autism must account for atypical processing in both social and sensory domains.” (pp 681)

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Chapter 3: Sensory Processing Dysfunction

& Social-emotional Disorders

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Shelly J. Lane, Stacey Reynolds, Levent Dumenci , 2012

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Baseline EDA

Response to Sensory Input

Total Anxiety

SOR Anxiety

Lane, Reynolds, & Dumenci 2012

Green, Hernandez, & Tottenham, 2015; Hannant, et al., 2016; Hannant, P., Cassidy, S., Tavassoli, T., and Mann, F. , 2016

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