Sensory Integration and ASD

Lorraine Ringland

Clinical Specialist in Autism, Occupational Therapy

Lorraine Ringland

Clinical Specialist in Autism, Occupational Therapy

This Talk Aims to ExplainThis Talk Aims to Explain

What is Sensory Integration? What is Sensory Integration Difficulties? What have they to do with Autism? How do Sensory Integration Difficulties

present and what parents can do?

The Concept of Sensory IntegrationThe Concept of Sensory Integration

Sensory Integration is the ability to take in, sort out, process and make use of information from the world around us.

Ineffective Sensory ProcessingIneffective Sensory Processing

Can effect one or more of sensory systems. Impacts upon ability to:

– Learning – Cope with daily demands and stress– Direct behaviour effectively

A comparison can be drawn to indigestion…

Sensory Processing Disorder and AutismSensory Processing Disorder and Autism

Literature indicates that 42% to 88% of children diagnosed with Autism will also experience sensory processing difficulties.

– (Baranek, 2002).

These children often have difficulty regulating responses to sensations and specific stimuli and may use self-stimulation to compensate for limited sensory input or to avoid overstimulation.

– (Roberts, King-Thomas, & Boccia, 2007; Schaaf & Nightlinger, 2007; Smith, Press, Koenig, & Kinnealey, 2005).

Behaviours such as stereotypic motor movements, aimless running, aggression, and self-injurious behaviours have been correlated with these sensory processing difficulties.

– (Case-Smith & Bryan, 1999; Dawson & Watling, 2000; Linderman & Stewart, 1999; Watling & Dietz, 2007).

• 7 Sensory Systems

• How Difficulties Present

• Tips for Parents

7 Sensory Systems7 Sensory Systems

Body Position (Proprioception)

Movement(Vestibular)

Touch (Tactile)

Sight (Visual)

Taste (Gustatory)

Sound (Auditory)

Smell (Olfactory)

PROPRIOCEPTIONPROPRIOCEPTION(Body awareness) Location: receptors located

in muscles and joints and is activated by muscle contraction

Function: provides information about where a body part is and how it is moving. Has a calming effect on the sensory system.

Proprioception – exhibiting behavioursProprioception – exhibiting behaviours

Heavy handed or footed Poor judgement and grading of movement Poor posture, frequently props head on

hands/table Bumps into things, falls frequently Tip toe walking Drops things frequently Tires easily Poor body awareness May chew on non-food objects or grinds teeth

Proprioceptive StrategiesProprioceptive Strategies

Tug of war games Heavy loads: encourage child to carry the shopping bags Wheelbarrow walking Arm/foot wrestling Trampolining Climbing frames Monkey bars

Please Note, when a child is overwhelmed / overactive, engaging them in activities which activate the Proprioceptive sense should help them to become more calm.

Over SensitiveOver Sensitive – Low ThresholdsOver SensitiveOver Sensitive – Low Thresholds

Under SensitiveUnder Sensitive - High ThresholdsUnder SensitiveUnder Sensitive - High Thresholds

VESTIBULARVESTIBULAR(Movement and balance) Location: receptors in the

inner ear, stimulated by head movements and input from other senses

Function: Provides information about where our body is in space, whether we are moving standing still and what speed and direction we are going

Vestibular – exhibiting behavioursVestibular – exhibiting behaviours

Overly Sensitive Poor tolerance to

movement Easily become dizzy when

changing body position Dislike tipping their head

back Overly fearful of heights May experience motion

sickness May move quite rigidly

Under Registering Seeks fast moving

activities Spins, rocks, bounces

and jumps excessively Always ‘on the go’ Enjoys being upside

down Slouches and leans,

unable to sit upright for long

Tips for Parents - VestibularTips for Parents - Vestibular

Extra proprioception or pressure helps a child feel more secure.

Encourage active child propelled movements rather than passive movement.

Fast movements with changes in direction are alerting, slow rhythmical movements tend to be calming and soothing

Try having your child complete some activities in different positions, e.g. lying on stomach to read.

Take small steps towards more challenging activities, break them down so that movement is minimalised.

TACTILETACTILE

(Touch)Location: receptors under

the skin Function: Provide

information to the brain regarding the environment or object (touch, pressure, texture, hard, soft, sharp, dull, heat, cold and pain)

Tactile – exhibiting behavioursTactile – exhibiting behavioursOverly Sensitive Fussy Sensitive to textures Dislikes and avoids likes

messy play Can react aggressively to

another’s touch Feels pain excessively Very sensitive to temperature

changes. Distressed at grooming

activities, e.g. brushing hair/teeth, cutting nails

Under Registering Responds only to firm touch Can invade space / be

overly tactile Can be heavy handed Grips objects too firmly Has difficulty responding to

pain/temperature. May be unaware of food

left in his mouth Frequently seeks the feel

of objects in his/her environment

Tips for Parents - TactileTips for Parents - Tactile

If your child is seeking out tactile experiences, feed them. If the child avoids tactile experiences, incorporate

proprioceptive tasks and consider the texture of toys, clothes, towels, etc.

Light touch can be irritating, firm and constant pressure organising

Remember self-initiated touch produces a less defensive reaction to the sensory system.

Avoid situations of close proximity to others Always watch for signs of overstimulation and discomfort,

remember that tactile experiences can be painful for some children.

AUDITORYAUDITORY

(Sound)Location: inner ear

stimulated by sound/air waves

Function: Provides information about sounds in the environment (loud, soft, high, low, near or far)

Hearing – exhibiting behavioursHearing – exhibiting behaviours

Overly Sensitive Reacts as though noise

levels are magnified Dislikes loud noise Is easily startled Engages in unusual

behaviours in noisy environments

Is anxious before expected noises (school bell)

Holds hands over ears Highly aware of all

environmental noises

Under Registering Enjoys really loud noise Fails to pick up expected

cues. Makes unusual noises

themselves Seek out irritable noises,

e.g. white noise May become more

engaged in noisier environments

Tips for ParentsTips for Parents

Prepare the child for noisy environments. Use headphones or ear defenders to ‘dampen

down’ the level of noise for the child. Teach your child strategies within noisy

environments, e.g. standing close to the door. Agree methods for your child to tell you there is

too much noise, e.g. token exchange, loud gauges or happy/sad faces.

Encourage the child to attend to sounds by playing games based on auditory cues, e.g. Simon Says.

VISUALVISUAL

(Sight)

Location: retina in the eye which is stimulated by light

Function: provides information about what we see in the environment and helps us define boundaries as move in space

Visual – exhibiting behavioursVisual – exhibiting behaviours

Difficulty finding what they are looking for unless the item is strongly motivating

Difficulty concentrating in a very bright, visually stimulating room

May become overly focused on visual detail

Advanced drawing skills String visual memory

Tips for ParentsTips for Parents

Reduce lighting, particularly when the child appears overwhelmed

Reduce the amount of visual distractions Be aware of visual challenges, e.g. copying

from a board, reading text Present work in visual blocks Remember it may be difficult for the child to

look at you and listen to you simultaneously

OLFACTORY and GUSTATORY

OLFACTORY and GUSTATORY

(Smell)

Location: chemical receptors in the nose (closely linked to the taste sense)

Function: Provides information about different types of smell (musty, acrid, putrid, flowery and pungent)

(Taste) Location: Chemical receptors in the tongue (closely linked with the smell sense) Function: Provides information about different types of taste (sweet, sour, bitter, salty, spicy)

Taste and Smell – presenting behavioursTaste and Smell – presenting behaviours

Overly Sensitive Dislikes strong tastes

prefers bland Tastes or smells objects,

clothes etc Likes consistent

temperature of food Over-reacts to common

smells Gags easily at subtle

smells

Under Registers Mouths and or smells non-

food items Craves strong tastes and

flavours Under-reacts to strong

smell, may seek them.

Tips for ParentsTips for Parents

Incorporate foods into messy play Introduce tastes in a fun way and expand on established

tastes Use calming scents or scents the child prefers, in small

amounts e.g. lavender etc Use scented stickers to assist in desensitising Allow the child to chew gum/suck hard sweet In environments with distinctive smells, e.g. canteen or

dentist, have the child’s favoured scent on cotton wool / sleeve to help calm

Use calming activities when the child is overwhelmed, i.e. proprioceptive activities

IMPORTANT POINTSIMPORTANT POINTS

When a child displays unacceptable behaviour consider an underlying sensory processing cause.

Acknowledge the difficulties children with sensory processing experience across contexts and how this affects their life skill development and academic readiness

Accentuate the positive and always offer understanding and support

Thank you for your Attention Any Questions?Thank you for your Attention Any Questions?