Sensory Integration and ASD

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Sensory Integration and ASD

• Lorraine Ringland
• Clinical Specialist in Autism, Occupational
  Therapy

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This 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?

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The 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.

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Ineffective 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

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Sensory 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).

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Sensory Systems

• 7 Sensory Systems
• How Difficulties Present
• Tips for Parents

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7 Sensory Systems

• Body Position (Proprioception)
• Movement
• (Vestibular)
• Touch (Tactile)

• Sight (Visual)
• Taste (Gustatory)
• Sound (Auditory)
• Smell (Olfactory)

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PROPRIOCEPTION

• (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.

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Proprioception 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

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Proprioceptive 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.

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Over Sensitive Low Thresholds
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Under Sensitive - High Thresholds
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VESTIBULAR

• (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

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Vestibular exhibiting behaviours

• 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

• 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

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Tips 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.

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TACTILE

• (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)

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Tactile exhibiting behaviours

• Overly Sensitive
• Fussy
• Sensitive to textures
• Dislikes and avoids likes messy play
• Can react aggressively to
• anothers 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

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Tips 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.

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AUDITORY

• (Sound)
• Location inner ear stimulated by sound/air waves
• Function Provides information about sounds in
  the environment (loud, soft, high, low, near or
  far)

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Hearing 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

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Tips 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.

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VISUAL

• (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

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Visual 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

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Tips 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

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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)
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Taste 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.

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Tips 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 childs favoured
  scent on cotton wool / sleeve to help calm
• Use calming activities when the child is
  overwhelmed, i.e. proprioceptive activities

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Final Thoughts
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IMPORTANT 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

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Thank you for your Attention Any Questions?