BLOG #5H SENSORY CATEGORIES

4.         EP-ACTIVITY…  Enhanced Perception (EP) activity has emerged as the fourth proposed pattern of sensory response possibly unique to individuals with ASD in the Diagnostic and Statistical Manual of Mental Disorders-V (DSM-5). This DSM-5 version of the psychiatric manual is currently used by clinicians for the diagnosis of Autism Spectrum Disorders.

EP activity is characterized by sensory strengths in visual and auditory perception; plus, enhanced low-level discrimination or low-threshold detection, and hyper-systemizing cognitive styles. These powers could be enhanced motion perception, superior visual perception and/or auditory processing.

< My Thoughts >       “…These powers could be enhanced perception, as in the following intelligences –“

• Musical – become proficient without previous training or practice.
• Mathematical – intuitively develop calculations quickly & accurately without aids or devices.
• Kinesthetic/tactile – knowing and working on the exquisite details of machinery without prior knowledge.
• Spatial & pictorial – creation of 3-diamensional drawings, paintings, sculptures and memorization of maps & geography without first studying them.
• Linguistic – ability to understand, read, write, speak & translate multiple previously unknown languages quickly & accurately.

One way teachers are encouraged to present the school curriculum in the classroom, is by addressing the child’s learning styles or preferences. We design lesson plans to reach the basic learning styles of visual (sight), auditory (sound), tactile (touch), & kinesthetic (movement & doing). Added to that, personally I’ve found that students with musical interests tend to learn math concepts more easily. Although, it isn’t always easy to convince a Music Teacher to welcome Special Education students into their classes. Just saying. Smiles.

Hagmann, et al. (2016) believe that their visually enhanced perception may allow for searching superiority by individuals with autism, compared to their typically developing peers. The study found that this enhanced ‘local’ processing was related to both detection and discrimination abilities, including performance on visual search tasks. Persons with these powers of enhanced perception were better at detecting a target in an array of distracters which shared common features, or in disembedding figures quickly and efficiently.

< My Thoughts >       “…disembedding figures.”

When hearing about disembedded figures, my mind jumped to the game of ‘Finding Waldo’, or of finding the ‘Hidden Picture’ in the puzzles we love. And, the term ‘local processing, or ‘locally oriented’ brings to mind the idiom… “Can’t see the forest for the trees.” The person with EP will most likely uses their ‘local’ processing to immediately search out the tree. While their peers, without EP, using their ‘global’ processing to automatically see all the trees as a forest. Smiles.

Bouvet, et al. (2013) tell us that persons with enhanced auditory perception possess superior talents and abilities. An atypical pattern of expression resulting in being able to see enhanced perceptual patterns. These can be the discrimination of superior pitch among multiple musical examples. This ability allows for the person to recognize the differences in the increase and decrease in frequencies between two melodies. But, these individuals with superior perceptual processing are NOT always able to filter out auditory information from background noise.

< My Thoughts >       “NOT always able to filter out auditory information…”

So this may be like visual pattern discrimination of finding the dark purple letter among the solid black ones. Only, this is auditory pattern discrimination - finding the superior pitch among several melodies with partially 'pitchy' refrains. Smiles.

Baron-Cohen, et al. (2007) talk about the mathematical challenge of systemizing, and the drive to analyze and/or build a system of any kind. These authors say that those with a combination of autism and EP often become obsessed by analyzing and memorizing things such as: train tables, calendars, calendrical calculation, traffic systems, electrical light switches, collections of objects, especially spinning objects. And how for that reason, many of those with Asperger’s are often found excelling in domains such as mathematic, physics, and computer science.

They tell us that when Jacob Barnett’s parents enrolled him in school they were soon told to forget about sending him to school. That their son would never be able to learn anything, he had Asperger’s. But his parents and teachers eventually discovered that Jacob had a tremendous memory. This memory allowed him to attend university classes, after learning the entire high school curriculum in just two weeks.

At nine years old, he went to Purdue University where he worked on Einstein’s Theory of Relativity. He has an IQ over 170 – higher than Einstein’s, but because of Asperger's, still is troubled by tying his own shoes. He’s a charmer as one can see by watching his TED Talks on You Tube. (See credits in References under Barnett, below).

< My Thoughts >       Just an ‘aside’, for your information… Smiles.

Nader, et al. (2016) announces that the commonly given IQ test, the Wechsler Intelligence Scale for Children (WISC) doesn’t reveal any hidden intelligences an atypical child may have. Saying that Raven’s Progressive Matrices (RPM) scores have been reported as significantly, and sometimes even dramatically higher, than the Wechsler Full-scale IQ (FSIQ). And finally, that the new Wechsler Intelligence Scale for Children- IV Perceptual Reasoning Index (WISC-IV PRI) is better suited to capture autistics’ visual and abstract reasoning abilities.

Another form of Enhanced Perception, Meilleur, et al. (2015) say is perceptual reasoning. In their article, they are calling it perceptual peaks (PP) which they believe are frequent features of autism. The prevalence of perceptual peaks includes special isolated skills (SIS), which they report as the ability of having enhanced visual pattern detection and manipulation. Thus, believing that their developed strengths and/or talents are genetically defined modifications to affect perceptual encoding.

Happe, F., & Frith, U. (2011) found that autism and talent are often found to be synonymous. They suggest that detail-focused processing may be a “starting engine” for talent. The sensitivity to sensory information, attention to detail, and their systemizing ability, probably helps autistics with the ability to see multiple patterns at once. Plus, the enhanced skill of associating and linking that information together, is likely a key talent factor. These special skills in association with restricted and repetitive behaviors and interests emphasize their strengths to reduce ‘mentalizing’, or over-thinking input.

Little, et al. (2015) suggest that enhanced perception (EH) was found to support children’s participation in activities across contexts. These children reflected a unique processing style or an over-focus on detail which gave them advantages for perceiving and interpreting environmental stimuli with a super ability to complete puzzles or engage in extraordinary art activities.

Mottron, et al. (2006) propose that enhanced perception (EH) is a special ability of those persons whose brain regions typically allow for higher control over performance in certain areas. This, they say, is enhanced by exemplifying the restricted nature of the autistic interest, sometimes culminating in Savant Syndrome.

According to Treffert (2014), Savant Syndrome is not a new disorder, nor is it Autism. Hence, not all autistic persons are savants, and not all savants are autistic. Admittedly, savant skills do lie on a spectrum of abilities.

Most common are ‘splinter skill’ savants who have obsessive preoccupation with an remarkable need for memorization of music & sports trivia, birthdays, license plate numbers, historical facts, train or bus schedules; and remarkable navigation abilities of maps, for example.

Talented savants are those in who musical, artistic or other special abilities are more conspicuous. And prodigious savants have an extremely high threshold for special skills. They are often called a prodigy or genius.

Then Treffert, who studied savants throughout his lifetime, tells us there are the Acquired or Accidental Savants. Mr. Z, at age nine, after a bullet wound to the left brain produced muteness, deafness, and left-sided paralysis, demonstrated savant mechanical skills and traits.

A three-year-old child appeared to be a musical genius after a bout with meningitis. While an eight-year-old boy showed exceptional calendar calculating skills after a left brain hemispherectomy.

He tells of more instances of acquired savant syndrome after the person has had a blow to the head, been struck by lightning, or suffering from a cerebral stroke.

Thus raising the curious challenge – about the possibility that all of us have dormant savant capacity within us.

REFERENCES used here are:     
    
Barnett, J. (2018). Forget What You Know; TED Talk; http://sciencevibe.com/2018/01/30/autistic-teens-iq-higher-einstein-says-forget-know-videos/; and https://www.physics-astronomy.org/2017/12/autistic-teenager-with-higher-iq-than.html; Boy Genius on You Tube.

Baron-Cohen, S., Bor, D ., Billington, J., et al. (2007). The Assumption That all Human Minds are Wired the Same; Journal of Consciousness Studies; V14:9 &10, p237-251.

Bouvet, L., Mottron, L., Valdois, S., & Donnadieu, S. (2013). Auditory Stream Segregation in Autism Spectrum Disorder: Benefits & Downsides of Superior Perceptual Processes; Journal of Autism & Developmental Disorders; V46, p1553-1561.

Happe, F., & Frith, U. (2011). Autism & Talent, edited book by Clarke, P.; Oxford University Press; p242.

Little, L., Ausderau, K.,  Sideris, J., et al. (2015).  Activity Participation & Sensory Features Among Children with Autism Spectrum Disorders; Journal of Autism & Developmental Disorders; V45, p2981-2990.

Hagmann, C., et al. (2016). Children with Autism Detect Targets at Very Rapid Presentation Rates, with Similar Accuracy as Adults; Journal of Autism & Developmental Disorders; V46, p1762-1772.

Meilleur, A., Jeleic, P., Motton, L. (2015). Prevalence of Clinically & Empirically Defined Talents & Strengths in Autism; Journal of Autism & Developmental Disorders; V45, p1354-1367.

Mottron, L., Dawson, M., Soulieres, I., et al. (2006). Enhanced Perceptual Functioning in Autism: An Update, & Eight Principles of Autistic Perception; Journal of Autism & Developmental Disorders; V36, p27-43.

Nader, A.M., et al. (2016). Does WIX-IV Underestimate the Intelligence of Autistic Children?; Journal of Autism & Developmental Disorders; V46, p1582-1589.

Treffert, D. (2014). Savant Syndrome: Realities, Myths & Misconceptions. Journal of Autism & Developmental Disorders; V44, p564-571.
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Note: NEXT BLOG #5-I SENSORY PROFILE
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< My Thoughts >       What I am offering here is a powerful story which may capture in a moment, what it is like to have this experience. (Amazing combinations of ability & disability.)

Curious Incident of the Dog in the Night-time, by Mark Haddon; eBook 2003 Edition. An Extended Book Review with < My Thoughts  > by Sara Luker

Focused Excerpts from the book (2% indicates location in the Kindle version of the book, instead of page numbers.)

This story is a wonderful work of fiction about a 15 year old mathematically gifted Autistic boy. Author Mark Haddon tells us that Christopher was NOT a “15 year old savant…” but just very good at Maths. 

2%          My name is Christopher John Francis Boone. I know all the countries of the world and their capital cities and every prime number up to 7,057.

6%     I watched the sky as we drove toward the town center. It was a clear night and you could see the Milky Way. I have decided to give my story chapters’ prime numbers 2, 3, 5, 7, 11, 13, and so on because I like prime numbers.

This is how you work out what prime numbers are. First you write down all the positive whole numbers in the world. Then you take away all the numbers that are multiples of 2. Then you take away all the numbers that are multiples of 3. Then you take away all the numbers that are multiples of 4 and 5 and 6 and 7 and so on.
The numbers that are left are prime numbers.

< My Thoughts >             “…islands of genius…”

Treffert (2014) tells us that other central nervous system (CSN) disorders have some spectacular ‘islands of genius’ that stand in jarring juxtaposition to overall limitations.” Talents which are waiting to be tapped by recruitment, rewiring, and/or release. This may be genetic memory which is based on the fact that particular people “know things they’ve never learned.” That is, knowledge which had to be ‘factory installed’ and genetically transmitted; amazing combinations of ability and disability.

REFERENCES used here are:

Treffert, D. (2014). Savant Syndrome: Realities, Myths & Misconceptions. Journal of Autism & Developmental Disorders; V44, p564-571.
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< My Thoughts >       What I am offering here is a powerful story which may capture in a moment, what it is like to have this experience. (G/T & 2E students)
  
The Aspie Parent, the First Two Years A Collection of Posts from the Aspie Parent Blog by Liz Cademy, eBook 2013 Edition; an Extended Review with < My Thoughts > by Sara Luker

Focused Excerpts from the book (8% indicates location in the Kindle version of the book, instead of page numbers.)

< Short excerpt from Liz’s Alphabet Soup >
 
8% - 11%  Hello, before I get into any topics of substance, I thought I would ‘define my terms’, as the professor would say. And, if I use any other terms, I will define them in context in hopes of clarifying the meaning.
 
ALPHABET SOUP:
 
Aspie and AS – are both short for Asperger’s Syndrome, condition where the brain is wired differently than normal. In severe cases, this rewiring can cause autism. Most Aspies are able to be productive members of our modern world, even if seen as a bit quirky…
 
Gifted, GT – Lots of people with Asperger’s are smarter than average, either in a few areas or overall. The term Gifted refers to anyone of above average intelligence, and sometimes those with excellent visual learning pattern abilities. 
 
Twice Exceptional, 2E –  2E simply means a person is both Gifted and has some other issue, usually a learning difference such as AS (Autism Spectrum),  ADHD (Attention Deficit Hyperactivity Disorder), or similar.
 
She goes on to explain that some on the spectrum are described this way –

• May have a savant skill or strong talent.
• May be a self-taught reader (hyperlexic). Being hyperlexic is a syndrome characterized by an intense fascination with letters or numbers and an advanced reading ability.
• May be highly educated but will have had to struggle with social aspects of college. May have one or many partial degrees of this.
• Highly intelligent, yet sometimes can be slow to comprehend due to sensory and cognitive processing issues.

 
54%       Aspies tend to have slower processing speed than neurotypicals – we’re not less intelligent, we just think a bit slower. We need to be given time to think before being pressed for an answer.
 
< My Thoughts >             “…need think time before answering.”
 
Except with those things they are passionate about! Smiles.
 
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What I am offering here is a powerful story which may capture in a moment, what it is like to have this experience. (Answering Questions)
 
What Color is Monday?  How Autism Changed One Family for the Better by Carrie Cariello; eBook Edition 2015 with < My Thoughts > by Sara Luker
 
Focused Excerpts from the book (21% indicates location in the Kindle version of the book, instead of page numbers.)
 
21%       Jack’s limited working memory results in significant communication challenges. In his mind words are as slippery as falling snowflakes, and as quickly as he grabs hold of one idea, another one slides out of his cerebral grasp.
 
When he’s asked a question it’s as though he has to mentally bend down and retrieve that one idea out of many, re-examine it, and figure out if it’s what he needs. It takes him a while to answer.
 
< My Thoughts >             “It takes him a while to answer.”
 
“When he’s asked a question it’s as though he has to mentally bend down and retrieve that one idea out of many, re-examine it, and figure out if it’s what he needs. It takes him a while to answer.”  This so perfectly states what I think that many children on the autism spectrum go through. Some high-functioning autistics are literal thinkers. Literal boys like Jack. Smiles.
 
57%       Literal boys like Jack, boys who start looking around wildly for giraffes when their mother announces that the Walmart parking lot is a zoo!
 
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< My Thoughts >       What I am offering here is a powerful story which may capture in a moment, what it is like to have this experience. (Hyper-systemizing)
 
A Spot on the Wall by Martha Squaresky, eBook 2014 Edition; an Extended Review with < My Thoughts > by Sara Luker

Excerpts from the book – (14% indicates location in the Kindle version of the book, instead of page numbers).
 
14%       My husband Jay has a tremendous memory for numbers, and I speak Spanish and French. There is no question about our son Greg’s genetics. I remember events from the past with ease, and Jay adds long figures of numbers in his head. When we examine Greg’s idiosyncrasies, we find that both Jay and I possess many of those ourselves.
 
Autism affects Greg’s speech, hearing, touch, taste and smell. Too much of something mired his brain. As a toddler, the smell of chicken cooking made him cry. He screamed and resisted wearing a crinkly snow suit. We picked and chose our battles, because Greg outlasted us in everything.
 
< My Thoughts >       “…Too much of something mired his brain.”
 
Hughes et al. (2018) tell us that practice alone does not act as the only catalyst for talent to emerge. Talent can emerge from autism traits such as – attention to detail and hyper-systemizing, which could allow the increased detection of patterns. And, savant syndrome can co-occur with developmental conditions such as autism. Yet, they say, it is not clear why some with ASD develop savant skills while others do not.
 
REFERENCES used here are:
 
Hughes, J., Ward, J., Gruffydd, E., et al. (2018). Savant syndrome has a distinct psychological profile in autism; Molecular Autism, published online.
 
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< My Thoughts >       What I am offering here is a powerful story which may capture in a moment, what it is like to have this experience. (Spatial, pictorial, & linguistic EP)
 
The Journey to Normal: Our Family’s Life with Autism by I.D. Johnson, eBook 2014 Edition; with < My Thoughts > by Sara Luker

Focused Excerpts from the book (11% indicates location in the Kindle version of the book, instead of page numbers.)
 
11%       Despite the fact that the PALS (scores) showed that Sophie was behind in cognitive and linguistic skills, neither of the professionals mentioned during this initial evaluation that they felt that she may be autistic.
 
12%       Let’s face it, it’s a lot easier to get along in this world if you can speak and understand verbal communication. So, why would I want my child to try to navigate in life without those basic skills? 
 
Of course I want her to continue to have all the amazing gifts she has. Sophie is extremely gifted in many areas, especially when it comes to math and spatial reasoning. I’ve literally watched in amazement as she has put together complicated puzzles quickly, just by glancing at the shape of the piece she needs next…she doesn’t even need a picture.
 
< My Thoughts >             “I’ve literally watched in amazement as she has put together complicated puzzles quickly…she doesn’t even need a picture.”
 
Surprising talents and strengths are reported in studies of Meilleur (2015), state the prevalence of Special Isolated Skills (SIS). These are exceptional strengths or talents which appear suddenly, are somewhat of a mystery. Having SIS may be dependent upon exposure and materials available in the child’s environment. These strengths and talents also seem to increase with one’s age; and are more common in girls than boys with autism. Some SIS won’t surface until adolescence.
 
There also seems to be a genetic component, but some ‘performances’ may be the result of independent mechanisms. Mottron, one of the authors of this Meilleur study believes that this is explained by the way the brain allows for or approaches tasks. She calls this a “regional cerebral synaptic response”, or how plasticity in the brain reacts to the environment or to an event. Some authors on the subject refer to the appearance and prevalence of these talents and strengths as a sort of ‘adaptive functioning’. Lots to consider here. Smiles.
 
22%       The school psychologist who had performed Sophie’s autism evaluation suggested that we look into hyperlexia.
 
It is not a stand-alone diagnosis, but it was possible this was part of Sophie’s gift.
 
Hyperlexia is the opposite of dyslexia.  It has different forms, like all conditions, but it is generally characterized by an over-emphasis on a fascination with letters, letter sounds, numbers, reading, and the alphabet it general.
 
“This sounds like my daughter.” Unfortunately, very few people are familiar with hyperlexia and there is no “treatment” program for hyperlexia.
 
< My Thoughts >             “…very few people are familiar with hyperlexia.”
 
Hyperlexia is when a child’s natural ability to read is far above what is expected for that age level; usually without being taught. The trade-off is that the child often has difficulty with verbal skills and may even need to have everyday communication put in written form for better understanding. Some children are encouraged to follow a written ‘script’, in order to interact with others socially. Retrieved from: www.csld.org/HyperlexiaDefinition.htm.

Hyperlexia is the opposite of dyslexia.  Dyslexia is a learning disability that includes trouble spelling, reading and writing. Often, the words and letters may appear backward. This makes comprehension quite difficult.

REFERENCES used here are:
 
Meilleur, A., Jelenic, P., Mottron, L. (2015). Prevalence of Clinically & Empirically Defined Talents & Strengths in Autism. Journal of Autism & Developmental Disorders; V45, p1354-1367.
 
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Note: Next BLOG is #5J - SENSORY INTEGRATION

BLOG #5H SENSORY CATEGORIES

3. SIRS-ACTIVITY
                        c. Seeking Behavior
'Sensory seeking' behavior has its own criteria which is the ASD brain craving more sensory stimuli than what it is already getting. But, sensory ‘seeking behavior’ also includes ‘sensory avoidance’ behavior, as you will see.
 
Sensory Seeking Behavior –
Bogdashina & Casanova (2016) introduce us to  sensory ‘seeking behavior’ by saying that sometimes the brain just seeks more sensory stimuli, like when we feel more comfortable having ‘white noise’ in the room while we’re reading. Each person it seems has different thresholds for their sensory seeking needs.
 
The problem comes in when that 'need', or ‘sensory seeking’ leads to inattentive or overfocused behavior, due to the inability of the person to modulate their needs. They say that ‘sensory seeking’, ‘sensory craving’ are very common in autism. This can also seem to be influenced by the person’s high or low energy and/or activity levels.
 
Typical ‘sensory seeking’ behaviors, as these authors see it, are those seeking sensory input by twirling, chewing, and needing constant auditory input (sounds). In a play setting, the ‘sensory seeking’ child will choose to play roughly with nearby individuals.
 
Kranowitz (2006) gives examples of recognizable ‘sensory seeking’ behaviors –

• Splashing in mud, seeking types of play in dirt 
• Dumping toy bins rummaging through them aimlessly
• Chewing on objects or clothing
• Rubbing against walls or furniture and bumping into people
• Loves spinning in circles, amusement rides, and is constantly moving
• Fidgets, has difficulty sitting still and takes bold risks
• Frequently wants bear hugs and vigorous playground activities
• Seeks visually stimulating things, shiny objects, strobe lights, or sunlight
• Loves loud noises, TV or music volume, crowds and places with lots of action
• Problems sleeping
• Enjoys strong odors, even unattractive ones
• May lick or taste inedible objects and prefers spicy or hot foods
• Frequently attempt to engage in rough play, such as wrestling

She suggests that you begin by figuring out what your child craves. Brainstorm with another person who knows your child well (parent, grandparent, caregiver, etc.) so you have a long list. Your list may look something like this: 'blue things', 'ocean sounds', and 'funny faces'. Ask your child, siblings and your child’s friends and teachers what your child likes as well. Determine how you can engage in sensory integration to fit desired experiences into your child's routine.

Sensory ‘seeking behavior’ has its own criteria which also includes ‘sensory avoidance’ behavior. This behavior may preclude persons from a natural social interaction with others, because they tend to avoid some, but not all, of the following sensory experiences; according to Green, et al. (2016) –
 
Sensory Avoidance Behavior –
Tactile avoidance:

• Touching or getting too close to someone
• Being groomed or grooming self
• Going barefoot
• Being splashed with water
• Rubbing or scratching a spot that’s been touched

Taste/smell avoidance:

• Certain foods
• Certain tastes
• Certain textures or temperatures
• Covers mouth or won’t open it

Movement avoidance:

• Feet leaving the ground
• Heights
• Being tipped upside-down
• Holds on to things

Auditory avoidance

• Distracted by noise (near or far away)
• No background noise
• Doesn’t respond to name when s/he hears it called
• Covers ears

Visual avoidance

• Refuses eye contact
• Bothered by lights
• Concerned with a lot of movement
• Covers eyes

Green (2016) goes on to say that atypical responses to sensory stimuli are a new criterion in DSM-5, and using the Short Sensory Profile (SSP) is still acceptable, but that so many things remain to be seen about how to compare and affirm findings. As well as how these altered responses may impact function and participation in learning and daily living; or, how they may change over time.
 
Amanda Morin (2018) feels that most ‘sensory seekers’ are undersensitive (hyposensitive). They look for more sensory stimulation in order to make them feel less sluggish and more ‘in their bodies’ and ‘in their space’. They may stand too close, keep touching people or objects, like loud noises, and chew on whatever is handy.

Saying that there are also ‘sensory avoiding’ (hypersensitive) kids that experience sensory input more intensely.
 
They avoid it because it’s overwhelming to them. They may seem timid, be picky eaters, and be fussy about what they wear. They may be able to calm themselves down… or, may have many, many meltdowns, because they cannot cope with tactile, visual, taste, and noise sensitivity.
 
< My Thoughts >       “…fussy about what they wear.”
 
“Keep your clothes on until Mom or Dad tells you to take them off!” Smiles.
 
Morin continues, “It’s not always one or the other.” Some kids show a combination of the two reactions, both 'hyper' and 'hypo' reactivity. She says that responses can change based on their level of arousal or ability to self-regulate. That knowing your child’s reactions and triggers can help. Amanda Morin – classroom teacher and early intervention specialist.  www.everythingkidslearning.com
 
Mays, et al. (2011) tell us that it becomes critical for teachers to intervene and decrease or replace self-stimulatory behaviors so the student may attend to instruction and learn new skills.
 
Bobby’s teacher laments, “He is constantly rocking, flapping his hands, and hopping in his chair!” When a student is engaged in ‘stereotypy’, it can be difficult to gain his or her attention or engage him or her in a learning activity because of the reinforcing nature of the self-stimulatory behavior. Note: One of the defining characteristics of autism is the presence of ‘stereotypy’ behavior. This is a behavior, which when it is repetitive, does not appear to serve a purpose and appears inappropriate for the environment.
 
This teacher, Mays relates, one day decides to let Bobby jump on the trampoline before reading group. This helps, but still his rocking time is up to 30 minutes. She tries replacing the trampoline jumping with rocking in a rocking chair. This slower, more controlled movement works so well, she lets him sit in it and rock during reading group. He is now completing more assignments and participating in class activities more frequently without rocking.
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NOTE: Next time... 4. EP-ACTIVITY (Enhanced Perception).
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BLOG #5H SENSORY CATEGORIES

​3. SIRS-ACTIVITY
                        b. Repetitious Behavior – 
 
Raulston & Machalicek (2017) point out that within the repetitive behavior literature, there are generally two categories described – Lower-order: involving motor stereotypy like hand flapping, rocking, lining up toys, or flipping pages of a book; usually found in those very young children. Higher order: including obsessive preoccupation with odd interests and excessive question asking; usually found in those with advanced language skills.
 
Also, telling us that the latest edition of the Diagnostic & Statistical Manual of Mental Disorders – DSM-5, describes four areas of Restrictive & Repetitive Behaviors (RRB) to include:

1. Stereotypy – repetitively tapping or banging an object on a surface; clutching, spinning, rolling, moving, or placing objects in a stereotypical manner.
2. Insistence on sameness – inflexible adherence to routines or ritualized patterns of verbal (echolalia) or non-verbal behavior.
3. Perseverative interests – uncontrollable repetition of a word, phrase or gesture despite the absence or cessation of a stimulus. Insisting to continue an act or activity without purpose.
4. Hyper or hypo activity to sensory input or unusual interest in sensory aspects of the environment

They give an example of a child spinning only one wheel of a toy car very closely in front of his or her eyes, over and over again. Thus not engaging in a more appropriate imaginative play or including others; becoming physically aggressive if his or her preferred activity is interrupted or stopped. Parents included in this study commented that these kinds of repetitive behavior were the most difficult aspects of autism for them. And, that they felt higher levels of stress as a result of this behavior.
 
< My Thoughts >         “…four areas of Restrictive & Repetitive Behaviors in the newer DSM-5.”
 
One of the reasons clinicians say this is an important part of the newer DSM-5 is because it changes how they arrive at an accurate diagnosis for persons with autism.
 
The Centers for Disease Control & Prevention (CDC) put it this way –

• Stereotyped or repetitive motor movements
• Insistence on sameness, inflexible patterns.
• Highly restricted &  fixated interests of abnormal intensity
• HYPO (under) or HYPER (over) activity to sensory input

Based on social communication impairments & restricted, repetitive patterns of behavior as noted in the CDC website – https://www.cdc.gov/ncbddd/autism/hcp-dsm.html
 
In an Overview of Repetitive Behaviors in Autism, expert and parent, Lisa Jo Rudy tells us that repetitive, purposeless behaviors, like lining up toys, spinning objects, or opening and closing drawers or doors can become a problem when getting in the way of ordinary daily activities.
 
She tells us that the DSM-5 lists abnormal, intense focus on repetitive motor movement of objects, speech and highly restricted fixated interests, or preoccupation with unusual objects. Focus on such things as – ritualized patterns of verbal or nonverbal behavior, flipping objects, echolalia, and/or idiosyncratic phrases. As well as, insistence on sameness; or, inflexible adherence to routines, and extreme distress at small changes. Above text by Lisa Jo Rudy; retrieved from: https://www.verywellhealth.com/repetitive-behaviors-in-autism-260582
 
< My Thoughts >         “…focusing on things…”
 
Sonny is nonverbal, he makes sounds and laughs, but no language, so all of his repetitive behavior is nonverbal. We purposely give him ‘interactive’ toys so that he can engage in ‘purposeless behaviors’. “Wait, what?” My reasoning is that, much like the autistic child or adult who repeats video scripts as a type of communication, Sonny can use his ‘See and Say’ toy. Of course, this is where the perseverance comes in.
 
“Someone poisoned the waterhole!” “Someone poisoned the waterhole!”  “Someone poisoned the waterhole!”…  (Courtesy of Tom Hanks’ voice, Toy Story 3) Sometimes accompanied by Sonny’s laughter… and sometimes by his sounds of frustration if his juice cup is empty.
 
Pushing the same button, over and over and over, for no apparent reason, can make the listener crazy. But, we have taken a cue from Sonny’s playbook, and just tune out what we don’t want to hear. Or, in the case of some really irritating sounds or phrases we just make a slight adjustment to that ‘See and Say’ button. Sometimes, I laugh, move him over and start hitting the button that yells “HELP MEEEE! HELP MEEEE! Smiles.
 
What perseverating may look like would be for the child to continue to have an adverse reaction to a noise, an action, or some undesirable stimuli… long after that stimuli has ceased. They may be unable to bring themselves out of prolonged stimming, even though the stimming isn’t calming them.
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BLOG #5H SENSORY CATEGORIES
3. SIRS-ACTIVITY, a. Sensory Interests, continued –
                           (a.1.)  Self-Injurious Behavior
 
In the DSM-5, part of, and listed under Sensory Interests, is Self-Injurious Behavior (SIB). Thompson (2012) states that the most common emergent forms of self-injury are finger, hand, and wrist biting and hitting head with fists or against hard surfaces. Once self-injury becomes entrenched behavior, it is often difficult to eliminate.
 
A parent reports that there were periods that her son struck his head so hard and so often, it caused severe bruising on the back of his head. His only form of communication, as soon as she gave him what he wanted he stopped.
 
Often SIBS are found to be included in ‘Challenging Behavior’, or ‘Behavioral Disturbances’ instead of a stand-alone sensory issue. Soke et al. (2017) the reasons may be that studies find both environmental and biological factors have been implicated in studies of SIBs since 1977.
 
These authors say that generally SIBs are difficult to manage and may result in hospitalizations, exclusion from educational or vocational activities, admission to residential facilities, and even in death. They believe that previous studies are lacking and SIBs have been associated with everything from maternal smoking, sensory issues, gastrointestinal problems, aggression, insomnia, age and gender, severity of co-morbid behaviors; and everything in between.

Chezan et al. (2017) claim that SIBs is a relatively common problem behavior among children with Autism Spectrum Disorder (ASD). This review covers a broad category of problem behaviors, including verbal and physical aggression, property destruction, and tantrums. Severe SIBs require an intervention that is both effective and efficient.
 
Without effective interventions, they say, it can have a negative impact on children’s quality of life, limiting development and even leading to health-related problems. Interventions have the potential to prevent or reduce the frequency and severity of SIB, but if allowed to persist across time may continue until adolescence and adulthood.
 
Sicile-Kira  (2014) thinks that some children with autism participate in self-aggressive behavior because they could be in pain and don’t have any other way of communication this. She also has seen ASD persons self-injuring in the throes of a PTSD flashback.
 
She defines SIBs as hitting, biting, head banging, flicking fingers, or slapping oneself as a possible method of sensory seeking stimulation to relieve anxiety, pain, or frustration. Others believe that there is something missing in their diet or something they are getting in their diet that they should avoid.
 
Those lacking stimulation from their environment may seek it through self-abuse. Some self-abuse is in response to smells, being touched, auditory and visual overstimulation or under-stimulation. Still others believe medication can be found to counteract symptoms.
 
< My Thoughts >       “Others believe medication can be found to counteract symptoms.”

Some of the things that Sonny does, as a result of his autism, is self-injurious behavior (SIBs). With him, this seems to be compulsive, ritualistic, and some sort of stimulation or communication. This was before finding a method of communication and a therapeutic dosage of medication to help him, too. He would strike out to bite or hit himself and others. He would stick a finger in his eye, poking and poking until restrained. When Sonny is under medicated, stressed, and/or can’t get what he wants he will tantrum and bite himself until his needs are satisfied.

He has other undesirable and even dangerous behaviors, which I will not go into here. I’m sure you get the idea of how frightening this can be. The caveat with Sonny is that as well as sad or mad, he can and will often do this self-injurious behavior as a result of being happy and excited about something he’s thinking about or doing. So first, we must stop the risky behavior and then try to find out why. Smiles.

Bogdashina & Casanova (2016) believe self-stimulating behaviors can occur when autistic children are seeking control of their Autonomic Nervous System. One intervention can be a desensitization intervention of the affected areas performed by a qualified and experienced therapist. Another intervention can be exploring deep pressure, squeezing by cushions, or a weighted blanket may help.
 
They say that when excessive aggression, anxiety meltdowns and panic attacks occur, physical exercise like swinging, climbing, or pushing heavy objects relieve some people. Self-monitoring behavior and other coping mechanisms can be taught for less severe cases of SIBs, to help your child feel safe, trusting their environment.
 
Sarris (2012) tells parents that early symptoms of autism may be among the most puzzling. Some are barely noticeable, such as response to lights, heat, cold, or physical discomfort. Using their hands or body to manipulate things is not always seen as problematic behaviors.
 
 < My Thoughts >      “Some are barely noticeable…”
 
Sometimes the sensory response causing the self-injurious behavior is an attempt to fix what’s wrong. But often, they don’t know what is wrong or how to fix it. A child who bites themselves because they are too hot or too cold, doesn’t know that putting on or taking off a sweater can make them more comfortable. Of course, trying to get a sweater on or off, may be a challenge of its own! Sonny just reacts as if there is some sort of task assignment taking place. Smiles.
 
Sarris (2015) cautions that self-injury can persist into adolescence. Violent episodes of challenging repetitive behavior can lead to cuts, bruises, dental problems, and even broken bones, concussions, and detached retinas. She tells how frightening this is because it seems to violate our basic instinct of self-preservation. Those parents are deeply challenged to protect their offspring. They childproof their homes, buckle their seat belts, walk them to school, shielding them from outside harm. But she questions how they can protect them from themselves?
 
Wright (2018) believes that a behavior consultant is able to offer new insight for the entire family to digest and begin to shift the perspective needed to track and record behavior. An example would be – The family is concerned that Johnny seems to be an aggressive child, frequently hitting those in his environment. Through BEHCA data collection the behavior consultant is able to find that Johnny is NOT doing this on purpose but as a sensory response to his environment. He is also NOT aware of how hard he is hitting.
 
Taking this further, she says that perhaps Johnny’s behavior is due to his NOT knowing what his body is doing. He is lacking spatial awareness. Or, by slamming his body/arms into things or people, he is seeking sensory input. But, he is NOT intentionally trying to hurt anyone.
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BLOG #5H - SENSORY CATEGORIES
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3.         SIRS-ACTIVITY… (a. sensory interests, b. repetitious behavior, & c. seeking behavior).
 
Occupational therapists often observe that some children demonstrate extreme behaviors which have been labeled ‘sensory interests’, ‘repetitious’ behavior, and ‘sensory seeking’ behaviors; according to Kirby, et al (2015). Multiple types of behaviors, include – spinning, flapping hands while fixation on spinning objects, fascination with certain noises, interest in bright lights, moving objects, mouthing and smelling objects.
 
Therapists say that interestingly, 59% of children whom they have observed, did not display many expressions of enjoyment while engaging in sensory activity. Yet, finally considering that few conclusions can be drawn from this about what emotional associations children may have when participating in these sensory activities.
 
Ausderau, et al. (2014) believe that while for Diagnostic and Statistical Manual of Mental Disorders -5 (DSM-5) define sensory features uniquely and distinctly, they say that –
 
Their research suggests that certain patterns of HYPO & HYPER activity can co-occur within individuals in reaction to stimulus from the environment. Saying that within each sensory pattern there are underlying concepts. For instance, SIRS activity is characterized by fascination with or craving the sensory stimulation such as with flickering lights or rubbing textures. And, movement, especially jumping up and down, as on a trampoline.
 
Depriving a person of engaging in intense repetitive behaviors, experts expect may increase anxiety, and depression. This may even cause separation anxiety. Cautioning that those with higher ‘sensory seeking needs’ will often disengage from the behavior more slowly.
 
< My Thoughts >       “…within each sensory pattern there are underlying concepts.”
 
These are thoughts I have gathered while pursuing information about ‘sensory activity’ on gossamer wings. Smiles. Sensory activity is considered to be part of:

• A biological process
• ‘Attentional’ disengagement, of sorts
• Weak stimulus, creating a strong reaction, and/or
• Strong stimulus, creating a weak reaction
• Feelings of being overwhelmed by irrelevant stimuli
• Change in brain activity, topography, and function

Wigham, et al. (2015) say indications are that intolerance of uncertainty plays an important role in sensory activity. That sensory activity can be ‘heightened and unpleasant’ and/or ‘reduced and under responsive’, alternately. And, that the same modalities can be fluctuating within the individual at any time.

Kirby, et al. (2015) states that a personal account by Naoki Higashida (2013) corroborates an positive affect association of sensory behaviors – “in his book, The Reason I Jump” is because when I jump, it feels so good.”

REFERENCES used here are:

Ausderau, K., Sideris, J., Furlong, M., et al. (2014). National Survey of Sensory Features in Children with ASD: Factor Structure of the Sensory Experience Questionnaire; Journal of Autism Developmental Disorders; V44, p915–925.

Kirby, A., Little, L., Schultz, B., Baranek, G., (2015). Observational Characterization of Sensory Interests, Repetitions, and Seeking Behaviors; American Journal of Occupational Therapists; V69:3, published online.

Wigham, S., Rodgers, J., South, M., McConachie, H., Freeston, M. (2015). The interplay Between Sensory Processing Abnormalities, Intolerance of Uncertainty, Anxiety & Restricted & Repetitive Behaviors in Autism Spectrum Disorder; Journal of Autism & Developmental Disorders; V45:4, p943-952.
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< My Thoughts >       What I am offering here is a powerful story which may capture in a moment, what it is like to have this experience.
 
Ido in Autismland: Climbing Out of Autism's Silent Prison by Ido Kedar, eBook 2012 Edition; an Extended Review with < My Thoughts > by Sara Luker

(7% indicates location in the Kindle version of the book, instead of page numbers.)
 
7%       Ido (pronounced – ee-doh), a 15 year old boy, explains: Imagine being unable to communicate because you have a body that doesn’t listen to your thoughts. Imagine living in a body that paces or flaps hands or twirls ribbons when your mind wants it to be still or, freezes when your mind pleads with it to react.
 
8%       On the outside, the scream came out through his hands, vigorously flapping at the wrists. This was quickly redirected with the command, “Hands quiet.” He was trapped.
 
< My Thoughts >        “…the scream came out through his hands…”
 
Eventually, because his mother never gave up, Ido learned to communicate through those ‘screaming’ hands onto a letterboard created by Soma Mukhapadhyay. This, he says – “lifted him from darkness.”
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According to Ausderau, et al. (2014), there are four sensory response categories, or sensory patterns. This is about the second one they discussed in their study, Hyper-Activity. 
​
2.         HYPER-ACTIVITY…  (overactive), is defined by an exaggerated or avoidant response to sensory stimuli.

Bogdashina & Casanova (2016) describe HYPER-Activity as the channel that is too open, and as a result, too much stimulation gets in for the brain to handle. Continuing to say that children with hyper-activity often ‘stim’ in order to try to normalize their sensory input.

Sometimes they rock, spin, flap, or tap in order to calm themselves. Coping with unwanted stimulation can often result in covering eyes or ears and making noises to block out sensory stimulation.
 
These authors explain that Hyper-activity is said to be an acute, heightened, or excessive sensitivity to what is going on around in the environment. Under florescent lights such children can see a 60-cycle flickering where the whole room pulsates, as a result. One person said, “My world was fragmented. My mother was a smell, my father a tone, my brother was something moving.” Another said, “I remember being attracted to pieces of people’s faces. Their hair, their, eyes, or their teeth attracted me.” Seeing parts instead of wholes, saying  perception is often fragmented, distorted, or delayed.
 
< My Thoughts >       “perception is often fragmented, distorted, or delayed.”
 
Phelan (2015) further explains the circumstances of one’s perception. She says that upon hearing a dog bark, many of us pay attention briefly then carry on. But a child having a negative experience with dogs may respond with a startle response, feeling anxious until s/he feels assured they are out of harm’s way. For some with sensory issues, that heightened state of alertness will continue throughout the day.
 
Bogdashina & Casanova continue, quoting Tito Muknopadhyay who describes his hyper excitable state: “Panic took over my eyes, blinding them shut. It took over my ears, deafening me with the sound of a scream which was my own. I had no power to stop it.”
 
< My Thoughts >       “Coping with unwanted stimulation can often result in covering eyes or ears…”
 
Ausderau, et al. (2014)believe that while for Diagnostic and Statistical Manual of Mental Disorders -5 (DSM-5) define sensory features uniquely and distinctly, they say that –
 
Research suggests that certain patterns of HYPO & HYPER activity can co-occur within individuals in reaction to stimulus from the environment.
 
Donkers, et al. (2015) talk about ‘mismatched’ reactions to environmental stimulus. They say that brain response can cause them to cover their ears because it triggers a memory, not necessarily because the sound is extremely loud and painful.
 
Neil, et al. (2017) remind us that it is important to choose which behaviors are HYPO and which are HYPER, because measuring and labeling is important to provide funds for various services from insurance companies. This may not optimally account for the full range of sensory symptoms the child is experiencing. For instance, the question may be… “Does your child show an unusual response to…”. The scoring does not divide hypo from hyper responsiveness. Then there is our Sonny who reacts the same for ‘happy’, ‘sad, and ‘mad’! Smiles.
 
REFERENCES used here are:
 
Ausderau, K., Sideris, J., Furlong, M., et al. (2014). National Survey of Sensory Features in Children with ASD: Factor Structure of the Sensory Experience Questionnaire; Journal of Autism Developmental Disorders; V44, p915–925.
 
Bogdashina, O. & Casanova, M.(2016). Sensory Perceptual Issues in Autism and Asperger Syndrome, Different Sensory Experiences – Different Perceptual Worlds; Second Edition: London; Philadelphia: Jessica Kingsley Publishers.
 
Donkers, F., Schiput, S., Baranek, G., et al. (2015). Attenuated Auditory Event-Related Potentials & Associations with Atypical Sensory Response Patterns in Children with Autism; Journal of Autism Developmental Disorders; V45, p506–523.
 
Neil, L., Green D., Pellicano, E. (2017) The Psychometric Properties of a New Measure of Sensory Behaviors in Autistic Children; Journal of Autism Developmental Disorders; V47, p1261–1268.
 
Phelan, S. (2015). Understanding the Subtypes of Sensory Processing Disorder; Retrieved from
nspt4kids.com › Resourses > Occupational Therapy.
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NOTE: Stories which may reveal real-time evidence of Sensory Issues ~
 
Someone I’m With Has Autism by Carrie Cariello & Jordan Capell, eBook 2015 Edition; an Extended Review with < My Thoughts > by Sara Luker
 
Extended Review with < My Thoughts > by Sara Luker (18% indicates location in the Kindle version of the book, instead of page numbers.)
 
18%       Jack has common self stimulation practices include things like hand-flapping and humming.  He tends to gallop across the room with his fingers in his mouth and to grunt or loudly clear his throat.  We call it his “zoomies.”
 
31%       “But wait,” Rose said with a  worried look. “What if Jack, you know, bounces around? Because of his owt-ism?” Charlie added quietly, “Yeah mom. You know, he has a hard time sitting still. What if he has his zoomies?” “Jack do you need to zoom?” “NO! I WAS STILL!”
 
We all looked over at him, galloping across the kitchen at that very second. Henry leaped up from his seat and joined his big brother. Together they bounced the span of the kitchen and family room, back and forth, back and forth.
 
52%       “Mom, remember last year at your sister’s party how excited Jack was? He was bouncing from room to room, making his way around the guests as he stimmed and zoomed. Every once in a while he would take his fingers out of his mouth long enough to screech about the dogs getting out.”
 
“Yes, I watch him every day through the school bus windows, stimming and zooming, eventually taking a seat. By himself.”
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BLOG #5H - SENSORY CATEGORIES, (including  #5H - 1. HYPO-ACTIVITY)
 
According to Ausderau, et al. (2014), there are four sensory response categories, or sensory patterns. They are –

1. HYPO (under active), considered a lack of or delayed response to sensory input, or even lack of orienting to loud sounds and slow to react to pain.

​2. HYPER (over active), is defined by an exaggerated or avoidant response to sensory stimuli. Such as discomfort to grooming (dressing) activities, covering ears in response to sounds.

3. SIRS (sensory interests, repetitious & seeking behavior), is characterized by fascination with or craving the sensory stimulation as with flickering lights or rubbing textures.

4. EP (enhanced perception) has emerged as the fourth pattern of sensory response possibly unique to individuals with ASD. EP is characterized by strengths in locally oriented visual and auditory perception and enhanced low-level discrimination or low threshold detection and hyper-systemizing cognitive styles.

< My Thoughts >    "...four sensory response categories, or sensory patterns."

The four 'sensory response' categories/patterns, according to Ausderau, et al. (2014), are Hypo-Activity, Hyper-Activity, SIRS (Sensory Interests), EP (Enhanced Perception). My attempt here is to understand them one at a time, starting with BLOG #5H - 1. Hypo-Activity.

1.         HYPO-ACTIVITY… (under active), Ausderau finds that the brain is deprived because too little stimulation gets in and the channel is not open enough. The sensory system is under-responsive. Or, the normal processing of smells, sights, sounds, touch, and movement is dulled, under-developed, or processing the stimuli incorrectly.
 
Always on the move… frequently twirling, spinning, running round & round. Attracted to lights. Rocks back & forth when watching TV. Likes to look at things upside down. No safety awareness. Jumps off furniture & high places; loves the trampoline. Often sudden outbursts of self abuse. Easily vomits from excessive movements. Has difficulty changing body position. Shuts out the world when engaged in body movements. Thinks in movements.
 
Has low muscle tone, weak grasp, drops things. Doesn’t feel hunger. Likes to lean on things & people. Bites & sucks on fingers & hands. Chews on things, grinds teeth. Hits, bumps & pushes others. Enjoys crashing into things. Intentionally falls on the floor. Engages in ritualistic body movements when frustrated or bored. Watches feet when walking & hands when doing something. Talks about non-existent experience… “I am flying…”.
 
Sabatos-DeVito, et al. (2016) explain that hypo-responsive behaviors are particularly associated with autism and have been reported as early as 9-12 months of age. They also point out that hypo-responsive children may be less sensitive to novelty, thus taking longer to notice and process ‘novelty’ in the environment.
 
< My Thoughts >       “…taking longer to notice and process ‘novelty’ in the environment.”
 
To better understand why taking longer to notice and process ‘novelty’ in the environment can become a critical issue, here is a quote from Evans, et al. (2012) – “Children scoring high on ‘novelty’ awareness tend to be more social, can control impulses, and are better able to comply with tasks they are given.”
 
As you can see, the hypo-responsive child doesn’t recognize that this ‘novelty’ may be something new and fascinating in their environment. Without being able to peak the child’s interest, the parent, teacher, or clinician will have difficulty finding a teachable moment which can bring the child closer to learning. My own son becomes so fixed on what he is looking at that he refuses to disengage long enough to see a new toy or puzzle. Then when he finally responds, maybe hours later, he gives it the ole periphery look, out of the corner of his eye as he passes by. Smiles.
 
REFERENCES used here are:           
 
Ausderau, K., Sideris, J., Furlong, M., et al. (2014). National Survey of Sensory Features in Children with ASD: Factor Structure of the Sensory Experience Questionnaire; Journal of Autism Developmental Disorders; V44, p915–925.
 
Evans, C., Nelson, L., Porter,C. (2012). Making Sense of Their World: Sensory Reactivity & Novelty Awareness as Aspects of Temperament & Correlates of Social Behaviors in Early Childhood; Journal of Infant & Child Development; V21, p503-520.
 
Sabatos-DeVito, et al. (2016). Eye Tracking Reveals Impaired Attentional Disengagement Associated with Sensory Response Patterns in Children with Autism; Journal of Autism Developmental Disorders; V46, p1319–1333.
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POSTER sayings…
Clockwise @ 12 o’clock, starting with –

• I can be sensitive to loud noises
• I don’t like to brush, wash, or cut my hair
• I like to smell people & objects, sometimes
• I don’t like tags on my clothes
• I don’t like to wear clothes
• I enjoy being squeezed, I like pressure
• I don’t want my hands dirty
• I have poor fine motor skills
• I get overstimulated & meltdown
• I get fearful & anxious sometimes
• I overreact to minor scrapes & cuts
• I cling to adults I trust
• I sometimes walk on my toes
• Poor body awareness
• I crave fast spinning
• I lose my balance
• I like wearing the same clothes
• Sometimes I don’t like to be touched
• I have poor gross motor skills
• Can be clumsy & fall over things sometimes
• I am a picky eater
• Some smells really bother me
• I don’t like bright lights
• I don’t like to brush my teeth

Part 7 BLOG #5G Sensory Response
​Know Your Child: 
Bogdashina & Casanova (2016) give examples which are often reported by those with sensory issues may be… unable to tolerate smells from the lunch room, or intolerance for noise such as that of other children or fireworks/vacuum cleaners, being unable to move without fear or feeling nauseous, clothes that are intolerable, craving bumping and crashing into things/people.
 
Or, perhaps the opposite is observed where the child does not seem cuddly or recognize when they are hurt, does not seem to hear auditory information, or will not sit still. Often one may hear this being described as being over-reactive or under-reactive to eat, drink, and learn new skills.
 
Sensory Reactivity definition
 
Important here is that sensory reactivity is a Diagnostic & Statistical Manual of Mental Disorders, Fifth Edition, 2013 (DSM-5) criterion for autism spectrum disorder (ASD). The Sensory System Modalities are Auditory (what we hear), Visual (what we see), Tactile (what we feel or touch), Gustatory/olfactory (taste & smell) and Vestibular/propriceptive (sensory signals from ears & eyes which affect body movement & balance).
 
Tavassoli, et al. (2015) help clarify between the two terms – Sensory Reactive and Sensory Responsive. In their article, they clarify the term Sensory Reactive is more consistent with the DSM-5 language. As in the new DSM-5, Sensory Reactivity is included in the criteria for Autism Spectrum Disorder specifications.
 
Specifically, hyper or hypo reactivity to sensory input or unusual interest in sensory aspects of the environment. While these authors feel there is a need for more objective direct clinical assessments, here is a list of some currently used by clinicians –

• Sensory Processing Scale Assessment (SPS)
• Sensory Integration & Praxis Tests (SIPT)
• Sensory Processing Assessment for Young Children (SPA)
• Tactile Defensiveness & Discrimination Test (TDDT-R)
• Infant Test of Sensory Functioning

​The Sensory Processing Scale Assessment (SPS) is described by Tavassoli, et al. as fifteen structured games which participants play as clinicians observe and note the behavior displayed as they perform these tasks. (See description below).
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Aggression, violence, challenging behavior –   Sensory Impairment
 
Aggression, violence, and other challenging behavior may really be signs of Sensory Issues. Denman, et al. (2016) say… Families of a child diagnosed with autism can find themselves trying to understand their child’s behavior while on the waiting list for ‘formal diagnosis.’ How this ‘parental making sense’ of behaviors affects parenting. Continuing saying that confusions can also occur with children who have insecure attachment patterns and sensory impairments.
 
Also that it is hard for parents to understand how a slight change in routine can cause a child to have a ‘meltdown’ in the middle of the street. At the same time, parents are concerned about the need to present a ‘positive identity’ to others; while allowing ‘face saving’ while around friends and family members.
 
< My Thoughts >       Uninformed society says, “Bad kid… bad parenting… or both.” Or as someone so appropriately stated… “He’s not giving me a bad time…”  “He’s having a bad time…”
 
 What I am offering here are powerful stories which may capture at this moment, what it is like to have this experience.
 
What Color is Monday? How Autism Changed One Family for the Better by Carrie Cariello, eBooks 2015 Edition; with < My Thoughts > by Sara Luker
 
Focused Excerpts from the book (13% indicates location in the Kindle version of the book, instead of page numbers.)
 
13%     We accepted the diagnosis and forged ahead, getting Jack into as many services as we could.  I do think in the back of our minds we both harbored the notion that he would outgrow this, that his symptoms would diminish and he would blossom into a typical child.
 
14%     Jack was very difficult that spring.  In his preschool back in Buffalo he’d started biting and kicking both kids and teachers, and everyone seemed at a loss as how to control his behavior.  At home he’d started to hit both Joe and I, and to get into mischief…
 
< My Thoughts >  “…he’d started to hit both Joe and I…”
 
Frea, et al. (2001), tell us that “…exhibiting extremely challenging behaviors can be improved with some sort of intact communication system which allows the child to express choices and preferences, in all settings.”
 
REFERENCES used here are:
 
Frea, W., Arnold, C., Vittimberga, G., Koegel, R. (2001). A Demonstration of the Effects of Augmentative Communication on the Extreme Aggressive Behavior of a Child With Autism Within an Integrated Preschool Setting; Journal of Positive Behavior Interventions; Vol.3:4, p194.
 
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Part 5 BLOG #5E Know Your Child: More About Law & Autism & Parenting and < My Thoughts > by Sara Luker
 
LIGHTING UP FAMILY LAW IN BLUE: AUTISM’S IMPACT ON THE FAMILY AND FAMILY COURTS
By:Ron Payne Ed. Note: This article was authored by Kimberly J. Byrd, Esq
 
Byrd (2018) tells us that parents often battle with the diagnosis of autism. Instead they may choose isolation from extended family and community. The unpredictability of their child’s behavior when experiencing episodes of ‘sensory overload’, ‘social issues’, ‘cognitive’ and ‘behavioral’ limitations.
 
Bogdashina & Casanova (2016) tell us that behaviors such as rocking, rhythmic head banging, spinning objects, or perimeter hugging in large spaces can be sensory perception issues.

​They go on to say that autism is often considered an ‘obsessional ritualistic behavior’ or unusual interest in their sensory environment. This results in the child heightened fascination with spinning objects, certain sounds, and or lights.
 
Excessive touching, or smelling objects, as well as other sensory behavior one might find normal with a blind person, can be early signs of sensory issues. Some researchers believe these are often early signs of autism in young children.
 
Retrieved from:  http://senseablekids.com/sensInt.html

Widely recognized is A. Jean Ayres' definition of sensory integration. "Sensory integration is the neurological process that organizes sensations from one's body and from the environment, and makes it possible to use the body to make adaptive responses within the environment.
 
To do this, the brain must register, select, interpret, compare, and associate sensory information in a flexible, constantly-changing pattern."

Simply said, sensory integration is the relatedness of one to others, one to their environment, and one's ability to adjust oneself to function within the environment with oneself, others, and objects within it.
 
According to Byrd (2018), researchers typically describe the parenting stress of children with autism as greater for both parents than for other disabilities. Also imposed upon the family are limits on career opportunities and the high likelihood that one or more parents need to remain in the home to care for the autistic child/adult.
 
< My Thoughts > A story to share…  Focused Excerpt from –
 
Making Peace with Autism: One Family’s Story of Struggle, Discovery & Unexpected Gifts by Susan Senator, eBook  2006 Edition; an Extended Review with < My Thoughts > by Sara Luker
 
Focused Excerpts from the book – (3% indicates location in the Kindle version of the book, instead of page numbers).
 
3%       We as a family are frequently hamstrung by Nat’s unpredictability, our plans held hostage by autism. We can never simply go to a concert, a movie, a friend’s party without first wondering, “Can Nat Handle it?”

Despite intensive schooling and our Herculean efforts, he still has tantrums, and even when he doesn’t, he can be just plain unpleasant, unhappy, or embarrassing in public.
 
5%       Having Nat has tested our marriage, forcing us to stick together even when we have been tempted to run. My husband Ned has had to adjust his career; he has chosen to be a family man rather than a company man.
 
He says he’s never looked back, and I believe him.
 
End of Focused Excerpt from the book.
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