KNOW AUTISM, KNOW YOUR CHILD with < My Thoughts > by Sara Luker
UNIT 4 – When Is It Sensory?
INTRODUCTION
CHAPTER 1 – Sensory Issues
PART 1.
a. Sensory Defensiveness
b. Sensory Avoidance
APPENDIX A Sensory Processing Checklist
APPENDIX B ASD Sensory Profile
UNIT 4 – When Is It Sensory?
INTRODUCTION
CHAPTER 1 – Sensory Issues
PART 1.
a. Sensory Defensiveness
b. Sensory Avoidance
APPENDIX A Sensory Processing Checklist
APPENDIX B ASD Sensory Profile
POSTER sayings – Clockwise @ 12 o’clock SENSORY PROCESSING ISSUES –
KNOW AUTISM, KNOW YOUR CHILD with < My Thoughts > by Sara Luker
UNIT 4 – When Is It Sensory?
Introduction –
McNeill, C. (2020) maintains that humans have always been known to rely on the ‘five’ senses of touch, smell, taste, vision, and hearing to connect them with the surrounding world.
The latest Diagnostic & Statistical Manual of Mental Disorders, Fifth Edition,(DSM-5) now includes new criteria for diagnosing issues with ‘sensory’ experiences.
Bogdashina, O. (2011) believes that having a new sensory experience gives perception a new and different emphasis. Much like the same handful of sand being formed into different shifting patterns. She claims that we learn how to restructure sensory experiences, in order to reflect what ‘response’ is needed from us in the environment.
Those new sensory interpretations give us many different perspectives of reality, compared to ‘our own world view bubble’ we’ve formed around us. Therefore, a person’s ‘sensory experience needs’ can become very important to understanding and interpreting the behaviors, actions, or reactions we have to our surroundings. Also, it is important to discern whether children are receiving competing thoughts or competing sensory information from their surroundings. Knowing this could reveal any problematic ‘sensory issues’ which they may be having.
Note: See APPENDIX B below for an example of – Autism Spectrum Disorder Sensory Profile
Mazurek, M., Lu, F., et al. (2017) make known that the diagnostic classification of autism has changed substantially in the DSM-5. Now, along with criteria for the core symptoms of autism, there are tests and criteria to include rating a child’s bizarre ‘sensory’ responses to the environment.
Green, D., Chandler, S., et al. (2016) give greater distinction to atypical responses to sensory stimuli, in the DSM-5. Prior to this, ‘sensory’ experience issues were associated with high levels of anxiety, emotional disorders, and intellectual disability. New, diagnostic instruments look for unusual sensory interests, such as undue sensitivity to noise, and abnormal idiosyncratic responses to specific sensory stimuli.
< My Thoughts > “…diagnostic instruments look for…”
A child with unusual responses, not clearly identified as ‘sensory’ in origin, could ‘still’ understandably be treated as a child who is anxious, emotional, and/or mentally challenged. With the newer ‘sensory’ diagnostic criteria, comes the recognition that ‘sensory’ responses to loud noises, bright lights, hot rooms, or new socks can cause genuine episodes of discomfort, or meltdowns due to pain.
Note: See APPENDIX A below for Sensory Processing Disorder checklist.
CHAPTER 1 – SENSORY ISSUES
Miller, L. (2014) makes it known that many children and their families suffer needlessly for years because of sensory issues that could have been addressed if an experienced professional had determined that Sensory Processing Disorder was present and the child needed appropriate treatment.
The following are recognized assessment tools –
In addition, the Sensory Profile, Short Sensory Profile, and/or Sensory Processing Three Dimensions are screening instruments that are often completed by parents and teachers. They rate the child’s typical responses to specific sensory stimuli across 38 items, on a 5-point scale.
Note: See UNIT 4, Chapter 3, PART 2 Sensory Integration for more about Sensory Profile.
< My Thoughts > “…responses to specific sensory stimuli across 38 items…”
Perhaps this will be the first time that parents have made the connection between the strange and/or unwanted behaviors they are seeing with the many ‘sensory’ stimuli items listed in this screening assessment. For instance, behaviors with no purpose, like swaying back-and-forth, or, squirming away when being touched can now be considered from a different perspective, that of possible sensory issues.
Bogdashina, O. (2003) says there are many things that people with autism & ‘sensory issues’ often seek to avoid –
A person’s sensory needs can become very important to understand.
Note: External control for those with autism’s sensory needs may appear in ‘sensory defensive’ behaviors.
Our sensory perceptions overwhelm us. Imagine you were in a foreign & noisy city at night, not really understanding the language spoken, recognizing only a few words, but NOT really comprehending situations taking place around you, wanting to express a need for help, but not being able. Hearing of this experience may begin to help you relate to what a child with Autism feels on an ordinary day.
PART 1. SENSORY PROCESSING
a. Sensory Defensiveness
Sicile-Kira, C. (2014) says that some or all of our senses can be one hundred times more sensitive than normal. Therefore, they process the environment differently than they were meant to. More often now, it is being recognized that many people with autism have unrecognized ‘sensory’ processing challenges.
Staff Writer (2019) says that sensory defensiveness is important to understand. That each person develops his or her own set of behaviors. Sometimes, there are a combination of sensory processing behaviors. Symptoms may differ from mild, to moderate, to severe levels. The following are some types of defensive sensory processing behaviors.
Types of Sensory Defensiveness Behaviors –
These are ‘sensory’ reactions, NEVER thoughtful nor planned responses. Also, they are very complex issues. Any or all ‘sensory’ reactions can cause these undesirable behaviors. Keep in mind that sensory excitement can trigger ‘stimming’ like hand-flapping, head-banging, hair pulling, scratching or biting. This seems to break the sensory processing circuit, bringing relief.
< My Thoughts > “…bringing relief.”
Sensory Processing Integration Therapy, which often looks like, and may be called – ‘Play Therapy’, is designed to help by desensitizing defensive and avoidance behavior.
Note: See more in UNIT 4 Chapter 3 – Sensory Integration.
Elwin, M., Schroder, A., et al (2016) explain, in interesting remarks from participants in a sensory experience study, which they followed. Here are some of those remarks –
< My Thoughts > “…looking at speckled bits of quartz …”
Take Sonny into a jewelry store and he can be mesmerized for hours. Twinkling jewels, shiny rings and trinkets, plus the lighted cases and the soft music. He could stay there gazing for hours.
If Gardner, N. (2008) gives her son Dale so much as a single pea or slice of carrot, he would protest by vomiting at will.
Johnson, I. (2014) allows that their current district has no autism unit so daughter Sophie would be placed in a general education kindergarten classroom with special education support. “This is exactly what I had been hoping for her all along.”
I wanted Sophie to have the opportunity to demonstrate what she was capable of to be given the chance to learn from her non-disabled peers, and to have the same experiences any other child is given. If she couldn’t do it, then we would weigh our options. I wholeheartedly believed that Sophie would be successful in a general education kindergarten.
But, Sophie started off by “tasting” a few of her friends. Pretty quickly, it was determined by the school psychologist that this was a ‘sensory’ issue, not Sophie intentionally harming others. There seemed to be a lot of evidence pointing toward a ‘sensory’ disorder, which may have actually been the major issue all along. In fact, some of the experts on her team thought that it could be sensory integration disorder and not autism causing Sophie’s differences.
< My Thoughts > “Sophie started off by “tasting” a few of her friends.”
As a new inexperienced special education teacher, I sat at a classroom table next to an eight-year-old boy. Starting the lesson, I reached in front of him to pick up something we needed. As I did, he reached for me, pulling a handful of my underarm into his mouth, tightly closing his jaw. He didn’t break the skin, but that bite mark was there for a whole month! Knowing nothing about ‘sensory defensive’ issues at the time, I only knew how risky it could be to unexpectedly lean over into a child’s space.
Reguero de Atiles, J., Stegelin, D., et al. (1997) caution parents that children biting other children is a common and difficult consequence of group child care. They go on to say that there are four areas of represented research concerning this – Incidences of biting, reasons for biting, reactions to biting, and coping with biting behaviors. Some children, they believe appear to become overstimulated, biting when other children are close. Incidences can be distinguished between basic immaturity and a possible sensory integration dysfunction.
Reasons for biting behavior can be due to frustration, lack of communication abilities, sensory reaction, a form of imitation, teething, or just curiosity. Others believe that it may be a natural response to frustration of demands, an attempt to make things happen more quickly, a reaction to discomfort, or a simple lack of self-control.
Cariello, C. (2015) accepted the diagnosis and forged ahead, getting their autistic son 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.
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 to how to control his behavior. At home he’d started to hit both Joe and I, and to get into mischief.
Borutta, R. (2015), in human bodies the most important rhythms are in our heart and brain. Other organs establish their own rhythms to provide for respiration, locomotion, digestion, and other functions necessary for life to continue. A finely tuned system which goes mostly unobserved until illness or trauma temporarily upset that balance. And, traumatic inductions can result in behavior changes, sleep disruption, and symptoms resembling post-traumatic stress disorder (PTSD).
< My Thoughts > “…resembling post-traumatic stress disorder.”
Stress can also be caused by repetitive upsetting thoughts, or symptoms and flashbacks like those in Post Traumatic Stress Disorder (PTSD). Often, comorbid with autism is Obsessive Compulsive Disorder (OCD) causing individuals additional ritualistic behavior. Thus, repetitive, ritualistic thoughts become even more severely disruptive and anxiety producing.
Cariello, C. (2015) recalls that on January 2011, seven-year-old Jack’s behavior started to change more dramatically. Her son was afraid of ordinary things. From concern over peeing in the morning, to showering at night, every move had become a slow torturous crawl through the muddy waters of his anxiety.
Medication seemed like a last resort to us, so Joe and I resolved to explore alternative methods to help Jack cope. We couldn’t imagine having him taking anti-anxiety medicine every single day, potentially for the rest of his life.
For a month, the occupational therapist ‘brushed’ him at school and Joe and I took turns at home. This sensory ‘brushing’ technique is called the Wilbarger Protocol. It is designed to reduce sensory defensiveness by using a small brush to apply pressure on the limbs and back.
These three long months took a toll on our family. As a mother, I have never felt so fragile. I was scared that Jack would never get better, that I would never again see the happy little boy who had disappeared underneath this layer of distress.
Yau, A. (2012) thinks that if your child is one of those children who is always banging on things, it may be that he/she is (under) ‘hypo-sensitive’ to noise, and needs to bang on things to stimulate that sense.
If your child is always on the move and likes to spin, it may be their ‘vestibular’ system is hypo-sensitive and they are seeking out those sensory inputs which meet their sensory needs. Some people with autism even report being alternately ‘hyper-‘ and ‘hypo-‘ sensitive at different times. They are unable to hear something one minute and the next minute almost being deafened by the same sound and found covering their ears.
Davide-Rivera, J. (2013) divulges – I had two responses to my father’s violence; a withdrawal and calm, or a violent fighting back; that’s when I noticed my hypo-sensitivity to pain. If I withdrew into myself, I felt no pain.
Marks, S. (2012) tells us – My name is Paula. I am 38 years old, dark curly hair, bright green eyes. I have tiny, slender feet and I am very short. I am non-verbal. I look like other people you meet. I love to laugh and I often pray. I am autistic. I have Asperger’s. You may not know what that means to be me. It is my hope that if I share with you some of my secrets, you will get to know me and my autism better.
When I was small, I would bang my head and bang my head; over and over. I know there are lots of theories about self-stimulation. Why to choose a self-stimulation action that hurts? Because behaviors do not always stem from anger. They can stem from sadness, fear and despair. They can stem from a desire to escape a hurtful situation.
Click clack. Click clack. I love trains. I love the click clack. I love the repetition. I love the predictability. I know what to expect. Click clack, click clack, coming down the tracks. When I was a child, I could not find a way to stay in control. I will let you see a few of my days through my eyes.
A Day – A baby cried today while we were at the store. That is a sound I cannot handle. When will someone figure it out? I am eight and I cannot speak to tell them. Just get me away. That is what I need. Why can’t they figure it out? I lost control and screamed. They called it a temper tantrum. Really it was a baby crying. Click clack. Click clack. Click clack.
A Day – Click clack, click clack. It is my mental rocking. Even my closest friends and family have never figured that out. Listening to trains relaxes me. Click clack. Click clack. Click clack.
A Day – Well, there are times when I will scratch and scratch until I break the skin. It feels good at first and then it starts to hurt. Someone out there, help me to understand. Someone who feels the same way I do, NOT someone with a theory. Click clack. Click clack. Click clack
< My Thoughts > “…Someone out there help me to understand.”
Living life with a lot of sensory issues, along with the added problem of not being accepted, can seem that no one understands how hurtful life can become. Someone should recognize this is a response to something awful going on, either in the environment or within the person. Along with the strong impulse to ‘do something’, self-stimulation may happen to offset an internal pain or ‘perceived pain’ that a person is experiencing.
According to Rattaz, C., Michelon, C., et al. (2015), recent studies show that – Self-Injurious Behaviors (SIBs) were frequently associated with other challenging behaviors like irritability, stereotypy, hyperactivity, and impulsivity.” They go on to say that, abnormal sensory processing was also found to be a strong predictor of self-injury, and impaired social functioning.
This study found that there was no difference between risk factors in regards to gender, or associated medical conditions such as epilepsy, or an association with SIBs. Also, there was no correlation between risk factors such as parents’ age or socio-economic status. There was however, a correlation between a higher Childhood Autism Rating Scale (CARS) score and higher ‘risk of SIBs’ during adolescence.
Note: See more about Self-Injurious Behaviors (SIBs), in UNIT 4 Chapter 2 Sensory Categories.
Wetherby, S., Woods, J., et al. (2018) worry that there is a negative social effect of Restrictive Repetitive Behavior (RRB) which may interfere with necessary ‘receptive’ and ‘expressive’ language. This may also affect visual reception, stopping active engagement and age-appropriate developmental trajectories.
< My Thoughts > “…developmental trajectories.”
Also, an abundance of sensory issues may be affecting ‘developmental trajectories’. This interference may have more influence on a person’s development than was previously understood. And, may even be one of the reasons why ‘Sensory Issues’ are now featured more prominently in the latest edition of the DSM-5.
Rubin, E. (2016) reveals that 16-year-old Sam’s Individualized Education Program (IEP) objectives were shifted from those for passive responses throughout the day, to requesting preferred actions from others (e.g., "high five" for happy). After completing a task, he could choose a preferred ‘sensory’ activity, such as a head massage, a back rub, or tickling.
< My Thoughts > “…he could choose a preferred ‘sensory’ activity…”
As Special Education Teachers everywhere have found, students often respond to a ‘sensory activity’ rather than other more traditional ‘reward consequences’ of receiving a preferred food. Instead, having a minute or two on the trampoline, bouncing a ball (or watching you bouncing a ball), and/or being tickled can be wonderful motivators.
Damon, L. (2012) decides that for those with autism, sensory input is skewed. That each child is different and forever changing. At the top of the common sensory issues pyramid is ‘sensory information’. This ‘sensory information’ can get skewed as autistic kids receive it. Background noise that we would never notice can literally cause painful sensations. Like an airplane flying overhead, or the neighbor mowing his lawn two houses down. Or maybe textures of clothing, and certain food tastes. The sour piece of candy that made your face pucker just a little bit can be really painful to an autistic child. Hugs don’t feel good, and music that people think can be fun, or soothing, isn’t.
< My Thoughts > “…painful to an autistic child.”
Some children with autism have reported tasting certain foods for days because the aftertaste is so strong. This may not cause the ‘pain’ of sour candy, but it can be constantly distracting throughout the day and possibly even the thing of which ‘meltdowns’ are made.
Kedar, I. (2012) keeps us informed by saying, “Internal and external distractions – I can’t stop my senses. No one can. But mine overwhelm me. I hear my dog bark like a gunshot. My ears ring and I lose focus on my task.” 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. At times your body charges forward impulsively, snatching things, or dashing you into the street.
< My Thoughts > “I can’t stop my senses.”
What this looks like at home, in the community, and at school is the child will cover his or her ears and may also stim excitedly. Sometimes the stimming is a delayed reaction, but it is still tied to being startled or overwhelmed by a noise or sound.
- 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
- I have 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
- I 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
KNOW AUTISM, KNOW YOUR CHILD with < My Thoughts > by Sara Luker
UNIT 4 – When Is It Sensory?
Introduction –
McNeill, C. (2020) maintains that humans have always been known to rely on the ‘five’ senses of touch, smell, taste, vision, and hearing to connect them with the surrounding world.
The latest Diagnostic & Statistical Manual of Mental Disorders, Fifth Edition,(DSM-5) now includes new criteria for diagnosing issues with ‘sensory’ experiences.
Bogdashina, O. (2011) believes that having a new sensory experience gives perception a new and different emphasis. Much like the same handful of sand being formed into different shifting patterns. She claims that we learn how to restructure sensory experiences, in order to reflect what ‘response’ is needed from us in the environment.
Those new sensory interpretations give us many different perspectives of reality, compared to ‘our own world view bubble’ we’ve formed around us. Therefore, a person’s ‘sensory experience needs’ can become very important to understanding and interpreting the behaviors, actions, or reactions we have to our surroundings. Also, it is important to discern whether children are receiving competing thoughts or competing sensory information from their surroundings. Knowing this could reveal any problematic ‘sensory issues’ which they may be having.
Note: See APPENDIX B below for an example of – Autism Spectrum Disorder Sensory Profile
Mazurek, M., Lu, F., et al. (2017) make known that the diagnostic classification of autism has changed substantially in the DSM-5. Now, along with criteria for the core symptoms of autism, there are tests and criteria to include rating a child’s bizarre ‘sensory’ responses to the environment.
Green, D., Chandler, S., et al. (2016) give greater distinction to atypical responses to sensory stimuli, in the DSM-5. Prior to this, ‘sensory’ experience issues were associated with high levels of anxiety, emotional disorders, and intellectual disability. New, diagnostic instruments look for unusual sensory interests, such as undue sensitivity to noise, and abnormal idiosyncratic responses to specific sensory stimuli.
< My Thoughts > “…diagnostic instruments look for…”
A child with unusual responses, not clearly identified as ‘sensory’ in origin, could ‘still’ understandably be treated as a child who is anxious, emotional, and/or mentally challenged. With the newer ‘sensory’ diagnostic criteria, comes the recognition that ‘sensory’ responses to loud noises, bright lights, hot rooms, or new socks can cause genuine episodes of discomfort, or meltdowns due to pain.
Note: See APPENDIX A below for Sensory Processing Disorder checklist.
CHAPTER 1 – SENSORY ISSUES
Miller, L. (2014) makes it known that many children and their families suffer needlessly for years because of sensory issues that could have been addressed if an experienced professional had determined that Sensory Processing Disorder was present and the child needed appropriate treatment.
The following are recognized assessment tools –
- Sensory Integration & Praxis Tests (SIPT)
- Miller Function & Participation Scales (MFUN)
- Bruininks-Oseretsky Test of Motor Proficiency – 2nd Edition
- Movement Assessment Battery for Children – 2nd Edition
- Miller Assessment for Preschoolers (MAP)
- Goal-Oriented Assessment of Life Skills (GOAL)
In addition, the Sensory Profile, Short Sensory Profile, and/or Sensory Processing Three Dimensions are screening instruments that are often completed by parents and teachers. They rate the child’s typical responses to specific sensory stimuli across 38 items, on a 5-point scale.
Note: See UNIT 4, Chapter 3, PART 2 Sensory Integration for more about Sensory Profile.
< My Thoughts > “…responses to specific sensory stimuli across 38 items…”
Perhaps this will be the first time that parents have made the connection between the strange and/or unwanted behaviors they are seeing with the many ‘sensory’ stimuli items listed in this screening assessment. For instance, behaviors with no purpose, like swaying back-and-forth, or, squirming away when being touched can now be considered from a different perspective, that of possible sensory issues.
Bogdashina, O. (2003) says there are many things that people with autism & ‘sensory issues’ often seek to avoid –
- External control
- Disorder
- Chaos
- Noise
- Bright lights
- Touch
- Involuntary involvement
A person’s sensory needs can become very important to understand.
Note: External control for those with autism’s sensory needs may appear in ‘sensory defensive’ behaviors.
Our sensory perceptions overwhelm us. Imagine you were in a foreign & noisy city at night, not really understanding the language spoken, recognizing only a few words, but NOT really comprehending situations taking place around you, wanting to express a need for help, but not being able. Hearing of this experience may begin to help you relate to what a child with Autism feels on an ordinary day.
PART 1. SENSORY PROCESSING
a. Sensory Defensiveness
Sicile-Kira, C. (2014) says that some or all of our senses can be one hundred times more sensitive than normal. Therefore, they process the environment differently than they were meant to. More often now, it is being recognized that many people with autism have unrecognized ‘sensory’ processing challenges.
Staff Writer (2019) says that sensory defensiveness is important to understand. That each person develops his or her own set of behaviors. Sometimes, there are a combination of sensory processing behaviors. Symptoms may differ from mild, to moderate, to severe levels. The following are some types of defensive sensory processing behaviors.
Types of Sensory Defensiveness Behaviors –
- Tactile Defensiveness – usually avoids being touched and feels crowded. May grab or push in order to control being touched.
- Oral Defensiveness – may resist flavors, textures, or temperatures of the things put in their mouth. But, may agree to be the one to place food in their mouth.
- Visual Defensiveness – may avoid eye contact, startle when lighting changes. Oversensitive if placed under certain lights, such a fluorescent lighting.
- Auditory Defensiveness – very sensitive to certain frequencies and/or loud noises. May cover ears or emit screeching sounds to block out the offensive sounds they are hearing.
- Olfactory Defensiveness – certain smells can cause agitation. May become nauseous and/or repeatedly vomit in response to the offending odor.
- Gravitational/Postural Insecurity or Defensiveness – shows irrational fear of change in position and/or movement. May try to elevate their head and/or place their feet on the ground and try to run.
These are ‘sensory’ reactions, NEVER thoughtful nor planned responses. Also, they are very complex issues. Any or all ‘sensory’ reactions can cause these undesirable behaviors. Keep in mind that sensory excitement can trigger ‘stimming’ like hand-flapping, head-banging, hair pulling, scratching or biting. This seems to break the sensory processing circuit, bringing relief.
< My Thoughts > “…bringing relief.”
Sensory Processing Integration Therapy, which often looks like, and may be called – ‘Play Therapy’, is designed to help by desensitizing defensive and avoidance behavior.
Note: See more in UNIT 4 Chapter 3 – Sensory Integration.
Elwin, M., Schroder, A., et al (2016) explain, in interesting remarks from participants in a sensory experience study, which they followed. Here are some of those remarks –
- I often feel great discomfort when other people touch me.
- I feel no pain at times when other people think I should.
- When I look at certain patterns or colors or hear certain sounds or tones, I find them extremely fascinating.
- In everyday situations, I feel clumsy because I drop things, and sometimes I spill a lot.
- I can sit for hours on end looking at speckled bits of quartz inside stones.
- I have problems with daily routines and sleep.
< My Thoughts > “…looking at speckled bits of quartz …”
Take Sonny into a jewelry store and he can be mesmerized for hours. Twinkling jewels, shiny rings and trinkets, plus the lighted cases and the soft music. He could stay there gazing for hours.
If Gardner, N. (2008) gives her son Dale so much as a single pea or slice of carrot, he would protest by vomiting at will.
Johnson, I. (2014) allows that their current district has no autism unit so daughter Sophie would be placed in a general education kindergarten classroom with special education support. “This is exactly what I had been hoping for her all along.”
I wanted Sophie to have the opportunity to demonstrate what she was capable of to be given the chance to learn from her non-disabled peers, and to have the same experiences any other child is given. If she couldn’t do it, then we would weigh our options. I wholeheartedly believed that Sophie would be successful in a general education kindergarten.
But, Sophie started off by “tasting” a few of her friends. Pretty quickly, it was determined by the school psychologist that this was a ‘sensory’ issue, not Sophie intentionally harming others. There seemed to be a lot of evidence pointing toward a ‘sensory’ disorder, which may have actually been the major issue all along. In fact, some of the experts on her team thought that it could be sensory integration disorder and not autism causing Sophie’s differences.
< My Thoughts > “Sophie started off by “tasting” a few of her friends.”
As a new inexperienced special education teacher, I sat at a classroom table next to an eight-year-old boy. Starting the lesson, I reached in front of him to pick up something we needed. As I did, he reached for me, pulling a handful of my underarm into his mouth, tightly closing his jaw. He didn’t break the skin, but that bite mark was there for a whole month! Knowing nothing about ‘sensory defensive’ issues at the time, I only knew how risky it could be to unexpectedly lean over into a child’s space.
Reguero de Atiles, J., Stegelin, D., et al. (1997) caution parents that children biting other children is a common and difficult consequence of group child care. They go on to say that there are four areas of represented research concerning this – Incidences of biting, reasons for biting, reactions to biting, and coping with biting behaviors. Some children, they believe appear to become overstimulated, biting when other children are close. Incidences can be distinguished between basic immaturity and a possible sensory integration dysfunction.
Reasons for biting behavior can be due to frustration, lack of communication abilities, sensory reaction, a form of imitation, teething, or just curiosity. Others believe that it may be a natural response to frustration of demands, an attempt to make things happen more quickly, a reaction to discomfort, or a simple lack of self-control.
Cariello, C. (2015) accepted the diagnosis and forged ahead, getting their autistic son 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.
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 to how to control his behavior. At home he’d started to hit both Joe and I, and to get into mischief.
Borutta, R. (2015), in human bodies the most important rhythms are in our heart and brain. Other organs establish their own rhythms to provide for respiration, locomotion, digestion, and other functions necessary for life to continue. A finely tuned system which goes mostly unobserved until illness or trauma temporarily upset that balance. And, traumatic inductions can result in behavior changes, sleep disruption, and symptoms resembling post-traumatic stress disorder (PTSD).
< My Thoughts > “…resembling post-traumatic stress disorder.”
Stress can also be caused by repetitive upsetting thoughts, or symptoms and flashbacks like those in Post Traumatic Stress Disorder (PTSD). Often, comorbid with autism is Obsessive Compulsive Disorder (OCD) causing individuals additional ritualistic behavior. Thus, repetitive, ritualistic thoughts become even more severely disruptive and anxiety producing.
Cariello, C. (2015) recalls that on January 2011, seven-year-old Jack’s behavior started to change more dramatically. Her son was afraid of ordinary things. From concern over peeing in the morning, to showering at night, every move had become a slow torturous crawl through the muddy waters of his anxiety.
Medication seemed like a last resort to us, so Joe and I resolved to explore alternative methods to help Jack cope. We couldn’t imagine having him taking anti-anxiety medicine every single day, potentially for the rest of his life.
For a month, the occupational therapist ‘brushed’ him at school and Joe and I took turns at home. This sensory ‘brushing’ technique is called the Wilbarger Protocol. It is designed to reduce sensory defensiveness by using a small brush to apply pressure on the limbs and back.
These three long months took a toll on our family. As a mother, I have never felt so fragile. I was scared that Jack would never get better, that I would never again see the happy little boy who had disappeared underneath this layer of distress.
Yau, A. (2012) thinks that if your child is one of those children who is always banging on things, it may be that he/she is (under) ‘hypo-sensitive’ to noise, and needs to bang on things to stimulate that sense.
If your child is always on the move and likes to spin, it may be their ‘vestibular’ system is hypo-sensitive and they are seeking out those sensory inputs which meet their sensory needs. Some people with autism even report being alternately ‘hyper-‘ and ‘hypo-‘ sensitive at different times. They are unable to hear something one minute and the next minute almost being deafened by the same sound and found covering their ears.
Davide-Rivera, J. (2013) divulges – I had two responses to my father’s violence; a withdrawal and calm, or a violent fighting back; that’s when I noticed my hypo-sensitivity to pain. If I withdrew into myself, I felt no pain.
Marks, S. (2012) tells us – My name is Paula. I am 38 years old, dark curly hair, bright green eyes. I have tiny, slender feet and I am very short. I am non-verbal. I look like other people you meet. I love to laugh and I often pray. I am autistic. I have Asperger’s. You may not know what that means to be me. It is my hope that if I share with you some of my secrets, you will get to know me and my autism better.
When I was small, I would bang my head and bang my head; over and over. I know there are lots of theories about self-stimulation. Why to choose a self-stimulation action that hurts? Because behaviors do not always stem from anger. They can stem from sadness, fear and despair. They can stem from a desire to escape a hurtful situation.
Click clack. Click clack. I love trains. I love the click clack. I love the repetition. I love the predictability. I know what to expect. Click clack, click clack, coming down the tracks. When I was a child, I could not find a way to stay in control. I will let you see a few of my days through my eyes.
A Day – A baby cried today while we were at the store. That is a sound I cannot handle. When will someone figure it out? I am eight and I cannot speak to tell them. Just get me away. That is what I need. Why can’t they figure it out? I lost control and screamed. They called it a temper tantrum. Really it was a baby crying. Click clack. Click clack. Click clack.
A Day – Click clack, click clack. It is my mental rocking. Even my closest friends and family have never figured that out. Listening to trains relaxes me. Click clack. Click clack. Click clack.
A Day – Well, there are times when I will scratch and scratch until I break the skin. It feels good at first and then it starts to hurt. Someone out there, help me to understand. Someone who feels the same way I do, NOT someone with a theory. Click clack. Click clack. Click clack
< My Thoughts > “…Someone out there help me to understand.”
Living life with a lot of sensory issues, along with the added problem of not being accepted, can seem that no one understands how hurtful life can become. Someone should recognize this is a response to something awful going on, either in the environment or within the person. Along with the strong impulse to ‘do something’, self-stimulation may happen to offset an internal pain or ‘perceived pain’ that a person is experiencing.
According to Rattaz, C., Michelon, C., et al. (2015), recent studies show that – Self-Injurious Behaviors (SIBs) were frequently associated with other challenging behaviors like irritability, stereotypy, hyperactivity, and impulsivity.” They go on to say that, abnormal sensory processing was also found to be a strong predictor of self-injury, and impaired social functioning.
This study found that there was no difference between risk factors in regards to gender, or associated medical conditions such as epilepsy, or an association with SIBs. Also, there was no correlation between risk factors such as parents’ age or socio-economic status. There was however, a correlation between a higher Childhood Autism Rating Scale (CARS) score and higher ‘risk of SIBs’ during adolescence.
Note: See more about Self-Injurious Behaviors (SIBs), in UNIT 4 Chapter 2 Sensory Categories.
Wetherby, S., Woods, J., et al. (2018) worry that there is a negative social effect of Restrictive Repetitive Behavior (RRB) which may interfere with necessary ‘receptive’ and ‘expressive’ language. This may also affect visual reception, stopping active engagement and age-appropriate developmental trajectories.
< My Thoughts > “…developmental trajectories.”
Also, an abundance of sensory issues may be affecting ‘developmental trajectories’. This interference may have more influence on a person’s development than was previously understood. And, may even be one of the reasons why ‘Sensory Issues’ are now featured more prominently in the latest edition of the DSM-5.
Rubin, E. (2016) reveals that 16-year-old Sam’s Individualized Education Program (IEP) objectives were shifted from those for passive responses throughout the day, to requesting preferred actions from others (e.g., "high five" for happy). After completing a task, he could choose a preferred ‘sensory’ activity, such as a head massage, a back rub, or tickling.
< My Thoughts > “…he could choose a preferred ‘sensory’ activity…”
As Special Education Teachers everywhere have found, students often respond to a ‘sensory activity’ rather than other more traditional ‘reward consequences’ of receiving a preferred food. Instead, having a minute or two on the trampoline, bouncing a ball (or watching you bouncing a ball), and/or being tickled can be wonderful motivators.
Damon, L. (2012) decides that for those with autism, sensory input is skewed. That each child is different and forever changing. At the top of the common sensory issues pyramid is ‘sensory information’. This ‘sensory information’ can get skewed as autistic kids receive it. Background noise that we would never notice can literally cause painful sensations. Like an airplane flying overhead, or the neighbor mowing his lawn two houses down. Or maybe textures of clothing, and certain food tastes. The sour piece of candy that made your face pucker just a little bit can be really painful to an autistic child. Hugs don’t feel good, and music that people think can be fun, or soothing, isn’t.
< My Thoughts > “…painful to an autistic child.”
Some children with autism have reported tasting certain foods for days because the aftertaste is so strong. This may not cause the ‘pain’ of sour candy, but it can be constantly distracting throughout the day and possibly even the thing of which ‘meltdowns’ are made.
Kedar, I. (2012) keeps us informed by saying, “Internal and external distractions – I can’t stop my senses. No one can. But mine overwhelm me. I hear my dog bark like a gunshot. My ears ring and I lose focus on my task.” 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. At times your body charges forward impulsively, snatching things, or dashing you into the street.
< My Thoughts > “I can’t stop my senses.”
What this looks like at home, in the community, and at school is the child will cover his or her ears and may also stim excitedly. Sometimes the stimming is a delayed reaction, but it is still tied to being startled or overwhelmed by a noise or sound.
PART 1. SENSORY PROCESSING
b. Sensory Avoidance Behavior –
Siri, K. & Lyons, T. (2014) tell us that children with sensory issues have difficulty accurately understanding their body’s messages and thus have difficulty making sense of their world. Sensory issues can often be mistaken for behavioral problems. To cope, they may start squirming and fidgeting and could even fall over. It’s impossible for the child with sensory sensibilities to stay seated; especially on the toilet where so many other sensory things are going on.
They state that hypo-sensitivity, hyper-sensitivity or mixed-sensitivity occurs when the brain does not efficiently process information coming from the body or the environment. Children with hypo-sensitivity may require increased intensity in taste, texture and/or temperature in order to process sensations. These children tend to prefer crunchy textures, and strong flavors.
A hypo-responsive tactile system (sensory seeking) is generally associated with a low level of arousal. This child may typically appear “tuned out” and therefore also less available. In order to raise arousal level, they may gravitate to messy and unfamiliar textures in an effort to better process sensory things. Under-responsive to stimuli, they tend not to notice when clothing is uncomfortable or sticky things are on their hands and face.
Sensory issues can often be mistaken for behavioral problems. Sensory sensitive kids may have difficulty in accurately making sense of their world. Or, because of poor body awareness may be excessively rough without ill intent. Many may fidget or often leave their seat in order to provide themselves with better body alerting processing; but, may be terrified of ‘bumping’ into somebody.
< My Thoughts > “…mistaken for behavioral problems.”
One child with autism’s sensory seeking issue may deliberately crash into someone or something, just to feel the necessary impact. While another child with autism, even within the same family, may have a meltdown when being bumped or touched.
If your child’s sensory issues are ‘supersonic’ senses, air is likely to bother them. Yet, Sonny will sit in front of a fan for hours, his hair blowing in the wind. But we can never get his highness out of the house on a windy day.
Which brings up the subject of ‘isolation’. Very easily, a family or a child with hypersensitivity will stay isolated at home where they are ‘sensory’ comfortable. When there are sensory ‘avoidance’ issues, it becomes impossible to get that child through the door and out of the house. There are interventions to prevent family isolation. For some though, leaving the house may involve a lot of planning.
Types of 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
- Certain foods
- Certain tastes
- Certain textures or temperatures
- Covers mouth or won’t open it
- Feet leaving the ground
- Heights
- Being tipped upside-down
- Holds on to things
- Distracted by noise (near or far away)
- No background noises
- Doesn’t respond to name when s/he hears it called
- Covers ears
- Refuses eye contact
- Bothered by lights
- Concerned with a lot of movement
- Covers eyes
Bogdashina, O., & Casanova, M. (2016) say – Sensory deprivation studies show that sudden and nearly complete deprivation of stimulation through the senses can lead to autistic-like-behaviors of withdrawal, stereotypical movements, etc. For example, behaviors such as rocking, rhythmic head banging, spinning objects or perimeter hugging; especially in large spaces may occur. Also, the need to touch everything in a room before settling down, are typical for both autistic children and those with visual impairments.
Kedar, I. (2012) tells us how he also suffers from ‘temperature sensitivity’, another sensory avoidance behavior. I can’t stand being in a hot lunchroom or Physical Education class. It’s like being in a sauna for me. I try imagining that I’m in an icy cold lake, but it doesn’t help.
< My Thoughts > “…temperature’ sensitivity.”
Part of sensory avoidance behavior can be ‘temperature’ sensitivity, which is considered a ‘thermoregulation’ issue.
Temperature Changes & Autism
The weather is changing and you may find that the attitude of your favorite person with autism is changing too. ‘Hypo’ or ‘hyper’ sensitivity to temperature can affect those on the spectrum. A writer for the Spirit of Autism says, “My son’s refusal to wear a coat in winter I thought was either driven by stubbornness or laziness. But many people with ASD may feel ‘hot’ all the time, even when it’s ‘cold’. Or, they can feel ‘cold’ all the time, even when it’s ‘hot’ weather.”
If their nervous system is on ‘high alert’, they may suffer from poor or underdeveloped circulation. Their hands and feet are always cold because their blood leaves their extremities to deliver oxygen to the internal organs and muscles. Unfortunately, the body is unable to regulate and may become overheated or always have cold hands and feet due to thermoregulation issues.
Davide-Rivera, J. (2015) writes that 'temperature regulation' issues can put a person in a state of constant discomfort. This can lead to sensory overload, shutdowns, and even meltdowns. The body’s core temperature is regulated by neural feedback mechanisms in the brain, which operate through the hypothalamus. A very neutral temperature may be insisted upon by the ASD person’s bath, their food, and even for the room they’re in. Even when taking even moderately hot showers, those who are temperature sensitive may report feeling dizzy, light-headed, or seeing spots. And then when cooling down, they may feel the cold much faster than you would expect.
< My Thoughts > “…mechanisms in the brain…”
Sometimes when the endocrine system is ‘out of whack’, it’s easy to feel these same kinds of sensations. This may be hard to diagnose without very thorough and expensive tests, which clinicians and insurance companies tend to want to avoid. Just saying.
Davide-Rivera, J. (2013) divulges that one of the first things she learned about her Asperger’s diagnosis was that there were three core deficits that accompany this condition – the lack of theory of mind, executive dysfunction, and weak central coherence. There were also a host of other issues like sensory processing difficulties – being ‘hyper’ or ‘hypo’ sensitive to outside stimuli like to heat, cold, or pain.
< My Thoughts > “…a host of other issues…”
Parents may take years to find out that their ‘wild child’ has really painful sensory issues. Often, children really don’t want to give you a bad time… they’re just having a bad time with unsolved environmental issues.
van Someren, E., Dekker, K., et al.(2016) volunteer that clinicians use the Experienced Temperature Sensitivity & Regulation Survey (ETSRS) questionnaire to narrow down temperature regulation issues. Questions cover differentiating experiences of the individual’s body ‘heating-up’ and ‘cooling-down’, unexpectedly. Some persons with sensory issues only complain about problems with their extremities, and only under certain conditions. Determining whether this happens to them during the daytime or the nighttime. Whether the person is in an upright or supine position, awake or asleep. If they are inside or outside, in summer or in winter; and so on is helpful. These questions are designed to determine which parts of the body seem to be affected. Answering a variety of these types of questions further narrows down the specific regulation issue.
Decker, J. (2011) divulges that in elementary school, the counselors tried to solve Jake’s sensory overload by giving him a huge set of noise-reducing headphones. Yeah, that was nice. Now he not only didn’t fit in, but he had a monstrous set of yellow earphones to even further separate him from his peers. He looked like a big, sweaty bumblebee. Eventually they were replaced with orange ear plugs that he now wears in the gym, in the noisy hallways, and often in class. Add a mini bottle of antibacterial gel, for his Obsessive Compulsive Disorder (OCD) about germs, and he’s right out of central casting for Nerds III. “I am the Walrus, goo goo ga job.”
Staff Writer & Chen-Byerley, L. (2006) – Other examples of ‘sensory avoidance’ which have been reported are when the child may NOT be able to tolerate smells from the lunch room, or has an intolerance for noise such as that of other children, fireworks, or vacuum cleaners. Then there is the child who suddenly may NOT be able to move about without becoming afraid or feeling nauseous. Many children are NOT able to wear certain clothes that for some reason become intolerable.
Also, there is the child who will not swing his or her arms back and forth from right to left. This is known as an ‘inability to cross the body midline’ when asked to do so. This child is having difficulty with ‘directionality’. But it may be an inability to know where their body is in space. Or, they could be having difficulty ‘alternating limb movements’, thus resulting in a clumsy walk.
Included in difficulty with ‘directionality’ can be poor eye movements; such as having difficulty with directing their eyes as to where they are walking or running. There could be the unusual fear for certain positions or movement like being on their tummies, moving backwards, or going on stairs or escalators.
Some children also have difficulty putting their arms in sleeves, or legs in pants. Thus, executing activities like the daily living skills of self-dressing, becomes impossible. They are unable to button or zip clothes, nor can they make sense of right & left shoes. Often one may hear these types of difficulties described as having an ‘over-reactive’ or ‘under-reactive’ sensory system.
< My Thoughts > “…sense of right & left shoes.”
Sonny gets the most annoyed look on his face when after putting on one shoe, you want him to sit still while you help him put on a second shoe. It seems to be just more that he can be bothered with. Often, kids with autism will see no reason to distinguish between their right and left foot or shoe. Who can blame them, after all we don’t have right and left socks.
Some with ‘sensory’ issues have a combination of issues operating all at once; what are considered to be ‘competing’ issues, fighting for the needed response. And, ‘sensory avoiders’ may also be ‘sensory seekers’ in separate settings.
Note: More about ‘sensory seekers’ in UNIT 4, Chapter 2; Part 3.
REFERENCES: UNIT 4; CHAPTER 1 INTRODUCTION, SENSORY ISSUES, PART 1 a. Sensory Defensiveness behavior & PART 1 b. Sensory Avoidance behavior –
Barnes, E. (2014). Building in Circles: The Best of Autism Mom; eBook Edition.
Bogdashina, O. (2003). Sensory Perceptual Issues in Autism & Asperger Syndrome: Different Sensory Experiences – Different Perceptual World; Jessica Kingsley Publishers: London.
Bogdashina, O. ( 2011). Autism and the Edges of the Known World: Sensitivities, Language & Constructed Reality; eBook Edition.
Bogdashina, O., & Casanova, M. (2016). Sensory Perceptual Issues in Autism & Asperger Syndrome; eBook, 2nd Edition.
Borutta, R. (2019). The Music of the Soul & the Inner Light; Journal for Spiritual & Consciousness Studies, Inc.; V38:2, p113-120.
Cariello, C. (2015). What Color is Monday?: How Autism Changed One Family for the Better; eBook Edition.
Damon, L. (2012). Knowing Autism; eBook Edition.
Davide-Rivera, J. (2013). Twirling Naked in the Streets and No One Noticed: Growing Up with Autism; eBook Edition.
Davide-Rivera, J. (2015). Why Does My Child Refuse to Wear a Coat?; Autism Answers, Traits/Behaviors; Retrieved online from – http://aspiewriter.com/2015/07/temperature-regulation-why-does-my-autistic-child-refuse-to-wear-a-coat.html
Decker, J. (2011). I Wish I Were Engulfed in Flames: My Insane Life Raising Two Boys with Autism; eBook Edition.
Elwin, M., Schroder, A., et al (2016). Sensory Clusters of Adults with and without AS Conditions; Journal of Autism Developmental Disorders; V47, p579–589.
Gardner, N. (2008). A Friend Like Henry: The Remarkable True Story of An Autistic Boy & the Dog That Unlocked His World; eBook Edition.
Green, D., Chandler, S., et al. (2016). Brief Report: DSM-5 Sensory Behaviors in Children withand without an Autism Spectrum Disorder; Journal of Autism & Developmental Disorders; V46, p3597-3606.
Green, L. (2013). The Well-Being of Siblings of Individuals with Autism; ISRN Neurology; V:2013; Art. 417194.
Hus, V. & Lord, C. (2013). Effects of Child Characteristics on the Autism Diagnostic Interview-Revised: Implications for Use of Scores as a Measure of ASD Severity; Journal of Autism & Developmental Disorders; Feb/V43:2, p371-381.
Johnson, I. (2014). The Journey to Normal: Our Family’s Life with Autism; eBook Edition.
Kedar, I. (2012). Ido in Autismland: Climbing Out of Autism; eBook Edition.
Mazurek, M., Lu, F., et al. (2017). A Prospective Study of the Concordance of DSM-IV & DSM-5 Diagnostic Criteria for Autism Spectrum Disorder; Journal of Autism & Developmental Disorders; V47, p2783-2794.
Marks, S. (2012). Paula’s Journal: Surviving Autism; eBook Edition.
McNeill, C. (2020). Auditory Processing Disorder in Children; Mindd Foundation; Retrieved online from – https://mind.org/auditory-processing-disorder-children/
Miller, L. (2014). Sensational Kids: Hope & Help for Children with Sensory Processing Disorder (SPD); Retrieved online from – spdstar.org/basic/identification-of-spd.
Rattaz, C., Michelon, C., et al. (2015). Symptom Severity as a Risk Factor for Self-Injurious Behaviors in Adolescents with Autism Spectrum Disorders; Journal of Intellectual Disability Research; V59, p730-741.
Reguero de Atiles, J., Stegelin, D., et al. (1997). Biting Behaviors Among Preshoolers: A Review of the Literature & Survey of Practitioners; Early Childhood Education Journal; V25, p101-104.
Rubin, E. (2016). Sam: From Gestures to Symbols; Retrieved from Children with Autism Spectrum Disorders: Three Case Studies; Retrieved online from – https://leader.pubs.asha.org/doi/full/10.1044/leader.FTR2.15012010.14/
Sicile-Kira, C. (2014). Autism Spectrum Disorder (revised): The Complete Guide to Understanding Autism; Penguin Random House Company; New York, N. Y.
Siri, K. & Lyons, T. (2014). Cutting-Edge Therapies for Autism; 4th Edition: Skyhorse Publishing, N.Y., N.Y.
Staff Writer, & Chen-Byerley, L. (2006). Sensory Integration; Retrieved online from –http://senseablekids.com/sensInt.html/
Staff Writer (2019). Sensory Processing Disorder; Retrieved online from – http://www.sensory-processing-disorder.com/sensory-defensiveness.html/
van Someren, E., Dekker, K., et al.(2016). Experienced Temperature Sensitivity & Regulation Survey (ETSRS); Journal of Sleep Research; V25, p125.
Wetherby, S., Woods, J., et al. (2018). Changing Developmental Trajectories of Toddlers with ASD: Strategies for Bridging Research to Community Practice; Journal of Speech, Language & Hearing Research; V61, p2615-2628.
Yau, A. (2012). Autism – A Practical Guide for Parents; eBooks Edition.
APPENDIX A – Sensory Processing Disorder Checklist
Miller, L. (2014). Sensational Kids: Hope & Help for Children with Sensory Processing Disorder (SPD); Retrieved online from – spdstar.org/basic/identification-of-spd.
Infants and toddlers____ Problems eating or sleeping
____ Refuses to go to anyone but their mom for comfort
____ Irritable when being dressed; uncomfortable in clothes
____ Rarely plays with toys
____ Resists cuddling, arches away when held
____ Cannot calm self
____ Floppy or stiff body, motor delays
Pre-schoolers____ Over-sensitive to touch, noises, smells, other people
____ Difficulty making friends
____ Difficulty dressing, eating, sleeping, and/or toilet training
____ Clumsy; poor motor skills; weak
____ In constant motion; in everyone else's “face and space”
____ Frequent or long temper tantrums
Grade-schoolers___ Over-sensitive to touch, noise, smells, other people
___ Easily distracted, fidgety, craves movement; aggressive
___ Easily overwhelmed
___ Difficulty with handwriting or motor activities
___ Difficulty making friends
___ Unaware of pain and/or other people
Adolescents and adults
___ Over-sensitive to touch, noise, smells, and other people
___ Poor self-esteem; afraid of failing at new tasks
___ Lethargic and slow
___ Always on the go; impulsive; distractible
___ Leaves tasks uncompleted
___ Clumsy, slow, poor motor skills or handwriting
___ Difficulty staying focused
___ Difficulty staying focused at work and in meetings
___ Unmotivated; never seems to get joy from life
APPENDIX B – Autism Spectrum Disorder Sensory Profile
Referenced online from –
Sensory Processing in Low-Functioning Adults with Autism Spectrum Disorder: Distinct Sensory Profiles and Their Relationships with Behavioral Dysfunction; by Corentin Gonthier, Lucie Longue´pe´e, Martine Bouvard; Journal of Autism & Developmental Disorders; V46; p3078-3089.
Autism Spectrum Disorder Sensory Profile –
The final series of analyses examined whether patients in the different sensory clusters displayed different behavioral disorders. Results are synthesized in Tables 5 and 6 (see Online Information 1 for detailed descriptive statistics per cluster and per behavioral disorder subscale). The difference between clusters was statistically significant at the 0.05 level for all but four behavioral disorder subscales.
• Patients in Cluster A (over-sensitive) had a fairly typical level of impairment on most behavioral disorder subscales. These patients were mostly remarkable for a high level of isolation seeking, and for displaying less emotional liability than others. They were also relatively more autonomous than other clusters.
• Patients in Cluster B (under-sensitive) had a larger range of behavioral disorders than the over-sensitive patients of Cluster A. In particular, they displayed more emotional disorders than other clusters, with high scores in irritability and aggressiveness, emotional disorders and anxiety, and expression of affectivity. They had more difficulties with relationships to others, with high scores in social behavioral disorders and in other-aggression; their behavior was more influenced by environmental stimuli (‘‘environmental dependency’’), and they displayed more dysfunctional use of everyday objects (such as exploratory or destructive behaviors). These patients were also remarkable for demonstrating a significantly higher level of self-aggression than other clusters.
• Patients in Cluster C (passive) were characterized by their unresponsive behavior, with high isolation, hypo-activity and apathy, disinterest and indifference, but also deficits in social interactions and eye contacts. They displayed less reactivity to change and to sensory stimuli than other clusters, as well as less emotional liability. Unsurprisingly, these patients demonstrated less other-aggression than others.
• Patients in Cluster D (balanced profile) had lower scores on self-stimulation and reactivity to sensory stimuli, confirming their overall milder sensory dysfunction. These patients also had the least behavioral disorders of all: they were either equally impaired or significantly less impaired than other clusters on virtually all subscales. The only exception was that these patients demonstrated a high level of other aggression, presumably related to the fact that they were more active than other patients.
DISCLAIMER (2024) Know Autism – Know Your Child: with < My Thoughts > by Sara Luker; 2024
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