KNOW AUTISM, KNOW YOUR CHILD with < My Thoughts > by Sara Luker
UNIT 4 – WHEN IS IT SENSORY?
CHAPTER 2 – Sensory Categories
PART 1. HYPO-ACTIVITY
PART 2. HYPER-ACTIVITY
APPENDIX A – Wandering
PLEASE READ DISCLAIMER –
KNOW AUTISM, KNOW YOUR CHILD with < My Thoughts > by Sara Luker
UNIT 4 CHAPTER 2 – SENSORY CATEGORIES (Continued)
UNIT 4 – WHEN IS IT SENSORY?
CHAPTER 2 – Sensory Categories
PART 1. HYPO-ACTIVITY
PART 2. HYPER-ACTIVITY
APPENDIX A – Wandering
PLEASE READ DISCLAIMER –
KNOW AUTISM, KNOW YOUR CHILD with < My Thoughts > by Sara Luker
UNIT 4 CHAPTER 2 – SENSORY CATEGORIES (Continued)
According to Ausderau, et al. (2015), there are four sensory response categories, or sensory patterns in Autism Sensory Disorder (ASD). They are –
HYPO-ACTIVITY (under active), considered to be a lack of or delayed response to sensory input, or even lack of orienting to loud sounds, and slow to react to pain.
HYPER-ACTIVITY (over active), is defined by an exaggerated or avoidant response to sensory stimuli. Such as showing discomfort during grooming and dressing activities. Often covering ears in response to certain sounds.
SIRS (Subcategories of Sensory Interests, Repetitious and Seeking behavior), is characterized by a fascination with, or craving for, sensory stimulation; such as with flickering lights, or by rubbing textures. Note: Repetitious behavior includes – SIBs i.e., Self-Injurious Behaviors.
EP (Enhanced Perception), has emerged as the fourth pattern of sensory response. This response is possibly unique to individuals with ASD. EP is characterized by strengths in locally oriented visual and auditory perception. As well as having enhanced low-level discrimination, or low threshold detection, and hyper-systemizing cognitive styles; like somehow knowing random calendar days and dates.
Mazurek, et al. (2017), point out that over the years, the American Psychiatric Association (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM) has changed considerably. The DSM-III early classification was of ‘Infantile Autism’ with onset before age 30 months. Included then was the definition – ‘any bizarre responses to the environment’ which could encompass ‘less specific’ behaviors.
< My Thoughts > “…‘any bizarre responses to the environment’ …”
Any autism diagnostic criteria considered to be a ‘bizarre response to the environment’, including Sensory Response Behavior Categories, and Sub-Categories, can differ significantly in the latest Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
Individuals with a DSM-4 diagnosis may no longer meet the new criteria of DSM-5. Qualifications have changed for individuals with an IQ greater than 70; those with Asperger’s, PDD-NOS, and language delays. Added to that, ‘female specific’ symptoms, especially those of older girls with stronger cognitive and coping abilities, could be disproportionately negatively affected by the DSM-5 diagnostic criteria, than they were in the DSM-4.
Also, there does not seem to be an ‘alternative diagnosis’ which could keep individuals from losing current services. Previously, Attention Deficit Hyperactivity Disorder (ADHD) was the most common ‘alternative diagnosis’ made in these discordant cases. The DSM-5 was designed to allow more ‘child specific’ needs to be revealed, hopefully leading to more appropriate interventions and services for that child.
McNeill, C. (2020) sensory processing relies on the sense of ‘sight’ received from our eyes; the sense of ‘hearing’ is a ‘binaural’ system, relying on the input from our two ears; the sense of ‘touch’ is provided by the skin; ‘taste’ via the tongue; ‘smell’ through the nose and ‘balance’ via the movements detected by the vestibular system. Discriminating differences, shutting out any interfering environment influences, and understanding what the brain is signaling you to do; then doing it.
HYPO-ACTIVITY (under active), considered to be a lack of or delayed response to sensory input, or even lack of orienting to loud sounds, and slow to react to pain.
HYPER-ACTIVITY (over active), is defined by an exaggerated or avoidant response to sensory stimuli. Such as showing discomfort during grooming and dressing activities. Often covering ears in response to certain sounds.
SIRS (Subcategories of Sensory Interests, Repetitious and Seeking behavior), is characterized by a fascination with, or craving for, sensory stimulation; such as with flickering lights, or by rubbing textures. Note: Repetitious behavior includes – SIBs i.e., Self-Injurious Behaviors.
EP (Enhanced Perception), has emerged as the fourth pattern of sensory response. This response is possibly unique to individuals with ASD. EP is characterized by strengths in locally oriented visual and auditory perception. As well as having enhanced low-level discrimination, or low threshold detection, and hyper-systemizing cognitive styles; like somehow knowing random calendar days and dates.
Mazurek, et al. (2017), point out that over the years, the American Psychiatric Association (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM) has changed considerably. The DSM-III early classification was of ‘Infantile Autism’ with onset before age 30 months. Included then was the definition – ‘any bizarre responses to the environment’ which could encompass ‘less specific’ behaviors.
< My Thoughts > “…‘any bizarre responses to the environment’ …”
Any autism diagnostic criteria considered to be a ‘bizarre response to the environment’, including Sensory Response Behavior Categories, and Sub-Categories, can differ significantly in the latest Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
Individuals with a DSM-4 diagnosis may no longer meet the new criteria of DSM-5. Qualifications have changed for individuals with an IQ greater than 70; those with Asperger’s, PDD-NOS, and language delays. Added to that, ‘female specific’ symptoms, especially those of older girls with stronger cognitive and coping abilities, could be disproportionately negatively affected by the DSM-5 diagnostic criteria, than they were in the DSM-4.
Also, there does not seem to be an ‘alternative diagnosis’ which could keep individuals from losing current services. Previously, Attention Deficit Hyperactivity Disorder (ADHD) was the most common ‘alternative diagnosis’ made in these discordant cases. The DSM-5 was designed to allow more ‘child specific’ needs to be revealed, hopefully leading to more appropriate interventions and services for that child.
McNeill, C. (2020) sensory processing relies on the sense of ‘sight’ received from our eyes; the sense of ‘hearing’ is a ‘binaural’ system, relying on the input from our two ears; the sense of ‘touch’ is provided by the skin; ‘taste’ via the tongue; ‘smell’ through the nose and ‘balance’ via the movements detected by the vestibular system. Discriminating differences, shutting out any interfering environment influences, and understanding what the brain is signaling you to do; then doing it.
PART 1. HYPO-ACTIVITY (under active sensory response), is considered a lack of or delayed response to sensory input, or even lack of orienting to loud sounds, and slow to react to pain.
Ausderau, K., Sideris, J., et al. (2014) believe that hypo-activity results when 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.
Persons are always on the move, frequently twirling, spinning, or running round and round. They are attracted to lights, rocking back and forth when watching TV. They like to look at things upside down. No safety awareness; they jump off furniture and high places; and especially love the trampoline. Often sudden outbursts of self-abuse occur. May easily vomit from excessive movement, but have difficulty in changing body position. When becoming engaged and thinking in movements, it is possible for them to shut out the world.
The individual has low muscle tone, weak grasp, dropping things. Doesn’t feel hunger. Likes to lean on objects and people. Bites and sucks on fingers and hands; chews on things, grinds teeth. Hits, bumps and pushes others. Enjoys crashing into things. Intentionally falls on the floor. Engages in ritualistic body movements when frustrated or bored. They watch their feet when walking and their hands when doing something. May talk about a non-existent experience, like saying, “I am flying.”
Sabatos-DeVito, M., Schipul, S., 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. Also, it is pointed out that hypo-responsive children may be less sensitive to novelty, thus taking longer to notice and process something new in the environment.
< My Thoughts > “…taking longer to notice and process ‘novelty’ in the environment.”
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 gain the child’s interest, the parent, teacher, or clinician will have difficulty finding a ‘teachable’ moment which can bring the child closer to learning. Sonny can become so busy in his own world that he refuses to disengage long enough to see a new toy or puzzle. Then when he finally does respond, which maybe hours later, he will make two or three passes, looking at it out of the corner of his eye, first.
Siri, K. & Lyons, T. (2014) 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 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, the child may gravitate towards messy and unfamiliar textures, in an effort to better process sensory things. They tend not to notice when clothing is uncomfortable, or there are sticky things on their hands and face.
This child may be excessively rough without ill intent, because of poor body awareness. They can have difficulty in accurately making sense of the world. Their sensory issues will often be mistaken for behavioral problems. You will find them fidgeting or leaving their seat often, in order to provide alerting input and better body awareness. But they could be terrified to ‘bump’ into someone.
Ausderau, K., Sideris, J., et al. (2014) believe that hypo-activity results when 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.
Persons are always on the move, frequently twirling, spinning, or running round and round. They are attracted to lights, rocking back and forth when watching TV. They like to look at things upside down. No safety awareness; they jump off furniture and high places; and especially love the trampoline. Often sudden outbursts of self-abuse occur. May easily vomit from excessive movement, but have difficulty in changing body position. When becoming engaged and thinking in movements, it is possible for them to shut out the world.
The individual has low muscle tone, weak grasp, dropping things. Doesn’t feel hunger. Likes to lean on objects and people. Bites and sucks on fingers and hands; chews on things, grinds teeth. Hits, bumps and pushes others. Enjoys crashing into things. Intentionally falls on the floor. Engages in ritualistic body movements when frustrated or bored. They watch their feet when walking and their hands when doing something. May talk about a non-existent experience, like saying, “I am flying.”
Sabatos-DeVito, M., Schipul, S., 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. Also, it is pointed out that hypo-responsive children may be less sensitive to novelty, thus taking longer to notice and process something new in the environment.
< My Thoughts > “…taking longer to notice and process ‘novelty’ in the environment.”
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 gain the child’s interest, the parent, teacher, or clinician will have difficulty finding a ‘teachable’ moment which can bring the child closer to learning. Sonny can become so busy in his own world that he refuses to disengage long enough to see a new toy or puzzle. Then when he finally does respond, which maybe hours later, he will make two or three passes, looking at it out of the corner of his eye, first.
Siri, K. & Lyons, T. (2014) 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 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, the child may gravitate towards messy and unfamiliar textures, in an effort to better process sensory things. They tend not to notice when clothing is uncomfortable, or there are sticky things on their hands and face.
This child may be excessively rough without ill intent, because of poor body awareness. They can have difficulty in accurately making sense of the world. Their sensory issues will often be mistaken for behavioral problems. You will find them fidgeting or leaving their seat often, in order to provide alerting input and better body awareness. But they could be terrified to ‘bump’ into someone.
PART 2. HYPER-ACTIVITY (over active sensory response), is defined by an exaggerated or avoidant response to sensory stimuli. Such as discomfort when performing grooming or dressing activities, and covering one’s ears in response to stimuli.
Bogdashina, O., & Casanova, M. (2016) describe HYPER-Activity response as caused by a sensory channel that may stay ’wide open’, resulting in more stimulation than the brain can handle. Continuing to explain that children with hyper-activity often engage in ‘stim’ behavior in order to normalize sensory input. When involved in ‘stimulating behavior’ these individuals will rock, spin, flap, or tap in order to calm themselves. Coping with unwanted sensory input, or even their own ‘stimming’ behavior can result in the child covering their eyes or ears and making noises to block out input to the brain.
These authors explain that a Hyper-Activity response is an acute, heightened, or excessive sensitivity to what is happening around them in the environment. When being exposed to florescent lights, unfortunately these children will see a disturbing 60-cycle flickering, causing the whole room to pulsate.
One person said, “My world was fragmented, my sensory world was so skewed that my mother was a smell, my father a tone, my brother something always moving.” Another said, “I remember being attracted to pieces of people’s faces. Not the whole face, but their hair, their eyes, or their teeth attracted me.” Because their perception is often fragmented, distorted, or delayed they are seeing parts of things instead of wholes.
Storrs, C. (2015) says the study investigated found those with autism sensory issues who like to ‘sniff’ people. Even saying that they choose their friends based on their odor; even though that odor is imperceptible to most.
Phelan, S. (2015) further explains the circumstances of one’s perception. She says that upon hearing a dog bark, most of us pay attention briefly, then carry on. But a child having a negative experience with dogs may respond with a ‘startle’ response or feelings of anxiety until s/he feels they are out of harm’s way. For some with sensory issues, that heightened state of alertness will stay with them throughout the day.
Bogdashina, O., & Casanova, M. (2016) quote Tito Muknopadhyay as describing his hyper excitable state this way – “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 > “…hyper excitable state…”
Some research suggests that certain patterns of HYPO and HYPER Activity can co-occur simultaneously, as individuals react to a sudden sensory stimulus from the environment. Perhaps this was the cause of Tito’s response.
Donkers, F., Schiput, S., et al. (2015) detail about ‘mismatched’ reactions to environmental stimulus. They say that brain responses to stimuli causes persons to cover their ears because that particular stimuli triggers a memory, not necessarily because the sound is loud or painful.
Evans, C., Nelson, L., Porter, C. (2012) explain – “Children scoring high on ‘novelty’ awareness tend to be more social, can control more impulses, and are better able to comply with the tasks they are given.”
Neil, L., Green, D., et al. (2017) know that it is important to choose which behaviors are HYPO and which are HYPER responses, because measuring and labeling is necessary to provide funds for various services from providers and insurance companies. This may not optimally account for the full range of sensory symptoms the person is experiencing. For instance, the questionnaire may ask – Does your child show an unusual response to _____? The scoring does not determine the difference between HYPO and HYPER responsiveness.
< My Thoughts > “…an unusual response…”
Our Sonny sometimes expresses sadness when he is in fact very happy. And conversely, may express happiness when he is sad or disappointed. Some children start showing signs of anxiety, when they are really just happy and excited. This may or may not be the result of sensory input, but it is an ‘unusual response’.
Cariello, C. (2015) comments about her son Jack who has common self-stimulation practices including things like hand-flapping and humming. He even gallops across the room with his fingers in his mouth and grunts loudly or constantly clears his throat. She says they call it the ‘zoomies’.
Davide-Rivera, J. (2013) tells that as a child, when smells overwhelmed me, they just said I had a sensitive stomach.
< My Thoughts > “…smells overwhelmed me…”
Some children can also become nauseous from their ‘stimming’ behavior, like spinning or the motion of running purposely, like a wild child, back and forth across the room.
Bogdashina, O., & Casanova, M. (2016) tell us that ‘olfaction’, the sense of smell, has in its olfactory system 10 million smell receptors in the nose, of 20 different types. These receptors in the nostrils respond quickly, guiding the chemicals in the air through the nose. But the intensity of the smell can be lost very rapidly.
Some autistic individuals have ‘hyper-olfactory’ sensitivities, comparable to that of canines. To them, the smell or taste of food can be intolerable, no matter how hungry they are. Due to its smell, they will only eat certain foods.
Some children with ‘hypo-sensitivity’ will chew and smell everything they can. They will lick objects, play with feces, and easily regurgitate. Their ‘sense of taste’ is not very strong because one tastes the chemicals in liquids. Compared to the ‘sense of smell’ which operates on sensing chemicals in the air.
The authors go on to say that some people associate a particular smell with a feeling of calm. Especially if they have experienced scented oils during a body massage, this can trigger feelings of calmness. The opposite may also be true, if for some reason the person has had a bad experience associated with a smell, then that smell can trigger a negative emotion. When this happens, the individual may experience nausea, or even outbursts of emotion, as well as covering or rubbing their nose.
Howe, E. & Stagg, S. (2016) discuss the ‘smell’ sensitivity experiences some individuals may have. Saying that many people can have a ‘positive’ reaction to an environmental smell, while others can feel anything from severe physical discomfort to mere annoyance. Some state that certain smells make them feel stressful, anxious, and/or provoked. And, these sensitive reactions varied greatly in their intensity from mild to extreme.
< My Thoughts > “…‘smell’ sensitivity…”
One semester, in the Middle School Special Education classroom, there were a number of boys with various diagnoses, including ADHD. Erring on the side of caution, I found it necessary to make certain that the detergent, hand soap, and other chemical cleaning products that I used personally, and in the classroom had no ‘fragrance’, due to most of their sensitivity to smells.
Note: Here, under HYPER-Activity, Attention Deficit Hyperactivity Disorder (ADHD) will be discussed.
Squaresky, M. (2014) says her son Greg did not tolerate certain smells which caused him to shriek until dinner was over. Family mealtimes were often ruined.
Greg despised the smell of chicken, pasta, or fish in the kitchen. He gave new meaning to the need for sameness. Greg ate only Boston Style pizza from a pizzeria, almost every day.
I left Jay and Adam to dine alone while I took Greg out for a car ride, just to stop the agony.
We only thought of survival, unaware that we were teaching Greg that by screaming he could avoid the things he didn’t like.
< My Thoughts > “ which caused him to shriek…”
Often, ‘aversions’ are met with shrieking or screaming to avoid the unwanted experience. This could be because the child’s sensitivity is way beyond the intensity that you or I may experience under the same circumstances. And, when one is dealing with sensory issues, a child may shriek just to feel relief.
Storrs, C. (2015) says that researchers found children without autism took their time sniffing a rose, but not so with rotten fish. But children with autism that had either an exaggerated or numbed response to sight, sound, and touch, responded differently to smells. These ASD participants stayed an equal amount of time with both the roses and the rotten fish, as they did with the shampoo and the sour milk.
Wiggins, L., Robins, D., et al. (2009) found that although usually tactile sensitivity and auditory filtering were reported the most by parents of children with autism, they found that the next highly reported sensory problem was with abnormal responses to tastes or smells. In this sensory domain, children with ASD allowed only limited textures or temperatures in food, into their world. Because they avoided certain tastes and smells, parents described them as ‘picky eaters’.
Legis, J., Messinger, D., et al. (2013) were led to believe that children with autism were always thought to have facial expressions which displayed their reaction to match the odor they’re smelling. But they found studies which said that was not always true. Facial expressions were said to depend more upon which neural systems were receiving the information than anything else.
LaBianca, S., Pagsberg, A. et al. (2018) let us know that with the introduction of Diagnostic & Statistical Manual-5 (DSM-5 2013) there is a new diagnostic criterion for Attention Deficit Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD) as being co-morbid within the spectrum. Having early onset symptoms which persist throughout one’s lifetime; although symptoms often going undiagnosed until adulthood.
Ali, Z. (2019) quotes the Centers for Disease Control and Prevention (CDC) as claiming that 9.4% of 2 to 17-year-olds in the U.S. have received an ADHD diagnosis at some time. She explains that there is a mistaken belief that ADHD is a ‘boy’s disorder’, when in fact girls often just go undiagnosed. Studies show that girls with ADHD often develop coping mechanisms which allow them to disguise their symptoms until well into adulthood.
Risk factors. Some factors that may increase the risk of developing ADHD include –
Ali, Z. explains that there are three types of ADHD –
She found that girls were diagnosed with ADHD later in life, after seeking help for anxiety and depression.
Bogdashina, O., & Casanova, M. (2016) describe HYPER-Activity response as caused by a sensory channel that may stay ’wide open’, resulting in more stimulation than the brain can handle. Continuing to explain that children with hyper-activity often engage in ‘stim’ behavior in order to normalize sensory input. When involved in ‘stimulating behavior’ these individuals will rock, spin, flap, or tap in order to calm themselves. Coping with unwanted sensory input, or even their own ‘stimming’ behavior can result in the child covering their eyes or ears and making noises to block out input to the brain.
These authors explain that a Hyper-Activity response is an acute, heightened, or excessive sensitivity to what is happening around them in the environment. When being exposed to florescent lights, unfortunately these children will see a disturbing 60-cycle flickering, causing the whole room to pulsate.
One person said, “My world was fragmented, my sensory world was so skewed that my mother was a smell, my father a tone, my brother something always moving.” Another said, “I remember being attracted to pieces of people’s faces. Not the whole face, but their hair, their eyes, or their teeth attracted me.” Because their perception is often fragmented, distorted, or delayed they are seeing parts of things instead of wholes.
Storrs, C. (2015) says the study investigated found those with autism sensory issues who like to ‘sniff’ people. Even saying that they choose their friends based on their odor; even though that odor is imperceptible to most.
Phelan, S. (2015) further explains the circumstances of one’s perception. She says that upon hearing a dog bark, most of us pay attention briefly, then carry on. But a child having a negative experience with dogs may respond with a ‘startle’ response or feelings of anxiety until s/he feels they are out of harm’s way. For some with sensory issues, that heightened state of alertness will stay with them throughout the day.
Bogdashina, O., & Casanova, M. (2016) quote Tito Muknopadhyay as describing his hyper excitable state this way – “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 > “…hyper excitable state…”
Some research suggests that certain patterns of HYPO and HYPER Activity can co-occur simultaneously, as individuals react to a sudden sensory stimulus from the environment. Perhaps this was the cause of Tito’s response.
Donkers, F., Schiput, S., et al. (2015) detail about ‘mismatched’ reactions to environmental stimulus. They say that brain responses to stimuli causes persons to cover their ears because that particular stimuli triggers a memory, not necessarily because the sound is loud or painful.
Evans, C., Nelson, L., Porter, C. (2012) explain – “Children scoring high on ‘novelty’ awareness tend to be more social, can control more impulses, and are better able to comply with the tasks they are given.”
Neil, L., Green, D., et al. (2017) know that it is important to choose which behaviors are HYPO and which are HYPER responses, because measuring and labeling is necessary to provide funds for various services from providers and insurance companies. This may not optimally account for the full range of sensory symptoms the person is experiencing. For instance, the questionnaire may ask – Does your child show an unusual response to _____? The scoring does not determine the difference between HYPO and HYPER responsiveness.
< My Thoughts > “…an unusual response…”
Our Sonny sometimes expresses sadness when he is in fact very happy. And conversely, may express happiness when he is sad or disappointed. Some children start showing signs of anxiety, when they are really just happy and excited. This may or may not be the result of sensory input, but it is an ‘unusual response’.
Cariello, C. (2015) comments about her son Jack who has common self-stimulation practices including things like hand-flapping and humming. He even gallops across the room with his fingers in his mouth and grunts loudly or constantly clears his throat. She says they call it the ‘zoomies’.
Davide-Rivera, J. (2013) tells that as a child, when smells overwhelmed me, they just said I had a sensitive stomach.
< My Thoughts > “…smells overwhelmed me…”
Some children can also become nauseous from their ‘stimming’ behavior, like spinning or the motion of running purposely, like a wild child, back and forth across the room.
Bogdashina, O., & Casanova, M. (2016) tell us that ‘olfaction’, the sense of smell, has in its olfactory system 10 million smell receptors in the nose, of 20 different types. These receptors in the nostrils respond quickly, guiding the chemicals in the air through the nose. But the intensity of the smell can be lost very rapidly.
Some autistic individuals have ‘hyper-olfactory’ sensitivities, comparable to that of canines. To them, the smell or taste of food can be intolerable, no matter how hungry they are. Due to its smell, they will only eat certain foods.
Some children with ‘hypo-sensitivity’ will chew and smell everything they can. They will lick objects, play with feces, and easily regurgitate. Their ‘sense of taste’ is not very strong because one tastes the chemicals in liquids. Compared to the ‘sense of smell’ which operates on sensing chemicals in the air.
The authors go on to say that some people associate a particular smell with a feeling of calm. Especially if they have experienced scented oils during a body massage, this can trigger feelings of calmness. The opposite may also be true, if for some reason the person has had a bad experience associated with a smell, then that smell can trigger a negative emotion. When this happens, the individual may experience nausea, or even outbursts of emotion, as well as covering or rubbing their nose.
Howe, E. & Stagg, S. (2016) discuss the ‘smell’ sensitivity experiences some individuals may have. Saying that many people can have a ‘positive’ reaction to an environmental smell, while others can feel anything from severe physical discomfort to mere annoyance. Some state that certain smells make them feel stressful, anxious, and/or provoked. And, these sensitive reactions varied greatly in their intensity from mild to extreme.
< My Thoughts > “…‘smell’ sensitivity…”
One semester, in the Middle School Special Education classroom, there were a number of boys with various diagnoses, including ADHD. Erring on the side of caution, I found it necessary to make certain that the detergent, hand soap, and other chemical cleaning products that I used personally, and in the classroom had no ‘fragrance’, due to most of their sensitivity to smells.
Note: Here, under HYPER-Activity, Attention Deficit Hyperactivity Disorder (ADHD) will be discussed.
Squaresky, M. (2014) says her son Greg did not tolerate certain smells which caused him to shriek until dinner was over. Family mealtimes were often ruined.
Greg despised the smell of chicken, pasta, or fish in the kitchen. He gave new meaning to the need for sameness. Greg ate only Boston Style pizza from a pizzeria, almost every day.
I left Jay and Adam to dine alone while I took Greg out for a car ride, just to stop the agony.
We only thought of survival, unaware that we were teaching Greg that by screaming he could avoid the things he didn’t like.
< My Thoughts > “ which caused him to shriek…”
Often, ‘aversions’ are met with shrieking or screaming to avoid the unwanted experience. This could be because the child’s sensitivity is way beyond the intensity that you or I may experience under the same circumstances. And, when one is dealing with sensory issues, a child may shriek just to feel relief.
Storrs, C. (2015) says that researchers found children without autism took their time sniffing a rose, but not so with rotten fish. But children with autism that had either an exaggerated or numbed response to sight, sound, and touch, responded differently to smells. These ASD participants stayed an equal amount of time with both the roses and the rotten fish, as they did with the shampoo and the sour milk.
Wiggins, L., Robins, D., et al. (2009) found that although usually tactile sensitivity and auditory filtering were reported the most by parents of children with autism, they found that the next highly reported sensory problem was with abnormal responses to tastes or smells. In this sensory domain, children with ASD allowed only limited textures or temperatures in food, into their world. Because they avoided certain tastes and smells, parents described them as ‘picky eaters’.
Legis, J., Messinger, D., et al. (2013) were led to believe that children with autism were always thought to have facial expressions which displayed their reaction to match the odor they’re smelling. But they found studies which said that was not always true. Facial expressions were said to depend more upon which neural systems were receiving the information than anything else.
LaBianca, S., Pagsberg, A. et al. (2018) let us know that with the introduction of Diagnostic & Statistical Manual-5 (DSM-5 2013) there is a new diagnostic criterion for Attention Deficit Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD) as being co-morbid within the spectrum. Having early onset symptoms which persist throughout one’s lifetime; although symptoms often going undiagnosed until adulthood.
Ali, Z. (2019) quotes the Centers for Disease Control and Prevention (CDC) as claiming that 9.4% of 2 to 17-year-olds in the U.S. have received an ADHD diagnosis at some time. She explains that there is a mistaken belief that ADHD is a ‘boy’s disorder’, when in fact girls often just go undiagnosed. Studies show that girls with ADHD often develop coping mechanisms which allow them to disguise their symptoms until well into adulthood.
Risk factors. Some factors that may increase the risk of developing ADHD include –
- someone in their biological family having ADHD, or another mental health disorder
- maternal drug use or smoking during pregnancy
- premature birth
- maternal exposure to environmental poisons during pregnancy
- environmental toxins
- certain food additives in the diet
Ali, Z. explains that there are three types of ADHD –
- Inattentive – person doesn’t pay attention, but is not disruptive.
- Hyperactive and Impulsive – person focuses, but is disruptive.
- Combined – person shows a combination of both types.
She found that girls were diagnosed with ADHD later in life, after seeking help for anxiety and depression.
Smith, R., & Sharp, J. (2013), when interviewing a young woman with Asperger’s, found that she thought that if she had had an early diagnosis – “It would have saved a lot of the wondering ‘what’s wrong with me’ and I could have learnt to cope with things better sooner.”
Research indicates that while most boys with ADHD tend to express their frustration physically and verbally, girls are more likely to internalize their anger and pain. The symptoms in girls may be less obvious, and they may not fit the common stereotypes associated with ADHD.
Early signs of ADHD in girls include the following –
Girls with combined-type ADHD (hyperactive-impulsive and inattentive) are significantly more likely to self-harm or attempt suicide. However, around 40% of girls outgrow their hyperactive and impulsive symptoms in adolescence.
Nadeau, E., Littman, E., et al. (2000) need to explain the possible symptom complications with girls. They say that if a girl with ADHD does not receive a diagnosis or have treatment as she enters adolescence, or young adulthood, she will almost inevitably encounter a “range of adjustment problems.”
ADHD may have associations with one or more additional disorders, such as –
Women with ADHD are more likely to engage in high-risk sexual behavior and to develop substance addiction, according to these authors.
The problems that girls and women with ADHD may experience include –
These factors can lead to work and relationship problems, as well as underachievement in various aspects of life.
Schiltz , H., McIntyre, N., et al. (2017) say that parents of children on the autism spectrum often misinterpret signs of inattention, hyperactivity, tantrums and oppositionality, as symptoms of anxiety. When between 28 – 55% proportion of youth with ASD also have ADHD, as well as problems with emotional regulation (ER).
Miranda, A., Tarraga, R., et al. (2015) reveal that “recent studies have not only shown the high comorbidity rate between ASD and ADHD” but the two disorders also “share various characteristics.” Therefore, a child with both disorders, “are characterized with greater manifestations than would be expected for the individual’s developmental level.” In other words, the person has been given two lifetime disabilities to cope with. No wonder the parents feel that ‘something is missing.’ Just the hyper-vigilance needed to keep the child safe 24/7 can set them on edge and make them stressful. Then if, as is often the case, parents begin to question their ability to “manage the child’s behavior, make decisions about discipline,” or generally have anything left that is needed for parenting this child. “Parents begin feeling controlled by their child’s ‘impulsivity’, demands and needs. They begin to feel discontent with life, and may even begin to lack the emotional closeness that they once felt with their child.”
Shelton, T. (2015) shares – I grew up the oldest of eight children. My mom adopted six wild and wonderful, abused and challenged kids. My four adopted brothers had labels that ranged from autistic to angry.
I rolled my eyes when my mom would insist that the boys were able to feel the same feelings as me, but that their challenges meant the feelings would show up in different places and would probably seem different.
What I saw was one brother rocking, stimming, growling and hitting himself, another staring blankly in whatever direction he was facing, forever needing to pull up his socks, another threatening to beat up whoever was nearest, avoiding eye contact like the plague, and the little one repeating whatever you said while climbing the walls and putting his lips on heaters, licking the refrigerator, or biting a table leg.
Even the professionals in our world kept trying to tell my mom to stop getting her hopes up with these kids…
< My Thoughts > “…stop getting her hopes up…”
The best advice I’ve seen states that parents should remain hopeful, educate themselves in order to become empowered, and to find professionals who are willing to ‘partner’ with them in the planning and interventions ahead. While most parents tend to seek out others who have had successes, vigilantly researching is not to be ignored, in my opinion.
REFERENCES: UNIT 4 CHAPTER 2 SENSORY CATEGORIES; PART 1. HYPO-ACTIVITY, PART 2. HYPER-ACTIVITY
Ali, Z. (2019). ADHD in girls: How is it different?; Retrieved online from –https://www.medicalnewstoday.com/articles/315009/
Ausderau, K., Sideris, J., 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 & Asperger Syndrome; 2nd Edition, eBook.
Cariello, C. (2015). What Color is Monday? How Autism Changed One Family for the Better; eBook Edition.
Davide-Rivera, J. (2013). Twirling Naked in the Streets and No One Noticed: Growing Up with Autism; eBook Edition.
Donkers, F., Schiput, S., 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.
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.
Howe, E., & Stagg, S. (2016). How Sensory Experiences Affect Adolescents with an Autistic Spectrum Condition within the Classroom; Journal of Autism & Developmental Disorders; V46, p1931-1940.
LaBianca, S., Pagsberg, A. et al. (2018). Brief Report: Clusters & Trajectories Across the Autism &/or ADHD Spectrum; Journal of Autism Developmental Disorders; V48, p3629–3636.
Legis, J., Messinger, D., et al. (2013). Emotional responses in Children with High-Functioning Autism: Autonomic Arousal, Facial Behavior, & Self-Report; Journal of Autism & Developmental Disorders; V43, p869-879.
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.
McNeill, C. (2020). Auditory Processing Disorder in Children; Mindd Foundation; Retrieved online from – https://mind.org/auditory-processing-disorder-children/
Miranda, A., Tarraga, R., et al. (2015). Parenting Stress in Families of Children with Autism Spectrum Disorder and ADHD; Exceptional Children; V82:1 p. 81-95.
Nadeau, E., Littman, E., et al. (2000). Understanding Girls with AD/HD: How They Feel & Why They Do What They Do; eBook Edition.
Neil, L., Green, D., et al. (2017). The Psychometric Properties of a New Measure of Sensory Behavior in Autistic Children; Journal of Autism & Developmental Discord; V47:4, p1261-1268.
Phelan, S. (2015). Understanding the Subtypes of Sensory Processing Disorder; Retrieved online from –nspt4kids.com › Resources › Occupational Therapy.
Sabatos-DeVito, M., Schipul, S., 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.
Schiltz , H., McIntyre, N., Swain-Lerro, L., et al. (2017). The Stability of Self-Reported Anxiety in Youth with Autism Versus ADHD or Typical Development; Journal of Autism Developmental Disorders; V47, p3756–3764.
Shelton, T. (2016). Spinning In Circles & Learning from Myself: A Collection of Stories; eBook edition.
Siri, K. & Lyons, T. (2014). Cutting-Edge Therapies for Autism; 4th Edition; Skyhorse Publishing, New York, N.Y.
Smith, R., & Sharp, J. (2013). Fascination & Isolation: A Grounded Therapy Exploration of USE in Adults with Asperger’s; Journal of Autism Developmental Disorders; V43:4, p891-910.
Squaresky, M. (2014). A Spot on the Wall; eBook Edition.
Storrs, C. (2015). The Smell Test May Nose Autism Research Forward; Modern Healthcare; V45:29, p36.
Wiggins, L., Robins, D., et al. (2009). Brief Report: Sensory Abnormalities as Distinguishing Symptoms of Autism Spectrum Disorders in Young Children; Journal of Developmental Disorders; V39:7, p187-191.
DISCLAIMER (2024) Know Autism – Know Your Child: with < My Thoughts > by Sara Luker; 2024
Just to let you know that I, Sara Hayden Luker, have put forth my best efforts in presenting what I have learned about autism, by sharing the stories and studies of those who have gone before us. Any author’s mention of products, services, treatments, and interventions or actions are not to be considered an endorsement, thereof. Know that to some, autism is an ‘unregulated business’. The content of this website material, digital or in any other form does not represent medical advice; nor does it constitute medical suggestions in any way. The material, including any downloadable parts, is for informational and/or educational purposes only. Your download and/or use of any of this material indicates your acceptance of this disclaimer.
This is a Personal Use Electronic Download. By downloading, you hereby agree and acknowledge that you are not acquiring any right, title or interest in, or to, the material; nor any associated copyrights, other than the right to possess, hold and use for personal, non-commercial purposes. Furthermore, you agree that you will: (i) not scan, copy, duplicate, distribute or otherwise reproduce the material(s) to resell, (ii) not use the material(s) for any commercial purposes. By purchasing/downloading you agree to these terms unconditionally. No ‘rights’ are given or transferred.
Research indicates that while most boys with ADHD tend to express their frustration physically and verbally, girls are more likely to internalize their anger and pain. The symptoms in girls may be less obvious, and they may not fit the common stereotypes associated with ADHD.
Early signs of ADHD in girls include the following –
- difficulty keeping track of school assignments and deadlines, even if they are making a great effort to stay organized
- regularly running late, despite efforts to keep on schedule
- appearing to “daydream” and therefore missing out on information in class or other situations
- jumping from one topic of conversation to another without warning
- frequently interrupting people when they are talking
- being inattentive at school and home
- forgetting what they have just read or what another person has just said
Girls with combined-type ADHD (hyperactive-impulsive and inattentive) are significantly more likely to self-harm or attempt suicide. However, around 40% of girls outgrow their hyperactive and impulsive symptoms in adolescence.
Nadeau, E., Littman, E., et al. (2000) need to explain the possible symptom complications with girls. They say that if a girl with ADHD does not receive a diagnosis or have treatment as she enters adolescence, or young adulthood, she will almost inevitably encounter a “range of adjustment problems.”
ADHD may have associations with one or more additional disorders, such as –
- depression
- anxiety
- eating disorders, such as Bulimia Nervosa
Women with ADHD are more likely to engage in high-risk sexual behavior and to develop substance addiction, according to these authors.
The problems that girls and women with ADHD may experience include –
- chronic stress
- a higher risk of stress-related diseases such as fibromyalgia, a disorder that causes tiredness and pain
- low self esteem
- underachievement
- anxiety and depression
These factors can lead to work and relationship problems, as well as underachievement in various aspects of life.
Schiltz , H., McIntyre, N., et al. (2017) say that parents of children on the autism spectrum often misinterpret signs of inattention, hyperactivity, tantrums and oppositionality, as symptoms of anxiety. When between 28 – 55% proportion of youth with ASD also have ADHD, as well as problems with emotional regulation (ER).
Miranda, A., Tarraga, R., et al. (2015) reveal that “recent studies have not only shown the high comorbidity rate between ASD and ADHD” but the two disorders also “share various characteristics.” Therefore, a child with both disorders, “are characterized with greater manifestations than would be expected for the individual’s developmental level.” In other words, the person has been given two lifetime disabilities to cope with. No wonder the parents feel that ‘something is missing.’ Just the hyper-vigilance needed to keep the child safe 24/7 can set them on edge and make them stressful. Then if, as is often the case, parents begin to question their ability to “manage the child’s behavior, make decisions about discipline,” or generally have anything left that is needed for parenting this child. “Parents begin feeling controlled by their child’s ‘impulsivity’, demands and needs. They begin to feel discontent with life, and may even begin to lack the emotional closeness that they once felt with their child.”
Shelton, T. (2015) shares – I grew up the oldest of eight children. My mom adopted six wild and wonderful, abused and challenged kids. My four adopted brothers had labels that ranged from autistic to angry.
I rolled my eyes when my mom would insist that the boys were able to feel the same feelings as me, but that their challenges meant the feelings would show up in different places and would probably seem different.
What I saw was one brother rocking, stimming, growling and hitting himself, another staring blankly in whatever direction he was facing, forever needing to pull up his socks, another threatening to beat up whoever was nearest, avoiding eye contact like the plague, and the little one repeating whatever you said while climbing the walls and putting his lips on heaters, licking the refrigerator, or biting a table leg.
Even the professionals in our world kept trying to tell my mom to stop getting her hopes up with these kids…
< My Thoughts > “…stop getting her hopes up…”
The best advice I’ve seen states that parents should remain hopeful, educate themselves in order to become empowered, and to find professionals who are willing to ‘partner’ with them in the planning and interventions ahead. While most parents tend to seek out others who have had successes, vigilantly researching is not to be ignored, in my opinion.
REFERENCES: UNIT 4 CHAPTER 2 SENSORY CATEGORIES; PART 1. HYPO-ACTIVITY, PART 2. HYPER-ACTIVITY
Ali, Z. (2019). ADHD in girls: How is it different?; Retrieved online from –https://www.medicalnewstoday.com/articles/315009/
Ausderau, K., Sideris, J., 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 & Asperger Syndrome; 2nd Edition, eBook.
Cariello, C. (2015). What Color is Monday? How Autism Changed One Family for the Better; eBook Edition.
Davide-Rivera, J. (2013). Twirling Naked in the Streets and No One Noticed: Growing Up with Autism; eBook Edition.
Donkers, F., Schiput, S., 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.
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.
Howe, E., & Stagg, S. (2016). How Sensory Experiences Affect Adolescents with an Autistic Spectrum Condition within the Classroom; Journal of Autism & Developmental Disorders; V46, p1931-1940.
LaBianca, S., Pagsberg, A. et al. (2018). Brief Report: Clusters & Trajectories Across the Autism &/or ADHD Spectrum; Journal of Autism Developmental Disorders; V48, p3629–3636.
Legis, J., Messinger, D., et al. (2013). Emotional responses in Children with High-Functioning Autism: Autonomic Arousal, Facial Behavior, & Self-Report; Journal of Autism & Developmental Disorders; V43, p869-879.
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.
McNeill, C. (2020). Auditory Processing Disorder in Children; Mindd Foundation; Retrieved online from – https://mind.org/auditory-processing-disorder-children/
Miranda, A., Tarraga, R., et al. (2015). Parenting Stress in Families of Children with Autism Spectrum Disorder and ADHD; Exceptional Children; V82:1 p. 81-95.
Nadeau, E., Littman, E., et al. (2000). Understanding Girls with AD/HD: How They Feel & Why They Do What They Do; eBook Edition.
Neil, L., Green, D., et al. (2017). The Psychometric Properties of a New Measure of Sensory Behavior in Autistic Children; Journal of Autism & Developmental Discord; V47:4, p1261-1268.
Phelan, S. (2015). Understanding the Subtypes of Sensory Processing Disorder; Retrieved online from –nspt4kids.com › Resources › Occupational Therapy.
Sabatos-DeVito, M., Schipul, S., 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.
Schiltz , H., McIntyre, N., Swain-Lerro, L., et al. (2017). The Stability of Self-Reported Anxiety in Youth with Autism Versus ADHD or Typical Development; Journal of Autism Developmental Disorders; V47, p3756–3764.
Shelton, T. (2016). Spinning In Circles & Learning from Myself: A Collection of Stories; eBook edition.
Siri, K. & Lyons, T. (2014). Cutting-Edge Therapies for Autism; 4th Edition; Skyhorse Publishing, New York, N.Y.
Smith, R., & Sharp, J. (2013). Fascination & Isolation: A Grounded Therapy Exploration of USE in Adults with Asperger’s; Journal of Autism Developmental Disorders; V43:4, p891-910.
Squaresky, M. (2014). A Spot on the Wall; eBook Edition.
Storrs, C. (2015). The Smell Test May Nose Autism Research Forward; Modern Healthcare; V45:29, p36.
Wiggins, L., Robins, D., et al. (2009). Brief Report: Sensory Abnormalities as Distinguishing Symptoms of Autism Spectrum Disorders in Young Children; Journal of Developmental Disorders; V39:7, p187-191.
DISCLAIMER (2024) Know Autism – Know Your Child: with < My Thoughts > by Sara Luker; 2024
Just to let you know that I, Sara Hayden Luker, have put forth my best efforts in presenting what I have learned about autism, by sharing the stories and studies of those who have gone before us. Any author’s mention of products, services, treatments, and interventions or actions are not to be considered an endorsement, thereof. Know that to some, autism is an ‘unregulated business’. The content of this website material, digital or in any other form does not represent medical advice; nor does it constitute medical suggestions in any way. The material, including any downloadable parts, is for informational and/or educational purposes only. Your download and/or use of any of this material indicates your acceptance of this disclaimer.
This is a Personal Use Electronic Download. By downloading, you hereby agree and acknowledge that you are not acquiring any right, title or interest in, or to, the material; nor any associated copyrights, other than the right to possess, hold and use for personal, non-commercial purposes. Furthermore, you agree that you will: (i) not scan, copy, duplicate, distribute or otherwise reproduce the material(s) to resell, (ii) not use the material(s) for any commercial purposes. By purchasing/downloading you agree to these terms unconditionally. No ‘rights’ are given or transferred.