UNIT 4 – When Is It Sensory?
INTRODUCTION
Chapter 1 – Sensory Issues
PART 1.
a. Sensory Defensiveness
b. Sensory Avoidance
Chapter 2 – Sensory Categories
PART 1. HYPO-ACTIVITY
PART 2. HYPER-ACTIVITY
PART 3. SIRS (Sensory Interests,
Repetitions, & Seeking behaviors)
a. Sensory Interests
a. 1. SIBs Self-Injurious Behaviors.
b. Repetitious Behavior
c. Seeking Behavior
PART 4. ENHANCED PERCEPTION
APPENDIX A – Sensory Processing Disorder Checklist
APPENDIX B – Autism Spectrum Disorder Sensory Profile
Chapter 3 – Sensory Integration
PART 1. Sensory System
PART 2. Sensory Profile
PART 3. Sensory Diet
a. Brushing Techniques
PART 4. Sensory Room
Unit 4 – REFERENCES
PLEASE READ DISCLAIMER –
Unit 4 – SENSORY
CHAPTER 1 INTRODUCTION, SENSORY ISSUES
PART 1 Sensory Processing
a. Sensory Defensiveness behavior
b. Sensory Avoidance behavior
POSTER sayings – Clockwise @ 12 o’clock SENSORY PROCESSING ISSUES –
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.
INTRODUCTION
Chapter 1 – Sensory Issues
PART 1.
a. Sensory Defensiveness
b. Sensory Avoidance
Chapter 2 – Sensory Categories
PART 1. HYPO-ACTIVITY
PART 2. HYPER-ACTIVITY
PART 3. SIRS (Sensory Interests,
Repetitions, & Seeking behaviors)
a. Sensory Interests
a. 1. SIBs Self-Injurious Behaviors.
b. Repetitious Behavior
c. Seeking Behavior
PART 4. ENHANCED PERCEPTION
APPENDIX A – Sensory Processing Disorder Checklist
APPENDIX B – Autism Spectrum Disorder Sensory Profile
Chapter 3 – Sensory Integration
PART 1. Sensory System
PART 2. Sensory Profile
PART 3. Sensory Diet
a. Brushing Techniques
PART 4. Sensory Room
Unit 4 – REFERENCES
PLEASE READ DISCLAIMER –
Unit 4 – SENSORY
CHAPTER 1 INTRODUCTION, SENSORY ISSUES
PART 1 Sensory Processing
a. Sensory Defensiveness behavior
b. Sensory Avoidance behavior
POSTER sayings – Clockwise @ 12 o’clock SENSORY PROCESSING ISSUES –
- 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
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.
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). 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.
Note: UNIT 3 APPENDIX has a Temperament Assessment Scale for Children which includes ‘temperature’ sensitivity. More about ‘thermoregulation’ in Sensory Integration.
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.
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/
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
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.
UNIT 4 – WHEN IS IT SENSORY?
INTRODUCTION – Sensory
Chapter 1 – Sensory Issues
PART 1.
a. Sensory Defensiveness
b. Sensory Avoidance
Chapter 2 – Sensory Categories
PART 1. HYPO-ACTIVITY
PART 2. HYPER-ACTIVITY
PART 3. SIRS (Sensory Interests,
Repetitions, and Seeking behaviors)
a. Sensory Interests
a. 1. SIBs Self-Injurious
Behaviors.
b. Repetitious Behavior
c. Seeking Behavior
PART 4. ENHANCED PERCEPTION
APPENDIX –
Chapter 3 – Sensory Integration
PART 1. Sensory System
PART 2. Sensory Profile
PART 3. Sensory Diet
a. Brushing Techniques
PART 4 – Sensory Room
Unit 4 – REFERENCES
Unit 4 – APPENDICES
PLEASE READ DISCLAIMER –
UNIT 4 CHAPTER 2 – SENSORY CATEGORIES
INTRODUCTION – Sensory
Chapter 1 – Sensory Issues
PART 1.
a. Sensory Defensiveness
b. Sensory Avoidance
Chapter 2 – Sensory Categories
PART 1. HYPO-ACTIVITY
PART 2. HYPER-ACTIVITY
PART 3. SIRS (Sensory Interests,
Repetitions, and Seeking behaviors)
a. Sensory Interests
a. 1. SIBs Self-Injurious
Behaviors.
b. Repetitious Behavior
c. Seeking Behavior
PART 4. ENHANCED PERCEPTION
APPENDIX –
Chapter 3 – Sensory Integration
PART 1. Sensory System
PART 2. Sensory Profile
PART 3. Sensory Diet
a. Brushing Techniques
PART 4 – Sensory Room
Unit 4 – REFERENCES
Unit 4 – APPENDICES
PLEASE READ DISCLAIMER –
UNIT 4 CHAPTER 2 – SENSORY CATEGORIES
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 (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 (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 (2015) believes 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, 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 & Lyons (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 (2015) believes 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, 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 & Lyons (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 & Casanova (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 (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 (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 & Casanova (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, et al. (2015) talk 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, et al. (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, et al. (2017) remind us 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 (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 & Casanova (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 & Stagg (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 (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 (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, 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, et al. (2013) believed 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 (2018) lets 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 (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 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 & Casanova (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 (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 (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 & Casanova (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, et al. (2015) talk 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, et al. (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, et al. (2017) remind us 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 (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 & Casanova (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 & Stagg (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 (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 (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, 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, et al. (2013) believed 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 (2018) lets 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 (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 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 & Sharp (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 –
- 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, et al. (2019) 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, 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, et al. (2015), “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 (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., Pellicano, E. (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, 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.