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, & Seeking behaviors)
               a. Sensory Interests    
                                      a.1.SIBs Self-Injurious Behaviors
               b. Repetitious Behavior
               c. Seeking Behavior
          PART 4. ENHANCED PERCEPTION
                        
Chapter 3 – Sensory Integration
          PART 1. Sensory System
          PART 2. Sensory Profile
          PART 3. Sensory Diet
                         a. Brushing Techniques
           PART 4. Sensory Room
 ​      APPENDIX A Sensory Processing Scale (SPS)
Unit 4 – REFERENCES
Unit 4 – APPENDICES
 
PLEASE READ DISCLAIMER –

CHAPTER 3 SENSORY INTEGRATION –

​INTRODUCTION
 
Leong, H., Carter, M., et al. (2014) say simply, ‘sensory integration’ is the relatedness of one to others, one to their environment, and one's ability to adjust oneself to function within the environment with oneself, others, and objects within it.
 
What is Sensory Integration? It is the process by which our body receives information through our senses, organizes this incoming information. And then, the information is processed, responded to, used to participate in everyday activities; or is ignored.   
 
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 things are going on). And yet another child with severe tactile defensiveness may be terrified to stand next to someone for fear of being touched by them.
 
< My Thoughts >         “…mistaken for behavioral problems…”
 
Sensory problems can be so complex, often causing persons with autism to be put into long lasting ‘behavior treatment’ programs which aren’t very successful. That’s because they’re being treated for their responses to unidentified sensory issues, and not for the challenging behavior the program was designed for.

Family Education Editor (2020) finds yet another explanation of Sensory Integration dysfunction. This one refers to how people may have difficulties using the information provided by ‘all’ the sensations coming from within and from outside the body, as well as from the external environment. We usually think of the senses as separate channels of information, but they actually work together to give us a reliable picture of the world and our place in it.
 
Your senses integrate to form a complete understanding of who you are, where you are, and what is happening around you. Because your brain uses information about sights, sounds, textures, smells, tastes, and movement in an organized way, you assign meaning to your sensory experiences. 
 
Bogdashina, O. (2011) – These are complex issues, because when the sensory system is not naturally integrated, any or all sensory reactions will seem to be undesirable behaviors. Keep in mind that sensory excitement can trigger stimming, hand-flapping, head-banging, hair pulling, scratching or biting, or whatever seems to break the circuit. These are reactions, not thoughtful actions.

Classic Sensory Integration Therapy (SIT), according to the meta-analysis reported on in Leong et al. (2014), is an intervention for an individual, but delivered in a small group session.
 
Therapists use various forms of sensory stimulation in SIT –
​

• rubbing with brushes or other textured items
• being placed in a hammock, or spun in a swing
• rocked back and forth in a rocking chair or while lying on a gym ball.

 
Sometimes, the individual needs joint compression from wrist weights, or rolling movement on a scooter board.
 
Doumas, M., McKenna, R., et al. (2915) explain that we receive sensory information from three main channels, our eyes, our ears, and our touch. They state that control of a task does not rely equally on all three channels simultaneously, but rather on information from the channel most relied upon for receiving that information.

For instance, one uses their sight to see where they are going, until it becomes dark. Then the other two sensory channels of hearing and touch are relied upon, or needed the most for sensory information because there is no longer reliable visual information available in the dark.
 
Sensory issues come with a long history of ideas that they are really what is behind most unwanted behavior we see in our children. How the sensory integration and sensi-motor control processes affect the person with Autism Spectrum Disorder; or even in ourselves, has been explored in three early programs by their innovators, as follows:

• Sensory Integration by A. Jean Ayers
• Sensory Profile by Winnie Dunn
• Sensory Diet by Patricia Wilbarger

Widely recognized is Ayres' definition of sensory integration – "Sensory integration is the neurological process that organizes sensations from one's body and from the environment, and makes it possible to use the body to make adaptive responses within the environment. To do this, the brain must register, select, interpret, compare, and associate sensory information in a flexible, constantly-changing pattern" A. Jean Ayres, 1989; Retrieved online from – http://senseablekids.com/sensInt.html
 
Leong, H., Carter, M., et al. (2014) lead us to think that the problem of authenticating the value of Sensory Integration Therapy may lie with the integrity of the trials, or with ‘pre’ and ‘post’ test validity. They point out that the therapy response differences could also be with the state of brain ‘plasticity’ of the child/adult receiving the therapy. Different practices, interpretations and theories have been explored since the A. Jean Ayres’ Sensory Integration strategies began to be considered, in 1972.
 
While Lydon, H., Healy, O., et al. (2017) in their study, found that participants in Sensory Integration Therapy (SIT), attended a variety of settings with the therapist working directly with them, using techniques and equipment, during a 30-minute block. They found that this type of therapy was successful, but it often needed to be applied throughout the day, and it consistently needed reinforcement when part of behavioral intervention. Also, review and follow-up of data was needed at 1 month.
 
Thompson, T. (2012) tells us that the Ayers’ method of satisfying sensory needs through sensory integration therapy ranged from the calming input of massage and weighted vests, to listening to music which massages the middle ear hair cells in the cochlea. These various sensory-based stimulation techniques are incorporated into programs or used in isolation.
 
Jones, S. (2013) exclaims – What you don’t see are the amazing victories I accomplish every day. Because all the work I have put in has only succeeded in making me appear flawed in your eyes instead of disabled. I have worked so hard and accomplished so much only to be told that if I work a little harder, I might measure up to mediocre. This is something you really need to understand if you want to know what it’s like to be me, one Autistic girl, trying desperately to find a place of safety and comfort in this world.

You want to go out and check your mailbox but there are people out there and you’re not ready to face people with their strange demands and their unexpected questions. So, you wait until 3 am to go take out your trash and see what mail came that day.
 
And you savor the chill night air and the bright stars and the position and phase of the moon. You wish that you could float up into that blue night sky and hover amidst all the beauty. To escape the chaos and pain of a world you have never felt you belonged to, not even before you knew what, or who autism is.

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 (withdrawal, stereotyped movements, etc.). For example, behaviors such as rocking and rhythmic head banging, spinning objects or perimeter hugging (especially in large spaces), and the need to touch everything in a room before settling down, are typical for both autistic children and those with visual impairments.

Borutta, R. (2015) believes that 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. Traumatic inductions can result in behavior changes, sleep disruption and even symptoms resembling post-traumatic stress disorder.

​PART 1. SENSORY SYSTEMS  

Ayres' theory and intervention is based on categorizing seven neuro-sensory systems and the relationship of each with one another. Alfred Tomatis, MD, also developed his framework similarly identifying the same basic systems as Ayres. Current neuroscience research continues to verify and confirm these sensory systems as:

• Tactile: As it sounds, this system is responsible for our sense of touch. The tactile system addresses surface area of our body including the skin, hair, hands, feet, and oral motor cavity. Ineffective processing of this system leads to sensory discrimination disorder or sensory modulation disorder.
• Auditory: This system serves as the sensory integrator of two basic systems within the ear, the vestibular and the cochlear. The sensory integrator is responsible for 90% of our brain's processing, while 60% percent of the stimuli to the brain originate from the bones, joints and muscles, through the ‘vestibular’ system. The remaining percent is from the sound processed through the ‘cochlea’. Since the brain needs stimuli to be nourished, the stimuli and significance of it from the ear is the perception of different sound wave frequencies.
• Visual: This system is now known to be reflective of auditory processing and therefore, it is the ability to perceive and make sense of spatial orientation and direction (vertical vs. horizontal), color, shape, assess intensity of light, process form, etc.
• Olfactory & Gustatory: This system is responsible for our sense of smells, odors, and tastes, and measures the intensity of them. Often, we find that individuals who seek excessive salt, sweetness, or hot spice are under-reactive, while people who tolerate only very bland, or have a limited repertoire of foods are overly-reactive. Likewise, some demonstrate difficulty with smells which may result in nausea or emesis.

 
There Are More than 5 Senses – Most people are familiar with five senses: sight, hearing, smell, taste, and touch. However, we also receive input through three additional senses, they are vestibular, proprioception, and interoception.
 
Vestibular sense, or movement and balance sense, gives us information about where our head and body are in space. Vestibular sense allows us to stay upright while we sit, stand, and walk.

• Vestibular: Known to be one of the first sensory organs completed in utero, this system provides us with information to help detect and process our sense of movement, the pull of earth's gravity, and position in space. "A well-modulated vestibular activity is very important for maintaining a calm, alert state. The vestibular system also helps keep the level of arousal of the nervous system balanced. An under-active vestibular system contributes to hyperactivity and distractibility because of its modulating influence." A. Jean Ayres Ineffective processing of this system may lead to sensory-based motor disorder or sensory modulation disorder.

 Proprioception, or body awareness sense, tells us where our body parts are relative to each other. It also gives us information about how much force to use in certain activities, allowing us to crack open an egg without crushing it in our hands.

• Proprioception: This system allows one to process information and gain information from our internal sense which comes from our joints and muscles. One could say this system is a necessary foundation for muscle memory. Generally, problems in the area are associated with tactile and/or vestibular issues which lead to sensory modulation and sensory-based motor disorder.

​Interoception, which some call ‘neuroception’, is the conscious detection and perception of sensory signs in the body and on the skin that is processed as sensations.

• Interoception: This involves the internal regulation responses in our body such as hunger, thirst, fulness, heart rate, blood pressure, and even toileting urges. Gives clues to being tense, anxious, or overly emotional. Helps answer the question “How are you?”

Brain Balance Staff Writer (2018) believes that Sensory Seeking Activities could be Proprioceptive activities, involving anything with slight pressure to the muscles and joints. So, actions like squeezing or massaging can give input to this sense.
 
Another sensory seeking activity could be Vestibular activities involve anything with movement, and children tend to seek that out by spinning, swinging, or climbing; just make certain that you put safety first.
 
Examples of free or quick ways to implement activities that get a lot of mileage with an active sensory seeking ‘wild’ child are –
 
·        Jumping – Any jumping activity is great for sensory seekers because it is loaded with tons of proprioceptive and vestibular input. You can let your child jump on the couch, bed, or a trampoline.
 
·        Climbing – Climbing also stimulates proprioception and vestibular input! Using jungle gyms and stairs in the home are great activities. Or, try a fabric tunnel, which requires some adult help to hold one end of the tunnel open. A lot of deep pressure is also happening with the tunnel, which is very calming.
 
·        Vibrating toys – Vibration gives a lot of proprioceptive input and some vestibular too, believe or not. Not all children like vibration but, if you know your child responds well to vibration try a vibrating toy, or seat which is perfect for meals, homework, story time.
 
·        Pressure – Squeezing into tight spaces like a designated cool down spot or behind the couch achieve this, as well as big bear hugs.  
 
Try activities, such as playing with building blocks, are relatively harmless. Work with a professional to create an even balance. Limit screen time and use sensory resources like ‘chewelry’ and fidget toys to help appropriately tame seeking behaviors.

See if your child will accept appropriate sensory integration, especially activities that involve being with another person. Examples include taking a gymnastics class, where a child would get to jump high on a large trampoline with teammates, or cooking with a parent, where a child would get to smell spices and experience the ingredients first hand while making a dish to taste later.
 
< My Thoughts >        “…experience the ingredients first hand…”
 
Some children, our Sonny included, go through phases where they will only eat that one thing with a recognized flavor, shape or color. When we started cutting crusts off the sandwiches, they became more acceptable. Then when we used a Mickey Mouse cookie cutter, that worked even better. No more spit-out crusts found around the house. Sonny also goes through another phase of eating only green things, or red things. Even when we know this, it sometimes takes a moment to catch on that the family is now going to have to eat all the ‘green’ things we’ve stocked up on, because Sonny has suddenly switched to eating only ‘red’ things. Oh well, at least he’s eating. And yes, we’ve even used food coloring to pass off a food as the color-of-the-week.

Kranowitz, C. & Miller, L.J. (2006) give other examples of Sensory Seeking Behaviors –
​

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

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

Barron, J. (2011) – Sean described his sensory issues. These can be sensory sensitivities or under-sensitivities. I have both. High pitched noises make me dizzy and nauseated. I get so dizzy that sometimes I fall down. My head aches and I feel like throwing up.
 
But there is another sense that doesn’t always get talked about when we talk about the sensory issues and it’s called proprioception. That is the sense of knowing where your body is in space and I have an under-sensitivity in that sense. I can’t feel the ground well under my feet. Combinations of movements and balance like mounting a bike by throwing my leg over it are very difficult for me.
 
Sean’s mother said that his perception of himself appeared to be that of a cardboard cutout – he didn’t realize that there was a back or sides to his body, he only washed the front of himself.
 
< My Thoughts >        “…he didn’t realize that there was a back or sides to his body…”
 
People with ASD, often experience poor ‘proprioception’. ‘Proprioception’ – is a ‘sense’ that tells our bodies what position our body parts are in and where they are. Imagine walking after one of your legs has ‘fallen asleep,’ that will give you some idea of poor ‘proprioception’.
 
We were told that Sean needed, to be put on a retraining program at once. All his movements had to be reversed, many of his perceptions altered. It was going to take half an hour every day, and I was to do it with him. I wasted no time. Here was something I could do, something that would help Sean at last!
 
< My Thoughts >      “put on a retraining program at once…”
 
I’m not certain what Sean’s retraining program consisted of, but when students with ASD receive services from an occupational or physical therapist for ‘proprioception’, one activity might be to move the child’s arm or leg into a certain position. Then ask them to describe the position of that extremity; “Is your arm straight or bent?”
 
Jones, S. (2013) says – I love the sensory input I get from swinging on a swing. In the last couple of years, I have begun sleeping in a Brazilian hammock. I find the swaying movement very soothing. I go to sleep so much more quickly and stay asleep more soundly.
 
< My Thoughts >       “I find the swaying movement very soothing.”
 
Sensory or therapy swings offer opportunities for improving body awareness, sensory and proprioceptive integration. Plus, swinging and swaying has the added benefit of acting as a relaxing and calming effect on the person with autism. 

Elwin, M., Schroder, A., et al (2016) found sensations which can be the foundation of an emotional experience that someone may or may not fully register in their consciousness. But this sensation can become a sensory issue needing sensory integration intervention.
 
Quintiliani, A. (2017) questions – What is interoception, and why is it important? ‘Interoception’ is what a person may feel as that nagging sense of being uncomfortable. Also, ‘interoception’ is considered to be a brain-body-mind-heart interaction, signaling the flight and/or fight responses. These are sensory signals which the body senses as a warning of unsafe conditions. Sensory sensations may be anything from craving, hunger, being too hot or too cold; to any unidentified personal danger in the environment.
 
< My Thoughts >            “…nagging sense…”
 
Because this ‘interoception’ sense is so subtle, it may not fully register with the child. A middle school special education student in my classroom would have a meltdown when the heater clicked on. My first thought was that the faint clicking sound possibly triggered his response. Some students can’t sit near computers or even electrical outlets, or in rooms with fluorescent lighting, due to the buzzing and clicking sounds which they may hear. Many students with autism seem to have supersonic hearing of sounds unheard by the rest of us.
 
But it wasn’t the clicking or buzzing, my classroom was too hot for this student’s skin comfort. So, when the thermostat ‘clicked’ signaling an increase in temperature, it was very upsetting to him. Once I figured it out, just adjusting the temperature when he came into the room solved the problem. Plus, allowing him to sit where he felt the most comfortable helped him feel more in control of his sensory issue.
 
Brain Balance Center Staff Writer (2016) – If a child has a sensory processing disorder, he or she may be sensory craving, sensory seeking or exhibit sensory offensiveness. This is defined as highly interested in movement, lights, colors, sounds, smells and tastes that excite. What should you do to help satiate a sensory-seeking child? First, determine what your child wants to experience and then learn the effects of the items or behaviors that your child uses to fulfill these sensory needs. You can then work on sensory integration by redirecting to more appropriate sensory experiences or by providing small doses of what your child seeks over time to help integrate and reduce the behavior.
 
< My Thoughts >       “…help integrate and reduce the behavior.”
 
Sensory Processing/Integration Therapy can look and seem like play, while reducing the undesirable behavior. In fact, it is sometimes called Play Therapy. It’s not really the stuff that Playdates are made of for the child who resists social activities, but it goes something like this. The child who doesn’t like to touch messy, gooey things is desensitized by playing with something messy and gooey in a game directed by an Occupational Therapist. Or, the child with no sense of balance is guided to swing in a swing to overcome gravitational insecurity. The child wearing headphones is hearing music instead of upsetting environmental noises. And, the child doing yoga is practicing ‘mindful’ awareness postures and thoughts.
 
Many participants say that after their prescribed sessions, they are better able to focus, to learn more easily, and may even sleep better at night. Investigate what’s available in your area, but make certain that the therapist is appropriately qualified, licensed, registered, and has a good track record with a child such as yours. Best to get referrals, if possible

PART 2 – SENSORY PROFILE
 
Morton, H. (2013) made it known that Winnie Dunn, with her ‘Sensory Profile’, added to the development of an understanding of a child’s sensory processing abilities and/or disabilities. Dunn felt that these undesirable sensory responses, plus the individual’s temperament, may negatively impact their daily life as well as their academic learning. The Dunn Sensory Profile is intended to create a comprehensive picture of the person’s sensory performance; this, together with other data will help with diagnostic and intervention planning.
 
Note: More about ‘temperament’ in UNIT 3, Ch. 3.
 
Simpson, K., Adams, D., et al. (2019) say that the ‘sensory needs’ found in a ‘sensory profile’ can appear early in the life of young children on the autism spectrum, impacting them across their lifespan. Types of sensory responses have been associated with differing behaviors in differing environments and/or settings. In addition, one of the challenges in tailoring ‘sensory’ support for individuals on the spectrum may be addressing the many sensory-based subtypes; as 35% of ASD children also have sensory-based subtypes.
 
Simpson adds that the Short Sensory Profile-2 (SSP-2), similarly provides useful information to inform intervention, sensory integration, efforts. And, they advise all participants fortunate enough to have their child tested to be attentive to obtaining copies of their child’s diagnosis reports confirming any diagnoses. These copies may be needed before desired services can be provided, or insurance will be paid.
 
< My Thoughts >             “…have sensory-based subtypes…”
 
Sensory Profiles are used to inform how the therapists create a child’s ‘sensory diet’ to include therapies for sensory-based ‘subtypes’. Once again, a ‘sensory diet’ seldom has anything at all to do with ‘food’, or the traditional ‘diet’ protocols, but does inform therapeutic activities designed for each individual child’s sensory needs. ‘Subtypes’ are described by Ausderau,et al. in the following paragraph.
 
Ausderau, K., Furlong, M., et al. (2014) believe ways to better identify sensory patterns when determining a person’s sensory profile features would be to also know about any existing feature ‘subtypes’. In this study, a large number of ASD children from ages 2-12 years old, participated in a one-year study of subtypes. During this time, it was said that 91% of the participants remained steady in their ‘latent profile transition analysis’.
 
The four subtype features which emerged ranged from mild to extreme. They were labeled – ‘mild’, ‘sensitive-distressed’, ‘attenuated-distressed’, and ‘extreme-mixed’. Profiles were found to show differing response patterns, as well as differing responses within the same domains of ‘hypo’, ‘hyper’, ‘SIRS’, and ‘EP’. Also, new subtypes were added to the profile; they were – ‘gender’, ‘developmental age’, ‘chronological age’, ‘autism severity’, and ‘family characteristics’.
  
APPENDIX A - Sensory Processing Scale (SPS)
 
NOTE: The Sensory Processing Scale Assessment (SPS) is described by Tavassoli, et al. (2015).

The Sensory Processing Scale Assessment (SPS) is described by Tavassoli, et al. (2015) as fifteen structured games which participants play and clinicians observe and note the behavior displayed as they perform these tasks. (Described there in five categories).

1. The ‘paint your arm’ game – participants paint their arm with a feather, a brush, & rough sponge
2. The ‘goo’ game – participants remove two plastic animals from goo.
3. The ’sparkle’ game – participants observe a spinning sparkle wheel for 20 seconds.
4. The ‘round & round’ game – participants observe a black & white spinning wheel for 20 seconds.
5. The ‘orchestra’ game – participants play along to music, making noise with certain instruments.

 
These games are said to address each sensory domain – vision, hearing, and touch. The Sensory Reactivity is determined by clinicians; for instance –

• Hyper-reactivity was identified by an adverse response, discomfort, worries and/or avoidance.
• Hypo-reactivity was identified when participants did not respond, or were slow to respond.
• Sensory seeking behavior was identified when the participant continued to use items after tasks were completed.

 
Balance sensory behavior was identified when participants completed each task within a reasonable time frame and appeared comfortable.
 
Note: More about different types of integration treatments in UNIT 7.
 
REFERENCES: UNIT 4, CHAPTER 3 – SENSORY INTEGRATION, INTRODUCTION, PART 1. SENSORY SYSTEMS, PART 2 SENSORY PROFILE

Ausderau, K., Furlong, M., et al. (2014). Sensory Subtypes in Children with Autism Spectrum Disorder: Latent Profile Transition Analysis Using a National Survey of Sensory Features; Journal of Child Psychology & Psychiatry; V55:8, p935-944.

​Ayres, J. (1989).  Jean Ayres 1920–1988 Therapist, Scholar, Scientist, & Teacher; American Journal of Occupational Therapy, July 1989, V43, p479-480.
 
Barron, J. (2011). There’s a Boy in Here: Emerging from the Bonds of Autism; eBook Edition.
 
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.

​Brain Balance Center Staff Writer, (2016). Sensory Integration Ideas for Sensory Seekers; Retrieved online from – sensory-integration-ideas-for-a-sensory-seeker;
 
Doumas, M., McKenna, R., et al. (2915). Postural Control Deficits in ASD: The Role of Sensory Integration; Journal of Autism Developmental Disorders; V46, p853–861.
 
Elwin, M., Schroder, A., et al (2016). Sensory Clusters of Adults with and without AS Conditions; Journal of Autism Developmental Disorders; V47, p579–589.
 
Family Education Editor (2020). Sensory Integration Dysfunction; Retrieved online from – https://www.familyeducation.com/school/sensory-integration-dysfunction/what-sensory-integration/
 
Jones, S. (2013). No You Don’t – Essays from an Unstrange Mind; eBook Edition.

Kranowitz, C. & Miller, L.J. (2006). Out-of-Sync Child; Penguin Publishers.
 
LaFrance, D., Miquel, C., et al. (2015). A Case Study on the Use of Auditory Integration Training as a Treatment for Stereotypy; Behavioral Intervention; V30, p286-293.
 
Leong, H., Carter, M., et al. (2014), Meta-analysis of Research on Sensory Integration Therapy for Individuals with Developmental and Learning Disabilities; Journal of Developmental Physical Disabilities; V27, p183-206.
 
Lydon, H., Healy, O., et al. (2017). Comparison of Behavioral Intervention & Sensory Integration Therapy on Challenging Behavior of Children with Autism; Behavioral Interventions; V32, p 297-310.
 
Morton, H. (2013). Occupational Therapy for Children Assessment Portfolio; Retrieved online from – https://otforchildrenassessmentportfolio.blogspot.com/2013/04/sensory-profile.html/
 
Quintiliani, A. (2017). What is Interoception, and Why is it Important?; Retrieved online from – https://mindfulhappiness.org/2017/what-is-interoception-and-why-is-it-important/
 
Simpson, K., Adams, D., et al. (2019). Exploring the sensory profiles of children on the autism spectrum using the Short Sensory Profile-2 (SSP-2)  Journal of Autism & Developmental Disorders, V49, p. 2069-2079.

Siri, K. & Lyons, T. (2014). Cutting-Edge Therapies for Autism; 4th Edition: Skyhorse Publishing, N.Y., N.Y.
 
Thompson, T. (2012). Making Sense of Autism; Second Edition. Baltimore, Maryland: Brookes Publishing Company.

PART 3 – SENSORY DIET 
 
Biel, L, & Penske (2018) may surprise us by saying that the ‘Sensory Diet’ is actually NOT about food, but about sensory enriched activities to fulfill a person’s sensory needs. Occupational Therapist, Patricia Wilbarger devised a personalized activity plan which was soon called a Sensory Diet Plan. The purpose of this individualized plan, when followed for 10-20 minutes per day, was to help assist with adaptive, positive responses to environmental stimuli. These activities are designed to keep the brain’s neuro-chemicals flowing steadily throughout the day to improve learning. But when you create a ‘Sensory Diet’, it helps to know what sensory issues are at risk.
 
Gay, Baranek, et al. (2008) draw the conclusion that Dr. Winnie Dunn believed we are ‘seekers’ of sensations in our environment. Dunn understood how bodies differ, and that we could assess those differences in ourselves and others; therefore, she devised the ‘Sensory Profile’.
 
< My Thoughts >       “…‘Sensory Profile’.”
 
A ‘sensory diet’ is developed from the data collected on the ‘sensory profile’ by a trained professional; usually an occupational therapist. The ‘diet’ is actually a determined set of activities to be used to help a specific individual cope with their problematic sensory issues.

Fitzgibbon & O’Sullivan (2018) want to know if you are still asking – “What is a Sensory Diet?” A ‘sensory diet’, they tell us, is a range of ‘sensory strategies and activities’ used throughout the day to help maintain positive feelings and a sense of wellbeing in the individual. When introduced into daily routines, a ‘sensory diet’ activity can support a person. Support will help them to use just the right amount of sensory input necessary to suit their needs and preferences. This helps them to meet the demands of the day by feeling less stressed, calmer and more in control.

< My Thoughts >      “…‘sensory strategies and activities’...”
 
A ‘sensory diet’ is a range of ‘sensory strategies and activities’, developed for a specific individual, to be used throughout the day to help them meet the demands of that day. To signal the need for sensory strategies and activities’, some have embraced the ‘spoon theory’, with a ‘spoon’ as an available daily stress or energy unit. Thus, signaling losing or gaining ‘spoons’, with ‘spoons’ becoming a metaphor for the need to ‘increase’ or ‘decrease’ stress or energy levels.
 
For example, if a child has had a great number of challenges that morning, signaling that they have used most of their ‘spoons’, the rest of the day might be better spent with enjoyable or already learned activities. Thus, keeping a spoon or two in reserve by spending time doing ‘sensory diet’ activities, and perhaps gaining a spoon or two.

Hatch-Rassmussen (2019) has described a Sensory Diet as a prescribed group of activities, specifically scheduled into a child’s day to assist with input, attention, arousal and adaptive ‘sensory responses’. These activities are designed for brain regulation and should be monitored by an Occupational Therapist to ensure a positive effect on the child with sensory needs. 
 
Kelly (2019) once again reminds us that a ‘sensory diet’ has nothing to do with food, but is a series of tailored activities and accommodations to meet sensory needs. This ‘sensory diet’ routine is carefully designed to help children get what they need to pay attention to learning in school, instead of being distracted by sensory issues. An accommodation routine to make them feel more sociable and more alert throughout their day.
 
Usually, the Occupational Therapist (OT) develops this activity diet to exactly fit their sensory needs. Parents can also be taught to do this unique activity plan at home. This is what part of a ‘sensory diet’ might look like:

• Jumping Jacks for 20 minutes
• Bouncing on a therapy ball, 20 times
• Holding a yoga pose for 19 seconds

Because they may not know when they are having sensory needs, ‘self-awareness’ can also be taught to individuals. This will help the them identify when these activities are needed and when they are working for them.
 
​< My Thoughts >      “…identify when these activities are needed …”

Whatever you do, activity-wise, whatever sensory tools you choose for your child, make certain that it ‘works easily and comfortably for you, too. Make it fit with the your (and the school’s) daily schedule. That way, the Sensory Diet will become more effective, providing for the child / student more consistency. And, remember that as a parent or as a teacher, you can add these ‘sensory need’ accommodations to your child’s Individualized Educational Program (IEP). Goals; and revisit them as sensory needs change.
 
The Key Takeaways this author Kelly (2019) gives us are –
​

•         A ‘sensory diet’ helps children get in a “just right” state so they can pay attention and learn.
•        Activities in a ‘sensory diet’ can help children who are over-reactive feel more calm, and under 

                reactive children feel more alert.

•       You and your Occupational Therapist can work ‘sensory diet’ activity goals into your child’s school day,

                through their Individualized Education Program (IEP).

Kelly, an Occupational Therapist (OT) herself, says that with your child’s OT, you can be guided to do routine activities at home with the whole family. Saying that it’s helpful when the parent or caregiver can implement ‘sensory diet’ activities as they are needed. But that it’s also okay for them to wait for the OT if they aren’t feeling confident on their own.
 
Moore, et al. (2015) caution that in a study of 8-19 year old autistic participants with motor ‘stereotypy’ movement disorder characteristics, the use of a ‘sensory diet’ alone was not effective. They claim that despite a large amount of access to sensory items, the ‘sensory diet’ did not effectively reduce stereotypy for participants.
 
Examples of ‘sensory diet’ items available to participants were –
 
·        Koosh ball
·        Rainstick
·        Therapy ball
·        Slinky
·        Electronic toothbrush
·        Vibrating massager
·        Squishy balls,
·        Confetti bin
 
They noted that the ‘sensory diet’ activity items were carefully chosen by an occupational therapist such that they would provide the same type of sensory stimulation as stereotypy provided. Thus, they found that a long-term treatment would be needed for treatment of their particular stereotypy.

PART 3 a. –  SENSORY DIET
                    a. Brushing Techniques

​Cariello (2015) recalls that on January 2011, seven-year-old Jack’s behavior started to change more dramatically. He was afraid of ordinary things. From 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, and Joe and I resolved to explore alternative methods to help Jack cope. We couldn’t imagine having him take an 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. A sensory ‘brushing’ technique called the Wilbarger Protocol was used to reduce sensory defensiveness. This was accomplished by using a small therapeutic brush to apply pressure on the limbs and back.
 
< My Thoughts >             “…brushed him at school…”
 
Under certain circumstances, an Occupational Therapist can instruct parents and school staff to use this brushing technique. The Wilbarger Protocol can reduce sensory defensiveness by using a small brush to apply pressure on the person’s body.
 
Thompson (2012) states that there is no consistent evidence that ‘sensory-based’ treatments have specific lasting effects on the behavior of children or adults with ASD. But he says the lack of evidence does not necessarily prove that a treatment is ineffective.
 
< My Thoughts >           “…prove that a treatment is ineffective.”
 
Many Occupational Therapists use a combination of therapy methods, depending upon the individuals needs. They may try deep-pressure methods, plus massage, along with brushing treatments to provide a sensory-integration therapy. Only one of these treatments may be the ‘one’ that is effective, but it needs to be done in combination with the others to get the desired or lasting results.
 
APPENDIX
 
In their definitive handbook, Raising a Sensory Smart Child, Lindsey Biel, OTR/L & Nancy Penske give parents an idea of what a Sample Sensory Diet may look like. Retrieved online from: https://www.sensorysmarts.com/index.html/

Sample Sensory Diet –
 
Here is a sample sensory diet, created for a second-grade child with sensory processing disorder. Activities must be individualized for each child and modified frequently to meet changing needs. A separate program was worked out for this child with the school, including frequent movement breaks, an inflatable seat cushion for wiggling while remaining seated, and providing crunchy/chewy oral comfort snacks during seated time.

In the Morning
·        Massage feet and back to help wake up
·        Listen to recommended therapeutic music CD
·        Use vibrating toothbrush &/or vibrating hairbrush
·        Eat crunchy cereal with fruit and some protein
·        Spin on disc, as directed by OT / PT
·        Jump on mini-trampoline as directed by OT / PT
​
After school
·        Go to playground for at least 30 minutes
·        Push grocery cart or stroller
·        Spinning as directed by OT / PT
·        Mini-trampoline. Add variety: have him play catch or
         toss toys into a basket while jumping.
·        Massage feet to “reorganize,” use therapy putty, make
         “body sandwiches,” wheelbarrow walk
·        Do ball exercises as directed by OT / PT
·        Listen to therapeutic music CD
·        Oral work — suck thick liquids through a straw, eat
         crunchy and chewy snacks, or chew gum before and/or
         during seated activities

At dinnertime
·        Help with cooking, mixing, chopping, etc.
·        Help set table, using two hands to carry and balance a
         tray
·        Provide crunchy and chewy foods

At night
·        Family time: clay molding projects, painting projects,
         etc.
·        Warm bath with bubbles and calming essential oil
·        Massage during reading time

Note: Creating a Sensory Diet: The Ingredients. It is strongly recommended that you work with an occupational therapist who has a solid understanding of sensory processing issues. One of the trickiest aspects of sensory difficulty is recognizing when a child is over-reactive or under-reactive in any given moment, and then calibrating sensory input to meet him where he is and provide a “just right challenge” to help him move forward into a “just right” state of being.

End of excerpt from – Sample Sensory Diet by Biel & Penske

​PART 4 – SENSORY ROOM

Morin (2017) cautions that children’s perceptions change over time. As your child ages, peers and other adults will encourage the pursuit of new interests. It's normal for a child to want to play different sports, hear new types of music and engage in new artistic activities. Be cautious but unafraid.
 
Work with your child to allow experimentation and growth. Over time, you will come up with additional safe, appropriate and positive types of sensory sensations for your child, together.

< My Thoughts >   “…positive types of sensory sensations…”
 
Starting to investigate those types of sensory sensations which have a positive effect on a child may help families feel that they are doing something while they are ‘waiting’. Whatever you already have available, like a swing or a trampoline. Just remember – SAFETY FIRST!
 
Ben-Sasson (2018) believed that one in twenty young children may experience sensory processing disorder. Saying that the numbers are even greater in children with autism; perhaps affecting even three-quarters of the autism population. Today, the expanding scope of screening and knowledgeable clinicians and therapists presents an opportunity to see early signs of sensory issues in children. Increased confidence in repeated testing and compliance with ethical standards may well improve the efficacy of professional referrals and recommendations.
 
When barraged by sensations that others would not notice such as a loud shopping mall, a child who is over-reactive to sensory stimuli might for example feel overloaded and exhibit dysregulated behavior. By the time a child with SPD enters school, relationships may be compromised and they may present with emotional and behavioral problems. Consequently, empathy may be impaired in SPD because these challenges make it difficult to respond appropriately to another person’s emotions.
 
Koscinski (2014) confides that children with autism often feel dysregulated, or confused and overwhelmed within their environment. They may over-react or under-react to various noises, sensations, sights, tastes, touch and more. Many of them find that the smooth rocking and swaying of a swing will help them to relax and feel soothed. They may be better able to focus and concentrate, during and after engaging in activities involving movement.
 
< My Thoughts >   “…help them to relax and feel soothed.”
 
Some homes, schools, and caregiving facilities have established Sensory Rooms. These are places filled with things known to help people feel better able to meet the demands of the day. Therapists, clinicians, and teachers have made these items available to provide feelings of pressure through fabric, weight, and/or touch.
 
There would be equipment to give a rocking sensation or get the person jumping or moving. A place where there are a variety of sounds, scents, images, and other things to change the mood. This is why knowing the child and their ‘sensory needs’ becomes so important. There are known ways to help individuals feel more motivated and active if they seem to be lethargic. Ways to become calmer when agitated, and ways to become distracted from perseverating about something stressful.
 
Editor (2019) explains that no matter how big or small it is, a ‘sensory room’ can make a world of difference for your autistic child. A room where your child can go to feel safe and secure to reduce anxiety, harmful behaviors, and sensory overload.
 
A few essentials are –
​

• Diffused lighting to block out unwanted bright lights, or even a nightlight that can be controlled. Or, a rotating star projector light with multiple settings to play around with.
• Comfortable seating like a soft child-size chair, small mattress, or a hammock or therapeutic swing for relaxing.
• Sounds of silence or nature piped in somehow. Headphones with favorite music, or noise-cancelling headphones for the child preferring silence.
• Basket of sensory items to soothe. Spill proof bottle of bubbles, stress balls, fidget toys, soft squishy toys, or whatever your child prefers.

​< My Thoughts >          “…a ‘sensory room’...”
 
Depending on the size of your sensory room, you may be able to fit in a very small trampoline, which topped with a weighted blanket or mummy bag can also be a place to sit or lie down. A small tent made for indoor adventures can become your sensory room. Hopefully, there will be a separate temperature control or fans available, also. Make certain that visits to the sensory room are supervised; ‘SAFETY FIRST!!!
 
Kedar (2012) writes in his essays – I love being in nature. Noisy environments drive me mad inside. I can only tolerate baseball games and restaurants with headphones on. In nature it’s just soothing sounds like birds or wind in the trees, or ocean waves.

Sensory integration – this theory used in occupational therapy that hopes to help organize our senses through swings and other movements. Sensory integration and swings don’t help me if I can’t do anything bilateral. If I have trouble crossing my midline in exercise I can’t do much, right? Why did my mom have to figure that out and not any of the professionals?

Well, at least she saw it, so I’m learning to triumph over my body thanks to my getting the greatest trainer ever.

Ido continues, I can deal with the one-hundred plus degree temperature, but lunch, nutrition, and P.E. are like saunas. I try to imagine swimming in an icy lake. It doesn’t help.
 
< My Thoughts >     “I can deal with the one-hundred plus degree temperature, but…”  

As we have said, due to ’introception’, some children with autism are very sensitive to temperature, or temperature change. This is also a very hard one to catch on to and often the child doesn’t really know what is annoying them. 
 
Ido tells us the main problem that he struggles with is that of ‘output’. Surely he has other problems and difficulties, such as working memory attention, sensory sensitivity, and control of arousal and urges. At times your body charges forward impulsively, snatching things, or dashing you into the street.
 
< My Thoughts >     “…body charges forward impulsively…”
 
For impulsive children and those who love to spin, there is the ‘swing’. There are ‘Therapeutic Swings’ in all shapes and sizes, along with trampolines to be found. Many parents and schools have a place, like a sensory room, where the child can go to jump on the trampoline, or spin on a swing, or run around until they get their body back in control.

​
Harkla (2019) asks you to close your eyes and imagine yourself swinging on a warm sunny day. Feel the breeze blowing past you and fluttering butterflies in your stomach as the swing reaches its highest point. The freedom of a flying sensation is why swings continue to be used by therapists, remaining the staple in backyards and playgrounds all over the world. 

​Marks (2012) mentions a day she spends on a swing –
 
Swing
 
Swing way up high. Touch the sky.
Feel the cool breeze in my face.
Floating through the air. 
Just feeling normal for a few minutes.
Swing up high, touch the sky.
Click clack. Click clack. Click clack.
 
< My Thoughts >   “Swing. Swing way up high. Touch the sky.”

So that students can swing, schools provide therapeutic swings. Students may have regular times that they utilize this avenue to sensory integration. Programs for autistic children may have a sensory integration room where swings and other vestibular activities are available rain or shine. Swinging for a child who is autistic is more than just ‘play’. You might try some ways to discover the effects and balances of a child’s sensory needs by trying different non-invasive, but playful activities within a special Sensory Room.

Moore (2019) offers some insight on how and why swinging offers many benefits as a part of an overall sensory integration regime. She writes: “Sensory integration is difficult for many autistic children. Swings offer help allowing for better sensory integration.”

Parents of autistic children who wish to provide similar sensory integration to school programs may explore commercially made equipment through special needs equipment suppliers. Swinging provides essential vestibular movement to help children achieve normal developmental milestones, calming them and letting them have fun.

Family Education Staff Writer (2020) finds yet another explanation of Sensory Integration. This refers to how people use the information provided by all the sensations coming from within and from outside the body and from the external environment. We usually think of the ‘senses’ as separate channels of information, but they actually work together to give us a reliable picture of the world and our place in it.
 
Your senses integrate to form a complete understanding of who you are, where you are, and what is happening around you. Because your brain uses information about sights, sounds, textures, smells, tastes, and movement in an organized way, you assign meaning to your sensory experiences. 
 
< My Thoughts >   “…brain uses information…”
 
The brain uses information about sights, sounds, textures, smells, tastes, and movement in an organized way to understand a person’s environment. So, moving a child who is in ‘sensory stress’ into a ‘sensory room’ or an area where s/he can have their ‘sensory needs’ met can prevent them from escalating. Some families are able to have a whole room devoted to giving a child a supervised calming experience. Teachers also can set-up a corner or area in the classroom where a child can find relief from sudden sensory stress.
 
APPENDIX B- Ayres 4 Sensory Categories
 
Dr. Ayres sought out initially to identify how poor processing of sensory stimuli affected the child, resulting in atypical motor, social/emotional, and functional patterns of behavior. These behaviors were hypothesized to interfere with end product competencies in speech/language, attention, motor.
 
Dr. Ayres further established four categories in the 1960's to classify and refine specific sensory manifestations as seen by sensory modulation dysfunction (SMD), developmental dyspraxia, bilateral integration dysfunction, and generalized dysfunction (a combination of all areas). The SPD global umbrella identifies three primary diagnostic categories as sensory modulation disorder, sensory discrimination disorder, and sensory-based motor disorder.

Sensory modulation dysfunction (SMD) is the ability one has to take in sensory sensations be it auditory, visual, gustatory, olfactory, or tactile stimuli, by interpreting what it is and filtering what is important while ignoring what is not by inhibiting that sensation. Often, children with SMD are unable to process information, causing them to have ineffective sensory modulators.

Examples which are often reported may be being unable to tolerate smells from the lunch room, or intolerance for noise such as that of other children or fireworks/vacuum cleaners, being unable to move without fear or feeling nauseous, clothes that are intolerable. Or, perhaps the opposite is observed where the child does not seem cuddly or recognize when they are hurt, does not seem to hear auditory information, or will not sit still. Often one may hear this being described as being over-reactive or under-reactive.
 
Developmental Dyspraxia is reflected when a child has a coordination disorder being unable to execute new skilled movements. These children often are unable to visualize mentally a plan (ideation), or know how to complete novel tasks (affordances). Dr. Ayres' later work on dyspraxia identified these children to have underlying sensory processing issues resulting in difficulties with detection, organization, discrimination of sensory information from the tactile (skin), proprioceptive (joints and muscles) and/or vestibular (movement) systems. These children sometimes are moving very quickly but when asked to grade their movements they fall or look clumsy.
 
School age children who may exhibit this are often delayed in learning how to formulate handwriting skills, eat with their fingers because they are unable to negotiate utensils, demonstrate delays cutting, or cannot ride a bike, skate, or perform large muscle actions as they are unable to have the ideation and/or if they do, do not have the affordances. Dr. Ayres believed that intervention addressing the underlying sensory processing issues rather then using and educational process of teaching was more successful. For that reason, rather then working on handwriting (as an example), therapy is focused on the integration of the sensory systems as the primary goal.
 
Postural-Bilateral Integration Dysfunction is due largely to the immature developmental integration of primitive reflexes and core muscle patterns. This results in an inability to use two sides of the body together, lack of lateral dominance (switches hand use where parents say their child is ambidextrous), and inability to cross the body midline. Often this translates to observing the child to have difficulty with directionality, inability knowing where their body is in space. They may have difficulty alternating limb movements, show poor conjugate eye movements, or extreme gravitational insecurity. Some have an unusual fear of certain positions (being on their tummies, moving backwards, going downstairs, etc.). Others have difficulty executing activities of daily living skills; that of self-dressing, as they are unable to button or zip, and/or reverse motions. Retrieved online from – http://senseablekids.com/sensInt.html
 
Prosopagnosic people. Stantic, M., Ichijo, E., et al. (2022). say that remembering and/or recognizing faces in everyday life can be difficult for many people with autism. Problems may be wide-ranged and contradictory. Some autistic persons can recognize a familiar face, but not match it to an identical picture in a test setting. Test subjects, it was noted, may also have been influenced and/or distracted; or, have other issues like test anxiety, or poor attention-span. 

REFERENCES:
UNIT 4, CHAPTER 3, PART 3 SENSORY DIET, PART 4 SENSORY ROOM –
 
Ben-Sasson, A., Cermak, S., et al. (2007). Extreme Sensory Modulation Behaviors in Toddlers with Autism Spectrum Disorders; American Journal of Occupational Therapy; V61; p 584-592.
 
Biel, L, & Penske, N. (2018). Raising a Sensory Smart Child; Retrieved online from: https://www.sensorysmarts.com/index.html/
Cariello, C. (2015). What Color is Monday? How Autism Changed One Family for the Better; eBook Edition.
 
Editor (2019). How to Create a Simple Sensory Room on a Budget; Spectrum Sense: Daily Life. Retrieved online from – https://www.spectrumsenseformoms.com/2019/05/14/how-to-create-a-simple-sensory-room-on-a-budget/
 
Fitzgibbon, C. & O’Sullivan, J. (2018). Sensory Modulation: Resource Manual; Sensory Modulation Brisbane, Australia.

Gay, E. & Baranek, G. (2008). Winnie Dunn, Living Sensationally: Understanding Your Senses; Kingsley Publishers, London.
 
Hatch-Rasmussen, C., M.A., OTR/L (2019). This Is A Sensory Diet For---; Retrieved online from – https://www.ssdmo.org/cool_tools/inclusive/.../trying_to_make_sense_resources.pdf/
 
Harkla, K. (2019). What Are the Benefits of Autistic Swings? Learn How They Can Help Your Child; Retrieved online from – https://harkla.co/blogs/special-needs/sensory-swings-autism/
 
Kedar, I. (2012). Ido in Autismland: Climbing Out of Autism; eBook Edition.
 
Kelly, K. (2019). Sensory Diets: What You Need to Know; Retrieved online from –https://www.understood.org/en/learning-thinking-differences/treatments-approaches/therapies/sensory-diet-treatment-what-you-need-to-know/
 
Koscinski, C. (2014). The Special Needs School Survival Guide Handbook for Autism: Pocket Occupational Therapist Book Series; eBook Edition.
 
Marks, S. (2012). Paula’s Journal: Surviving Autism; eBook Edition.
 
Moore, K., Cividini-Motta, C., et al. (2015). Sensory Integration as a Treatment for Automatically Maintained Stereotypy; Behavioral Interventions; V30, p95-111.
 
Moore, L. (2019). Sensory Processing Disorder; Retrieved online from – http://www.sensory-processing-disorder.com/sensory-integration-products.html/
 
Morin, A. (2017).  Amanda Morin – Classroom Teacher & Early Intervention Specialist. Retrieved online from – www.everythingkidslearning.com/
 
Stantic, M., Ichijo, E., et al. (2022). Face Memory & Face Perception in Autism. Retrieved from – https://pubmed.ncbi.nlm.nih.gov/34160282/

Thompson, T. (2012). Making Sense of Autism; Second Edition. Baltimore, Maryland: Brookes Publishing Company.
 
DISCLAIMER –

NOTE: My intention here is informational and educational only. Remember that even if your child hasn’t been diagnosed, s/he may still be eligible for Early Intervention Services. Under the IDEA Law says that children under the age of 3-years-old who are at-risk for having developmental delays may be eligible for services. Most literature recommends that parents clarify and prioritize what concerns you the most.
 
Some of you will have mild concerns, while others are living in a state of high situational stress and hyper-vigilance because of your child’s actions. Both need to be addressed. This is NOT a phase which will pass; these are serious concerns which can be dealt with through ‘intervention’.
 
The sooner you act the better, but NOT before you check things out thoroughly. Remember too, that most programs and therapies require ‘follow-up’ and possibly some sort of ‘tune-up’ after the ‘intervention’ has been in place for a period of time. Or, there are changes which impact behavior, such as medication or other therapy. Don’t sign-up for anything you cannot easily STOP if it’s not working for you and/or your child. You know, like that gym/spa contract you couldn’t get out of!
 
< My Thoughts >              “…serious concerns…”
 
The severity of a child’s behavior, the amount of support available, the temperament of the child and the parents will all contribute to the family either becoming isolated or seeking help. Help may come from local, private, county, state, and federal programs; and sometimes at no cost at all. Look for ‘FREE’ first.
 
Note: See more about ‘temperament’ in UNIT 3, Chapter 3.
​
​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.

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