When is ASD Sensory?

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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 Assessments
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 –
When Is It Sensory? UNIT 4 CH 2 PART 3. SIRS

SIRS – Subcategories of a. Sensory Interest, a. 1. Self-Injurious Behaviors (SIBs), b. Repetitious Behavior & c. Seeking Behavior

SIRS INTRODUCTION

Kirby, A., Little, L., et al. (2015) say that Sensory Interests, Repetitions, and Seeking behaviors (SIRS) are common among children with Autism Spectrum Disorder (ASD) and other developmental disabilities (DD). These sensory behaviors involve unusual actions that intensify or reinforce a sensory experience.

Kirby, A., Little, L., et al. (2015) believe that SIRS, sensory interests, repetitions, and seeking behaviors are response patterns mostly allow for solitary activity with the autistic. Thus, children are engaging in SIRS more than participating in life fulfilling activities. That they are participating less frequently and with less variety than children with developmental disabilities; or those who are considered to be ‘typical’ developmentally. Concluding that children with ASD are most likely to have cascading effects from SIRS, which effects overall the developmental skills; and can compound and perpetuate skill and activity limitation.

This study also found the opposite. They found that those in the autism population who are older and higher functioning, will have increased opportunities to engage in activities, at school and in the community. Thus, they are allowed chances to practice and build on their skills, with less interference from distracting sensory responses.

< My Thoughts > “…older and higher functioning...”

Sometimes persons with autism also have additional disabilities, such as Attention Deficit Hyperactivity Disorder (ADHD), Hearing and/or Vision Impairment, Learning Disability, or Intellectual Disability. But, having a ‘Developmental Disability’ alone does not mean that this person also has autism; although co-morbidity is possible.

While, CDC Staff Writer (2020) defines those diagnosed with Developmental Disabilities (DD) as a group of lifelong conditions due to impairment in physical, learning, language, or behavior areas. Such as –

Attention Deficit Hyperactivity Disorder (ADHD)
Cerebral Palsy
Hearing and/or Vision Impairment
Learning Disability
Intellectual Disability

Included in possible Developmental Disability causing conditions are maternal infections, pre-natal complications, birth trauma, infant chemical exposure; as well as Autism, Fragile ‘X’ Syndrome, and Down Syndrome.

Kirby, A., Little, L., et al. (2015) know that the diagnostic specificity and developmental course of SIRS are not well understood. Another question not fully answered in the literature concerns the degree to which SIRS may be associated with specific emotional or affective states. In fact, the literature has reflected considerable disagreement about the theorized direction of association. Likewise, practitioners are advised in this study, to assess SIRS using a combination of parent report and observed clinical measures and to use appropriate interventions in the child’s natural environments (e.g., home, school) to optimize occupational performance and participation.

(Picture showing boy exhibiting Repetitive Behavior)

PART 3. SIRS a. Sensory Interest –

Ausderau, K., Sideris, J., et al. (2014) agree that within each sensory pattern there are underlying concepts. For instance, SIRS activity is characterized by fascination with, or craving of, sensory stimulation such as with flickering lights or rubbing textures. Movement, especially jumping up and down as on a trampoline.

Depriving a person of these things or preventing them from intense repetitive behavior may increase anxiety, depression, and even cause separation anxiety. Cautioning that those with higher sensory seeking needs should be asked to disengage from the behavior more slowly.

< My Thoughts > “…disengage from the behavior more slowly.”

It seems that this behavior ‘disengaging’ might be better handled in a therapy setting. Also, clarification that “sensory stimulation such as with flickering lights or rubbing textures” can mean that some persons may ‘like’ or ‘dislike’ these things. Flickering lights may be painful for some, while others can spend hours flipping light switches on and off. Or, some can’t tolerate certain fabrics against their skin, while some may pocket a soft piece of cloth to rub.

Bogdashina, O., & Casanova, M. (2016) believe self-stimulating behaviors can occur when autistic children are seeking control of their Autonomic Nervous System. One intervention can be a desensitization intervention of the affected areas, performed by a qualified and experienced therapist. Another intervention can be exploring deep pressure, squeezing by cushions, or a weighted blanket may help.

They say that when excessive aggression, anxiety meltdowns and panic attacks occur, physical exercise like swinging, climbing, or pushing heavy objects may relieve some people. Self-monitoring behavior and other coping mechanisms can be taught for less severe cases of SIBs, to help your child feel safe, and begin trusting their environment.

Sarris, M. (2012) tells parents that early symptoms of autism could be among the most puzzling. Some are barely noticeable symptoms, such as response to lights, heat, cold, or physical discomfort. Using their hands or body to purposely manipulate things is not always seen as a problematic behavior.

< My Thoughts > “Some are barely noticeable symptoms…”

Sometimes the sensory response causing the self-injurious behavior is an attempt to fix what’s wrong. But often, the person doesn’t know what is wrong or how to fix it. A child who bites themselves because they are too hot or too cold, doesn’t know that putting on or taking off a sweater can make them more comfortable. Of course, trying to get them to put a sweater on or take it off, may be a challenge of its own!

Wright, T. (2018) believes that a behavior consultant is able to offer new insight for how the entire family can begin to shift the perspective needed to track and record behavior. An example would be – The family is concerned that Johnny seems to be an aggressive child, frequently hitting those in his environment. Through BEHCA data collection the behavior consultant is able to find that Johnny is NOT doing this on purpose but this is a sensory response to his environment. He is also NOT aware of how hard he is hitting.

Taking this further, she says that perhaps Johnny’s behavior is due to his NOT knowing what his body is doing. He is lacking spatial awareness. Or, by slamming his body/arms into things or people, he is seeking sensory input. But she says that he is NOT intentionally trying to hurt anyone.

< My Thoughts > “He is not intentionally trying to hurt anyone.”

With data collection, when the behaviorist shares this information with family and teachers, they can see that Johnny is NOT an aggressive child. Johnny is engaging with his environment in the only way he knows how to, in order to satisfy his sensory needs. Also, children with autism may ‘over’ or ‘under’ process the information they are receiving or perceiving from the environment, at a particular time.

Note: Created by Torri Wright (2018), “BEHCA is a behavior tracking software application designed to help families, educators, and providers and specific to collecting and analyzing behavior data. This software application can be used as a communication tool from one environment to another for a variety of providers within various settings; can also be viewed by support people; (behca.com).

APPENDIX A - Sensory Issues Assessments

Caregiver reporting assessments which include evaluating for Sensory issues –

Repetitive Behavior Scale - Revised RBS-R
Sensory Experiences Questionnaire (SEQ)

Given only by trained professionals evaluating for Sensory issues –

Mullen Scales of Early Learning
ADOS Autism Diagnostic Observation Schedule

Given by a professional interviewing Teachers, Parents, and/or Caregivers –

Vineland Adaptive Behavior Scales II

< My Thoughts > “…assessments...”

Most of these assessments are conducted through questionnaires which are filled out by parent or caregiver. This makes the information subjective to the perspective of that person or persons completing the assessment. When his dad and I answered questions about Sonny’s behavior, for instance, we seldom had the same ‘take’ on what was happening. That doesn’t mean that the information was wrong, but that it wasn’t as accurate as it probably could be, due to its subjectivity. Sometimes we see what we want to see.

PART 3. SIRS   a. 1. Self-Injurious Behaviors (SIBs) –

Ausderau, K., Sideris, J., et al. (2014) state that SIBS activity is characterized by fascination with, or craving of, sensory stimulation.

< My Thoughts > “…SIBS activity…”

SIRS – Sensory Interests, Repetitions, Seeking behaviors INCLUDE Self-Injurious Behaviors (SIBs). SIBS are an integral part of SIRS possibly because the person seems to find this self-injurious behavior (SIBs) so necessary for stress relief that they do it repetitiously, until becoming a dangerous fixed behavior. Sonny had chewed his right wrist, almost to the bone. The powers overseeing him at the time, decided that it was his way of communicating distress because he was non-verbal.

As a remedy, he wore a leather wristlet covering the area to prevent him from continually and permanently damaging his wrist. Before long, he had chewed through leather wristlet; now beginning to bite and chew on his exposed ‘left’ wrist.

The next decision they made was to medicate him for anxiety. It was over a year after living with us before we were able to reduce that Self-Injurious Behavior to only happening very occasionally. Unfortunately, completely discontinuing the medication they had prescribed for him took much longer. After becoming Sonny’s foster parents, we were able to get the doctor to start him on a more effective anxiety medication, with less side-effects. Also, we successfully introduced signing and ‘low tech’ communication methods to help him let us know what he needed.

Sarris, M. (2015) cautions that self-injury behavior (SIBs) can persist into adolescence. Violent episodes of challenging repetitive behavior can lead to cuts, bruises, dental problems, and even broken bones, concussions, and detached retinas. She tells how frightening this is because it seems to violate our basic instinct of self-preservation. Parents become deeply challenged to protect their offspring on a daily basis. They childproof their homes, buckle their seat belts, walk them to school, continually shielding them from outside harm. But she questions how they can protect them from themselves?

In the DSM-5 2013, listed under Sensory Interests, is Self-Injurious Behaviors, (SIBs). Thompson, T. (2012) states that the most common emergent forms of ‘self-injury’ are finger, hand, and wrist biting. Next, are the head hitting with fists, or hitting head against hard surfaces behaviors. One parent reported that there were periods when her son struck his head against the wall so hard and so often that it caused severe bruising on the back of his head. Because this was his only form of communication, he stopped as soon as he was given what he wanted.

< My Thoughts >              “…he stopped as soon as he was given what he wanted.”

This is a very dangerous situation in need of professional intervention. Some children will temporarily be required to wear a bike helmet in order to prevent brain damage from their frequent head-hitting episodes. Meanwhile, there is a critical need to establish some form of communication which provides the child with a way to express what they want or need, thus eliminating their need for the SIBs behavior.

Also, children can bite themselves and others so severely that the bite requires wound care. Without which a very serious infection, or even amputation may occur.

Squaresky, M. (2014) shudders to think how son Greg’s fingers showed evidence of his own personal attacks. For years during tantrums, he bit his fingers. Calluses built up to the point that when we held his hand, we felt the hard spots on each side of his index fingers.

To better understand why Greg exhibited this self-injurious behavior, I compared it to cutting. ‘Cutters’ seek a release from the emotional pain that they are experiencing, and may cut on impulse. Greg felt better when he bit his fingers.

Hendriksen, E. (2016) has said that “…the technical term for cutting is ‘non-suicidal’ self-injury. That the ‘intent’ of the cutter is not to seriously hurt themselves but have an emotional release, a way to ‘cope’ with the severe stress they are feeling.” ‘Cutting’ as a ‘self-injury’ allows the person to take charge, to localize the pain, if only for the moment.

< My Thoughts > “‘Cutting’…”

This may be why persons with autism seek out SIBs as a way to cope with the unidentified, possibly even primal pain they are feeling.

Another thought for is that while ‘cutters’ participate in what they perceive as a ‘taking charge’ behavior, this seems to be in direct opposition to the ‘out-of-control’ core behaviors we know as ‘autism’. But, as parents and professionals have been observed, persons with all degrees of autism have had their ‘neuro-typical’ moments. Moments of ‘need’ when they seem to ‘slip out of their autism’. This may support the comparison of SIBs to ‘cutting’ behavior.

Sicile-Kira, C. (2014) explains that most children with ASD have NO notion of safety. This is an area often overlooked yet vitally important, and can range from NOT understanding the dangers of traffic or fire, to the possibility of personal danger from strangers, aggressive individuals, or danger from themselves.

< My Thoughts >             “…danger from themselves…”

They may have little or no connection to their extremities, possibly due to a lack of ‘proprioception’; the body awareness sense which tells us where our body parts are and what stimuli those parts are receiving. A lack of a sense, alerting that person when they are inflicting bodily harm. Or, knowing when they are in danger from the amount of force being used when engaging in self-inflicted behavior.

Other things could probably be involved, such as the satisfaction derived from repetitious behavior. An example might be ‘head-banging’. Sonny will bang or hit his head once or twice, then stop; seemingly looking around to see who that was hitting him. But many children, once they get started, continue to hit their head repetitiously until someone intervenes to stop them.

Sicile-Kira, C. reasons that some children with autism participate in self-aggressive behavior because they are in pain and don’t have any other way of communicating this. She also has seen ASD persons self-injuring in the throes of a Post Traumatic Stress Disorder (PTSD) flashback.

She defines SIBs as hitting, biting, head banging, flicking fingers, or slapping oneself as a possible method of ‘sensory seeking’ stimulation to relieve anxiety, pain, or frustration. Others believe that there is something missing in their diet, or something they are getting in their diet that they should avoid.

Those lacking stimulation from their environment may seek it through self-abuse. Some self-abuse is in response to smells, being touched, auditory and visual overstimulation or under-stimulation. Some professionals believe that medication can be found to counteract these symptoms.

Note: You may wish to get the latest about Chantal Sicile-Kira on Social Media.

< My Thoughts > “…medication can be found to counteract these symptoms.”

Something that Sonny engages in, as a result of his autism, is self-injurious behavior (SIBs). With him, this seems to be compulsive, ritualistic, and some sort of stimulation or communication. He strikes out to bite or hit himself and others. His SIBs decreased significantly after we found a method of communication and a therapeutic dosage of medication to help him. When Sonny is under-medicated, stressed, and/or can’t get what he wants he will still tantrum and bite himself until his needs are satisfied. Looking back, the ‘eye-poking’ may have been that he was seeing auras before having and epileptic seizure.

Sonny has additional undesirable, even dangerous and frightening behaviors which occur suddenly, but not often. Along with ‘wrist biting’ and the afore mentioned SIBs, he sticks a finger in his eye, poking and poking until restrained. This may be because he is seeing auras as part of an epileptic seizure. The caveat here with Sonny is that he will engage in SIBs as a result of feeling happy and excited about something he’s thinking about or he’s doing. So, we must be hypervigilant at all times to ‘first’ keep him safe from the risky behavior, and ‘then’ try to find the cause.

Boesch, M., Taber-Doughty, T., et al. (2015) believe that – “Self-injurious behavior is a result of communication and/or language deficits. “SIB’s are behaviors causing direct physical harm to one’s own body, resulting in physical injury and tissue damage.” This is exhibited through self-hitting, self-pinching, and/or self-biting. Occasionally they will also bite others nearby.

Soke, G., Rosenberg, S., et al. (2017) say that SIBs can be so serious and difficult to manage that they may require the person be hospitalized, and/or admitted to a residential facility for care. Failure to do so can result in permanent damage or even death.

Chezan, L., Gable, R., et al. (2017) claim that SIBs are relatively common problem behaviors among children with Autism Spectrum Disorder (ASD). Their review covers a broad category of problem behaviors, including verbal and physical aggression, property destruction, and tantrums. Severe SIBs require an intervention that is both effective and efficient.

Without effective interventions, they say, it can have a negative impact on children’s quality of life, limiting their development and even leading to health-related problems. Interventions have the potential to prevent or reduce the frequency and severity of the SIB, but if allowed to persist across time this behavior may continue until adolescence and adulthood.

PART 3. SIRS b. Repetitious Behavior –

Raulston, T. & Machalicek, W. (2018) point out that within the repetitive behavior literature, there are generally two categories described – ‘Lower-order’, involving motor stereotypy usually found in those very young children; like hand flapping, rocking, lining up toys, or flipping pages of a book. ‘Higher order’, usually found in those with advanced language skills; behaviors including obsessive preoccupation with odd interests, and excessive question asking.

Decker, J. (2011) declares – I headed off to find out what was broken in the other room, hoping Jaxson didn’t need stitches.

“Mom, who is more irritating, me or Jaxson?” I stood over a broken dish on the kitchen floor.

“You both have your moments,” I told Jake. “What do I do that’s as bad as Jake’s fists?”

“You ask a lot of questions. Questions, questions, questions. Questions are good, but sometimes when they’re coming as fast and furious as you ask them, it feels like getting hit with one of your brother’s little fists. Or a stun gun.”

“I guess I’m just curious,” Jake smiled as he helped me pick up the broken dish.

< My Thoughts > “…excessive question asking.”

Perhaps by asking never-ending questions Jake also finds some comfort in communicating and connecting with the adults in his world.

Raulston, T. & Machalicek, W. (2018) reiterate that the latest edition of the Diagnostic & Statistical Manual of Mental Disorders – DSM-5 (2013), describes four core areas of Restrictive & Repetitive Behaviors (RRB) to include:

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

They give an example of a child spinning only one wheel of a toy car very closely in front of his or her eyes, over and over again. Thus, not engaging in a more appropriate imaginative play or including others; becoming physically aggressive if his or her preferred activity is interrupted or stopped. Parents included in this study commented that these kinds of repetitive behavior were the most difficult aspects of autism for them. And, that they felt higher levels of stress as a result of this behavior.

< My Thoughts > “…four core areas of Restrictive & Repetitive Behaviors in the newer DSM-5.”

One of the reasons clinicians say that this is an important part of the newer DSM-5 is because it changes how they can arrive at a more accurate diagnosis for persons with autism.

Note: The word ‘restrictive’ was added to better inform the extent of these ‘repetitive’ behaviors; Restrictive & Repetitive Behaviors (RRB).

The Centers for Disease Control & Prevention (CDC) describes the symptoms of a person with Autism this way –

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

Based on social communication impairments & restricted, repetitive patterns of behavior as noted in the CDC website – https://www.cdc.gov/ncbddd/autism/hcp-dsm.html

Kirby, A., Little, L., et al. (2015) keep reminding us that multiple types of behaviors are consistent with this construct – flapping hands, fascination with certain noises, interest in bright lights or moving or spinning objects, spinning themselves around, or mouthing objects and smelling nearby things; or doing a combination of behaviors, all at once.

Rudy, L. J. (2020) tells us that the DSM-5 lists an individual with Autism as having abnormal repetitive, purposeless behaviors, like lining up toys, spinning objects, or opening and closing drawers or doors. That many parents worry about autism when they see their child repeatedly doing those things. Restrictive repetitive behaviors can also involve saying, thinking about, or asking questions about the same thing over and over again. In rare cases, repetitive behaviors can actually be dangerous; more often, though, they are a tool for self-calming. They can become a problem, when insistence on sameness; or, inflexible adherence to routines, and extreme distress at small changes get in the way of ordinary activities or interfere with school or work.

< My Thoughts > “…a tool for self-calming.”

Sonny is nonverbal. He makes sounds and laughs, but has no language, so his repetitive behavior is nonverbal, but he makes repetitive sounds. We give him ‘interactive’ toys which enable him to engage in ‘purposeless behaviors’ with sound. My reasoning is that, much like the autistic child or adult who repeats video scripts as a type of communication, Sonny can use his ‘See and Say’ toy and interactive sound board books to communicate, even if seemingly without purpose.

Pushing the same button, over and over and over, for no apparent reason, may unnerve the listener, but seems to calm him. “Someone poisoned the waterhole!” “Someone poisoned the waterhole!” “Someone poisoned the waterhole!” (Courtesy of Tom Hanks’ voice, Toy Story 3) Which is sometimes accompanied by Sonny’s laughter, and sometimes by his sounds of frustration, if his juice cup is empty, or he can’t find what he’s looking for.

But we have taken a cue from Sonny’s playbook, and just tune out what we don’t want to hear, unless he really wants or needs something. Or, in the case of some really irritating sounds or phrases I laugh, move him over and start hitting the button that yells “HELP MEEEE! HELP MEEEE! Or, the button with the voice of Buzz Lightyear that yells, “Stop, I have a laser and I will use it!

Wolff, J., Dimian, A. et al. (2019) say that despite a long-standing association with autism, it was not until recently that ‘atypical sensory responsiveness’ was included as part of the ASD diagnostic criteria. Patterns or clusters of sensory responses are not mutually exclusive. A child may exhibit distress associated with the din of a busy classroom, but show no reaction to a loud vacuum.

They also say that restrictive repetitive behaviors (RRBs) and sensory responsiveness may share common underlying neural circuitry. This is when RRBs elevated at 12 months of age, in high-risk infants who are later diagnosed with ASD.

Wolff, et al. also found that the results of their study seemed to indicate that by the age of two, atypical ‘sensory responses’ increased overall for children with ASD, while generally decreased for children who didn’t develop the disorder of autism. That problems with ‘sensory stimuli’ early on, accumulated to show later social communication deficits in children with ASD. And finally, that ‘sensory-related’ behaviors were associated with wide ranging restricted and repetitive behaviors.

Rudy, L. J. (2020) regards "stereotyped" restrictive repetitive behaviors (RRBs) as a core part of autism. Saying that practitioners and researchers call repetitive, apparently purposeless behavior "stereotypy" or "perseveration," and such behaviors are actually described as symptoms of autism in the official diagnostic manual, the DSM-5. As is clear from the wording of the diagnostic criteria, being a "creature of habit," and preferring to follow a set schedule or eat certain foods, for example, is not enough to suggest autism. Rather that autism behaviors must be "abnormal in intensity or focus," and “changes” to those behaviors must cause "extreme distress."

She reminds us that ‘perseverative’ behaviors are not unique to people with autism. Many people engage in some such behaviors. Continual nail biting, pacing, pencil or toe tapping, compulsive cleaning, or even a ‘need’ to watch the same TV shows or sporting events without fail are all some form of perseveration.

< My Thoughts > “…perseveration behaviors...”

My new understanding of ‘perseverative’ behavior is that those empty actions may actually fulfill some sort of sensory need. In the classroom, or in a meeting with colleagues, the constant motions of pen clicking, or pencil and toe tapping seemed to serve no purpose, yet they continue. Now I think that I may know why.

For many people with autism, though, perseveration or repetitive behavior is not only disturbing to others but it can be a major roadblock to communication and engagement in the world. Most important is to know the purpose they serve so that when identified, an intervention can be initiated.

Ruzanno, L., Boorsboom, D. et al. (2014) remind us that there are also recent efforts to “unravel the nature of relationships between autism and associated disorders. Our aim is to explore and understand psychological disorders, as well as, to identify which restrictive repetitive behaviors interact in autism and compare with Obsessive Compulsive Disorder (OCD).”

APPENDIX B 'Stereotyped' Behavior Description

Here is the 'stereotyped' behavior description from the (DSM-5) Diagnostic and Statistical Manual of Mental Disorders; Fifth Edition (2013) –

Restricted, repetitive patterns of behavior, interests, or activities, as manifested by at least two of the following, currently or by history (examples are illustrative, not exhaustive; see text):

Stereotyped or repetitive motor movements, use of objects, or speech (e.g., simple motor stereotypes, lining up toys, or flipping objects, echolalia, idiosyncratic phrases).

Insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal or nonverbal behavior (e.g., extreme distress at small changes, difficulties with transitions, rigid thinking patterns, greeting rituals, need to take the same route or eat the same food every day).

Highly restricted, fixated interests that are abnormal in intensity or focus (e.g., strong attachment to or preoccupation with unusual objects, excessively circumscribed or perseverative interests). End of DSM-5 stereotyped" behavior description.

REFERENCES for – When Is It Sensory? UNIT 4 CH 2, PART 3. SIRS b. Repetitious Behavior

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.

Boesch, M., Taber-Doughty, T., et al. (2015). Using a Behavioral Approach to Decrease Self- Behavior in an Adolescent with Severe Autism: A Data-Based Case Study; Education & Treatment of Children, V38:2, p305-328.

Bogdashina, O., & Casanova, M. (2016). Sensory Perceptual Issues in Autism & Asperger Syndrome; 2nd Edition, eBook Edition.

CDC Staff Writer (2020). Facts About Developmental Disabilities; Retrieved online from – www.cdc.gov/ncbddd/developmental disabilities/facts/

Chezan, L., Gable, R., et al. (2017). Current Perspectives on Interventions for Self-Injurious Behavior of Children with Autism Spectrum Disorder: A Systematic Review of the Literature; Journal of Behavioral Education; V26, p293-329.

Hendriksen, E. (2016). Self Harm: Self-Injury; Retrieved online from – www.psychologytoday.com/

Kirby, A., Little, L., et al. (2015). Observational Characterization of Sensory Interests, Repetitions, and Seeking Behaviors; American Journal of Occupational Therapists; V69:3, Retrieved online from –https://www.researchgate.net/publications/

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

Raulston, T. & Machalicek, W. (2018). Early Intervention for Repetitive Behavior in Autism Spectrum Disorder: a Conceptual Model; Journal of Autism & Developmental Discord; V30, p89-109.

Rudy, L. (2020). An Overview of Repetitive Behaviors in Autism: Medically reviewed by Joel Forman, MD; Retrieved from – https://www.verywellhealth.com/repetitive-behaviors-in-autism-260582/

Ruzanno, L., Boorsboom, D. et al. (2014). Ruzanno, L., et al. (2014). Repetitive Behaviors in Autism & Compulsive Disorder: New Perspectives from a Network Analysis; Journal of Autism & Developmental Disorders; V45:2, p192-202.

Sarris, M. (2012). Behaviors that Puzzle: Repetitive Motions & Obsessive interests in Autism; Retrieved online from – https://iancommunity.org/cs/challenging_behaviors/repetitive_motions_and_obsessions/

Sicile-Kira, C. (2014). Autism Spectrum Disorder (revised): The Complete Guide to Understanding Autism; New York, NY: Penguin Random House Company.

Soke, G., Rosenberg, S., et al. (2017). Factors Associated with Self-Injurious Behaviors in Children with Autism Spectrum Disorder: Findings from Two Large National Samples; Journal of Autism Developmental Disorders; V47, p285–296.

Squaresky, M. (2014). A Spot on the Wall; eBook Edition.

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

Wolff, J., Dimian, A. et al. (2019). A Longitudinal Study of Parent-Reported Sensory Responsiveness in Toddlers At-isk for autism; Journal of Psychology & Psychiatry; V60:3, p314-324.

Wright, T. (2018). See Beyond Behavior: BEHCA: a Method for Understanding & Influencing Behavior Change; Retrieved online from – behca.com/

PART 3. SIRS c. Seeking behavior –

Sensory ‘seeking behavior’ has its own criteria for the person with autism. Intermittingly, their brain seems to seek or crave more sensory stimuli from the environment. This may result in a sudden ‘sensory seeking behavior’ response to the environment. Green (2016) says that atypical responses to sensory stimuli are shown as a new criterion which is stated in the 2013 Diagnostic & Statistical Manual of Mental Disorders (DSM-5). Clinicians may identify sensory behaviors by administering the Short Sensory profile (SSP) assessment. But Green cautions that many things remain to be seen about how to compare and affirm this instrument’s findings with observable behaviors. Also, how these altered types of seeking responses may impact the function of, and participation in, learning and daily living; or, how these things may change over time.

Morin (2017) feels that most ‘sensory seekers’ are undersensitive (hyposensitive). They look for more sensory stimulation in order to make them feel less sluggish and more ‘in their bodies’ and ‘in their space’. They may stand too close, keep touching people or objects, like loud noises, and may chew on whatever is handy. There are also ‘sensory avoiding’ (hypersensitive) kids that experience sensory input more intensely.

They avoid sensory input because it’s overwhelming to them. They may seem timid, be picky eaters, and act fussy about what they wear. They may be unable to calm themselves down; and, may have many, many meltdowns, because they cannot cope with tactile, visual, taste, and noise sensitivity.
Sensory input can help stimulate kids to feel less sluggish. It can also soothe an “overloaded system” and help kids feel more organized in their own bodies and in space. Morin also says that a sensory seeker may –

Stand too close when talking to others and not have a good sense of personal space.
Have an unusual tolerance for pain.
Walk with loud, heavy steps.
Enjoy jumping, hopping, and crashing into things and people—sometimes to the point of being unsafe.
Not knowing his/her own strength. They may rip paper when writing, break toys, or hurt others by accident.
Prefer “rough play” on the playground.
Touch people and objects, often.
Seek out or make loud noises.
Chew on shirt sleeves or collars and other non-food items.

Interestingly, Kirby (2015) finds that 59% of the sensory interests, repetitions, and seeking behaviors (SIRS) participants in the study, did not display many facial expressions typically representative of enjoyment. This changes the previous belief that SIRS engagement was associated with pleasure.

Morin (2017) continues that “It’s not always one or the other,” some kids show a combination of the two reactions. She says that responses can change based on their level of arousal or ability to self-regulate; that knowing your child’s reactions and triggers can help.

She believes that too much of anything could be a bad thing. Make sure your child knows there are limits to engaging in high-sensory activity. For example, if your child likes the pressure of giving unsolicited hugs to other children, provide alternative options that support this type of sensory need, like a weighted blanket. Watch how your child behaves before, during and after sensory-seeking experiences. Learn what works, what is best enjoyed in moderation and what should be eliminated. Give your child frequent breaks and chances to decompress.

< My Thoughts >      “…Watch how your child behaves…

This is necessary to help document what is happening with your child. Admittedly, it is very difficult to physically, emotionally, and effectively deal with a crisis while accurately documenting it at the same time. Perhaps this is where videotaping the incident could make it easier. The standard approach to determining the cause of the incident is to document the duration, and what has helped to deescalate it. But, this doesn’t always clarify things enough to prevent a similar incident.

In my personal experiences with classroom students, and with Sonny in a variety of settings, the ‘cause’ of the behavior may have occurred hours or even days before the outburst. Something triggers the person to relive an unpleasant situation, or to fear that something ‘bad’ is going to happen. What makes ‘identifying the cause’ so much more difficult is that often, as an observer, we can’t immediately relate, since the ‘triggering event’ doesn’t affect us in that same way.

Stangliano & McCarthy (2010) tell us that the family checked into the magnificent resort hotel. Bella was in her glory at the sight of a lobby waterfall. Mia was entranced by the glass elevators going up and down. Gianna was awestruck by absolutely everything. Mark and I spied the Starbucks and grinned. Vacation!

All was well until my mom, who had joined us for the trip, was talking on the phone to my brother and had her back to the door. Mia slipped out of the room. And Bella followed her.

I ran out the door. Bella was in the hallway. I shoved her back into the room. My poor mother was crushed with guilt, but I didn’t have time to worry about her. My child was missing in a 2,000-room hotel on 200 acres.

I raced to hotel security, panting, “She’s missing! My daughter is missing! She has autism, you have to find her!”

Finally, I heard a voice – “We have her! She’s here!” What a relief. Mia had gone exploring. Those elevators were too interesting for her to pass up. She didn’t have the speech to tell us that she was twelve years old, bored in the hotel room, and wanted to take an excursion. A woman passenger in the glass elevator recognized Mia’s mannerisms as she was counting the hotel floors aloud, because the woman had a grandson with autism. She immediately guided Mia back to the lobby, where security took over.

< My Thoughts >           “…She didn’t have the speech to tell us…”

Mia was bored, and for a sensory seeking child, even a verbal one, boredom can lead to wandering, or even elopement. This ‘seeking’ behavior need can be identified through a Sensory Profile assessment. These assessments can assign meaning to a child’s sensory feelings and identify an intervention point. Without help, parents may have a very difficult time figuring out which sensory experiences can be determined to fit their child’s ‘seeking’ needs. And of course, be aware that future sensory interests and needs may suddenly change.

Louise (2011) lets us know that a child with sensory-seeking behavior may be satisfied by great big deep pressure hugs and tics. While another with the same disorder may need more to provide help for their outbursts, periods of despondency and contact avoidance, and self-abusive behavior. Thus, it is true to say that autism is a ‘group of symptoms’ rather than one particular thing.

For some, their ‘sensory needs’ translate to walking around naked, or playing with their feces or tasting, touching, and smelling everyone and everything that catches their attention. As a result, many with autism are kept from circulating with the population. Another parents’ fear is the child’s desire to self-stimulate his or her groin on various inanimate objects. This is often a symptom of sexual abuse in neuro-typical kids and might be similarly interpreted for those with autism.

< My Thoughts >             “…parents’ fears…”

As a parent and educator, the fear that a child’s desire to self-stimulate is going to draw unwanted attention causing a disruption to others in that setting. Sonny can suddenly drop to the floor, beginning to exaggeratedly roll back and forth, which once he gets started is almost impossible to stop. Another example is a 6-year-old-student at school would jump up out of his seat, grab whatever object was close by and begin attacking his groin area. Girls are known to put something on their chair or seat to rock on, as their stimulation method of choice.

Answering questions about autism and sexual behavior has usually been ‘uncharted’ territory, according to Realmuto & Ruble (1999). They say that what is known is that public displays of sexual behavior such as removing clothes and/or touching private parts, while in public has been reported in studies of persons from age 9 to age 39. Additional known behaviors are inappropriately touching others (including parents), looking down shirts, and looking up skirts. Future studies have been suggested, such as the sexual behavior of persons with autism and delayed puberty. As well as, the relationship between sexual and aggressive behaviors, and the effect of hormonal treatment on these behaviors.

Stevens & Stevens (2011) say that Bristol Zoo is a second home to families with youngsters. The walls are high, the gates are guarded, dogs, scooters and bicycles are banned, and there are no cars. But still parental vigilance failed, one day just before Christmas.

I called David’s name, once or twice, half-heartedly. I was too scared to care whether strangers thought I was a bad father for losing my child, but I knew there was no point in shouting. He had never come at our call. Never, not once.

Then I saw him, he was lunging forward, disappearing up a woman’s skirt. “Sorry!’ I said, “Sorry, he thinks you’re his mum.” I had no idea if this was true.

“Stop it! Stop it!” she said, jerking her leg, shouting at the squirming form. She slid a hand down her waistband to dislodge him, but it was obvious David had taken firm hold of something. I could only hope it was only her thigh.

I didn’t know if I should reach inside her skirt. It might seem too forward: I’m not sure about the etiquette in that situation.

David was beaming when he emerged. Since no apology or explanation would be enough, I simply dragged him away, while his victim gaped after us.

“How was the zoo?” Nicky asked later.
“David had fun,” I told my wife.

A study, Sokhadze, et al. (2014) state that “Neurofeedback improved executive functioning and behavioral symptoms in autism.” The study found that a myriad of environmental noise which persons cannot separate or identify “could account for the strong aversive reactions to auditory, tactile and visual stimuli that are common in autism.”

< My Thoughts > “…strong aversive reactions…”

Sensory stimuli causing a child with autism to have extremely ‘strong’ reactions which strongly impact their daily life. So, even when most of the day has been reasonably well balanced, a sudden outburst as a result of an unexpected sensory reaction can upset everything.

Louise (2011) relates – I come by my attraction to balance naturally. I am relatively attracted to balance so this makes me happy. I know that to be true because my main and most-used therapy to achieve balance is ‘neurofeedback’. It is a means of reading brain wave activity and then giving the brain information about how to balance that activity. Balance, as it turns out, is the secret to mental and physical health and all life is endowed with the desire to achieve it. Sometimes we call that desire for balance “the pursuit of happiness.”

Grogram (2020) gives us the most common word that parents use to describe their sensory seeking child – ‘wild'. They say something like – “You’ve never seen a kid like mine, they climb the furniture, run constantly, plow through other kids. You would think they’d be exhausted, but most nights they have trouble getting to sleep.”

Of course, the truth is we have seen many kids like this! These kids seem to be in constant motion and sometimes have a hard time playing with other kids because they are so rough. They also may have a hard time sitting down to focus on activities. Those activities can be anything from homework to eating dinner.

The reason that kids’ activity becomes rough, and even dangerous could be due to the differences in the way their brain processes the sensory input received throughout the day. The input to sensory seeking kids could be diet related, behavioral, or a difficulty with processing the normal sensations they receive during the day. As a result of trying to ‘balance’ their input, they may seek out even more sensory sensations.

Kids that are always seeking sensory input may even be unaware of dangers other kids seem to notice. They may run into the street or a parking lot without a second thought or participate in some really scary behaviors like trying to climb the refrigerator, or whatever is close.

< My Thoughts > “…climb… whatever is close…”

An active 7-year-old, Sonny once ran into the kitchen pulled out the drawers, used them as a stepladder to the counter. Climbed up, stood on the counter and opened the cabinet door above; probably in hopes of climbing to a higher place. By happenstance, he spotted a bag of potato chips at eye-level. Grabbing the chips, he bounded to the floor. He was making his quick escape, only to meet me standing in the middle of the kitchen doorway, blocking his exit. Clutching the bag, he tried to push past me.

Gardner (2008) gives us a sense that Dale had no sense of danger. He knew how to use kitchen drawers as ladders if he wanted to climb them to sit on the stove.

Grogham (2020) answers the question – Why Is your child a Sensory Seeker? Why are some kids so active, rough, and even dangerous at times? Well, for a variety of reasons actually, one is that there are more than 5 senses. Most people are familiar with the 5 senses – sight, hearing, smell, taste, and touch. But we also receive input through two additional sources of sensory stimuli for the sensory seeking, through their ‘proprioception’ and/or ‘vestibular’ stimulation systems. The first – ‘proprioception’ is the need for activities like squeezing, hanging, climbing, and jumping. The second – ‘vestibular’ is the need for activities like spinning, swinging, climbing heights.

‘Proprioception’, or body awareness sense, tells us where our body parts are relative to each other. This sense 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. Poor visual-motor control problems may become more severe in adolescence.

‘Vestibular’ sense, or movement and balance sense give us information about where our head and body are in space. Vestibular sense allows us to stay upright while we sit, stand, and walk.

Sensory seeking kids are often NOT processing the normal sensations they receive to stimulate those sensory systems throughout the day. As a result, they seek out more stimulation. Meaning, they want activities that give them lots of proprioceptive and/or vestibular input.

Kirby, et al. (2015) considers that ‘proprioception’ is basically a continuous loop of feedback between sensory receptors throughout the body and the nervous system.

Jones (2013) believes that when we talk about the sensory issues we should talk about proprioception. That is the sense of knowing where your body is in space. Jones continues, I have an under-sensitivity in that sense. I cannot 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.

But 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 in my swing.

< My Thoughts > “I find the swaying movement very soothing.”

Therapists say that sensory or therapy swings offer opportunities for improving body awareness, sensory and ‘proprioceptive’ integration. Plus swinging and swaying has the added benefit of relaxing and calming the person with autism. Now, there is one more sense to be considered; that sense is ‘Interoception’.

Note: More about ‘vestibular’ and ‘proprioception’ in SENSORY CATEGORIES. And, more about ‘swings’ in the Chapter on Sensory Integration.

Interoception – There is another important ‘sense’ – Interoception which involves the internal regulation responses in our body. Sensory responses are such as hunger, thirst, blood pressure, and even toileting urges.

Quintiliani (2017) says conscious detection and perception of sensory signals in the body and on the skin are often processed as sensations; even emotional experiences are known as ‘interoception’. These neuro pathways connect external sensory experience with an internal sense of inner body sensations. Experiences, which in times of extreme stress, can become a warning of personal danger, unsafe conditions, or even impending death. These are brain-body-heart-mind experiences for which ‘Mindfulness’ training such as yoga and/or meditation can help a person to recognize the actual situation and return to feeling safe in their environment.

Note: More about ‘mindfulness’ in Chapter on Sensory Integration in UNIT 4.

< My Thoughts >          “…warning of personal danger…”

If Sonny became overheated because he had too many layers of clothing on, he went into a frenzied ‘fight or flight’ response. Being cold never seemed to bother him, but when he was very young, we learned that he couldn’t tolerate becoming overheated. Problem was that once he started taking clothes off, he didn’t want to stop until he was in the buff.

Yau (2012) says that individuals with autism often have sensory difficulties, which may include hypersensitivity (being over sensitive), and/or hyposensitivity (being under sensitive) for any of the five basic senses. He also tells us that children with autism actually have 7 senses; two additional areas of sensitivity to deal with. There is the vestibular sense (the sense of movement and balance) and proprioception (the sense of body awareness).

The vestibular sense, or movement and balance sense, gives us information about where we are in space. It allows us to stay upright while we sit, stand, and walk. Our proprioception system allows us to locate our bodies in space, to be aware of where our arms and legs are in relation to one another, as well as, where they begin and where they end.

< My Thoughts > “…actually have 7 senses…”

So, when exhibiting what seems to be ‘unusual’ behavior that may be a child’s way of having some of those 7 sensory needs met. And, those two added senses can just be enough to make teaching new skills to your child, extremely difficult. They may have little or no connection to their extremities; hands or feet, or the top of their head. Putting on hats, gloves or shoes and socks can bring forth a very strange look on your child’s face. They are probably saying, “Why would I want to do that?”

As often as I have taken off my son’s shoes asking, “Sonny, do you want me to take off your shoes?” He will look at me quizzically, until I touch or point to his feet, then he understands. “Oh, those shoes?” As if he has never noticed them before. After taking off one shoe, I point to his other foot, saying that we need take off the other shoe. Again, the quizzical look. He’s perfectly happy to hobble around with one shoe on and one shoe off. On the other hand, if we try to get him to let us put on a new pair of shoes he’s never seen before, it’s a no go! We have to put the shoes out on a shelf in his room until he gets used to seeing them, before we can expect any level of cooperation when trying them on.

Note: More about vestibular sense and proprioception sense in Chapter on Sensory Integration.

Schaaf & Lane (2015) talk about ‘proprioception’ as the sense of body position and movement, as it interacts with the environment. Reminding us that ‘motor clumsiness’ is one of the hallmarks of ASD which previously was thought to be caused by over-reliance on visual information. More recent literature seems to say that persons with ASD have enhanced ‘proprioception’, but that the inability of the ‘mirror neuron system’ to utilize that information may be limited.

Some say that limited mirror neuron system (MNS) information is like taking input from an alien commander; the inability to copy actions. Dapetto, et al. (2006) say those with a lack of MNS information seem not to be able to perform the task of imitation. Or, they must adopt increased visual and motor attention to perform the task of imitation at all, and then it is usually performed poorly.

Cohen (2011) recalls that every once in a while, Ezra poops in the bathtub and presses it between his fingers. Or he poops in the toilet and plays with it in the toilet water. Sometimes we find him in the back yard scooping up mud and putting it in his mouth. He shreds covers from his books and chews on the paper. He eats sand, dirt, and muddy leaves.

Ezra mouthed things, like most babies, and then he stopped when most toddlers do. Only more recently has he started with the ‘pica’ behavior. The words – ‘autism pica sensory seeking’ could not possibly describe what the behaviors really are, or what it really its like for either him or for us. Pica, a childhood disorder characterized by compulsive and persistent cravings for nonfood items, such as mud and paper. Pica is common among children with autism.

< My Thoughts > “Pica is common among children with autism.”

Pica behavior usually decreases with age, however some adults with the combination of severe Autism Spectrum Disorder (ASD) and Intellectual Disabilities (ID) may still engage in this dangerous and challenging behavior.

According to Matson, et al. (2012), the underlying causes of the ‘pica’ disorder and impairment of daily functioning and poor impulse control, are still unknown, today.

Hirsch & Myles (1996) tell us that the name ‘pica’ originates from the Latin word for magpie, a bird known to pick up non-food items to satisfy hunger or curiosity. They sound the alarm that this “abnormal craving for non-food items such as paint, dirt, clay, grass, paper, even glass and small batteries can result in hospitalization and even death.” For instance, swallowing multiple magnets can cause those magnets to engage, closing off parts of the intestine or bowel, resulting in tissue perforation and death. This often goes unnoticed as the child may only experience flu-like symptoms.

These authors explain that the ‘pica box’ can be successful when used as an intervention to reduce, control, or eliminate this behavior. With hyper-vigilance, in a controlled setting, when the child shows an interest in eating non-food items in the environment, they are offered safe items from the ‘pica box’ which mimic the chewy items they crave.

The ‘pica box’ substitutes are things such as beef jerky for tree bark, raisins or Grape Nuts for dirt/mud/sand, marshmallows for cloth items, and a clean wash cloth to suck on. If this therapy works, it can save the child from severe illness, poisoning, broken teeth, mouth lacerations, or even death. An indicator that the child is about to look for a non-food item is they sometimes start scavenging around on the ground or floor, mouthing toys, beginning to breath rapidly and make low throaty sounds.

Note: More about the ‘pica box’ in other chapters.

Grogham, A. (2020) adds that your child can seek sensory input from all of the senses, but the wild and dangerous behaviors are usually due to needs of the ‘proprioception’ and ‘vestibular’ systems. With the other 5 senses, as well the ‘proprioception’ and ‘vestibular’ systems, your child may be sensory seeking by –

smelling different objects in their environment
touching everything in sight and being messy
liking loud noises, sound, and certain music
bright lights, spinning objects, and high contrast pictures
tasting, mouthing or biting on different items, toys, and foods frequently

What is the solution to Sensory Seeking Behavior? The solution is to give them opportunities to participate in activities that meet their sensory needs. For kids that seek sensory input that tends to be described as wild, rough, or dangerous, means they need activities that give them a chance to move their bodies in space. But it also would mean giving them a productive or safe outlet before challenging times of the day; like before meals, homework, and bedtime, for example. That may mean setting up sensory activities somewhat routinely (otherwise known as following a sensory diet), depending on what is comfortable and effective for you and your child.

Note: More information about ‘sensory diet therapy’ and ‘sensory integration’ in Chapters on Therapy and/or Complementary & Alternative Medicine (Unit 7-3 CAMS).

REFERENCES for – When Is It Sensory? UNIT 4 CH 2 PART 3. SIRS, c. Seeking Behavior

Cohen, K. (2011). Seeing Ezra: A Mother’s Story of Autism, Unconditional Love, and the Meaning of Normal; eBook Edition.

Dapetto, M., Davies, M., et al. (2006). Understanding Emotions in Others: Mirror Neuron Dysfunction in Children with Autism; Nature Publishing Group; http:www.nature.com/natureneuroscience.

Gardner, N. (2008). A Friend Like Henry; eBook Edition.

Green, L. (2013). The Well-Being of Siblings of Individuals with Autism; ISRN Neurology; V:2013; Art. 417194/

Grogham, A. (2020). Genius Activities for Sensory Seeking Behavior in Your Child; Retrieved online from – https://yourkidstable.com/sensory-strategies-wild-kids/

Hirsch, N., Myles, B. (1996). The Use of a Pica Box in Reducing Pica Behavior in a Student with Autism; Focus on Autism & Other Developmental Disabilities; V11N4, p222-225.

Jones, S. (2013). No You Don’t – Essays from an Unstrange Mind; eBook Edition.

Kirby, A., Little, L., et al. (2015). Observational Characterization of Sensory Interests, Repetitions, and Seeking Behaviors; American Journal of Occupational Therapists; V69:3, Retrieved online from –https://www.researchgate.net/publications/

Louise, L. (2011). Miracles Are Made: A Real-Life Guide to Autism; eBook Edition.

Matson, J., Hattier, M.,(2012). An Evaluation of Social Skills in Adults with Pica, Autism Spectrum Disorders, and Intellectual Disability; Journal of Developmental Physical Disability; V24, p505-514.

Morin, A. (2017). Amanda Morin – Classroom Teacher and Early Intervention Specialist. Retrieved online from – www.everythingkidslearning.com/

Quintiliani, A. (2017). Mindful Happiness: What Is Introception & Why Is It Important?; Retrieved online from – https://mindfulhappiness.org/2017/what-is-interoception-and-why-is-it-important/

Raulston, T. & Machalicek, W. (2018). Early Intervention for Repetitive Behavior in Autism Spectrum Disorder: a Conceptual Model; Journal of Autism & Developmental Discord; V30, p89-109.

Realmuto & Ruble (1999). Sexual Behaviors in Autism: Problems of Definition & Management; Journal of Autism & Developmental Discord; V29:2, p121-129.

Rudy, L. (2020). An Overview of Repetitive Behaviors in Autism: Medically Reviewed by Joel Forman, MD; Retrieved from – https://www.verywellhealth.com/repetitive-behaviors-in-autism-260582/

Ruzanno, L., Boorsboom, D. et al. (2014). Ruzanno, L., et al. (2014). Repetitive Behaviors in Autism & Compulsive Disorder: New Perspectives from a Network Analysis; Journal of Autism & Developmental Disorders; V45:2, p192-202.

Schaaf, R. & Lane, A. (2015). Toward Best-Practice Protocol for Assessment of Sensory Features in ASD; Journal of Autism Developmental Disorders; V45, p1380–1395.

Sokhadze, E., El-Baz, A., et al. (2014). Neuromodulation Integrating TMS & Neurofeedback for the Treatment of Autism Spectrum Disorder: An Exploratory Study: Applied Psychophysiology & Biofeedback; V39:3/4, p237-257.

Stagliano, K. & McCarthy, J. (2010). All I Can Handle, and I Am No Mother Teresa: A Life Raising Three Daughters with Autism; eBook Edition.

Stevens, C. & Stevens, N. (2011). A Real Boy: How Autism Shattered Our Lives & Made a Family from the Pieces; eBook Edition.

Wolff, J., Dimian, A. et al. (2019). A Longitudinal Study of Parent-Reported Sensory Responsiveness in Toddlers At-Risk for Autism; Journal of Psychology & Psychiatry; V60:3, p314-324.

Yau, A. (2012). Autism – A Practical Guide for Parents; eBook Edition.

PLEASE READ DISCLAIMER –

When Is It Sensory? UNIT 4 CH 2, Part 4

PART 4. EP (enhanced perception)

ENHANCED PERCEPTION (EP)

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

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

Baron-Cohen, et al. (2007) talk about those with EP are able to take on the mathematical challenge of systemizing because they have the drive to analyze and/or build a system of any kind. These authors believe that those with autism may become obsessed by analyzing and memorizing train tables, calendars, calendrical calculation, and traffic system schedules. Notably they excel in areas requiring attention to and memory for detail, and a strong drive to detect patterns. They believe that is why those with EP and Asperger’s are often found in domains such as mathematics, physics, and computer sciences.

Having a neurological basis, EP can also be associated with cognitive strengths, various talents, and even extreme conditions such as savantism They report a single case study of a man who had all three of these conditions, co-occurring. And, another case of a neuro-typical person with both savantism and synesthesia who may have had undiagnosed Autism.

< My Thoughts > “…savantism and synesthesia…”

Studies show that ‘synesthesia’, seeing auras around objects, letters, numbers, musical notes and so forth, has often been expressed by children and adults with autism. In the 1980’s when Dustin Hoffman gave his Oscar acceptance speech for the movie Rain Man he publicly thanked and acknowledged savant Kim Peek – the man who was the inspiration for the character Hoffman played. Retrieved online from: https://www.appliedbehavioranalysisedu.org/5-mind-blowing-things-kim-peek-could-do-that-you-cant/

Sasaki (2019) ascertains that a certain percentage of people have a condition called synesthesia; this means they mix their senses. For example, a synesthete can see a color while looking at a letter or experience a taste while listening to music. The link between synesthesia and autism may possibly be found on the sensory level.

Nobel Prize-winning physicist Richard Feynman says, "I see vague pictures of ‘Bessel functions’ (a mathematical term) with light-tan j's, slightly violet-bluish n's, and dark brown x's flying around." Feynman was describing his grapheme-color (GC) synesthesia – a condition in which individuals sense colors associated with letters and numbers.

Synesthesia is a family of conditions where individuals perceive stimulation through more than one sense. GC synesthesia is just one form. In others, musical notes evoke colors; words have associated tastes; sequences of numbers are sensed as points in space; numbers suggest people, like an elderly man or a baby girl. Many synesthetes have expressed how their condition has enhanced their lives.

Cherry (2015) claims that colors can give you more positive or negative effects than you may think. Colors can alter moods, influence behavior and even cause physical reactions like changing your appetite.

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

Johnson (2014) justifies concerns about her daughter by saying, “Let’s face it, it’s a lot easier to get along in this world if you can speak and understand verbal communication. So, why would I want my child to try to navigate in life without those basic skills?”

Of course, I want her to continue to have all the amazing gifts she has. Sophie is extremely gifted in many areas, especially when it comes to math and spatial reasoning. I’ve literally watched in amazement as she has put together complicated puzzles quickly, just by glancing at the shape of the piece she needs next. She doesn’t even need a picture.

There also seems to be a genetic component, but some ‘performances’ may be the result of independent mechanisms. Mottron (2009), one of the authors of this study believes that this is explained by the way the brain allows for, or approaches tasks. She calls this a “regional cerebral synaptic response”, or how plasticity in the brain reacts to the environment, or to an event.

< My Thoughts > “…how plasticity in the brain reacts...”

Some authors on the subject of brain plasticity, refer to the appearance and prevalence of these specialized talents and strengths as a sort of ‘adaptive functioning’ response. Lots to consider here.

Baron-Cohen (2019) believes that enhanced perception has to do with the core ‘attention-to-detail’ and ‘systemizing’ traits of the autistic. Early stage ‘advanced information processing’ may also be linked to the presence of ‘synaesthesia’. This is detection of letters and numbers as a sound or a color.

Treffert (2014) tells us that the “Savant syndrome is a rare but spectacular condition in which persons with developmental disabilities, including but not limited to autism, or other central nervous system (CSN) disorders have some spectacular ‘islands of genius’ that stand in jarring juxtaposition to overall limitations.” That “not all savants are autistic, and not all autistic persons are savants.”

For nearly 50 years, Dr. Darold Treffert of the University of Wisconsin has been studying savants— he tells us that there are a small number of what he called "acquired savants," people who had their talents unlocked after an illness or injury affected the brain. Here are six that he mentions –

1. At a park in 1994, Tony Cicoria, an orthopedic surgeon, was hanging up a pay phone when lightning from a gathering storm struck the booth, shooting through the phone and into his head. Soon afterward he learned that he could play the piano.
2. Britain's Tommy McHugh was in the bathroom getting ready for work as a carpenter when he suddenly felt a sharp pain in his head; he collapsed to the floor. Upon recovery, he began scribbling poetry, filling notebooks.
3. A 23-year-old, with the mental age of seven, contracted pneumonia and meningitis. His doctors soon discovered that inside his mind lived a musical genius which was apparently released upon his recovery. Now, he could play hundreds of tunes flawlessly, becoming a living jukebox.
4. Sabine, at age six, contracted typhoid fever. The illness left her blind, mute, and with a childlike personality that she never outgrew. But she could perform complex mathematical calculations with astonishing ease.
5. 10-year-old Orlando Serrell was playing baseball when he was hit on the left side of his head. He finished the rest of the game. Figuring that he was okay, he never sought medical attention, despite a headache that lasted for days. Serrell soon found he had a special talent called "calendar calculating." Give him a date and he could tell you the day of the week that date fell on.
6. When Alonzo Clemons was three, he fell hitting his head, sustaining a serious head injury that changed his life forever. Now, he could look at any animal—from a horse to a dolphin to a rhinoceros—for just a few moments and then create a lifelike sculpture.

Mottron (2009) links savant talent to the enhanced ability of autistic individuals to a particular style of enhanced local processing.

Surprising talents and strengths are reported in studies of Meilleur (2015), stating the prevalence of Special Isolated Skills (SIS). These are exceptional strengths or talents which appear suddenly, are somewhat of a mystery. Having SIS may be dependent upon exposure to materials available in the child’s environment. SIS strengths and talents seem to increase with one’s age; and are more common in girls with autism than boys. Some SIS won’t surface until adolescence.

REFERENCES: When Is It Sensory? UNIT 4 CH 2 – PART 4. EP (enhanced perception).

Baron-Cohen, S. (2019). The Concept of Neurodiversity Is Dividing the Autism Community; Scientific American Mind; V30: 4.

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

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DISCLAIMER (2024) Know Autism – Know Your Child: with < My Thoughts > by Sara Luker; 2024

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