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Sensory Integration and ASD
Lorraine Ringland
Clinical Specialist in Autism, Occupational Therapy
Lorraine Ringland
Clinical Specialist in Autism, Occupational Therapy
This Talk Aims to ExplainThis Talk Aims to Explain
What is Sensory Integration? What is Sensory Integration Difficulties? What have they to do with Autism? How do Sensory Integration Difficulties
present and what parents can do?
The Concept of Sensory IntegrationThe Concept of Sensory Integration
Sensory Integration is the ability to take in, sort out, process and make use of information from the world around us.
Ineffective Sensory ProcessingIneffective Sensory Processing
Can effect one or more of sensory systems. Impacts upon ability to:
– Learning – Cope with daily demands and stress– Direct behaviour effectively
A comparison can be drawn to indigestion…
Sensory Processing Disorder and AutismSensory Processing Disorder and Autism
Literature indicates that 42% to 88% of children diagnosed with Autism will also experience sensory processing difficulties.
– (Baranek, 2002).
These children often have difficulty regulating responses to sensations and specific stimuli and may use self-stimulation to compensate for limited sensory input or to avoid overstimulation.
– (Roberts, King-Thomas, & Boccia, 2007; Schaaf & Nightlinger, 2007; Smith, Press, Koenig, & Kinnealey, 2005).
Behaviours such as stereotypic motor movements, aimless running, aggression, and self-injurious behaviours have been correlated with these sensory processing difficulties.
– (Case-Smith & Bryan, 1999; Dawson & Watling, 2000; Linderman & Stewart, 1999; Watling & Dietz, 2007).
7 Sensory Systems7 Sensory Systems
Body Position (Proprioception)
Movement(Vestibular)
Touch (Tactile)
Sight (Visual)
Taste (Gustatory)
Sound (Auditory)
Smell (Olfactory)
PROPRIOCEPTIONPROPRIOCEPTION(Body awareness) Location: receptors located
in muscles and joints and is activated by muscle contraction
Function: provides information about where a body part is and how it is moving. Has a calming effect on the sensory system.
Proprioception – exhibiting behavioursProprioception – exhibiting behaviours
Heavy handed or footed Poor judgement and grading of movement Poor posture, frequently props head on
hands/table Bumps into things, falls frequently Tip toe walking Drops things frequently Tires easily Poor body awareness May chew on non-food objects or grinds teeth
Proprioceptive StrategiesProprioceptive Strategies
Tug of war games Heavy loads: encourage child to carry the shopping bags Wheelbarrow walking Arm/foot wrestling Trampolining Climbing frames Monkey bars
Please Note, when a child is overwhelmed / overactive, engaging them in activities which activate the Proprioceptive sense should help them to become more calm.
VESTIBULARVESTIBULAR(Movement and balance) Location: receptors in the
inner ear, stimulated by head movements and input from other senses
Function: Provides information about where our body is in space, whether we are moving standing still and what speed and direction we are going
Vestibular – exhibiting behavioursVestibular – exhibiting behaviours
Overly Sensitive Poor tolerance to
movement Easily become dizzy when
changing body position Dislike tipping their head
back Overly fearful of heights May experience motion
sickness May move quite rigidly
Under Registering Seeks fast moving
activities Spins, rocks, bounces
and jumps excessively Always ‘on the go’ Enjoys being upside
down Slouches and leans,
unable to sit upright for long
Tips for Parents - VestibularTips for Parents - Vestibular
Extra proprioception or pressure helps a child feel more secure.
Encourage active child propelled movements rather than passive movement.
Fast movements with changes in direction are alerting, slow rhythmical movements tend to be calming and soothing
Try having your child complete some activities in different positions, e.g. lying on stomach to read.
Take small steps towards more challenging activities, break them down so that movement is minimalised.
TACTILETACTILE
(Touch)Location: receptors under
the skin Function: Provide
information to the brain regarding the environment or object (touch, pressure, texture, hard, soft, sharp, dull, heat, cold and pain)
Tactile – exhibiting behavioursTactile – exhibiting behavioursOverly Sensitive Fussy Sensitive to textures Dislikes and avoids likes
messy play Can react aggressively to
another’s touch Feels pain excessively Very sensitive to temperature
changes. Distressed at grooming
activities, e.g. brushing hair/teeth, cutting nails
Under Registering Responds only to firm touch Can invade space / be
overly tactile Can be heavy handed Grips objects too firmly Has difficulty responding to
pain/temperature. May be unaware of food
left in his mouth Frequently seeks the feel
of objects in his/her environment
Tips for Parents - TactileTips for Parents - Tactile
If your child is seeking out tactile experiences, feed them. If the child avoids tactile experiences, incorporate
proprioceptive tasks and consider the texture of toys, clothes, towels, etc.
Light touch can be irritating, firm and constant pressure organising
Remember self-initiated touch produces a less defensive reaction to the sensory system.
Avoid situations of close proximity to others Always watch for signs of overstimulation and discomfort,
remember that tactile experiences can be painful for some children.
AUDITORYAUDITORY
(Sound)Location: inner ear
stimulated by sound/air waves
Function: Provides information about sounds in the environment (loud, soft, high, low, near or far)
Hearing – exhibiting behavioursHearing – exhibiting behaviours
Overly Sensitive Reacts as though noise
levels are magnified Dislikes loud noise Is easily startled Engages in unusual
behaviours in noisy environments
Is anxious before expected noises (school bell)
Holds hands over ears Highly aware of all
environmental noises
Under Registering Enjoys really loud noise Fails to pick up expected
cues. Makes unusual noises
themselves Seek out irritable noises,
e.g. white noise May become more
engaged in noisier environments
Tips for ParentsTips for Parents
Prepare the child for noisy environments. Use headphones or ear defenders to ‘dampen
down’ the level of noise for the child. Teach your child strategies within noisy
environments, e.g. standing close to the door. Agree methods for your child to tell you there is
too much noise, e.g. token exchange, loud gauges or happy/sad faces.
Encourage the child to attend to sounds by playing games based on auditory cues, e.g. Simon Says.
VISUALVISUAL
(Sight)
Location: retina in the eye which is stimulated by light
Function: provides information about what we see in the environment and helps us define boundaries as move in space
Visual – exhibiting behavioursVisual – exhibiting behaviours
Difficulty finding what they are looking for unless the item is strongly motivating
Difficulty concentrating in a very bright, visually stimulating room
May become overly focused on visual detail
Advanced drawing skills String visual memory
Tips for ParentsTips for Parents
Reduce lighting, particularly when the child appears overwhelmed
Reduce the amount of visual distractions Be aware of visual challenges, e.g. copying
from a board, reading text Present work in visual blocks Remember it may be difficult for the child to
look at you and listen to you simultaneously
OLFACTORY and GUSTATORY
OLFACTORY and GUSTATORY
(Smell)
Location: chemical receptors in the nose (closely linked to the taste sense)
Function: Provides information about different types of smell (musty, acrid, putrid, flowery and pungent)
(Taste) Location: Chemical receptors in the tongue (closely linked with the smell sense) Function: Provides information about different types of taste (sweet, sour, bitter, salty, spicy)
Taste and Smell – presenting behavioursTaste and Smell – presenting behaviours
Overly Sensitive Dislikes strong tastes
prefers bland Tastes or smells objects,
clothes etc Likes consistent
temperature of food Over-reacts to common
smells Gags easily at subtle
smells
Under Registers Mouths and or smells non-
food items Craves strong tastes and
flavours Under-reacts to strong
smell, may seek them.
Tips for ParentsTips for Parents
Incorporate foods into messy play Introduce tastes in a fun way and expand on established
tastes Use calming scents or scents the child prefers, in small
amounts e.g. lavender etc Use scented stickers to assist in desensitising Allow the child to chew gum/suck hard sweet In environments with distinctive smells, e.g. canteen or
dentist, have the child’s favoured scent on cotton wool / sleeve to help calm
Use calming activities when the child is overwhelmed, i.e. proprioceptive activities
IMPORTANT POINTSIMPORTANT POINTS
When a child displays unacceptable behaviour consider an underlying sensory processing cause.
Acknowledge the difficulties children with sensory processing experience across contexts and how this affects their life skill development and academic readiness
Accentuate the positive and always offer understanding and support