Sensory Differences
Sensory Differences
Sensory Differences
Overview
Among all these experiences, most of us are able to tune out the things that are
irrelevant to what we are currently engaged in and tune into the things we need in order
to be able to navigate and respond to our environment. However, some individuals with
autism spectrum disorder (ASD) often react differently. Some find these experiences to
be confusing and overwhelming, while others may be unresponsive to these
experiences in a way that may be different from most individuals.
In this module, you will learn about the senses and how our bodies use sensory
information to contribute to and support critical life functions such as our ability to
recognize and react to danger, regulate our level of alertness, and facilitate our
engagement in meaningful life activities. We will then focus on the sensory differences
that may be present in persons with ASD and how they may impact their day-to-day
behavior and performance.
Pre-Assessment
Pre-Assessment
Our senses give us the information we need to function in the world.
Select an answer for question 420
A child with sensory processing disorder has the ability to effectively and efficiently
organize sensory information.
Select an answer for question 421
Individuals with ASD who exhibit sensory processing difficulties can have more than one
sensory area affected.
Select an answer for question 428
Defining Sensory Differences in
Individuals with ASD
Do you enjoy...
riding in a car?
For most people, these sensations are pleasing or at least fully acceptable. However,
some individuals with ASD find these experiences overwhelming, others may not even
take notice of them, and still others may struggle with feeling overly sensitive to these
activities on some days and under-sensitive on other days. Abnormalities in processing
incoming sensations such as light, sound, touch, taste, pain, smell, movement, or
temperature are reportedly experienced by 70-80% of the ASD population (Harrison &
Hare, 2004; Myles, Cook, Miller, Rinner, & Robbins, 2000; Volkmar, Cohen, & Paul,
1986). In some, the differences affect only one sensory area, while in others multiple
senses are impacted.
Tactile/Touch
The skin is one of the largest sensory receptors in the human body. The skin is filled
with touch receptors that are activated when contact is made with the skin. There are
many different types of touch receptors, including those for pressure, temperature, and
pain, as well as different types of touch sensations. A large concentration of receptors
for the sense of touch are located in our mouth, hands, and the soles of our feet.
Behaviors such as mouthing objects and chewing hands are probably related to the
large number of receptors in these areas.
The other system, the discriminative system, allows us to determine where we are being
touched and what is touching us. It contributes to our ability to identify objects by size
and shape without the need to look directly at an object. For example, in the morning
when our alarm sounds, we are able to keep our eyes closed for just a few more
minutes but still locate the alarm to shut it off by feeling around on the bedside table,
locating the alarm, and finding the button to turn it off.
Visual/Sight
The receptors for vision are located in the eye, specifically the retina, and they are
activated by light. The function of the eye is to give us information about objects and
people around us, such as multidimensional awareness, patterns, and colors. Vision
also provides us with an awareness of our surroundings beyond arm's reach, such as
distance, proximity, and depth perception.
Effective visual processing helps us to identify and interpret the physical features of
people, events, and objects, as well as to navigate our environment safely. It also plays
a role in the development of pattern recognition, which contributes to our early ability to
recognize others. Pattern recognition also makes things memorable, which helps us to
learn and retain information.
Auditory/Hearing
The hearing receptors are located in the structures of the ear, and are activated by
vibrations produced by sound. They process sound so that speech, music, or noise can
be distinguished and interpreted by the brain.
Hearing provides the basis for developing oral language skills. Being able to hear the
sounds allows us to imitate and play with sounds to develop our own language skills. It
is the effective development of these oral language skills that provides the foundation
for spelling and grammar, which contributes to the later development of written
language as well.
Olfactory/Smell
The smell receptors are located in the nasal cavity, and are activated by chemicals
called odors. The function of the sense of smell is to assist us in discriminating people
and things. They also help to alert us to volatile and dangerous substances, such as
poisons, leaking gas, or smoke. In addition, our sense of smell has a strong connection
to long-term memory.
Gustatory/Taste
The receptors for the sense of taste are located on the tongue. The human tongue
detects only four or five basic taste components, sweet, sour, salty and bitter, with the
taste of savory recently added to the list by some scientists. So you might wonder how it
is possible that we can taste and identify so many different foods. Whereas the human
tongue can distinguish only among four or five distinct qualities of taste, the nose can
distinguish among hundreds of substances, even in minute quantities. It is the work of
the tongue and the nose together that allows us to enjoy and identify different flavors.
Vestibular
The vestibular receptors are located in the inner ear, and are activated by movement of
our head. We have probably all had the sensation of lifting our head too quickly and
finding the room briefly spinning. That is the work of the vestibular receptors. The
vestibular system gives us information about where we are in space, as well as how fast
and in what direction we are moving. It also contributes to our posture and overall
muscle tone.
When we are infants, an effective vestibular system allows us to find gentle rocking
soothing. Later, it helps us to maintain our balance when we walk, jump, run, and climb
so we can feel confident and safe to engage in these activities. It also allows most of us
to ride in cars, planes, trains, and boats without feeling uncomfortable.
Proprioception
Proprioception provides information about our position in space and general body
awareness. The receptors for this system are located in the joints, tendons, and
muscles. They are activated by bending, straightening, compressing, pulling,
contracting, and stretching the receptors.
This sense contributes to an infants' knowledge about their body position so they can
mold to a caregiver's body to cuddle. As children get older, proprioception contributes to
the development of coordinated crawling, walking, and running as well as our ability to
imitate body movements. As adults, we rely on the sense of proprioception to help us
participate in sports, dance, and other life activities requiring coordinated movement.
Propriception is critical for the development of motor skills and motor planning, or in
other words, our ability to move our bodies in a coordinated fashion in all of our life
tasks and activities.
Sensory Processing
What is Sensory Processing?
Sensory processing refers to the ability to take in the information we receive from our
senses, both external and internal, and then use that information to function effectively.
Specifically, our bodies send information from the senses to our brains through neural
pathways, which are much like roads. Once the information reaches the brain, it is
interpreted, and we can then act on the information.
Effective sensory processing allows the brain to locate, sort, and make sense of
incoming sensory information. The brain helps to decide if the input is something that
should make us be afraid and move away, if it is information we need to function in the
environment, or if it is something we should just disregard as not important to either of
those functions. In short, effective sensory processing provides us with protection from
danger, and helps us to attend, be appropriately alert, and engage in meaningful
activities.
We need a certain amount of sensory input to maintain life functions. It is that "just right"
amount of sensory input and our brain's processing of it that makes us appropriately
alert so we can engage in meaningful life activities during the day and yet allows us to
peacefully sleep at night. If we experience extreme sensory input for extended lengths
of time, it can have detrimental effects on our well-being, making us feel overwhelmed
and frightened, leading to behavior that is either frenzied or causes us to shut down.
Conversely, too little sensory input can make us dull, lifeless, and disengaged.
For the latter group, a small amount of sensory input can create feelings of being
overwhelmed and elicit responses such as shutdown. They may exhibit behaviors such
as distractibility or hyperactivity, or the opposite-limited and constrained actions. These
individuals may also be irritable, impulsive, defensive, defiant, overly reactive, anxious,
demanding routine and/or rituals, resistant to change, have negative attitudes, or
demonstrate emotional outbursts.
Here are some examples of behaviors we might see in the various senses if an
individual is overly responsive to sensory input.
Tactile (Touch)
Visual (Sight)
Auditory (Hearing)
o holds hands over ears when hearing what seems like normal noise to others
Gustatory (Taste)
Olfactory (Smell)
Vestibular/Proprioception
These individuals may try to meet their need for additional input by demonstrating a
tireless pursuit of sensory input, with associated behaviors of lacking caution in play,
fidgeting, and/or becoming easily overly stimulated. They appear to be sensory seeking
in their behaviors. Conversely, others, who are under-responsive, may appear as
sedentary, withdrawn, uninterested, difficult to motivate, and having very low energy.
Here are some examples of behaviors we might see in the various senses if an
individual is under-responsive to sensory input.
Tactile (Touch)
o may not recognize personal space and sits too closely to others
o may refuse to wear seasonally appropriate clothing; may seek heavy, warm
clothing on hot days
Visual (Sight)
o focuses of shiny or colorful objects
Auditory (Hearing)
o does not seem responsive to fire drill bells, class change bells, car horns, etc.
o may talk loudly with little understanding of the need to modulate voice volume for
various environments
Olfactory (Smell)
Gustatory (Taste)
Vestibular/Proprioception
o doesn't understand body position in space, and may have difficulty imitating
motor movements
o may have difficulty sitting with appropriate posture in a chair for a long periods of
time (slouches)
Some children demonstrate behaviors that would lead us to believe they are both
under-and over-responsive to sensory input. They may demonstrate these differences
among the different senses or within one sense. For example, a student might be
resistant to various foods, which would lead us to believe she is overly responsive to
taste sensations or the feel of food within her mouth. But that same student might not
respond when her name is called or if there are loud noises, leading us to believes she
is under-responsive to sound input. Additionally, a child may appear to be distracted by
even minor sounds, which might indicate over-responsiveness, but a little while later we
may have difficulty gaining her attention when we call her name, indicating she may be
under-responsive at that time.
Sally
Case Study: Sally
When Sally gets up in the morning and starts to get dressed, she finds a new shirt
provided for her by her mother. The shirt feels scratchy, and there is a tag in the back.
The tag is all Sally can think about during breakfast. Later she boards the bus. She
hates all the talking, laughing, and shouting on the bus. Not only that, soon a student
sits down next to her, accidentally bumping her and sitting so close they are touching. It
hurts when somebody bumps into her, and it makes Sally angry the other student is
sitting so close.
When the bus arrives at school, she gets off, and soon the bell rings. It is loud ... really
loud. The students line up, and in the process accidentally bump into each other. Sally
tries to get to the end of the line so she can keep an eye on the other students to avoid
getting bumped. But she feels increasingly anxious because students have filed in
behind her at the last minute, and she can't tell how close they are. One of them bumps
her. It hurts, and Sally is feeling angrier. When she gets to class, she discovers that her
teacher is wearing a new perfume. It smells really strong. The other kids are
complimenting the teacher on the perfume ... but not Sally. It is giving her a headache.
The bell rings again; it is loud. As the teacher begins the lesson, Sally suddenly blurts
out as she covers her ears with her hands, "That bell is just too loud!" The teacher
reminds Sally to raise her hand to comment in class. Sally becomes even angrier, and
starts arguing with the teacher.
The "meltdown" described above did not occur because of the loud bell, but because
Sally had reached her limit, or threshold, for sensory input or the combination of events
that occurred at school and at home. Sally had endured continued random challenges
to her sensory system since the moment she woke up, and the cumulative effect was
eventually too much for her to manage. This scenario illustrates the importance of
making observations of a student over a period of time, considering many things that
may be hidden in the environment and perhaps not obvious to most of us but that add to
a child's sensory challenges.
Many researchers are now working to identify the specific types of sensory processing
difficulties that may be associated with ASD. Following is an overview of some of the
recent research trends that are emerging related to ASD and sensory processing.
Thinking back to our discussion about over- and under-responsiveness to sensory input,
not surprisingly, much of the research has reported that children with ASD exhibit
variable and mixed responsiveness to sensory experiences (Adamson, O'Hare, &
Graham, 2006; Kern et al., 2007a; Kern et al., 2008; Lane Young, Baker, & Angley,
2010; Leekam, Nieto, Libby, Wing, & Gould, 2007). Because of this variability,
researchers are attempting to identify unique patterns of sensory processing in ASD.
Some have found that young children tend to exhibit more under-responsiveness or
nonresponsiveness to sensory input (Baraneck, David, Poe, Stone, & Watson, 2006;
Baraneck, Boyd, Poe, David, & Watson, 2007; Ben-Sasson et al., 2007; Rogers &
Ozonoff, 2005), whereas older children with ASD tend to exhibit more sensory-seeking
behaviors (Ben-Sasson et al., 2009; Liss, Saulnier, Fein, & Kinsbourne, 2006).
Other researchers are looking toward the specific sensory domains (auditory, taste,
smell, tactile, etc.) to determine if there are specific, unique connections with ASD. For
example, a recent study suggests that taste and smell sensitivities as well as
movement-related sensory behaviors are possible sensory subtypes associated with
ASD (Lane et al., 2010). Yet other researchers are examining the relationship between
the core deficits of ASD and sensory processing. To date, relationships have been found
among the presence of sensory processing difficulties and the severity of ASD and the
incidence of difficult behaviors and severity of communication deficits (Baker, Lane,
Angley, & Young, 2008; Gabriels et al., 2008; Kern et al., 2007b; Liss et al., 2006).
Researchers have identified many pieces to the puzzle related to sensory processing
difficulties and ASD. However, there is still much work to be done to determine the
specific contributions of sensory processing and the effectiveness of sensory
intervention strategies for persons with ASD.
Summary
Our senses give us information about the world around us; our brain processes the
input, and we respond based upon how we process that information. Our senses keep
us safe, provide us pleasure, and help us function. Individuals on the autism spectrum
may not receive, process, and react to sensory stimuli the same way as neurotypicals.
Some are overly responsive whereas others are under-responsive to sensory
experiences in the environment. Students with sensory differences may benefit from
services from an occupational therapy practitioner who can provide assessment and
intervention strategies to help them manage their sensory differences and improve their
access to successful home, school, social, and work experiences.
Q. Why does a child prefer certain sensory activities one day, but often not the
next?
A. The sense of proprioception uses information from the muscles and joints to give us
an awareness of our body position. This is the sense that makes it possible to guide our
arms and legs without watching the complete range of movement. Proprioception helps
adjust body position to prevent us from falling out of a chair, and allows us to manipulate
a pen or hairbrush.
A. The vestibular sense coordinates the movement of our body, head, and eyes. The
brain in turn responds to the movement through space and body position. The vestibular
sense allows us to balance, throw a ball, or stumble without falling. It maintains muscle
tone, helps coordinate the two sides of the body, and enables us to hold our head up
against the force of gravity.
Q. What are some of the red flags parents and professionals should be aware of
that might indicate somebody is experiencing sensory challenges?
A. The following is a checklist of some of the signs of sensory processing disorder. But
please keep in mind that some sensory challenges manifest themselves somewhat
differently in each individual.
o poor self-regulation: not able to calm themselves
Q. Who should I talk with if I suspect my child might have sensory processing
difficulties?
A. In a school setting, begin by talking with the child's classroom teacher. The teacher
can help to connect you with the school occupational therapist, who is the professional
trained to assess sensory processing dysfunction in children. If your child does have
some sensory processing issues, the occupational therapist can then provide
intervention strategies. If your child is not currently in school, you might speak with your
family physician about a referral to an occupational therapist.
Discussion Questions
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Post-Assessment
Post-Assessment
Our senses give us the information we need to function in the world.
Select an answer for question 429
A child with sensory processing disorder has the ability to effectively and efficiently
organize sensory information.
Select an answer for question 430
A child that is under responsive to touch may
Select an answer for question 431
Individuals with ASD who exhibit sensory processing difficulties may have more than
one sensory area affected.
Select an answer for question 437
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