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Sensory Perceptual Issues in ASD

Sensory Perceptual Issues in ASD. Colin Smith. Purpose of presentation. Reminder that sensory issues offer one possible explanation for challenging behaviour Sensory issues are very important in ASD

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Sensory Perceptual Issues in ASD

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  1. Sensory Perceptual IssuesinASD Colin Smith

  2. Purpose of presentation • Reminder that sensory issues offer one possible explanation for challenging behaviour • Sensory issues are very important in ASD • Interventions should acknowledge importance of sensory issues and organise environments and approaches accordingly • Nature of sensory issues often misunderstood • they are not uncommon • not just about hypersensitivity

  3. Some behaviours associated with ASD that may be linked to sensory issues: • Outbursts following crowded environments or group conversations • Bright lights uncomfortable/ dimness preferred • Disorientated in environments rich with visual stimulation • Plays with lights and shiny objects • Repetitive humming or loud outbursts • Discomforted by loud or low frequency noise • Delayed response or over reaction to sudden noises • Over reaction to smells –especially those no one else can detect • Flapping, spinning • Walking on tip-toes

  4. Further behaviours: Sensory? • Preference or insistence on (same) bland food • Fascination with how people smell • Aversion to perfumes and air fresheners • Strong preference for gentle or firm touch or pressure • Unusually high or low response to pain • Unusually high or low response to temperature • Unhappy in new clothes, sensitive to how clothes/ bedding feels

  5. Anna Jean Ayres (1920-1989) • Occupational Therapist and developmental psychologist known for her work in the area of sensory integration dysfunction, a term she coined in the 1960s to describe a theory used in occupational therapy

  6. The science bit! Sensory receptors (various parts of the body) Sensory nerve in these receptors recognises a stimulus Sensory Transduction to brain (which may be confused or misinterpreted) Arousal (timescales) Response

  7. The sensory system Sight Taste Hearing Vestibular Proprioceptive Smell Touch

  8. Sensitivity • Hyper sensitive - (overpowering registration) sensation avoidance • Hypo sensitive – (low registration) sensation seeking

  9. Prevalence – increasing trends • Studies in early part of millennium suggestive of 30% in ASD • Schoen, S. Miller L. Brett-Green, BA. & Nielsen, DM. (2009) suggest 90% of individuals with an ASD have sensory differences • DSM-V & ICD-11 Incorporating it within diagnostic criteria circa. 2013

  10. Smell/Taste (Olfactory/Gustatory System) Hypo (low registration/sensation seeking) Hyper (sensitive/ sensation avoidance) Behaviours Ignores bad smells Eats inedible objects Can eat strong foods with no adverse effects Fascination with how people smell Overwhelmed Panic Refusal to go into particular environments Intolerance to people

  11. Sight (Visual System) Hypo (low registration/sensation seeking) Hyper (sensitive/ sensation avoidance) Behaviours Things appear darker Relies on peripheral vision Blurred vision Clumsiness Terror in dimly lit places Things appear brighter Distortion of objects Highly sensitive to light (particularly fluorescent light) Reacts violently to light Objects jump around Distorted perspective Insistence on gloom

  12. Hearing (Auditory System) Hypo (low registration/sensation seeking) Hyper (sensitive/ sensation avoidance) Behaviours Sound distorted or magnified Inability to filter or discriminate Acute painful hearing Overwhelmed by sound Reacts violently to sound Holds hands over/fingers in ears Disturbed or distracted by background sound (e.g. fridge) ‘Tunes out’ Sounds partially heard Sounds are muffled No response to sound (may appear deaf) Enjoys/seeks loud noise

  13. Touch (Tactile System) Hypo (low registration/sensation seeking) Hyper (sensitive/ sensation avoidance) Behaviours Overwhelmed Avoids certain fabrics Reacts violently to touch Refusal to wear clothes Avoids hair/nail cutting Even light touch may be painful BUT May enjoy and seek out firm consistent pressure/ touch Low response to pain Poor reporter of illness At risk of harm (burns) Clumsy Cannot handle tools Weak grasp

  14. Balance (Vestibular System) Hypo (low registration/sensation seeking) Hyper (sensitive/ sensation avoidance) Behaviours Fear of being moved Panic if feet leave floor Refusal to travel in vehicles Preference for sitting or lying Avoidance of all physical activity Marked reaction to movement (vomiting) Hyperactivity Restlessness Rocking Spinning Twirling Swinging Jumping Hitting self

  15. Body Position (Proprioceptive System) Hypo (low registration/sensation seeking) Hyper (sensitive/ sensation avoidance) Behaviours Fidgety Difficulty with fine motor control and manipulation of objects e.g. Laces, buttons Rigid body posture and movement- will turn whole body around to look at something Poor or erratic sleep Hyperactivity Poor body awareness Crashes into things Falls over a lot Weak compared to same age Tires easily Props self up during activity Clumsy Chews clothing

  16. Other related factors:Body Temperature Hypo (low registration/sensation seeking) Hyper (sensitive/ sensation avoidance) Behaviours Feels cold Insists on warm or heavy clothing whatever the weather Active Thirsty Distractible Strips off Prefers light clothing whatever the weather

  17. Other related factors:Central Auditory Processing Hypo (low registration/sensation seeking) Hyper (sensitive/ sensation avoidance) Behaviours Thoughts jumbled Excitable Poor concentration Unable to process language unless written down Unable to discriminate foreground from background Interrupting/ speaking over people ADHD type problems Slow processing of language Getting stuck Repetitive thoughts If interrupted - having to go back to beginning Need for prompting Catatonic type states

  18. A personal view Stephen Shore ‘Beyond the Wall: Personal experiences with Autism and Aspergers Syndrome’

  19. Shore: An inside view

  20. Shore: An inside view

  21. Some phenomenon • Allochiria – stimuli presented to one side are perceived as presented in the other • Sensory agnosia – experiencing something out of context • Topographical agnosia – inability/difficulty recognising landmarks • Two sensory synaesthesia – stimulation of one modality triggers perception in another • Multiple sensory synaethesia – further complexity of two sensory synaethesia

  22. Intervention Ideas

  23. Intervention ideas

  24. Intervention ideas

  25. Intervention ideas

  26. Intervention ideas

  27. Intervention ideas

  28. Sensory Assessment • Occupational Therapist • NHS Lanarkshire • Education (Additional Support for Learning) (Scotland) Act 2004 vs Co-ordinated Support Plan

  29. Further reading • http://www.falkirk.gov.uk/services/social_work/children_and_family_services/support_for_children_affected_by_disabil/making_sense_of_sensory_behaviour.pdf

  30. Thank you • Please complete evaluations

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