Autism & Sensory Processing Disorder
Sensory Processing Disorder (SPD) Overview
By: Allison Cost, OTR/L
Summary of Condition
- Sensory Integration is the whole process of
- taking in information through our senses;
- putting it together with information we already have from memories & knowledge;
- processing a plan;
- responding in what way seems most appropriate.
- Sensory Processing Disorder (SPD) occurs when input is not detected or organized, causing inappropriate responses. This can be caused from genetic factors, environmental exposures, and life experiences.
- Symptoms include emotional, behavioral, social, attentional, or motoric problems. People with SPD misinterpret everyday sensory information, such as touch, sound, and movement. They may feel bombarded by information, they may crave intense sensory experiences, or they may be unaware of sensations that others feel. They may also have sensory-motor symptoms such as a weak body, clumsiness or awkwardness or delayed motor skills.
- SPD is generally broken down into the three major pattern with corresponding subtypes
- Sensory Modulation Disorder (SMD)
- Sensory Under-Responsivity
- Sensory Over-Responsivity
- Sensory Craving
- Sensory-Based Motor Disorder (SBMD)
- Postural Disorder
- Dyspraxia
- Sensory Discrimination Disorder (SDD)
- Related to any sensory systems of Visual, Auditory, Tactile, Smell, Taste, Vestibular, Proprioception, or Interoception
Role of Rehabilitation
- Occupational Therapists have the expertise to identify where in the sensory process the individual is having challenges, how this is impacting perception & behavior, and providing strategies to help the individual adapt and adapt the environment to support the individual.
- “Sensory integration therapy aims to enable children with sensory challenges to accurately detect, regulate, and interpret sensations, and the execution of appropriate motor and behavioral responses to sensations so that children are able to perform everyday activities in a functional manner.” (www.sensoryhealth.org/basic/occupational-therapy-for-children)
- Physical Therapist and Speech Language Pathologists are equally as important in the treatment with their expertise in identifying the physical or speech/oral motor differences that are occurring; along with adapting their treatment plans to include a sensory diet to accommodate each person.
About Autism Spectrum Disorder
By Kristine Movsisian M.S. CCC-SLP
About the Diagnosis: Individuals diagnosed with Autism Spectrum Disorder (ASD) have great variability with their behaviors, functioning level, skills, and learning needs (Heflin & Alaimo, 2007).
- Pathology: ASD is a disorder that is related to brain development which does not have a single known cause due to the variability of symptoms and severity. It is believed that there are many probable causes; environmental and genetic. (Autism spectrum disorder 2018)
- Classifications: There are three main behavioral classifications which are commonly associated with individuals diagnosed with ASD: Communication impairment, social impairment and interests/compulsivity.
- Communication impairment: Communication abilities within the ASD community vary from poor or limited communication to highly sophisticated language. Deviations from typical communication include: absent or delayed verbal and nonverbal language, immediate or delayed echolalia, limited comprehension skills, and inability to use alternate forms of communication (ex. Augmentative alternative communication). (Heflin & Alaimo, 2007)
- Social impairment: Individuals with ASD appear uninterested in social aspects of interpersonal relationships by avoiding eye contact with a communication partner, lack of joint attention, and unawareness of pragmatic and social rules. (Heflin & Alaimo, 2007)
- Interests/Compulsivity: Individuals with ASD typically demonstrate a limited range of interests and prefer particular objects or parts of objects. They engage in perseverative and repetitive behaviors such as lining objects up. Individuals with ASD prefer routines and insist on sameness. They may also engage in repetitive motor movements such as hand flapping. (Heflin & Alaimo, 2007)
Important information
Individuals with ASD may struggle with gastrointestinal problems, feeding issues, sensitivities to tastes, or smells. They may also have difficulty with a healthy sleeping routine, and anxiety. Comorbidities of epilepsy, depression, ADHD and OCD are common.
Intervention Strategies
- Play therapy
- Child directed therapy that uses the child’s natural motivations and interests to promote development.
- Floortime/DIR
- Child directed therapy done on floor at the level of the child similar to play therapy
- ABA Therapy
- Therapist led and focused on behavior modification (Very controversial, do research prior to implementing)
- Augmentative Alternative Communication
- Implementation of alternate forms of communication that best suit the skills of the child (ex. Signs, gestures, picture communication system)
- Social skills groups
- Teaching how to read social cues and to respond appropriately to them, starting conversation, ending conversation, understanding body language and hidden rules.
Additional Resources
- Autismspeaks.org
- Autismnow.org
- Researchautism.org/resources/
References
Heflin, J., & Alaimo, D. F. (2007). Students with autism spectrum disorders: effective instructional practices. Pearson/Merrill Prentice Hall.
Mayo Foundation for Medical Education and Research. (2018, January 6). Autism spectrum disorder. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/autism-spectrum-disorder/symptoms-causes/syc-20352928.
Sensory Processing Disorder (SPD) Overview
By: Allison Cost, OTR/L
Summary of Condition
- Sensory Integration is the whole process of 1) taking in information through our senses; 2) putting it together with information we already have from memories & knowledge; 3) processing a plan; 4) responding in what way seems most appropriate.
- Receive 🡪 Interpret 🡪 Combine🡪 Decide🡪 Execute
- Sensory Processing Disorder (SPD) occurs when input is not detected or organized, causing inappropriate responses. This can be caused from genetic factors, environmental exposures, and life experiences.
- Symptoms include emotional, behavioral, social, attentional, or motoric problems. People with SPD misinterpret everyday sensory information, such as touch, sound, and movement. They may feel bombarded by information, they may crave intense sensory experiences, or they may be unaware of sensations that others feel. They may also have sensory-motor symptoms such as a weak body, clumsiness or awkwardness or delayed motor skills.
- SPD is generally broken down into the three major pattern with corresponding subtypes
- Sensory Modulation Disorder (SMD)
- Sensory Under-Responsivity
- Sensory Over-Responsivity
- Sensory Craving
- Sensory-Based Motor Disorder (SBMD)
- Postural Disorder
- Dyspraxia
- Sensory Discrimination Disorder (SDD)
- Related to any sensory systems of Visual, Auditory, Tactile, Smell, Taste, Vestibular, Proprioception, or Interoception
Role of Rehabilitation
- Occupational Therapists have the expertise to identify where in the sensory process the individual is having challenges, how this is impacting perception & behavior, and providing strategies to help the individual adapt and adapt the environment to support the individual.
- “Sensory integration therapy aims to enable children with sensory challenges to accurately detect, regulate, and interpret sensations, and the execution of appropriate motor and behavioral responses to sensations so that children are able to perform everyday activities in a functional manner.” (www.sensoryhealth.org/basic/occupational-therapy-for-children)
- Physical Therapist and Speech Language Pathologists are equally as important in the treatment with their expertise in identifying the physical or speech/oral motor differences that are occurring; along with adapting their treatment plans to include a sensory diet to accommodate each person.
Evaluation
- Note: Sensory Processing dysfunction has not yet been recognized as a mental disorder in the DSM-5 or ICD-10 so treatment is often provided under ASD or ADHD as primary diagnosis.
- Standardized testing
- Sensory Profile 2
- SP3D (Sensory Processing Three Dimensions Scale)
- Sensory Processing Measure
- Sensory Integration & Praxis Test (SIPT)
- Detailed clinical observations
- How an individual avoids, is attracted to, and responds to different sensory input.
- How an individual adapts to novel environments, situations, or input.
- Caregiver and Self Reporting
- The subjective, lived experience of the individual.
- Caregiver observations can provide objective measures in different settings.
Treatment
- Sensory Integration
- Identifying what part of sensory integration process and which senses are being impacted.
- Clinical reasoning to determine what is needed, what is working, what are the strengths of the individual.
- Sensory Self Self-Regulation
- Sensory Diets = personalized daily schedules of specific sensory activities and environmental modifications. Protocols are adapted for each individual’s differences and distinct needs.
- Goal is self-awareness combined with self-advocacy.
- Relationships
- Family-centered. Focused on teaching clients and their support system how to advocate for themselves.
Helpful Resources
- www.sensoryhealth.org
- www.sensoryintegrationeducation.com
- www.sensory-processing-disorder.com
References
- Cavaliere, Catherine M.(2021) Sensory Health: The Missing Piece in the Wellness Conversation. https://www.occupationaltherapy.com/ot-ceus/course/sensory-health-missing-piece-in-5261
- Ochsenbein, Mim. (2022) STAR Foundations of Development Course: Sensory Processing, Regulation, and Relationship. STAR Institute for Sensory Processing. Livestreamed via Zoom May 3-May 24, 2022.
- Stock Kranowitz, Carol. (2022) The Out-of-Sync Child, Third Edition: Recognizing and Coping with Sensory Processing Differences. TarcherPerigee
- Spielmann, Virginia. (2021) 5282: Sensory Integration and Processing 101. https://www.occupationaltherapy.com/ot-ceus/course/sensory-processing-101-5000