What’s your favorite burger? Is it in the picture above? (Sorry if you are reading this while hungry). How can burgers help us to understand Autism Spectrum disorder? Well, Burgers have different toppings; some have cheese, some have eggs, some have lettuce and some have tomatoes while some burgers are purely Vegan. However, One striking similarity is that, whatever the toppings, they all have buns. The buns may vary; we can have Potato Burger Buns or Brioche Burger Buns or even Black Brioche Buns.
In the same way, Autism Spectrum Disorder has it’s “buns”. These are the common signs which all children with this Developmental disorder have.
The “buns” (common) signs in Autism Spectrum Disorder are:
- Impairment in Social interaction and verbal communication, and
- Narrow range of interests, routine and repetitive behaviors.
There are other signs that may be present with some children with Autism Spectrum Disorder and not show in others. These are the “topping” signs. They include:
- A reduction in imagination, ideas and creativity.
- Limited gestures and non-verbal communication.
- Unusual sensory responses (Sensory Processing Disorder or Sensory Integration Difficulties)
This article takes a look at one of the “topping” signs of Autism Spectrum Disorder – Sensory Processing Disorder. Many a times, children with Autism Spectrum Disorder (ASD) will have Sensory Processing Disorder (SPD). However, not all children with Sensory Processing Disorder are Autistic (that’s why we called it a “topping” sign). A child can be having Sensory Processing Disorder as a condition which is not linked to Autism Spectrum Disorder.
What is Sensory Processing Disorder?
We use our senses for everyday functions such as self-protection, academic skills, self-regulation, Body awareness, balance, Fine motor skills (hand movements) and Gross motor skills (body movements). Sensory processing is the process of how the nervous system receives messages from our five senses and turns them into meaningful responses.
Sensory Processing Disorder (SPD) comes about when the brain inefficiently processes sensory messages coming from a person’s own body and his or her environment.
As much as sensory processing differences/challenges are real, SPD is not considered a disorder by psychiatrists and some other mental health professionals. Some doctors consider SPD as a symptom of other disorders (ASD, Hyperactivity, Attention Deficit Disorder and anxiety etc)
Patterns of Dysfunction in Sensory Processing Disorder
When a child has SPD, the underlying problem could be one or more patterns of dysfunction. These patterns include: Sensory Modulation Dysfunction, Sensory Discrimination Dysfunction and Postural Disorder.
1. Sensory Modulation Dysfunction
When a child has Sensory Modulation Dysfunction, they will be over responsive or “sensory defensive”, Under-responsive or a sensory craver.
a) Over Responsive
The child will be over-responsive to certain sensory stimuli. For example, a child will not wear any clothes with a tag on it; they feel as if something poking them (Tactile challenges). They may not want to have their hair cut since to them the shaving machine sounds like a saw machine. In a church setting, they might frequently try to shut their ears since for them the sound feels like they are in a really noisy car (“Nganya matatus” to be precise) – Auditory challenges.
When in a bright environment, the child will constantly shut their eyes since they feel like a spotlight is on their face (visual challenges). They might fight and scream while approaching an elevator or escalator due to the fact when on it they feel it is like one of the tests at the National Aeronautics and Space Administration (NASA) – Vestibular challenges.
They will avoid certain food textures such as Yogurt with a little bit of fruit, mashed foods, foods with soup etc (Oral motor). This is greatly contributed by poor oral-Motor Skills.
When a child has sensory over responsiveness, they can either fearful and cautious or negative and defiant.
b) Under Responsive
For the under-responsive child their attention will not be aroused by the various sensory stimuli as expected. They will not participate in play or any other social activities since they do not get any sensory feedback out of it.
c) Sensory Craver
For the sensory craver, they seek for intensity. They will spin, jump, constantly bite non food objects, touch and smell people and objects. Generally they are constantly on the ‘go’.
2. Sensory Discrimination Dysfunction
When a child has Sensory Discrimination Dysfunction, they will have a challenge differentiating between and among sensory stimuli. They find it hard to gauge things like, how hard should I throw this ball, how loud is his/her voice, how hot or cold is the surface?
3. Postural Disorder
When a child has postural disorder, he/she will have difficulty with movement patterns, balance and using both sides of the body together (bilateral co-ordination). Activities such as getting up and down steps will be difficult; balancing on a pavement will be a tall order, tying shoe laces will be extremely taxing for them.
Sensory Overload and Meltdowns
A meltdown is a way of responding to extreme stress and sensory overload. It is not limited to screaming and shouting but can also include self-injury. Stressors that lead to meltdowns can be internal (e.g. anxiety) or external (e.g. a noisy environment). Sensory processing difficulties can also be stressors; hence identifying a child’s sensory triggers can help avoid an imminent meltdown.
Sensory Integration Therapy - Treating Sensory Processing Disorders
Sensory Integration Therapy is necessary for treating a child with SPD. This form of therapy calms or resets a child but it does not cure. The children with Sensory Processing Disorder don’t “grow out of it” but they find ways to cope through sensory integration. Sensory Integration prompts self regulation. It enables the child to know what they need in terms of sensory stimuli at any particular time and how to safely access it.
Who does Sensory Integration Therapy?
Sensory Integration Therapy is done by a qualified Paediatric Occupational Therapist (OT) with knowledge and experience on Sensory Integration. The paediatric OT does assessments and evaluations which enables them to know which sensory factors are affected.
Once this is done, they start the sensory integration therapy, which will involve fun activities that will aid the child learn how to process the different sensory stimuli appropriately. In addition, the Pediatric OT creates a Sensory Diet (A program of sensory activities) for the school and home environment.
In some cases, a sensory gym is built at home to enable the child to participate in the sensory circuit effectively and have a multi-sensory environment at home.
Sensory diet Toys, Equipment and tools
Below is a list of some sensory diet Toys, Equipment and tools and the various sensory areas the items aid in.
- Chewys – Oral Motor.
- Vibrating Toothbrush – Oral Motor.
- Therapressure Brush – Tactile.
- Theraputty/slime – Tactile and or Proprioceptive.
- Ball baths – Proprioceptive and or tactile.
- Weighted Jacket – Proprioceptive.
- Weighted Blanket – Proprioceptive.
- Weighted therapy ball – Proprioceptive.
- Trampolines – Proprioceptive and or Vestibular.
- Swing (Indoor or Outdoor) – Vestibular.
- Noise cancellation Head phones – Auditory.
- Scented toys – Olfactory.
- Glow in the dark toys – Visual.
- Sensory bottles – Visual.
Sensory Integration in a School Environment
Students with SPD have great inconsistencies and fluctuation in processing information. In a school set up they may show the following signs:
- Have difficulty regulating their arousal levels: either hyperactive (always on the go) or hypoactive (rarely moves even in the playground).
- Are distractible and/or have difficulty paying attention.
- Chews/licks on non-food objects.
- Avoids getting their hands messy.
- Are sensitive to certain fabrics; avoids wearing clothes made of the fabric they can’t tolerate.
- Can’t stay in line when it is time to “line up”.
- Have sloppy, disorganized handwriting.
- Demonstrate letter reversals.
- Shouts or whispers constantly while talking.
- Exhibit poor use of space on paper/difficulty with spatial concepts. Their writing will be too spaced or too close to each other. They might also find it hard to stay between page boundaries.
- Have difficulty following directions as to how to perform a task.
- Have poor organizational skills: academics as well as self.
- Difficulty in gross motor skills (e.g throwing and catching a ball)
- Tires easily, especially when standing or holding a particular body position.
- Play too roughly or avoids playing
- Avoids certain texture like sand etc.
- Difficulty going to sleep during nap time.
Teachers, parents and therapists can work together to adapt the child’s school environment. These adaptations involve:
Developing a quiet corner or sensory corner
Having a sensory basket in this corner is important. This will give the child various options of what they can do while they are there. A bean bag chair is also a great asset in this corner. Clear consistent rules regarding what is acceptable in corner and what is not should be communicated the student both verbally and visually. If a quiet corner is hard to create due to limited space, a small black tent can work.
If the student does not like noisy areas, a separate working table can be created. When the student feels the noise levels increasing they can go work at their quite work station. If it during lunch break and the hall is very noisy, let the students wear their noise cancelation headphones, this enable them enjoy lunch with their peers. If the student is visually distracted by the lights in the class, turn the lights off and provide a temporary widow blinder.
Creating individualized sensory diets that would have great alerting, organizing and calming activities that are targeted to meet the students need. The sensory diet can be also a whole class activity e.g. doing jumping jacks or running one lap in the field. These are great alerting activities that all the students can participate in.
The school can have a play ground with sensory play equipments such as trampolines, different types of swings, small mountain climbers, tunnels, sit and spins or stand and spins etc. This play ground will encourage the children to perform various sensory circuits just while playing.
Understanding Sensory Processing Disorders is important as it aids in helping the child with Sensory difficulties. It is also important to find out if a child’s sensory processing difficulties are caused by or related to Autism Spectrum Disorder. A qualified Pediatric OT will provide proper Sensory Integration Therapy using the right sensory diet toys, equipment and tools.
Do you have any experience with Sensory Processing Disorders? Do you have any questions regarding Sensory Processing Disorder or Autism Spectrum Disorder? Visit our Online shop to buy products such as the Therapressure Brush which are used in Sensory Integration Therapy. Leave a comment or chat with us on WhatsApp. You can also get in touch with us. Don’t forget to share widely.