Sensory Processing 101 Implications of Sensory Challenges in ASD Chris Filler Transition Coordinator Ohio Center for Autism and Low Incidence.

Sensory Processing 101Sensory Processing 101

Implications of Sensory Challenges in ASD

Chris FillerTransition Coordinator

Ohio Center for Autism and Low Incidence

• Sensory Processing challenges can influence how students respond to:

– Environment– People

– Instruction/Tasks/Activities

• Understanding these influences leads to the selection of effective interventions

What is Your Response to……What is Your Response to……Cold showerWool clothingPanty hoseSweatpantsThe feel of Jell-O in your mouthThe sound of birdsBright colored walls in the bedroomThe smell of perfumeElevatorsRoller Coasters

Sensory Processes

Sensory Processes include:• Sound/Auditory

• Sight/Vision• Smell/Olfactory• Taste/Gustatory

The Power Senses• Touch/Tactile

• Vestibular• Proprioception

Research suggests that the following areas of the brain are affected in Autism which can cause change in sensory

processing:

• Cerebellum – Purkinje Cells

• Limbic System– Hippocampus

– Amygdala

• Frontal Lobes– Gray and White Matter

• Occipital Lobes

A Process by which we:

1

““Breakdowns”Breakdowns”

• Breakdown may occur at any point– Challenges to the “intake system”

are more easily recognized– Faulty operation of the

“interpretation and integration” of information may be seen as a behavioral issue

• Negative consequences may only make the situation worse

Sensory Processing Gone Astray

Struggles to stay alert or awake

Cannot stay focused … attention shifts continually

Overly alert, unable to attend

Delays in processing and shifting attention

Sensory Processing Gone Astray

Unable to touch many items, picky eaters

Explores the environment by touching everything

Luke, a 13 year old with AS had wandered away from his family at the beach. In attempt to find Luke, his parents paged him overhead.

Luke writes…..

“Coastguards, police, a pack of Brownies and every available person were all shouting my name over a loudspeaker. I didn’t hear a thing! I have a strange kind of hearing and can only concentrate on listening to things I know I am meant to. Distinguishing between background and foreground noise has always been a problem, so however loud they shouted I would have presumed that it was a background noise.”

From “Freaks, Geeks, and Asperger Syndrome

Review of challenges/characteristics…..

• Slow Processing - Difficulty shifting attention

• Inattentive, Difficult to arouse

• Does not like change or transitions - Rigid – Demands routine

• Difficulty with, or seeks out, certain types of foods/textures

• Smells all food before eating - smells objects

• Unable to sit with anyone behind them in class

• Difficulty attending from the back of the room

• Explosive emotions or lack of emotions or incongruent emotional

responses

• Aggression to self or others• Compulsive Behaviors

• Difficulty with clothing, type of clothing, and

change of clothing

• Perseveration on topic or activity - Fixation on sensory stimuli

• Clumsy, awkward, difficulty in sports

• Over or Under-reaction to pain• Unsure of group situations,

cautious, or a loner 2

SEEKERSEEKERHeightened Awareness with

Low Sensitivity to StimulationWill Seek Out Input

(Frequently and Intensively Moving, Jumping,

Spinning, Touching)

ACTIVE AVOIDERHigh Awareness, with

High Sensitivity and Active Responses. Will actively avoid(Searching out Escape Areas,

Covering ears/eyes, Aggression to “Protect” self)

UNDER-RESPONDERPoor Awareness & Low Sensitivity to Stimulation.Misses Environmental CuesSlow Processing (Acts as if does not hear, misses gestures and cues, sedentary)

OVERWHELMEDHeightened awareness, High Sensitivity but lacks active response, Can become easily overwhelmed.( Complains of things “bothering”Frequently anxious/upset,overreacts to small changes in the environment)

Summary of

Processing

Challenges

SEEKERSEEKERHeightened Awareness with

Low Sensitivity to StimulationWill Seek Out Input

(Frequently and Intensively Moving, Jumping,

Spinning, Touching)

ACTIVE AVOIDERHigh Awareness, with

High Sensitivity and Active Responses. Will actively avoid(Searching out Escape Areas,

Covering ears/eyes, Aggression to “Protect” self)

SeekerSeeker and Active AvoiderActive Avoider can appear similar

•Both may move frequently

•Seekers are looking for the stimulation

•Avoiders are attempting to escape

the stimulation

UNDER-RESPONDERPoor Awareness & Low Sensitivity to Stimulation.Misses Environmental CuesSlow Processing (Acts as if does not hear, misses gestures and cues, sedentary)

OVERWHELMEDHeightened awareness, High Sensitivity but lacks active response, Can become easily overwhelmed.( Complains of things “bothering”Frequently anxious/upset,overreacts to small changes in the environment)

Under-ResponderUnder-Responder and OverwhelmedOverwhelmed can also have some similarities

•May not appear as “sensory needy” as the

seeker/avoider

•Overwhelmed are vigilant and will have anxiety to the environment and will

resist change

•Under-responders also may not respond to environmental cues,

however due to lack of awareness and not

vigilance

SEEKERSEEKERHeightened Awareness with

Low Sensitivity to StimulationWill Seek Out Input

(Frequently and Intensively Moving, Jumping,

Spinning, Touching)

ACTIVE AVOIDERHigh Awareness, with

High Sensitivity and Active Responses. Will actively avoid(Searching out Escape Areas,

Covering ears/eyes, Aggression to “Protect” self)

UNDER-RESPONDERPoor Awareness & Low Sensitivity to Stimulation.Misses Environmental CuesSlow Processing (Acts as if does not hear, misses gestures and cues, sedentary)

OVERWHELMEDHeightened awareness, High Sensitivity but lacks active response, Can become easily overwhelmed.( Complains of things “bothering”Frequently anxious/upset,overreacts to small changes in the environment)

Summary of

Processing

Challenges

The “Sensory Diet” includes….

• PROVIDING SENSORY EXPERIENCES– A combination of sensory experiencescombination of sensory experiences

needed by a person to adaptivelyadaptively interactinteract with the environment (“make it through the day”).

• MAKING ENVIRONMENTAL MODIFICATIONS– Modification and organization of the

environment in order to decrease stressdecrease stress on a fragile sensory system.

Those with sensory processing challenges

• May not be able to filter and focus

• May attempt to adjust in a maladaptive way

(Ex: Escalation of Mood, Shutting Down)

• Will require a “sensory diet” enriched with unique sensations and experiences

Creating The Sensory D.I.E.T.

D …..Do an Informal Assessment

I …..Individualize

E …..Environmental Supports

T …..The Power Senses

Do an Informal Assessment

Assess the Environment and the Individual’s response to a variety of

sensory experiences

• Seeker?• Active Avoider?

• Under-Responder?• Overwhelmed

Individualize the Sensory Diet

What has worked for one person may not

work at all for someone else!

SEEKERProvide sensory experiences frequently & proactivelyMay need to limit excitatory experiences

ACTIVE AVOIDERModify the environment to reduce the need to escape Gentle introduction to new experiences

UNDER-RESPONDERIncrease the use of visual supports and routines. Structure the environment. Time to respondCareful encouragement to try new experiences

OVERWHELMEDControl the environmentLimit stimulation Limit change but prepare for changes when they need to occur.

Considerations for the Sensory

Diet

Environmental Supports

• Other People• Organization• Predictable, Structured,

Consistent Environment• Task or Curriculum

• Visual Supports• Escape Environments

The Power Senses

• Vestibular – Movement

• Proprioception – Input through

joints and muscles

• Tactile – Deep Pressure Touch

Vestibular Input

Proprioceptive Input Tactile Input

Taste, Smell, Vision, Auditory

To“fill the sensory bucket”

quickly use the Power

Senses

Three Power Senses will provide:• more input

•more quickly •to make changes

that are more rapid Based on Work of Bonnie HanshuBased on Work of Bonnie Hanshuwww.sensoryprocessing.comwww.sensoryprocessing.com

Proactively Schedule Sensory Activities

• Use the Power Senses throughout the throughout the dayday in order to help a person alert, attend, act, and react

• Activities should be non-contingent on non-contingent on behavior!behavior!

• At times, additional activities or input may be needed based on the behaviors

observed

The Power Senses

Tactile System

Proprioceptive System

Vestibular System

The Power Senses

Tactile System

Two Tactile Systems

Tactile System

• Pertains to the sense of touch

• Alerts to danger

• Gives body boundaries

• Helps provide a basis for body image

Protective System

Activates “Fight, Fright, or Flight”Born with this system- “Primal”Stimulated by light touch, pain, temperatureProcessed through the emotional, excitatory

portion of the limbic system  NOT a cognitive response

Discriminative Pressure Touch

• Deep touch/pressure, and vibration• Activates Parasympathetic System• Calms and organizes• Allows for more cognitive

response • Helps us learn and think

Dysfunction of the Tactile System

• Distractibility• Hyperactivity• Over/Under Sensitivity

• Hyper-vigilant• Inappropriate pain sensation• Avoids getting hands dirty• Difficulties with clothing/textures• Avoids whole hand• Disorganized when touched• Intolerant of wearing glasses/hearing aide

• Difficulty with Social Space

- Sensitive to light touch- Touch causes difficulty

organizing behavior and concentration

- Touch causes negative emotional responses

- Can become aggressive, if feeling threatened or stressed

Tactile Defensiveness is when…

Interventions for Tactile Defensiveness

• Brushing Protocols– Wilbarger Protocol

– PRRBrushing over arms, legs, back with a soft brush , followed by joint compressions

• Caution– A brushing protocol should

only be implemented after an assessment and training by a qualified professional

Program Supports Specific to Tactile

Challenges

Environmental Supports• Access to an escape/private area

• Caution with placement. Student may want to sit where no one is behind him

• Some feel secure with boundaries that keep others at a distance…..

• Others need space in order to make a

“quick escape”

The “Front Porch”

Quiet Sensory AreaQuiet Sensory Area

Other Tactile Supports

Choose carefully…..Choose carefully…..

Other Tactile Supports

• Consider the type of clothing and the way it fits– Tight?– Loose?– Fabric?

• Swimming/Water Play

• Body Sock

Remove tags from

clothing

People Supports: What Others Can Do

• Avoid unnecessary touch and Ask Permission

• Avoid touching face to gain attention

• Move slowly and provide “Waiting Time”-

up to 10 seconds

• When touch is necessary, use Deep Pressure Touch

The Power Senses

Proprioceptive System

Proprioceptive System

Muscles, joints, and tendons provide a person with a subconscious awareness of body position via the feedback from receptors in the muscles, tendons and joints

Motor Planning

Awareness of body in time and space without constant visually monitoring

Proprioceptive System

Dysfunction of Proprioceptive System

• Clumsiness, a tendency to fall

• Lacks awareness of body position/odd posture

• Difficulty with small objects (buttons/ snap)

• Disorganized….. Materials & Thoughts

• Poor or resistance to handwriting

• Eats in a sloppy manner

• Resists new motor movement activities

What Happens when Proprioception

Occurs?

How Does it Work?

Activities that Provide Proprioceptive Input

 •Joint compression or

extension

•“Heavy work” activities

•The larger the joint, the more proprioceptive input

Examples of “Heavy Work”

• Passive Joint Compressions• Jumping/Trampoline

(floor may be better..)• Stacking Chairs• Weight Lifting

• “Bungee Cord” on Chairs• Chewing Gum

• “Pretzel Hugs”

Fine Motor Supports

• “Hand-prep” exercise

• Limit Handwriting Requirements

• Alternatives to handwriting– Keyboarding– Software – Set of notes– Grips– Velcro on Shoes

• Alternatives & Accommodations– Options in Word and

PowerPoint

• Sensory Breaks between tough fine motor activities

• Organizational Supports•Visual Supports•Color coding•Timers/Watches•Written directions•Written rule reminders

What Can Others Do

–Stay on schedule–Pace language–Use Concrete Language

–Use Wait Time

The Power Senses

Vestibular System

Vestibular System

The vestibular system refers to structures within the

inner ear (the semi-circular canals)

These structures detect movement and changes in the position of the head.

• The brain needs vestibular input in order to function

• Vestibular input provides the

Strongest Sensation

• Movement can change an individual’s attention, arousal and alertness in the shortest period of time

• The effects from vestibular input can last longer than any other input.

Hyper-sensitiveHyper-sensitiveActive Avoider and Active Avoider and

OverwhelmedOverwhelmed• Fearful reactions to ordinary

movement activities • Apprehensive walking or crawling on

uneven or unstable surfaces• Seem fearful in open space• Appear clumsy • Want their feet on the ground!

• These folks need gentle experiences and support as they become more comfortable

• Seeker: Actively seek and demonstrate a need for intense movement experiences (whirling, jumping, spinning, spinning objects, pacing)

• May includes visual stim• Be aware: Seeker can become over-excited

– Needs monitoring– “Cap-off” vigorous vestibular activity with

proprioception (“heavy work” or joint compression)

• Under-Responder may need gentle encouragement to engage in movement activities

Hypo-sensitiveHypo-sensitive Under-Responders and Seekers

Activities that Provide Vestibular Input

 • Seeker/Avoider/Overwhelmed– Linear, Calm, Slow, Controlled

movement to gain attention

• Under-Responder– Unpredictable, multi-directional,

spinning (if individual requests), to alert and orient someone who is under-responsive

– Be very cautious imposing vestibular movement – can be very frightening

Selected Strategies

• Swinging• Rocking Chair• Sit & Spin/Dizzy Disc

• Therapy Balls as Chairs• Moveable Cushions

or Deflated Beach Balls as Chair Cushions

• Delivering Messages or Packages (or any job that requires walking, moving, bending, etc.)

• Running Track or possible a Treadmill

• Movement breaks placed proactively in the day – Non contingent on behavior or work Non contingent on behavior or work

completion!completion!

Selected Strategies

Remember……Remember……

• Do NOT withhold recess/gym based on the child’s behavior or inability to complete work

• Movement and activity may be the input the child needs in order to maintain behavior, concentrate and learn!

Alecia Video Example

“Monday”

Creating The Sensory D.I.E.T.

D …..Do an Informal Assessment

I …..Individualize

E …..Environmental Supports

T …..The Power Senses

Post-Assessment • More alert?

• More “tuned in”?• Able to respond more quickly?

• Able to focus on task?• Able to attend for longer periods?

• Less “explosive” or unpredictable?• Calmer?

• More interactive?• Less stressed?