1. Sensory Integration and ASD
Lorraine Ringland
Clinical Specialist in Autism, Occupational Therapy

2. This Talk Aims to Explain
What is Sensory Integration?
What is Sensory Integration Difficulties?
What have they to do with Autism?
How do Sensory Integration Difficulties present and what parents can do?

3. The Concept of Sensory Integration
Sensory Integration is the ability to take in, sort out, process and make use of information from the world around us.
It is an unconscious process of the brain providing
Basic, survival info
Complex info helping us attend, learn from and respond appropriately to the environment and people within it.
Significant in determining our actions in various situation.
Our interpretation of senses is individual, therefore our responses - ‘behaviour’ - can be very individual.

4. Ineffective Sensory Processing
Can effect one or more of sensory systems.
Impacts upon ability to:
Learning
Cope with daily demands and stress
Direct behaviour effectively
A comparison can be drawn to indigestion…
Indigestion does not mean that the stomach or intestines have bee damages, simply that they are not processing the food effectively. In the same way indigestion remedies are used, so are strategies to address sensory processing difficulties.

5. What does this look like??

6. Sensory Processing Disorder and Autism
Literature indicates that 42% to 88% of children diagnosed with Autism will also experience sensory processing difficulties.
(Baranek, 2002).
These children often have difficulty regulating responses to sensations and specific stimuli and may use self-stimulation to compensate for limited sensory input or to avoid overstimulation.
(Roberts, King-Thomas, & Boccia, 2007; Schaaf & Nightlinger, 2007; Smith, Press, Koenig, & Kinnealey, 2005).
Behaviours such as stereotypic motor movements, aimless running, aggression, and self-injurious behaviours have been correlated with these sensory processing difficulties.
(Case-Smith & Bryan, 1999; Dawson & Watling, 2000; Linderman & Stewart, 1999; Watling & Dietz, 2007).

7. How Difficulties Present
Sensory Systems
7 Sensory Systems
How Difficulties Present
Tips for Parents

8. 7 Sensory Systems Body Position (Proprioception) Movement (Vestibular)
Touch (Tactile)
Sight (Visual)
Taste (Gustatory)
Sound (Auditory)
Smell (Olfactory)
Information about the world
is gathered from our 7
Senses i.e.;

9. PROPRIOCEPTION (Body awareness)
Location: receptors located in muscles and joints and is activated by muscle contraction
Function: provides information about where a body part is and how it is moving. Has a calming effect on the sensory system.

10. Proprioception – exhibiting behaviours
Heavy handed or footed
Poor judgement and grading of movement
Poor posture, frequently props head on hands/table
Bumps into things, falls frequently
Tip toe walking
Drops things frequently
Tires easily
Poor body awareness
May chew on non-food objects or grinds teeth

11. Proprioceptive Strategies
Tug of war games
Heavy loads: encourage child to carry the shopping bags
Wheelbarrow walking
Arm/foot wrestling
Trampolining
Climbing frames
Monkey bars
Please Note, when a child is overwhelmed / overactive, engaging them in activities which activate the Proprioceptive sense should help them to become more calm.
Incorporate activities into the child’s routine which require muscle contraction
Deep pressure experiences to the jar area can help to alert the proprioceptive receptors

12. Over Sensitive – Low Thresholds
Fight, flight, fear

13. Under Sensitive - High Thresholds
Is unaware being messy
Tires easily
On the go
Seeks sensory experiences
Passive and Lethargic
Drops objects etc..
Is unaware of food left in mouth
Insensitive to temperature changes
Doesn’t notice detail
Clothes may be in disarray

14. VESTIBULAR (Movement and balance)
Location: receptors in the inner ear, stimulated by head movements and input from other senses
Function: Provides information about where our body is in space, whether we are moving standing still and what speed and direction we are going

15. Vestibular – exhibiting behaviours
Under Registering
Seeks fast moving activities
Spins, rocks, bounces and jumps excessively
Always ‘on the go’
Enjoys being upside down
Slouches and leans, unable to sit upright for long
Overly Sensitive
Poor tolerance to movement
Easily become dizzy when changing body position
Dislike tipping their head back
Overly fearful of heights
May experience motion sickness
May move quite rigidly

16. Tips for Parents - Vestibular
Extra proprioception or pressure helps a child feel more secure.
Encourage active child propelled movements rather than passive movement.
Fast movements with changes in direction are alerting, slow rhythmical movements tend to be calming and soothing
Try having your child complete some activities in different positions, e.g. lying on stomach to read.
Take small steps towards more challenging activities, break them down so that movement is minimalised.
Swaying and rocking

17. TACTILE (Touch) Location: receptors under the skin
Function: Provide information to the brain regarding the environment or object (touch, pressure, texture, hard, soft, sharp, dull, heat, cold and pain)
I feel that this is quite an important area for dentists to be aware of due to the nature of their work, for the following reasons

18. Tactile – exhibiting behaviours
Overly Sensitive
Fussy
Sensitive to textures
Dislikes and avoids likes messy play
Can react aggressively to
another’s touch
Feels pain excessively
Very sensitive to temperature changes.
Distressed at grooming activities, e.g. brushing hair/teeth, cutting nails
Under Registering
Responds only to firm touch
Can invade space / be overly tactile
Can be heavy handed
Grips objects too firmly
Has difficulty responding to pain/temperature.
May be unaware of food left in his mouth
Frequently seeks the feel of objects in his/her environment
Last point mouths objects etc

19. Tips for Parents - Tactile
If your child is seeking out tactile experiences, feed them.
If the child avoids tactile experiences, incorporate proprioceptive tasks and consider the texture of toys, clothes, towels, etc.
Light touch can be irritating, firm and constant pressure organising
Remember self-initiated touch produces a less defensive reaction to the sensory system.
Avoid situations of close proximity to others
Always watch for signs of overstimulation and discomfort, remember that tactile experiences can be painful for some children.
E.g. in school line, holds door or stands at back

20. AUDITORY (Sound) Location: inner ear stimulated by sound/air waves
Function: Provides information about sounds in the environment (loud, soft, high, low, near or far)

21. Hearing – exhibiting behaviours
Overly Sensitive
Reacts as though noise levels are magnified
Dislikes loud noise
Is easily startled
Engages in unusual behaviours in noisy environments
Is anxious before expected noises (school bell)
Holds hands over ears
Highly aware of all environmental noises
Under Registering
Enjoys really loud noise
Fails to pick up expected cues.
Makes unusual noises themselves
Seek out irritable noises, e.g. white noise
May become more engaged in noisier environments

22. Tips for Parents Prepare the child for noisy environments.
Use headphones or ear defenders to ‘dampen down’ the level of noise for the child.
Teach your child strategies within noisy environments, e.g. standing close to the door.
Agree methods for your child to tell you there is too much noise, e.g. token exchange, loud gauges or happy/sad faces.
Encourage the child to attend to sounds by playing games based on auditory cues, e.g. Simon Says.

23. VISUAL
(Sight)
Location: retina in the eye which is stimulated by light
Function: provides information about what we see in the environment and helps us define boundaries as move in space

24. Visual – exhibiting behaviours
Difficulty finding what they are looking for unless the item is strongly motivating
Difficulty concentrating in a very bright, visually stimulating room
May become overly focused on visual detail
Advanced drawing skills
String visual memory

25. Tips for Parents
Reduce lighting, particularly when the child appears overwhelmed
Reduce the amount of visual distractions
Be aware of visual challenges, e.g. copying from a board, reading text
Present work in visual blocks
Remember it may be difficult for the child to look at you and listen to you simultaneously

26. OLFACTORY and GUSTATORY
(Smell)
Location: chemical receptors in the nose (closely linked to the taste sense)
Function: Provides information about different types of smell (musty, acrid, putrid, flowery and pungent)
(Taste)
Location: Chemical receptors in the tongue (closely linked with the smell sense)
Function: Provides information about different types of taste (sweet, sour, bitter, salty, spicy)

27. Taste and Smell – presenting behaviours
Overly Sensitive
Dislikes strong tastes prefers bland
Tastes or smells objects, clothes etc
Likes consistent temperature of food
Over-reacts to common smells
Gags easily at subtle smells
Under Registers
Mouths and or smells non-food items
Craves strong tastes and flavours
Under-reacts to strong smell, may seek them.

28. Tips for Parents Incorporate foods into messy play
Introduce tastes in a fun way and expand on established tastes
Use calming scents or scents the child prefers, in small amounts e.g. lavender etc
Use scented stickers to assist in desensitising
Allow the child to chew gum/suck hard sweet
In environments with distinctive smells, e.g. canteen or dentist, have the child’s favoured scent on cotton wool / sleeve to help calm
Use calming activities when the child is overwhelmed, i.e. proprioceptive activities

29. Final Thoughts

30. IMPORTANT POINTS
When a child displays unacceptable behaviour consider an underlying sensory processing cause.
Acknowledge the difficulties children with sensory processing experience across contexts and how this affects their life skill development and academic readiness
Accentuate the positive and always offer understanding and support

31. Thank you for your Attention Any Questions?