Sensory Integration, Sensory Processing Disorder and Autism

Many people on the autism spectrum have difficulty managing their sensory input. They may over- or under-react to visual, tactile, and aural input - sometimes to the point where they are unable to participate in typical life activities. Even people with Asperger Syndrome, who are bright and capable in many settings, may be unable to go to movies, sit through concerts, or otherwise take part in social activities because the sound, lights or sensations are too overwhelming.

When this is the case, many practitioners will make a diagnosis of Sensory Processing Disorder, and will recommend Sensory Integration Therapy. Sensory Integration Therapy is generally provided by an Occupational Therapist.

It's important to know that Sensory Processing Disorder …

• IS NOT an official diagnosis in the Diagnostic Manual
• Is NOT a core deficit of autism or autism spectrum disorders
• Is NOT a fully accepted concept throughout the medical mainstream (The American Association of Pediatrics states: "Occupational therapy using sensory integration techniques to address sensory processing problems is commonly used in children with ASD. Although many believe occupational therapy is subjectively effective in educational and clinical settings, research data to support its effectiveness is scant. Occupational and physical therapy may be helpful in addressing coordination and motor planning deficits occurring in some children with ASD."

So what exactly is sensory processing disorder? Here is a definition from the KID Foundation (The Foundation for Knowledge in Development), which specializes in research into and treatment of Sensory Processing Disorder:

Sensory processing refers to our ability to take in information through our senses (touch, movement, smell, taste, vision, and hearing), organize and interpret that information, and make a meaningful response. For most people, this process is automatic. We hear someone talking to us, our brains receive that input and recognize it as a voice talking in a normal tone, and we respond appropriately.

Children who have a Sensory Processing Disorder (SPD), however, don’t experience such interactions in the same way. SPD affects the way their brains interpret the information that comes in; it also affects how they respond to that information with emotional, motor, and other reactions. For example, some children are over-responsive to sensation and feel as if they're being constantly bombarded with sensory information. They may try to eliminate or minimize this perceived sensory overload by avoiding being touched or being particular about clothing. Some children are under-responsive and have an almost insatiable desire for sensory stimulation. They may seek out constant stimulation by taking part in extreme activities, playing music loudly, or moving constantly. They sometimes don’t notice pain or objects that are too hot or cold, and may need high intensity input to get involved in activities. Still others have trouble distinguishing between different types of sensory stimulation.

If you think that you or someone else might have Sensory Processing Disorder in addition to an autism spectrum disorder, you may opt for an evaluation by an occupational therapist who specializes in the field. Be aware that (a) if you observe what you think are sensory issues, it is almost certain that the therapist will agree and (b) it is unlikely that private Sensory Integration therapy will be covered by insurance. That's why it's extremely important to be sure that the evaluating therapist has significant experience with SPD and autism: Occupational therapists with minimal training in sensory integration therapy often take on SPD patients assuming that they will be able to help. Unfortunately, their lack of knowledge may make any therapeutic intervention both expensive and useless.

References:

American Association of Pediatrics. Technical Report: The Pediatrician's Role in the Diagnosis and Management of Autistic Spectrum Disorder in Children. PEDIATRICS Vol. 107 No. 5 May 2001, p. e85.

Miller, Lucy Jane, Ph.D. Sensational Kids: Hope and Help for Children with Sensory Processing Disorder (SPD).

Overview of Sensory Processing Disorder from the Knowledge in Development Foundation website.