Sensory Processing Disorder & Autism

Most people referred to five-year-old Brandon as picky and ultra-sensitive. His socks had to be just right. He refused most food except a small handful of items, and bath time was a taxing and unpleasant experience for Brandon and his parents. But his challenging behaviors were not a result of defiance but distress. For Brandon, his peculiarities were symptoms of a sensory processing disorder commonly found among children on the autism spectrum.

Years later, his parents often reflect on the early warning signs. As an infant, he resisted their attempts to hold and cuddle him. As he grew older, his reactions to loud noises like blenders, leaf blowers, and vacuums grew in intensity and frequency, as did his aversion to bright lights and crowds.

If Brandon had the words back then, he would have told his perplexed parents that he often felt uncomfortable, confused, and overwhelmed by the sights, sounds, smells, and sensations surrounding him.

The family's story is not uncommon. Children with autism are more prone to balance issues, often lack fine and gross motor skills, and display a marked hypersensitivity or low sensitivity to pain, heat, and cold, all due to the unusual way of processing and assimilating sensory information.

Sensory Processing Problems

In its simplest terms, sensory processing disorder (SPD) is a neurological condition that results in abnormal responses to information from the external and internal senses:

• Sight
• Sound
• Touch
• Smell
• Taste
• Vestibular (movement, balance, and coordination)
• Proprioception (body awareness)

SPD is a distinct, stand-alone condition not exclusive to those with autism. Research suggests that between five and 16 percent of school-age children have some sensory processing problems, which can potentially interfere with daily functioning and learning.

While not everyone with sensory issues has autism, most people with autism, as many as 70 to 96 percent, experience sensory integration problems.

Sensory issues are so pervasive in those on the spectrum that the American Psychiatric Institute added sensory hypo- and hyper-sensitivity as a potential indicator of autism in 2013.

While sensory issues typically become apparent during the toddler years, they can change over time in both type and severity. Two of the most common are auditory and touch sensitivities, formally known as tactile defensiveness.

Children who are hypersensitive to high-pitched and competing noises like music in a crowded room often feel overwhelmed. Kids who are hypersensitive to touch may find shoes and jackets uncomfortable, certain textures unbearably and messy, sticky substances like paint and playdough revolting. As a result, these children often struggle with food textures, basic hygiene like tooth brushing, and displays of affection.

Much like autism itself, sensory processing issues exist on a spectrum with a wide range of abnormalities, unique sensitivities, and atypical behaviors that result.

Signs of Sensory Processing Issues

While sensory problems exist in most children with autism, the symptoms and severity vary widely. Some children may tolerate loud sounds yet struggle with food texture and bright lighting. Others seem to be immune to discomfort like extreme cold, heat, and pain.

Regardless of where they fall on the sensitivity spectrum, for children with sensory processing dysfunction, the world is often a confusing and overwhelming place that is hard to understand.

As a result, children with sensory problems often exhibit odd and disruptive behaviors and unusual motor skills responses. Meltdowns, sudden mood swings, and unruly behaviors are not uncommon.

Children on the hypersensitive end of the spectrum may engage in sensory avoidance where they withdraw, flee, or disengage. On the other hand, hypo-sensitive children often seek stimulation by spinning, self-injurious behaviors (hitting or pulling hair), or eating non-edible objects.

Here are some of the most common signs that a child may be experiencing sensory processing abnormalities:

• A high or low threshold to pain, heat, or cold
• Frequent tantrums
• Chewing inedible items
• Clumsiness, stumbling, lack of balance
• Extreme responses to food textures, tastes, and smells
• Limited range of food
• Intolerance to certain textures and fabrics
• Hypersensitivity to loud noises like barking dogs, mowers, sirens
• Deficits in fine motor skills like holding crayons, using buttons, or manipulating toys
• Extreme resistance to change, need for sameness
• Running away or fleeing
• Aggressive actions in time of sensory overload
• Overly sensitive or under reactive to touch, movement, sights, or sounds
• Lack of attention and focus
• Delays in speech, motor skills or academic achievement
• Difficulty with transitioning to other activities and settings
• Immature social skills
• Impulsivity, lack of self-control
• A tendency to withdraw, disengage
• Floppy, low muscle tone

Causes of Sensory Problems 

We know that children with autism experience the world differently than their peers, including how their brains assimilate sensory information. Some may experience sights, sounds, scents, and sensations at a higher intensity than expected, while the converse is true for others.

Sensory integration dysfunction disrupts how the central nervous system receives, filters, organizes, and uses sensory information in usual and helpful ways. The question is why.

The condition appears to be influenced by genetic and physiological factors.

A study conducted by the University of California San Francisco found that children with sensory processing disorder have noticeable and measurable differences in their brain structure compared to kids without sensory problems.

And studies involving twins show a strong genetic link to hypersensitivity to light and sound.

Whatever the cause, what is known is that people with sensory processing issues, including most children with autism, receive conflicting signals from the brain that are hard to decipher.

Risks of Sensory Processing Issues

The ramifications of sensory issues go far beyond complaints about an itchy tag on a shirt or aversion to water. They can—and often do—interfere with learning, peer interactions, and development.

Disruptions in internal senses that control movement, balance, posture, and body awareness contribute to poor coordination, balance, and fine and gross motor skills that impair daily functioning.

Without intervention, sensory processing issues can worsen over time, lower self-esteem, and hinder the child's ability to:

• Perform self-care and hygiene
• Learn
• Break from rigid, unyielding routines
• Make friends and socialize
• Participate in family activities and rituals
• Get adequate sleep

Due to the risks and complications, early intervention for sensory problems is crucial.

How Parents Can Help 

While there is no cure for sensory processing issues, there are ways parents can help their child learn to receive and respond to sensory information in more ordinary and helpful ways.

Parents need to identify what sensory experience drives their child's behavior, which often takes some detective work and astute observations. By understanding the reasons behind it, parents can address the source and alleviate some distress, reducing the need for maladaptive behavior.

Despite the challenging nature of some behaviors, parents should respect their child's feelings and accept that they experience the world in ways they may be hard to comprehend.

While it often takes some heavy lifting to get the root of the behavior, there are simple accommodations that often make drastic improvements in their child's sensory comfort.

For hypersensitive children:

• Dim lights and use white noise machines
• Provide sunglasses and visors to shield eyes from bright lights
• Use incandescent lightbulbs vs. fluorescent lighting
• Remove tags from clothes
• Avoid strongly scented perfumes, air fresheners, and soaps
• Allow the child to eat their preferred foods while working to introduce new ones
• Provide earplugs, headphones in noisy environments
• Rearrange furniture to make clear, safe pathways

For hypo-sensitive children:

• Allow opportunities for self-stimulation with rocking, swinging, and hand flapping
• Provide weighted blankets
• Create a sensory-rich environment with visual, tactile, and physical stimulation experiences

Therapy for Sensory Processing Disorder

Therapy interventions help children with sensory disorders reach an optimal state of stimulation—not over or under—that enhances learning opportunities, cognitive development and focus.

Two of the most commonly used therapies are occupational and behavior modification.

Occupational therapy utilizes physical activities and techniques to improve sensory information processing and focus on tasks instead of engaging in low-value behaviors like staring, rocking, or flapping.

Therapists often create a sensory integration diet tailored to the child's unique needs, including music, sand and water play, and motor exercises that improve balance and coordination and activities to enhance vestibular movement like jumping or swinging.

Occupational therapists can also help the child learn to tolerate new foods with various techniques that reward them for trying new items of different textures, colors, and shapes and address any common food aversions.

Cognitive-behavioral therapy helps children to increase their tolerance to different sensory experiences through behavior modification techniques. One of the most commonly used is systematic desensitization. By slowly improving their tolerance to certain stimuli, children can adapt to new environments, people, and experiences.

Psychotherapy is also helpful in improving anxiety and feelings of well-being for children who experience sensory processing challenges.

Bottom Line

There is no quick fix for children who suffer from a sensory processing disorder. But much can be done to lower distress, improve tolerance to stimuli, and reduce disruptive behaviors that result from sensory processing disorders so common among those with autism.

With help and maturity, children can experience fewer sensory challenges as they grow older and find ways to cope with them.

Does your child suffer from sensory challenges? Alliance ABA can help.