The sensory world
The picture exchange communication system PECS.
Vocabulary development project Makaton.
Autism Software Mouse trial.
To function and participate in the world that surrounds us, we need to use our senses. Senses provide individuals with unique experiences and allow us to interact and be involved with the rest of society. They help us to understand the environment around us and respond within it. They play a significant role in determining what actions we take within a particular situation. Imagine what happens when just one or all of your senses are intensified or are not present at all, often referred to as sensory integration dysfunction. This is the case for many individuals on the autistic spectrum.
There are several definitions of autism but they rarely state what an autistic individual feels. It is only through personal accounts from individuals themselves who can express and describe their unique and often painful sensory world that we find out more. Everyday functions, which the majority of individuals take for granted, can for autistic individuals be negative and upsetting experiences. Behaviours presented by someone with autism will often be a direct reaction to their sensory experience. It is therefore understandable why they create rituals, or have self-stimulatory behaviours such as spinning, flapping and tapping, because this makes them feel they are in control and feel safe in their unique world.
Ayre's (1979, in Smith Myles et al, 2000) defined sensory integration as "the organisation of sensation for use". It involves turning sensation into perception.
The central nervous system (brain) processes all the sensory information sent from various sensory systems in the body and helps to organise, prioritise and understand the information. From this it is able to action a response: these may be thoughts, feelings, motor responses (behaviour) or a combination of these. Throughout our bodies we have receptors, which pick up on sensory stimuli. Our hands and feet contain the most receptors. Most of the time the processing of sensory information is automatic
The sensory systems can be broken down into six areas. These can be divided into two main areas: hyper (high) and hypo (low) sensitivity. However, it is important to remember that the difficulties/differences may for some individuals fall into both areas.
Situated in the inner ear, this provides information on where our body is in space and its speed, direction and movement, all in relation to the pull of gravity. It is fundamental in helping us to keep our balance and posture. For an individual on the spectrum, difficulties/differences may be:
Situated in the muscles and joints it tells us where our bodies are. It also informs us where our body parts are and how they are moving. For an individual on the spectrum difficulties/differences may be:
Processed through chemical receptors in the nose, this tells us about smells in our immediate environment. Smell is a sense that is often neglected and forgotten about. It is, however, the first sense we rely upon. For an individual on the spectrum difficulties/differences may be:
Situated in the retina of the eye and activated by light, our sight helps us to define objects, people, colours, contrast and spatial boundaries. For an individual on the spectrum difficulties/differences may be:
Situated in the inner ear, this informs us about sounds in the environment. It is the most commonly recognised aspect of sensory impairment. For an individual on the spectrum, difficulties/differences may be:
Their hearing impairment can have a direct effect on their ability to communicate and may also affect their balance.
Situated on the skin, the largest organ of the body, it relates to touch, type of pressure, level of pain and helps us distinguish temperature (hot and cold).
Touch is a significant component in social development. It helps us to assess the environment we are in and enables us to react accordingly. For an individual on the spectrum difficulties/differences may be:
Processed through chemical receptors in the tongue it tells us about different tastes - sweet, sour, bitter, salty and spicy. Individuals will often have restricted diets as a result of their taste buds being extra sensitive. For an individual on the spectrum difficulties/differences may be:
This is a rare condition, separate from ASD, which some individuals on the spectrum say they experience. This is when confusion in the sensory channels occurs. A sensory experience goes in through one system and out through a different system. For example an individual hears a sound (auditory system) but sees colours (visual system).
A greater understanding of the sensory world of individuals on the spectrum allows you to help them develop in a more comfortable environment.
General points to remember:
Knowing that sensory dysfunction may be the reason for the problem, always examine the environment.
Use your imagination to come up with positive sensory experiences and/or strategies.
Always warn the individual of possible sensory stimuli they may experience, eg loud crowded places.
Sensory integration therapy
Sensory integration therapy involves the gentle exposure to various sensory stimuli. The aim of this therapy is to strengthen, balance and develop the central nervous systems processing of sensory stimuli. Delacato (1974), who introduced the concept of Sensory Integration Therapy, focused the therapy on the five core sensory systems - vision, taste, smell, auditory and tactility. Today, occupational therapists continue to focus on these areas, as well as incorporating the vestibular and proprioception systems, when creating and planning a schedule of activities for an individual.
Irlen lenses method
The Irlen Method believes that coloured filters worn as glasses can reduce or eliminate perceptual sensitivity and sensory overload. The colour may change the rate at which information can be processed by the brain, correcting misperceptions and eliminating the need for the individual to reduce sensory input or become distracted by the stimuli in the environment.
The Orthoscopics System provides a set of tools for the optician to determine the patient's optimum colour response. This optimum response is then integrated with the effects of differing illumination.
The Orthoscopics approach believes that with this data, lenses can be prescribed incorporating optimised colour filtering. These may reduce and possibly eliminate the effects of visual perceptual difficulties such as those found in visual dyslexia and migraines.
Auditory Integration Training (A.I.T.)
In the early 1980s Dr Guy Berard created a machine that tests and exercises individuals auditory system. This approach believes that behaviours are a consequence of difficulties in the auditory system. By producing and altering various sounds the machine is able to use its auditory filters to maximize the volume without causing discomfort. The aim is to train the auditory system and balance its input. Research into this approach is very limited. For further information see contacts/recommended reading.
The benefits of music therapy have been recognised, and it is often used with individuals on the spectrum. Music therapy provides individuals with a unique opportunity to communicate, interact and express. For further information see contacts/recommended reading.
Sensory environments are aimed at providing individuals with the opportunity to stimulate, develop or balance their sensory systems.
They are located mainly in specialist schools or hospitals so access is quite limited. However, many families have chosen to adapt a room in their home to create a space for sensory stimulation or reload.
Hulsegge & Verheul (1986, in Pagliano, 2000) developed the concept of the sensory room in the Netherlands. Drawing from the work of Clark (1966, in Pagliano, 2000) who established the idea of 'SNOEZLEN' rooms, this is a combination of two words, to 'smell' and to 'doze'. The terms more commonly used in the UK are sensory rooms or multi sensory environments.
Rooms or sensory spaces can take various forms, for example white, dark, sound, interactive, water, softplay or garden. The main functions for MSE tend to be therapeutic, educational and relaxation, all in relation to development.
Equipment used within the rooms varies depending on the type, function and needs of the individual using it. The following list gives examples of equipment to provide stimulation for all sensory systems. Stimuli can include soothing music, vibrating cushions, fibre optics, mirror balls, bubble tubes, waterbeds, tactile walls, disco lights and projectors to name just a few. Equipment can be set up using switches, pressure, sound and movement which then activate a piece of equipment in the room. The child comes to recognise cause and effect.
Benefits of MSE at present rely mainly upon personal experiences and observations, as there is only a limited amount of research.
Occupational therapist - they play a fundamental role in sensory difficulties by designing programmes and often making adaptations to environments to ensure individuals are able to live as independently as possible.
Sensory impairment team - accessed through local social and health services these teams specialise in sensory difficulties. Although they are not autism-specific some local authorities do cover individuals on the spectrum.
Speech and language therapist - often use sensory stimuli to encourage and support the development of language and interaction.
Music therapist - use instruments and sounds (auditory stimuli) to encourage and develop the sensory systems, predominantly the auditory system.
Problem - Possible Sensory Reasons - Ideas
© The National Autistic Society 2003