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Autism Spectrum Disorder - Practical Interventions for Build Basic Social Skills
Asperger: Practical Interventions to Build Basic Social Skills - 6 CEUs

Section 3
Sensory Processing in Autism

CEU Question 3 | CEU Test | Table of Contents
Social Worker CEUs, Psychologist CEs, Counselor CEUs, MFT CEUs

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In the last section, we discussed Effective Parenting to Build Basic Social Skills regarding structuring family life.  This included predictability, responsibility and flexibility.

Have you had a client with Autism Spectrum Disorder who is hypersensitive in one or all of the five senses?  Does he or she become overwhelmed by a sensory overload?  How do you respond to him or her? 

In this section, we will discuss Sensory Overload. This will include hearing, vision, smell and taste and touch.  As you listen, think of your client with Autism Spectrum Disorder.  How is this information applicable to him or her?

René, age 36 and Roman, age 38, had a daughter named Sage, age 7, who had Autism Spectrum Disorder. René stated, "Our little girl is extremely hypersensitive…not emotionally, but literally.  Sage’s teachers have called me saying that she’s disruptive in class because she can’t bear even the slight hum of the air conditioner and she complains of her seat being uncomfortable. I’ve also been told that during fire drills she cries and covers her ears, which causes her classmates to tease her and her teachers to chastise her." 

Roman stated, "And thunderstorms!  Sage becomes hysterical! Fireworks at the Fourth of July can prompt similar reactions, though she loves to watch them. Unfortunately, the noise of thunder is more difficult to shut out."

 I stated, "Sage seems to have sensory integration dysfunction. As you mentioned, this is hypersensitivity. Sage has difficulty modulating and regulating her sensory input. For example, in school, Sage probably can’t concentrate because it’s hard for her to ignore the discomfort of her chair and the hum of the air conditioner, which other children can shut out. It’s possible that she might even experience pain at some sounds, such as the fire alarm, which can be high-pitched.  I’m sure the chaos of people scrambling to evacuate the classroom doesn’t help her confusion, either." 

Roman stated, "René and I can accommodate Sage at home, as difficult as it is sometimes…but she will have to learn to live with a lot of these discomforts, especially the ones at school. How do we help her to become acclimated to them?" How might you have answered this question?

4 Sensory Overload Areas

♦ Area #1 - Hearing
I stated, "First, let’s discuss hearing. You may want to try to acclimate Sage to some sounds by controlled exposure to them. For example, with the sound of the air conditioner, you may want to try and go to Sage’s classroom sometime after school when the air conditioner is still on. You might try walking in the hallway outside the classroom with the door part-way open and see if she can hear it. If she can, take a walk up and down the hall with the door open part-way. Then open the door a little further and do the same thing. Maybe open the door all the way.  Eventually, try to work her up to an ability to be in the same room with the air conditioner humming without a lot of discomfort." 

Roman stated, "We have an air conditioner at home that we could try the same experiment with."  I stated, "Even better."  René asked, "What about the fire drills?" 

I stated, "Many of the sensory discomforts that children with Autism Spectrum Disorder experience are because the discomforts are unpredictable.  Sage can learn, for example, to know when a thunderstorm will happen because she will see the clouds gathering.  A fire drill, of course, might be more tricky.  Try calling the school’s main office and asking if they can tell you when scheduled fire drills might be.  If you can prepare Sage for them in advance, it might cut down on her anxiety. Of course, this can’t prepare Sage for the real thing.  However, if she can get through the drills without too much anxiety, chances are that she will be a little calmer for the real thing." 

In the same situation, what might you have suggested?

♦ Area #2 - Vision
I stated, "Second, let’s discuss vision. Does Sage experience any difficulties here?" Roman replied, "Actually, it’s funny…vision is the one sense that Sage doesn’t seem to have a problem with! I mean, she dislikes bright lights, but no more than anyone else I know." I stated, "Many children with Autism Spectrum Disorder have problems with fluorescent lights because they flicker on and off at a rate most people are unable to detect." 

Roman stated, "I don’t know that Sage has ever been around fluorescent lights...if they do bother her, what would you suggest?" I stated, "This might be another sensory discomfort that Sage will need to be acclimated to. Some people with Autism Spectrum Disorder experience fluorescent lights as brightly flashing, which, of course, could be a considerable distraction."

♦ Area #3 - Smell and Taste

Roman stated, "Sage also has heightened senses of smell and taste.  When she was in kindergarten, her class took a field trip to an apple orchard.  The smell of the old cider press that everyone else found pleasant was too much for her, and she got sick!"  René stated, "When she eats, she’s very picky, though…nothing crunchy.  She calls it ‘noisy food’ because the crunching resonates in her ears." 

Roman stated, "She doesn’t seem to like slimy foods either."I stated, "Third, in addition to hearing and vision, let’s discuss smell and taste. When food is an issue because of flavor, aroma, or texture, it may be wise to accommodate up to appoint, but to introduce new foods gradually.  Even when Sage retains her strong dislikes, she can learn to express them politely and refuse food graciously.  Roman stated, "We’re still working on that.  She’s a bit stuck on ‘Eeew, that’s yucky!’ like most 7-year-olds, but we’re making the transition to ‘No, thank you.’"

♦ Area #4 - Touch
René stated, "Sage can’t bear to be in any kind of even slightly uncomfortable clothing, either.  Most of the time it’s not a problem; I can buy her soft cotton clothing and everything’s fine. And I’ll tell you, when I do find a shirt that she likes, I’ll buy it in several sizes, so she can keep wearing the same thing as she gets older. However,  I had to take her in sweats to my sister’s wedding last year because she wouldn’t wear the dress I had picked out for her; it was too itchy. I was really embarrassed." How might you have responded? 

I stated, "Fourth, let’s discuss touch. Obviously you have tried to accommodate Sage’s discomfort in most situations. There are times, such as your sister’s wedding, when it is probably reasonable to seek compromise, however, to try and expand Sage’s tolerance. Perhaps you might want to invest in cotton jumpers and cotton tights or leggings. For a really formal occasion, such as the wedding, Sage might have to wear an uncomfortable dress for a while, but you might take along a change of clothing for her to slip into once the main event is over."  René asked, "So, you mean, I should ask her to try and compromise with me?"  I stated, "Exactly." 

René stated, "Of course, I’d be able to prepare her for wearing something uncomfortable ahead of time…I didn’t do that last time at my sister’s wedding…I kind of just expected she’d wear the dress. What I should really do is ask Sage if she has any ideas." I stated, "That’s a great idea. If Sage comes up with a solution to help her cope with a sensory issue, you can praise her for her creative and sensible approach toward coping with discomforts." 

Do you have a Roman or René trying to raise a child with hypersensitivity?  Do you have a Sage who has heightened senses?  Might playing this section be beneficial for him or her?

In this section, we discussed effective parenting regarding Sensory Overload.  These included hearing, vision, smell and taste and touch.

In the next section, we will discuss Intense Interests.  This will include controlling access to the interest and using the interest  constructively. 

Dunn, W., Saiter, J., & Rinner, L. (fall 2002). Asperger Syndrome and Sensory Processing: A Conceptual Model and Guidance for Intervention Planning. Focus on Autism and Other Developmental Disabilities, 17(3), 172-185.
(AS is now ASD per DSM-5.)

Peer-Reviewed Journal Article References:
Brandes-Aitken, A., Anguera, J. A., Rolle, C. E., Desai, S. S., Demopoulos, C., Skinner, S. N., Gazzaley, A., & Marco, E. J. (2018). Characterizing cognitive and visuomotor control in children with sensory processing dysfunction and autism spectrum disorders. Neuropsychology, 32(2), 148–160. 

Crown, N. J. (2021). Oh no! I see a pit: Making sense of the sensory on the autism spectrum. Psychoanalytic Psychology. Advance online publication.

Lowe, M. X., Stevenson, R. A., Wilson, K. E., Ouslis, N. E., Barense, M. D., Cant, J. S., & Ferber, S. (2016). Sensory processing patterns predict the integration of information held in visual working memory. Journal of Experimental Psychology: Human Perception and Performance, 42(2), 294–301.

Proff, I., Williams, G. L., Quadt, L., & Garfinkel, S. N. (2021). Sensory processing in autism across exteroceptive and interoceptive domains. Psychology & Neuroscience. Advance online publication.

Online Continuing Education QUESTION 3
How can many sensory difficulties be overcome in children with Autism Spectrum Disorder? To select and enter your answer go to CEU Test.

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