Sensory Issues and Co-morbid Conditions for People on the Autistic Spectrum A Cambian Education information sheet
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Many people with an ASD not only face challenges with the Triad of Impairment but also have sensory difficulties in certain areas, being either hypo-responsive (with low sensitivity) or hyper-responsive (with high sensitivity): Sensory issues Auditory System Hypo-responsive people may: • appear not to hear or seem to be ignoring others • make noise to block out or control the pitch of the other noise • listen to music/TV on a loud volume • have difficulty differentiating pitch and tone • benefit from having their name said before anything further is said to them Hyper-responsive people may: • dislike unexpected or loud noises • cover ears with hands • have difficulty staying on task due to noise distractions, such as a ticking clock, passing transport, other people, vacuum cleaner • benefit from wearing ear defenders or an iPod Visual System Hypo-responsive people may: • like bright contrasting colours • stare • rub or poke eyes to get the visual stimulation of the lights they see from doing it • flap hands/fingers in front of their eyes to see the contrast of light • benefit from having plain bays to minimise distraction Hyper-responsive people may: • be sensitive to light preferring to be in the dark • cover eyes from light or squint when others’ eyes have adapted • have difficulty differentiating things on busy backgrounds which will cause anxiety • have difficulty with jigsaws • have difficulty reading things on bright white paper Tactile System (touch) Hypo-responsive people may: • be unaware of pain or have reduced awareness and are therefore more likely to get injured or burned • have an unusual need to touch and feel objects often to process more information • like to be barefoot to feel floor/ground texture • be unaware when hands/face get mucky • need more supervision to help keep them safe • like to be touched firmly Hyper-responsive people may: • be fussy about cleanliness • dislike differences in temperature or varying textures • react negatively to being touched • dislike self care activities such as bathing/ showering, cleaning teeth, brushing or combing hair
• be a fussy eater • become irritated by certain textures of clothing and/or labels in clothes • benefit from having shorter hair, having labels cut out of clothes, or wearing socks inside out so seams do not irritate Olfactory System (smell) Hypo-responsive people may: • have difficulty smelling things, such as burning or gas • like strong smells/perfumes/aftershaves • smell fresh flowers • benefit from being supervised when cooking Hyper-responsive people may: • be sensitive to smells others may not notice • dislike shops/corridors at school due to too many smells • dislike strongly flavoured foods including mints Taste Hypo-responsive people may: • smell, mouth or lick items including food to gain more information, like a toddler would • have a preference for certain smells and tastes • crave certain foods • s eek more flavour, such as hot chillies, strong curries, spicy food since most food tastes bland to them • finger feed Hyper-responsive people may: • gag on food •b e picky eaters particularly regarding textures which could lead to a restricted diet •a void foods with certain smells such as cheese, spicy food etc • f avour certain foods and may become distressed when offered alternatives • also be dyspraxic •d islike other people touching their food but be fine with pre-packed shop bought sandwiches and snacks, providing they are the only one to open the packaging •b enefit from an oral desensitisation programme from an Occupational Therapist Motor System (movements) Hypo-responsive people may: •e xecute large movements in order for the brain to register them •e njoy movement activities with play equipment, spinning around, moving toys •u nconsciously rock back and forth and rock on chairs • like firmer touch •b enefit from weighted blankets, wobble-cushions and lap-pads
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Hyper-responsive people may: • become disoriented bending over and may feel dizzy or sick or fall over • avoid play equipment and moving toys • dislike activities such as gymnastics/swings • suffer from motion sickness • benefit from focusing on a certain fixed point Other issues Anxiety Older children in particular can be prone to psychiatric problems caused by depression, loneliness and low self-esteem. Enuresis, selfmutilation, and mood swings may result. Curiosity and lack of empathy This may lead to injury to self or others • “What will happen if I squeeze this drinking glass?” • “What will happen if I jump out of the window?” • “What will happen if I push her from behind?” • “I did not think it would hurt her as she wasn’t looking at me when I did it.” They will benefit from being taught about how behaviours have a consequence – for example, if I squeeze a glass it is likely to break and my hand will get cut. Epilepsy Adolescent onset is not uncommon. Pain Some people with ASD have a high pain threshold and therefore may be unaware they are injured or unwell and for this reason they will need to be closely watched if they have falls, high temperatures etc so that any serious injury or illness can be treated accordingly. Others may have a very low pain threshold and any scratch or knock can cause them considerable pain and distress and they may require a lot of reassurance. Personal hygiene Some people with ASD may have poor personal hygiene and this could be related to sensory issues. This can include using a hairbrush which, with a low pain threshold, could be painful. Low sensitivity to smell leads to lack of awareness of body odours and the discomfort this may cause others. There may also be a difficulty in understanding how to wash properly – although they may know that they have to have a bath/shower, they may not understand the actual process of doing that activity, other than to sit in a bath of warm water or to stand under a shower. Some may benefit from having this process written down, from putting soap on a flannel to washing various parts of their body and rinsing the soap off.
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Sensory Issues and Co-morbid Conditions for People on the Autistic Spectrum Other CONDITIONS which may coexist with ASD – and which in their own right may require some form of regular medication:
Dyspraxia * (Developmental Coordination Disorder, or ‘Clumsy Child Syndrome’).
• ADHD * excellent UK org ADDISS’ website is at www.addiss.co.uk Tel: 020 8952 2800
The Dyspraxia Foundation’s website is at www.dyspraxiafoundation.org.uk (Tel: 01462 454 986).
• Cerebral Palsy * SCOPE’s website is at www.scope.org.uk Tel: 0808 800 3333 • Epilepsy * the Epilepsy Action website is at www.epilepsy.org.uk Tel: 0808 800 5050 • Obsessive Compulsive Disorder * OCD Action’s website is at www.ocdaction.org.uk Tel: 0845 390 6232 or 020 7253 2664 • Tourette’s syndrome * Tourette’s Action’s website is at www.tourettes-action.org.uk Tel: 0845 458 1252 Other conditions seen with AS – but not necessarily requiring medication Dyslexia * The British Dyslexia Association’s website is at www.bdadyslexia.org.uk (Tel: 0845 251 9002).
Face-Blindness (‘prosopragnosia’) Not a common one, but has been known to co-exist with autistic spectrum conditions and particularly Asperger Syndrome. The condition makes the recognition of an individual’s face very difficult. For more information look at www.faceblind.org, the Prosopragnosia Research Centre at Harvard University and University College London. Semantic Pragmatic Disorder * Find more information at the Surrey NAS website www.mugsy.org/spd5.htm, Afasic’s website www.afasic.org.uk (Tel: Helpline 0845 355 5577 10.30am to 2.30pm Monday - Friday) and www.spdsupport.org.uk. Hyperlexia – a disorder of reading development, disordered language, social and behaviour problems (for more information see www.hyperlexia.org, the American Hyperlexia Association’s website) Developmental Apraxia of Speech – neurologically-based, affects speech development, the number and combination of sounds a child masters (to find out more see www.ability.org.uk/Apraxia.html) Irlen Syndrome – visual perception problem, coloured glasses needed www.irlen.org.uk. * Cambian produces free Information Sheets on these conditions.
PLEASE NOTE: Cambian has provided the details in this document in good faith and for information only and has not verified details provided by third parties. Nothing in this document implies any recommendation or endorsement of any course of action or service and you must ensure that anything you proceed with is appropriate for your requirements. Cambian accepts no responsibility for any loss or damage you sustain by taking action or dealing with third parties as set out in this document All the information sheets are checked and amended annually. Please ensure you have the current version.
Cambian is the largest provider of specialist residential education and care for young people with Autism, Asperger Syndrome and other associated complex needs in the United Kingdom. Cambian is trusted by hundreds of parents and over 70 Local Education Authorities. www.cambiangroup.com CAM076, Date of preparation 27/02/2011 ©CAMBIAN/SENSORY ISSUES
All Cambian Education publications can be downloaded from our web www.cambiangroup.com/specialist_education
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