Autism and Sensory Processing Disorder

a child holding a cone up to his eye
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The vast majority of 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 (high functioning autism), 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.

How Sensory Dysfunction Became a Core Symptom

In the past, sensory issues were not considered to be a core symptom of autism; in fact, sensory challenges were not even mentioned in the diagnostic criteria. The reality, however, was that most people with autism seemed to react differently to light, sound, physical pressure, smell, and taste.

In some cases, practitioners would essentially ignore these sensory issues; in other cases, they would make a separate diagnosis of Sensory Processing Disorder, despite the fact that such a disorder did not (and still does not) appear in the official DSM-5 diagnostic manual.

For many years, sensory dysfunction (sometimes referred to as sensory integration dysfunction or sensory processing disorder) was not taken seriously. People researching the field received little funding, and therapies were few and far between.

When sensory integration therapy was provided, usually by an occupational therapist, it was rarely paid for by health insurance. With the 2013 publication of the DSM 5 (a new diagnostic manual), sensory challenges were added as one possible symptom of autism spectrum disorder:

In essence, this addition acknowledges that the majority of people on the spectrum have some level of sensory processing disorder. In addition, it's clear that many people, children, and adults, have trouble processing sensory input.

While sensory issues are more prevalent among people with autism, ADHD, and related developmental issues, it can also exist as a separate problem. Even with the acknowledgment that sensory issues do exist and are problematic, however, the developers of the DSM-5 did not create a unique Sensory Dysfunction diagnosis.

Definition of Sensory Processing Disorder

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.

People 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 You or Your Child Have SPD

If you think that you or someone else might have Sensory Processing 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.

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Article Sources

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  • American Academy of Pediatrics: The Pediatrician's Role in the Diagnosis and Management of Autistic Spectrum Disorder in Children. Pediatrics. 2001;107(5):1221-6.

  • Centers for Disease Control. Autism spectrum disorder. Web. 2018.

  • Miller LJ, Fuller DA, Roetenberg J. Sensational Kids, Hope and Help for Children with Sensory Processing Disorder (SPD). Penguin; 2014.