Sensory processing and autism

Sensory Processing Disorder (SPD) or sensory issues describes the experiences children (and adults) have when their brains interpret the sensory messages they receive differently.  Their brains might find some sensory inputs overwhelming.  Or they might not notice sensory inputs as quickly as others. I describe what Sensory Processing Disorder is in my article ‘What is SPD?’  On this page I am going to take a closer look at autism/ASD and sensory processing issues.  I will cover

  • A quick description of autism and sensory issues

  • What sensory differences in autism might look like

  • What is might feel like to experience sensory differences (from an autistic perspective).

Sensory processing and autism

Sensory Processing Disorder (SPD) or sensory issues describes the experiences children (and adults) have when their brains interpret the sensory messages they receive differently.  Their brains might find some sensory inputs overwhelming.  Or they might not notice sensory inputs as quickly as others. I describe what Sensory Processing Disorder is in my article ‘What is SPD?’  On this page I am going to take a closer look at autism/ASD and sensory processing issues.  I will cover

  • A quick description of autism and sensory issues

  • What sensory differences in autism might look like

  • What is might feel like to experience sensory differences (from an autistic perspective).

What is Autistic Spectrum Disorder/Condition?

Autistic Spectrum Disorder (ASD), or autism, is a neurological condition.  It impacts how how a person communicates with others and experiences the world around them.  Autistic children and adults will experiences difficulties with social communication, this impacts social interactions.  Often they will have some form of restricted and repetitive patterns of behaviours, activities or interests.  As an adult this can often be put to use in highly skilled jobs requiring attention to details.   Differences in sensory responses are now formally included within the diagnosis criteria and can have a significant impact on a child or adult’s function.

Whilst it was well known for many years that sensory processing differences and autism/ASD often occurred together, the 2013 manual (1) update is is the first time it had been formally recognised.  The criteria states that the patterns of behaviours, activities or interests may be due to ‘Hyper or hypo reactivity to sensory input or unusual interests in sensory aspects of the environment (e.g., apparent indifference to pain/temperature, adverse response to specific sounds or textures, excessive smelling or touching of objects, visual fascination with lights or movement)’ (1). This means that autistic children or adults are likely to process sensory information in the environment differently to others.

How frequently do ASD and sensory processing issues occur?

In one survey (2) of adults with autism, 83% of respondents said that they had some challenges with sensory processing.  In the same survey respondents also listed sensory processing challenges as contributing to their increased levels of stress.  The percent of children with ASD and sensory processing issues has been reported to be between 69% to 95% depending on the study (3).  It also occurs frequently enough for it to be included as part of the diagnostic criteria in the DSM-5 update in 2013 (1).

Sensory overload at the shops

This video considers the sensory inputs that occur on a trip to the shops.  What seems like a simple activity is really full of ongoing sensory inputs.  The video considers how someone with ASD and sensory processing disorder might experience the world.

What might the sensory processing challenges in autism feel like?

Difficulties with sensory processing can affect every part of a child’s or adult’s life.  This is because our bodies are constantly receiving sensory messages.

Close your eyes for a minute and just think about all of the sensory input you are experiencing.

Do you hear any sounds or smell and scents? Can you feel what you are sitting on? Does your body know whether you are sitting up or lying down?

What about micro sensations? How do  your clothes feel against your skin? What about your watch or jewellery? Can you sense the seams of your socks or tights? How is the faint tick of a clock sound, or the flicker of a light affecting you?

Noticing micro sensations

Some of you who are reading this may have never noticed these micro sensations before. This is because your brain filters them out.  Autistic Spectrum Disorder can increase the intensity of these micro sensations.  So, everyday sensations are felt with greater intensity.  This can often lead to distraction or avoidance.  Over time, if these sensations become too much, this can lead to sensory overload.  Sometimes this might result in a meltdown or even shut down.

Children (or adults) that meltdown typically show their sensory overload in more obvious ways than those that shut down.  During a meltdown, a child’s behaviour will likely be quite intense, it may look similar to a tantrum.  However, the trigger for the response is too much sensory information.

It is important to also keep an eye out for shut down as these children (and adults) can be overlooked.  Children (or adults) who shut down may withdraw, go quiet or try to hide.  These indicators of shut down can often be missed.

A personal description

One description I found very useful in thinking about what it might feel like for an autistic person who experiences sensory processing challenges is from Anita Lesko.  She stated that:

‘Living with Asperger’s is like living with Dolby Surround sound, wearing 3-D glasses like those used in movie theatres and having your sense of smell and touch jacked up to the max’

Anita Lesko (2)

Is there always a pattern of sensory sensitivity in autism?

Interestingly, despite there being a lot of attention on sensory sensitivity in autism, the research reports a mix of sensory patterns.  Results show that there is no clear pattern of responses in autism to sensory information.  Different studies have given different results but most find that there is a mixed sensory profile in autism.

This is a good reminder that every person with autism is an individual.  Whilst some brains are more sensitive, others could be slower to respond to sensory inputs and others might seek out more sensory inputs.  There can also be differences with each sense.  One common finding in all studies is auditory sensitivity, or sensitivity to sounds. I see this clinically too.  Touch sensitivity is also frequently reported.

Overall, however, research does not support a specific pattern of responses.  Every autistic child or adult will have their own unique sensory profile and need their own individualised supports.  Newer research (4) has indicated that sensory seeking may be more prevalent in younger age groups (age 3-6), or when there is lower cognition.

There’s a lot of sensory information to process!

This video shows the sheer amount of sensory inputs in our environment every day.  It considers just how much information someone with ASD and sensory processing disorder has to process as they move through a normal day.  It’s useful to think about your child’s day and what sensory inputs they are experiencing.  I explore sensory overload in more depth here.

What might ASD and sensory processing challenges look like functionally day to day?

On a typical day, as the videos show, there are many different sensory inputs that our brains need to process.  The brain needs to decide whether to respond or to ignore these inputs.  The world is full of noises. If you’re sensitive to noise sirens, clocks ticking, loud vehicles, dogs barking, music class, playground noises, vacuum cleaners and hand dryers might be an issue.  The world is also full of things to look at and smell.  This can prove very distracting if you are more sensitive to visual inputs or smells.

Our touch sense is constantly working.  Difficulties might occur with clothing fabrics, shoes, socks, haircuts, hair brushing or washing, teeth brushing, messy play and food textures for those who are sensitive to touch.  If processing is slower it will take longer to respond to messages from the touch system.

Those who are slower to process proprioceptive sensory input have poor awareness of where their body is and poor coordination. Sometimes they find slow movements more difficult. This could mean seeking out more movement by constantly being on the go and fidgeting.  There could also be sensitivity to movement, or vestibular sensory input, which often results in avoidance of moving surfaces, swings and other playground equipment.

Consider the environment

Sensory inputs will change depending on the environment.  Often the environment at home is more predictable and can be easier to manage than school. There are less children, or sometimes no other children, at home.  The child has their own space they can retreat to if required.  They have more choice over the activities they participate in.  However, some children find the routine of school helpful.  Others can find the sheer volume of sensory inputs at school quite overwhelming.

The larger and more unpredictable the space is, the more sensory input there is for the autistic child or adult to process.  Think of a large supermarket compared to a small corner shop. There is much more to look at, the lights are typically brighter. There are more people, there is more movement and much more noise.  For those without sensory sensitivities, the brain ignores and filters out the information it doesn’t need.  This makes it much easier to be in the space. When the brain isn’t filtering out this information as well, such as in autism/ASD, the brain pays attention to everything.  This is why sensory overload can occur. There is just too much information for the brain to process.  This can sometimes result in meltdown or shutdown.

Responses can also change

Responses to sensory inputs can fluctuate and change. Children and adults with sensory issues can find these harder to manage towards the end the day. Or towards the end of the week or school term.  Tiredness or ill-health can exacerbate sensory issues. Clinically, I have seen a significant difference in children’s ability to manage sensory sensitivities when they are well compared to if they are unwell. Autistic children  can often have even less reserve when they are unwell.  This can lead to quicker sensory overload.

Another thing that will impact on sensory processing is stress. There is some research in this area (5).  It indicates that anxiety can increase sensory sensitivity.  However, it also shows that sensory sensitivity can increase anxiety.  The author of the research was unable to tease out which came first though, liking it to a chicken and egg scenario (5).

Let’s hear from an autistic adult

In this TED talk, Jolene Stockman describes here experiences growing up and also as an adult.

‘Living with Asperger’s is like living with Dolby Surround sound, wearing 3-D glasses like those used in movie theatres and having your sense of smell and touch jacked up to the max’  Anita Lesko

How can I help support sensory processing difficulties in ASD?

The good news is that you can use numerous sensory strategies and make many environmental adjustments.  The challenge is that, as every child or adult with autism has a different sensory profile, there is no one size fits all solution.  Each person with sensory challenges will require their own unique set of supports.  An occupational therapist (OT) is typically the best professional to provide you with support in this area.

The most recent recommendation from the American Journal of Occupational Therapy (AJOT) is that, before sensory strategies are used, there must be documented assessment of need.   Without assessment, a child may just be given what is available. For example,  ‘a wobble cushion helped Jack last year, so let’s give it to Suzie this year.’

It is really important that those providing sensory strategies have a good understanding of which senses the equipment or activity helps. This is why we explain clearly why you might use each strategy and the safety considerations in our online Sensory Processing Disorder training.

A useful starting point is Kim’s article Sensory regulation strategies – to help your child.

Sensory Assessment with Kim

For families based in the UK and with children aged between 5-12, Kim is now offering online sensory assessments. The assessments are designed for families who are unsure if the behaviours they are seeing are because of an underlying sensory need. For families who have concerns and want to know what they can do to help their child.   And for families who are tired of waiting for support from national services.  The assessment will be completed using an online form and provides a summary report and suggestions on how to help and support your child.  You can learn more about our sensory assessment here.

From 2024, Kim is also offering adult assessments, which can include a workplace assessment in London and Home Counties.

Additional resources for supporting sensory issues in autism

Online SPD courses

GriffinOT’s online courses explores sensory systems, sensory responses, and strategies to help in further depth.  We also give specific safety tips for using sensory strategies.  Our goal is to help you really understand why you are using sensory strategies so you can use them correctly.  To learn even more about the senses I recommend the Free Introduction to Sensory Processing.

Parent-friendly books on autism and SPD

  • For a very simple introduction and lists of ideas more specific to Sensory Processing & Autism: Building Bridges through Sensory Integration by Yack, Aquilla & Sutton (2015)
  • For a good introduction to Sensory Processing Disorder: The Everything Parent’s Guide to Sensory Processing Disorder by Terri Mauro (2014)
  • Another good introduction to Sensory Processing Disorder written by a parent: The Out of Sync Child by Carol Kranowitz (2005)
  • Although not specifically written on sensory processing, this book gives a lot of suggestions related to supporting sensory issues.  It also provides a very honest and in my mind helpful account of what it’s like living with a child who has autism:  Coming Home to Autism: A Room-by-Room Approach to Supporting Your Child at Home after ASD Diagnosis by Tara Leniston & Rhian Grounds (2018)
  • For extra strategies: Been There. Done That. Try This! By Atwood, Evans, & Lesko (2014)
  • For further information (however, if you’re completely new to ASD and sensory processing I recommend you read an introductory book first as this assumes prior knowledge on autism and sensory processing): Sensory Perceptual Issues in Autism and Asperger’s by Olga Bogdashina (2003)

Teacher-friendly books on ASD and sensory processing disorder

The above books would be suitable for teachers. In addition, these books also provide extra information:

  • Success with Sensory Supports by Kim Griffin (2023)
  • Sensory Processing Challenges – Effective Clinical Work with Kids and Teens by Lindsey Biel (2014)
  • A Buffet of Sensory Interventions by Susanne Culp (2011)

Page references

  • (1) DSM-V manual
  • (2) Atwood, T., Evans, C., & Lesko, A. (2014). Been There. Done That. Try This! Philadelphia: Jessica Kingsley Publishers
  • Bodison, S. C., & Parham, L. D. (2018). Specific sensory techniques and sensory environmental modifications for children and youth with sensory integration difficulties: A systematic review. American Journal of Occupational Therapy, 72, 7201190040. https://doi.org/10.5014/ajot.2018.029413
  • (3) Hazen, E. et al (2014) Sensory Symptoms in Autism Spectrum Disorders Harvard Review of Psychiatry Volume 22  Number 2  March/April 2014
  • (4) Ben-Sassoon (2019 https://link.springer.com/article/10.1007/s10803-019-04180-0
  • (5) Pfeiffer, B. A. (2012, June). Sensory hypersensitivity and anxiety: The chicken or the egg? Sensory Integration Special Interest Section Quarterly, 35(2), 1–4

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