Sensory Processing in Autism – 2

I was sprucing up some files, recently, and accidentally deleted my original post on this subject. Hours were spent attempting to recover that essay. And, yes, Virginia, I did back up – do file recovery programs ever actually work? I finally decided that, since the initial story was already more than a year old, the topic required a re-visit.

What sparked my original discussion was a recommendation from the AAP that advised clinicians to take a “Careful Approach to Using Sensory-Based Therapies.” What I thought back in June of 2012, and I still feel today is, “Are you guys f*$#ing kidding me?

Any parent of a child ‘on the Spectrum’ is fully aware of the problems and limitations due to ‘sensory issues’. ‘Concerned caution’ makes the AAP members appear insensitive and best, and ignorant at worst. Affected children might smell everything, bite or lick anything, bounce more than a kangaroo, hear sounds that you didn’t even know were there, and/or demonstrate unusual eye movements.

Is there such a condition?

  • A 1997 paper in The Journal of Autism and Developmental Disabilities  warned, “Evidence from clinical studies suggests that unusual sensory responses are present in a majority of autistic children… However the clinical and experimental research to date suffers from serious methodological limitations and more systematic investigation is warranted.”
  • In 2003, a study in the same journal “indicated that neither overall developmental level nor IQ was related to abnormal sensory reactivity in children with autism or general developmental disorders. However, abnormal sensory reactivity had a significant relationship with overall adaptive behavior.
  • By 2011, an NIH funded studySensory Processing in Autism: A Review of Neurophysiologic Findings, documented the presence of such a condition.
  • This past year, the journal NeuroImage: Clinical published, Abnormal white matter microstructure in children with sensory processing disorders, which reports the ability to see the problem, using technology.
  • An excellent academic review of the topic appears in this Child Mind Institute report.

What is the cause?

  • The recent literature demonstrates differences in the neural pathways of patients with autism. There is evidence of over-, under-, and cross– connectivity. Variations in processing speed have been documented, as well.
  • In clinical practice, the most obvious problem appears to be a lack of filtering. Affected individuals report that lights seems brighter, sounds are louder (or not there at all), textures (sand, water, e.g.) seem more noticeable, tastes and odors appear more or less remarkable.

What are the symptoms?

  • Sight – Not looking where expected, poor eye contact, difficulty reading. Room color and lighting may appear disturbing, and some visual fields may be ignored altogether.
  • Hearing – Hands constantly going over the ears. Avoiding or running from certain sounds (the bathroom). Many children respond negatively to certain frequencies rather than the actual amplitude of sounds. Turning to voices may be blunted.
  • Smell – Bringing the face close to objects, people. Licking and smelling.
  • Taste – Restricted diet, picky eater. Problems such as constipation, diarrhea, fungus, less vitamins and minerals available and poor absorption.
  • Touch – avoiding or seeking input. Increased apparent resistance to pain. Behaviors that reflect anxiety. Social isolation.
  • Combinations – Hands to the face while grimacing and pushing into objects, for example.

What can be done?

  • ♦ Identify and address any underlying problem(s). A thorough workup should include a detailed genetic evaluation, auditory and visual examinations, metabolic (laboratory) studies, exhaustive history of the G-I system, documentation of muscle coordination and strength.
  • ♦ Conventional therapeutic interventions such as ABA, S&L, OT, PT. These are the proven treatments, which are especially helpful as an affected child is restored to proper health.
  • ♦ Targeted therapies such as hearing, visual, RDI and sensory diet techniques.
  • ♦ Treatments that address the cranial, sacral and other vagal nerve issues.

The moral of the story is that my accidental file deletion actually helped. It has lead me to a number of discoveries:
1) A renewed examination of sensory processing.
2) Learning more about data recovery.
3) A better backup strategy.

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