Sensory & Behavior Integration
Sensory and Motor Problems in Autism
Children with autism spectrum disorder often have difficulty with sensory information, including textures, sounds, sights, smells, tastes, movements, and brightness. Sensory integration difficulties, or sensory sensitivity, occur in anywhere from 42% to 88% of children with ASD (Baranek, 2002). Children with sensory processing disorder find it difficult to respond appropriately to sensations and various stimuli and may result to self-stimulation to compensate for either overstimulation or limited sensory input. This could include the following behaviors: self-injurious, aggression, aimless running, or stereotypic motor movements.
Treatments options for children with sensory sensitivity include occupational therapy, sensory integration therapy, and physical therapy. Doctors recommend using these treatments either individually or in combination, dependent upon the needs of each child.
Sensory Integration Therapy
Sensory integration focuses on improving the tactile, vestibular, and proprioceptive senses along with additional brain functions.
When working correctly, the tactile system uses the skin surface nerves to inform the brain of touch, temperature, pain, and pressure. Dysfunction of this system may cause a child to withdraw from touch, refuse certain foods, avoid getting their hands dirty, or not realize when something is too hot to touch. Some children are diagnosed with tactile defensiveness, which means they are extremely sensitive to light touch.
The inner ear, or vestibule system, is used to detect movement or changes in head position. Vestibular dysfunction may be presented as either hypersensitivity to normal movements (such as climbing or descending stairs), or hypo-reactive to daily stimuli (body whirling, jumping, or spinning).
The proprioceptive system connects all of the muscles, joints, and tendons in the body – especially those that maintain a subconscious awareness of the person’s body position. A working system allows for automatic body correction while sitting, walking, or even holding a pencil, but people with proprioceptive dysfunction appear clumsy since they will have difficulty manipulating small objects (pencils or forks) or resist learning new motor movements.
A dysfunction in any of these three systems can be manifested in various ways depending on each child as some fluctuate between extremes of sensitivity. Dr. A. Jean Ayers has created a program, called Ayres Sensory Integration®, which has proven successful in its intervention of sensory response behavior when combined with occupational therapy.
Occupational therapy (OT) addresses a combination of cognitive, physical and motor skills in order to help its patients become independent by focusing on age-appropriate skills. Services for individuals with an ASD include evaluation, intervention, and measurement of outcomes, after which occupational therapists may assist with one or more of the following:
- Promote coordination and body awareness
- Assist the child with understanding proper communication skills
- Complete daily developmental activities, like brushing their teeth, combing their hair, toilet skills, and getting dressed in the appropriate order
- Learning adaptive strategies to cope with transitions and changes in their daily schedule
- Practicing fine motor skills
- Tasks for improving gross motor skills, such as walking, climbing stairs, or riding a bike
- Perceptual skills to recognize the differences in colors, shapes, and sizes
- Learning how to sit with proper posture
The goal of occupational therapy is to help a patient understand the position and placement of their body in relation to the rest of the world. By combining with a sensory integration program, a child will learn both motor skills and sensory detection.
Motor skills therapy will allow a child to gain several of the following: muscle tone, coordination, proper rhythm and timing while walking, balance, and gross and fine motor skills. Sensory detection therapy will help a child learn how to both detect and block out the various senses. All of these are done through various activities that promote these senses and skills, such as aerobic exercise or rhythm training.
Unlike occupational therapy, which concentrates on independent living skills, physical therapy concentrates on improving specific movements a child finds difficult to perform. For example, an autistic child may see a physical therapist if they are having difficulty moving from a sitting to standing position. The physical therapist will assess their current situation, and create a program with various exercises to improve the required muscle tone needed for the movement to be performed properly.
Should a baby appear to be struggling to develop the appropriate motor skills or has low muscle tone, parents may consider visiting a physical therapist before the child’s first birthday. Even if the delays or struggles are subtle, physical therapists can become involved before an official diagnosis, which may prevent or delay the worsening of movement.
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