Sensory Processing & Autism: Understanding Sensory Profiles

10/19/2022
Sensory
Processing &
Autism
Melinda Cooper
Senior Product Manager –
Occupational Therapy
October 19, 2022
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Introducing our presenters and panelists
Shelley Hughes, OTR
Director, Portfolio
Management & Delivery
- Therapeutics
Melinda Cooper, OT
Senior Product Manager
- Occupational Therapy
Liz Grose, SSP, NCSP
Senior Assessment Consultant
& Regional Manager, East
Becky Whalen, MA CCC-SLP
Assessment Consultant
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Disclosure
Financial:
Shelley Hughes and Melinda Cooper are employed by Pearson Clinical Assessment.
Non‐financial disclosure:
There are no relevant non‐financial relationships to disclose.
The Pearson Assessment Division, the sponsor of this webinar, develops and distributes assessments and
intervention tools for speech‐language pathologists, occupational therapists, and psychologists. This
webinar will address appropriate use of the Sensory Profile 2 and Adolescent/Adult Sensory Profile.
These assessments are published by Pearson.
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affiliates. All rights reserved.
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Requirements to receive AOTA CE credit
Pearson will provide attendees with a
certificate of continuing education if
you:
• Attend the entire 60 minutes of the
live session (confirmed by our
verification report)
• Participate in the knowledge check
questions in the post webinar survey
(participation is audited)
Pearson can NOT provide a certificate
of continuing education credit if you:
• Didn't attend the live presentation in
its entirety.
• Request “Partial credit” [not
available]
• View the webinar recording after the
live event
Questions about CEUs?
Contact Darlene Davis at:
[email protected]
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Learner Outcomes
Based on the content of the workshop, participants will be able to:
1. List three reasons why sensory differences may impact participation for
individuals with autism.
2. Identify three strategies which can be employed to support the sensory
needs of individuals with autism.
3. Explain how an atypical sensory processing pattern can be used as a
strength.
4. Describe two standardized assessment tools available for the
identification of sensory preferences of people with autism.
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Agenda
10:30 – 10:55
Introduction to sensory processing and Dunn’s sensory
processing framework
10:55 – 11:00
Overview of the Sensory Profile 2 and Adolescent/Adult Sensory
Profile
11:00 – 11:15
Implications of sensory processing differences for participation at
school, and interventions to assist
11:15 – 11:25
Review of recent research on sensory processing and autism
11:25 – 11:30
Questions and Answers
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Introduction to
sensory
processing and
Dunn's sensory
processing
framework
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Sensory Processing
• The process of detecting information via internal
and external sensory receptors, then receiving
and organizing it in the brain to shape a
response.
DSM-5 diagnostic criteria for autism include
• Hyper- or hyporeactivity to sensory input or
unusual interest 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).
American Psychiatric Association. Diagnostic and statistical manual of mental
disorders. 5th ed. Arlington, VA: American Psychiatric Association; 2013.
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"The experience of
being human is
embedded in the
sensory events of
everyday life" (Dunn,
2001)
Dunn, W. (2001). The sensations of everyday life: Empirical,
theoretical, and pragmatic considerations, 2001 Eleanor
Clarke Slagle lecture. American journal of Occupational
Therapy, 55, 608‐620.
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Dunn’s Sensory Processing Framework
(Dunn, 2014)
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Registration
More than others
• ‘Miss’ sensory information
• I don’t smell things that other
people say they smell
• Easygoing
Less than others
• Notices things others would
miss
• Eye for small detail
• “Sherlock Holmes”
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Seeking
More than others
• Continually adding sensory input
to tasks
• I add spice to my food
• Curious, engaged with sensation
• Consider function/purpose of
the seeking behavior
Less than others
• Not overly interested in sensory
experiences
• Comfortable in low-stimulus
environments
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Sensitivity
More than others
•
Continually detecting sensory input
•
I startle easily
•
Heightened awareness to sensation
Less than others
• Filters out sensations
• Less likely to be distracted
by extraneous input
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Avoiding
More than others
• Withdraws from overwhelming sensory
input
• I only eat familiar foods
• Thrives on routine, familiarity, control
Less than others
• Thrives on spontaneity, change, lack of
routine
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Overview of the
Sensory Profile 2
and
Adolescent/Adult
Sensory Profile
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Sensory Profile 2
• Standardized sensory processing
questionnaire
• Measures sensory processing
patterns as reported by caregiver
or teacher
• Ages birth – 14:11
•Infant
•Toddler
•Child
•School
•Short
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Adolescent / Adult Sensory Profile
• Standardized sensory processing
questionnaire
• Measures sensory processing
patterns via self report
• Ages 11:0 – 65+ years
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There is no "right" or "wrong" Sensory Profile
• Neither the SP-2 nor the AASP seek to label
or diagnose dysfunction
• Help gain a holistic picture of the person
• Understand the level of fit between sensory
preferences and sensory stimuli in
environment
• Identify and remediate barriers to
participation
• Not designed as outcome measures
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Implications of
sensory processing
differences for
participation at
school, and
interventions to
assist
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Participation
Physical Environment
• Building design
• Sensory qualities of
the environment
• Furniture and
materials
• Weather
Social Environment
• Proximity of adult
support
• Attitudes of others
• Group / peer culture
• Rules
Appropriate Services
• Difficulty accessing
needed services
• Services not
individualized
• Transportation
Task Demands
• Physical
• Sensory
• Motor
• Cognitive
• Social
What are the barriers to participation for the individual?
(Coster et al., 2013)
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Participation challenges for high threshold
At risk of under-stimulation
• Being seated for long periods
• May miss verbal / auditory instructions
• May miss visual social / nonverbal communication cues
• Limited opportunities to gain additional stimulation within constraints
of class schedule / environment
• May be labelled as disruptive / distracting due to seeking behavior
• Difficulty switching between sensory modalities (e.g. visual/auditory)
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Participation strengths for high threshold
Tolerance for input is a "superpower"
• Enthusiastic, curious and willing to try new things (seekers)
• Less likely to be bothered by highly stimulating environments
• Easygoing, less likely to be disruptive (bystanders)
• Seekers' seeking behavior may facilitate their engagement and show
you what they need more of
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Principles for Intervention – high threshold
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Participation challenges for low threshold
At risk of over-stimulation
• May have difficulty with change / novelty
• May have fight/flight responses to certain environments
• May be seen as distractible and have difficulty completing work on
time
• Need for control may impact on social abilities
• School is a "one size fits most" environment
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Participation strengths for low threshold
Heightened awareness is a "superpower"
• May excel at creative/arts
• Some autistic individuals show enhanced visual processing,
particularly in visual search activities
• Observant and aware of subtle changes
• Responds well to sameness and routine
• May work well in self-directed or solitary activities
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Principles for Intervention – low threshold
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Common Sensory Supports
Movement (Proprioceptive and Vestibular)
• Classroom errands
• Brain breaks, movement breaks, yoga
• Multi-sensory learning
Visual
• Changing lighting to more natural light
• Reduce visual stimuli on walls
• Preferential seating
Auditory
• Alerting feature e.g.bell
• Preferential seating
• Noise reducing headphones or ear plugs
(Asher, 2017;
Bodison & Parham, 2018;
Dunn, 2014)
Tactile
• Permitted "fidgets"
• Adjust physical environment to minimize unexpected touch
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What about
when all
four
quadrants
are atypical?
This Photo by Unknown author is licensed under CC BY‐SA.
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Interpretation in context
• It's not uncommon to see a score profile where all quadrants show a
difference
• Scores by themselves are not that meaningful
• Focus on a specific goal or problem
• Use Sensory Profile data to formulate evidence-based
recommendations
• Recommendations should be linked to the goal or problem
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"Everyone is a
genius. But if you
judge a fish by its
ability to climb a tree,
it will live its whole life
believing that it is
stupid.” (Unknown)
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Strengths-Based Approach
• Build on an individual's strengths
• Shift away from thinking how an individual
can "fit in"
• Shift away from deficit-based focus
• Aligns with WHO ICF Model (2007)
• Encourages self-advocacy
• Improves self-determination
• Closing the gap between capabilities and
expectations
(Dunn et al., 2017, p. 240)
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Recent research
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Executive Functioning: A Mediator Between Sensory
Processing and Behaviour in Autism Spectrum
Disorder (Fernandez-Prieto et al. 2021)
• Hypothesized that executive function deficits are associated with greater
behavioral problems and sensory processing impairments
• n =79 (65 male) with ASD diagnosis aged 4-16 years
• Sensory Profile 2 Child form, Child Behavior Checklist
• Increased reactivity to touch or body movement may be linked to emotion
regulation difficulties in children with ASD
• Executive functions at the emotion regulation and control level mediated the
relationship between sensory processing differences and behavioral problems
• Possible that autistic children/adolescents with atypical sensory profiles more
likely to show decreased emotion regulation and control
• No mediation effects of working memory found
Journal of Autism and Developmental Disorders (2021) 51:2091–2103
https://doi.org/10.1007/s10803‐020‐04648‐4
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The impact of atypical sensory processing on social
impairments in autism spectrum disorder (Thye et al. 2018)
• Reviewed behavioral and neurobiological studies on social and sensory
processing in ASD to explore the relationship between the two
• Sensory atypicalities are one of the earliest emerging markers of infants later
diagnosed with ASD
• Atypical sensory processing in ASD can interfere with obtaining an
accurate assessment of skills, progression of therapy, and intervention
outcomes
• Sensory hyposensitivity can impact selective attention to social stimuli,
decoding intentions, social reciprocity, and adherence to social norms of
behavior.
• Oversensitivity to sensory features can come at the expense of inability to
filter out extraneous information
Developmental Cognitive Neuroscience 29 (2018) 151–167
https://doi.org/10.1016/j.dcn.2017.04.010
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Sensory Processing Patterns in Autism, Attention Deficit
Hyperactivity Disorder, and Typical Development (Little et al. 2018)
• Examine sensory processing in children ages 3–14 years with ASD, ADHD, and
typical development (TD) using the Sensory Profile 2
• n = 239 (ASD = 77; ADHD = 78; TD = 84)
• Both ASD and ADHD groups had higher scores on the SP-2 than TD but no
distinctive diagnostic profile
• ASD group showed the highest rate of oral processing differences
• ADHD group had more visual processing differences than ASD and TD
• Sensory features may be an area of overlap of behaviors in ASD and ADHD,
which may have implications for intervention approaches for these groups
Little, L. M., Dean, E., Tomchek, S., & Dunn, W. (2018). Sensory processing patterns in autism, attention deficit
hyperactivity disorder, and typical development. Physical & Occupational Therapy in Pediatrics, 38(3), 243–254.
https://doi.org/10.1080/01942638.2017.1390809
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Classifying sensory profiles of children in the general
population (Little et al. 2017)
• Aim to subtype groups of children with and without developmental conditions,
based on sensory processing patterns
• SP-2 administered to n=1132, aged 3–14 with typical development (70%) and
conditions including ASD, ADHD and LD
• Profile 1 - “Balanced” (typical scores on all 4 quadrants)
• n=890 (79% of total sample) 88.6% of TD, 35% of ASD
• Profile 2 - “Interested” (higher scores on Seeking)
• n = 83 (7% of total sample) 6.1% of TD, 9.1% of ASD
Little LM, Dean E, Tomchek SD, Dunn W. Classifying sensory profiles of children in the general population. Child Care
Health Dev. 2017 Jan;43(1):81‐88. doi: 10.1111/cch.12391.
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Classifying sensory profiles of children in the general
population (Little et al. 2017)
• Profile 3 - “Intense” (more than others scores on all 4 quadrants)
• n= 58 (5% of total sample) 2% of TD, 19.5% of ASD
• Profile 4 - “Mellow until...” (higher scores on Registration and Avoiding)
• n = 50 (4.4% of total sample) 2.3% of TD, 11.7% of ASD
• Profile 5 - “Vigilant” (higher scores on Sensitivity and Avoiding)
• n = 51 (4.5% of total sample) 1% of TD, 24.7% of ASD
• Children with and without diagnoses presented across subtypes
• One subtype was significantly younger in age
• Atypical SP patterns are not unique to ASD but rather reflections of children’s
abilities to respond to environmental demands
Little LM, Dean E, Tomchek SD, Dunn W. Classifying sensory profiles of children in the general population. Child Care
Health Dev. 2017 Jan;43(1):81‐88. doi: 10.1111/cch.12391.
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How Sensory Experiences Affect Adolescents with an
Autistic Spectrum Condition within the Classroom
(Howe & Stagg 2016)
• n= 16 (12 male, 4 female) aged 12 - 17 in the UK
• Adolescent/Adult SP: 2 participants had one “difference” quadrant, 4 showed
differences on two quadrants, 6 on three quadrants and 2 on four quadrants
• Also completed a questionnaire asking how much each sense affected them
specifically in the classroom
• All reported difficulties in at least one sensory domain, with hearing affecting them
most (88%), followed by touch (75%), vision (50%) and smell (38%)
• Sensory sensitivity affecting concentration and therefore learning
• Keywords “anxious”, “uncomfortable”, “frustrated”, “annoyed”, “physical discomfort”
• Sensory experiences fluctuate with mental state and context
Howe, F.E.J., Stagg, S.D. How Sensory Experiences Affect Adolescents with an Autistic Spectrum Condition within the
Classroom. J Autism Dev Disord 46, 1656–1668 (2016). https://doi.org/10.1007/s10803‐015‐2693‐1
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Sensory Processing in Low-Functioning Adults with
Autism Spectrum Disorder: Distinct Sensory Profiles and
Their Relationships with Behavioral Dysfunction
(Gonthier et al. 2016)
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Data were collected for a sample of inpatients in autism care centers (n = 148) with severe-profound ID
and a non-clinical control group
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Adolescent/Adult Sensory Profile completed by the health or social worker who had the most frequent
interactions with the participant
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ASD group showed more low registration and significantly less seeking, sensitivity and avoiding than control
participants
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Low registration associated with hypoactivity and apathy, difficulty initiating activities, disinterest and
indifference, and self-aggression
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Low-functioning adults with ASD are especially vulnerable to sensory mismatches because their low
autonomy limits development of coping strategies
Gonthier C, Longuépée L, Bouvard M. Sensory Processing in Low‐Functioning Adults with Autism Spectrum Disorder:
Distinct Sensory Profiles and Their Relationships with Behavioral Dysfunction. J Autism Dev Disord. 2016
Sep;46(9):3078‐89. doi: 10.1007/s10803‐016‐2850‐1.
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Key Take Aways
•
Sensory differences are
prevalent in children,
adolescents and adults with ASD
•
Key is to identify how well
sensory needs are being met
and focus on increasing
participation
•
Employ a strengthsbased perspective
•
Sensory diversity makes the
world go round!
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Need help using
the Sensory
Profile?
Convenient on-demand
training now available!
Visit https://www.pearsonass
essments.com/professionalassessments/training.html
to find out more
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Questions?
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