Children and adults with autism have significant sensory needs. The most recent publication of the DSM identified criteria for autism to include responses to sensory input. Hypersensitivities often impair the ability to function in new environments and make connections with others. Hypo sensitivities make learning to coordinate the body for daily tasks and activities difficult due to inefficient neurological feedback.

Verbal and social communication is often impaired due to difficulty coordinating the body, efficiently processing both sight (facial expressions, body language) and sound (words, voice inflections) and adapting to quickly changing social demands.

Improving the ability to receive and process sensory input and to develop skills through sensory-motor feedback make lasting neurological connections. This improves the ability to successfully function and connect with others and the world. Sensory integration builds skills for long term peace, joy and success for children and adults with autism.

Attention is a skill that is learned and can be enhanced. When children (or adults) are having trouble learning how to pay attention there are many factors. The most prevalent are a heightened arousal state, problems with postural control, difficulty with praxis, and/or problems with vision.

When a person’s nervous system is in a high arousal or high alert state, it is the sympathetic nervous system that is in charge. In this state a person’s nervous system is in protection mode and screening out external sensory inputs such as sound and sights. A person in this state is often on edge, has difficulty settling down, appearing uncomfortable and hyperactive, and often distracted by things in the environment.

A problem becoming more prevalent in children today, likely due to cultural lifestyle changes, is poor postural control/stability or poor core strength. When children (or adults) do not have a secure postural base, static postures like sitting or standing still is very challenging, difficult, or almost impossible. In children especially, they are either leaning or laying down or in constant motion. Learning how to pay attention and fine motor skills suffer with poor postural control as a midline or center is not well established and the hands do not have a stable base to work together or work with the eyes to develop eye hand coordination. Avoidance of these skills often looks like poor attention or laziness.

Praxis is the unconscious ability to coordinate movement. It is like autopilot for most every day tasks and activities. Children (and adults) who have difficulties with praxis must put conscious effort and thought into how to coordinate movement. This mental exertion requires intensely more effort making challenging tasks all the more difficult. Sustained attention is difficult and tapped out. In an effort to conserve energy, challenging activities, tasks or learning may be avoided and is coupled with the appearance of not trying. But the reality is the child or adult is putting forth more effort than others trying to coordinate the body to perform.

Visual problems also contribute to difficulty with attention. Visual acuity, or how well the eye can provide a clear picture, is what we usually think of when we say vision. However, there are many other aspects of vision that contribute to our ability to use vision functionally. Eye muscles coordinate together to align the eyes both together as well as to integrate with head/neck movement and with our vestibular (balance, gravity, and movement processing) system. Coordinating eye movement is referred to as oculomotor control. When the eyes struggle to coordinate for tracking objects in the environment or lines on the page, shifting focus from one object to another, or even have difficulty fixating on an object, paying attention is very difficult.

The brain’s ability to interpret or provide meaning for what the eyes see, known as visual perception, makes identifying symbols such as numbers and letters, depth perception and spatial skills possible to participate in academic and daily activities easy and efficient. When visual perception is difficult, visual processing is strenuous resulting in taxed attention. Often, improving oculomotor skills and visual perceptual skills help to develop attention skills.

Children and adults with sensory processing disorder often have generalized anxiety as a result. When the world does not make sense, your body and brain have difficulty adapting, and expectations continue to mount as you get older. A person with a sensory processing disorder experiences a tremendous amount of stress and does not always have the understanding or skill to identify and utilize strategies to reduce stress. The first step in the Lamp Post’s occupational therapy program is to first organize sensory inputs to reduce stress and then to learn to identify stressors and develop strategies for self-regulation.

Rituals are often a self-regulation strategy. They offer predictability and a sense of control. When the world does not make sense and it feels overwhelming, a common strategy is to attempt to gain a sense of control by making the world as predictable as possible through rituals and doing and making things just so. Sensory integration treatment can help by reducing anxiety and stress and build skills for greater adaptability with tasks and environments.

Behavior is a form of communication about how a child or adult is experiencing the world. When a person’s nervous system has a low threshold for sensory input, or is easily excited, they are easily overwhelmed. It is also difficult to develop skills for self-regulation when a nervous system is flooded with input. The fight or flight protective mechanisms are quickly engaged resulting in oppositional, defiant, or avoidance behaviors.

Children and adults who have difficulty coordinating their bodies efficiently are often mentally taxing themselves by thinking through tasks that typically are performed without conscious effort as if on autopilot. Because exerting mental effort is more fatiguing than physical effort, when mental reserves are spent, frustration seems to come out of nowhere. In an effort to conserve mental energy, avoidance behaviors may develop. For many children, being “oppositional” is really trying to communicate that “this is too hard for me and I don’t know why and it is hugely frustrating.” Because sensory processing problems are often “hidden” in the neurological process, it may seem that it is a “behavioral” problem. Often, addressing the sensory needs and building adaptive skills through sensory integration, behavioral problems can be reduced and help behavioral strategies be more effective.