Sensory Integration: How To Decode What Your Child Is Telling You

by Dr. Katheryn Hansen

Child with glasses holding a model of an atom

So often, children with sensory issues are treated for behavioral problems, with or without acknowledging what sensory needs might be driving the behavior. When therapists focus on addressing unwanted behaviors without digging deeper, we can miss an opportunity to help a struggling child.

As an occupational therapist with a PhD in Occupational Science, a lot of my training has revolved around evaluating and addressing sensory issues in children with Autism Spectrum Disorder. In the OT world, sometimes we refer to this as a difficulty with sensory integration. In other words, these kids struggle with the ability to combine the information we get from our different senses and use it to operate in our everyday lives.

Sounds vital, right? It is! And for many people, sensory integration happens automatically. One of the biggest reasons why sensory integration can be difficult for people with ASD is that sometimes sensation doesn’t get detected in the brain (an issue we call under-responsiveness) whereas other times the brain detects even the slightest amount of sensory stimulation (which we call over-responsiveness). As you can imagine, this makes it hard for the brain to interpret and use sensory information.

We all know about the five senses: sight, sound, touch, taste, and smell. But there are two more senses that are very important to our ability to interact with the world around us: our proprioceptive sense, which tells us where our body is in space, and our vestibular sense, which detects balance and movement.

Here are some examples of what under- or over-responsiveness to sensory information may look like for a child with ASD.

Sense Under-responsive Over-responsive
Sight Appears not to see objects in the environment Covers eyes or squints in bright light
Sound Doesn’t respond to name being called Covers ears to everyday noises
Touch Has a high pain threshold Avoids certain fabrics or clothing
Taste Seeks out spicy foods Avoids eating certain food textures
Smell Seeks out strong smells Dislikes smells such as perfumes
Body Position Hits people or objects Finds many body positions uncomfortable
Balance and Movement Clumsiness Easily distressed when feet leave the floor

One of the best ways to help support individuals with ASD who have difficulty with sensory integration is to be intentional about the design of spaces that children frequent in their everyday lives. When you know what to look for, areas of the environment that are making sensory integration harder for children with ASD become clear, and can be addressed. Here are just a few examples of what you might observe at home if your child is over- or under-responsive to a sense:

Sense Under-responsive Over-responsive
Sight Difficulty finding toys/objects that are similar to their background color Repeatedly tries to turn off the lights
Sound Does not hear adult direction from a different room Easily distracted by background noises
Touch Does not notice extremes in hot/cold water from sinks and tubs Avoids bumping into other people or furniture
Taste Constantly craves food available in the kitchen Has trouble staying at the table during mealtimes
Smell Does not avoid noxious chemicals such as cleaning agents Avoids areas such as the kitchen
Body Position Leans against walls or furniture Avoids close spaces
Balance and Movement Climbs or jumps on furniture Does not enjoy playground equipment such as swings and slides

Every child is unique. They may be over-responsive in one sense and under-responsive in another. Patterns may change depending on where they are, or how familiar they are with a setting. This is why intentional sensory design is so important! With a careful assessment of which senses a child with ASD is having trouble with and in what way, the environment itself can become a support, and not a barrier, to full participation in their everyday lives.

Dr. Hansen is a licensed occupational therapist, researcher, teacher, and sensory-inclusive design consultant. She provides guidance to designers, architects, and families on how to support a person’s sensory needs and preferences through the built environment. Her work primarily focuses on children with autism spectrum disorder, as well individuals with other sensory-related conditions such as ADHD, genetic disorders, dementia, PTSD, and traumatic brain injury. 

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