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

by Dr. Kathryn Hansen

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.

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Dr. Hansen is a licensed occupational therapist, researcher, teacher, and sensory-inclusive design consultant. She has worked directly with children on the autism spectrum for over 10 years in home, school, and community settings. She also instructs other occupational therapists about autism assessment, evaluation, and choosing the right therapeutic approach. She is passionate about helping designers, architects, and families understand how the sensory needs and preferences of their clients or loved ones can be supported by the built environment in order for them to do the activities that they need and love to do. When she’s not working, you can find her exploring local restaurants with her husband or playing with their two dogs, Marky and Millie.