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Paul Isaacs outlines some of the main sensory difficulties faced by people with autism and how they affect his everyday life

As a child, I was non-verbal and I didn’t gain functional speech until the age of seven or eight. I was diagnosed with autism at the age of 24, in 2010.

It is becoming more widely recognised that autistic children and adults are challenged by sensory and information processing difficulties. The following is a summary of some of these issues and how I am affected by them. This is crucial information for educators because autistic children are not able to learn unless their sensory processing issues are properly appreciated and addressed. 

Visual processing

Object blindness (simultagnosia)
Some people on the spectrum, despite seeing simultaneous pieces of visual information, have an inability to generalise images. As a child, I would become fixated on pieces of things, neither understanding nor processing the whole picture. For example, my mother was horrified to find me swinging a cat around by its tail. I only understood that I had hold of a soft, furry long thing that felt nice.

Meaning blindness (semantic agnosia)
Gaining meaning from visuals alone can be an issue and often other senses must be brought into play. I am a sensory explorer. As a child, I would need to sniff, tap, rub, lick and tongue things to gain an appreciation of their shape, size and other information. This is how I found meaning and worked out what things, and people, are. I would take off my shoes to feel the ground. I would also lick my hand to sensitise my palm and give me a blueprint for how objects and things in my visual field felt.

Face blindness (prosopagnosia)
Facial recognition can be a problem for those with autism. To me, a face is a complicated piece of visual information – much like a puzzle – with a seemingly infinite amount of information to take in at once. I try to remember a voice as a blueprint for remembering people. A fellow autistic trainer I know uses hair style and colour to identify people – which is fine until they change. I knew a school child who consistently mistook two teachers who were physically very different but wore identical glasses.

Comprehension blindness (visual verbal agnosia)
This can be very misleading from an observation point of view. Some people on the spectrum can verbalise or read information, sounding as if they understand what they are saying or reading. I consider this to be a form of written echolalia. General information poses a problem for me; I can read and read (and also verbalise) but still gain little or no meaning from the text. I still need help with getting meaning from application forms and general information leaflets, for example.

Hearing (auditory processing)

Environmental meaning deafness (auditory agnosia)
Some people on the spectrum have difficulties comprehending auditory stimuli and their origins, even if they have heard the sounds many times. The meaning of sounds is not being processed or understood. This is often very frightening. Even as an adult, a simple verbal reminder, such as “that’s a lorry reversing outside”, helps me with processing and anxiety when I hear a noise. Even something seemingly obvious, like “that’s the school bell – time to go home”, will help children with this difficulty.

Meaning deafness (auditory verbal agnosia)
Obtaining meaning from language can cause problems. When my processing goes down, I can only understand the first three or four words spoken to me, then it reverts back to sounds with no meaning. For autistic children, short, direct sentences, with no flowery social niceties or rambling explanations, work best to help them understand you.

Tonal Deafness (tonal agnosia)
Some people on the spectrum do not pick up tone, inflection or emphasis from a person’s voice. Subtext is often implied and an autistic child is unlikely to hear the emphasis or tone and will completely miss any implied meaning; say what you mean and be clear and concise. One autistic child was considered naughty because when he was told to stop talking to Ben, he went to speak to David instead. He simply did not understand the implied meaning that he should stop talking altogether.   

Auditory cluttering/sound overload
Filtering auditory information is impossible for some people with autism, and for others it can be a painful experience. If I walk in a busy high street, I can hear every conversation clearly; I am not able to focus just on the person who is trying to converse with me. This was a lot worse when I was a child at school.

People with autism often experience the world very differently to their peers.People with autism often experience the world very differently to their peers.Smell (olfactory processing)

Over sensitivity to smell (hyperosmia)
A heightened sense of smell can create problems for those with autism, causing serious physical reactions such as nausea and vomiting. However, I know someone who uses her heightened sense of smell to calm down during times of stress and anxiety by putting perfume on a scarf. She also uses smell to help her remember things and people.  

Under sensitivity to smell (Anosmia)
Some people on the spectrum have no sense of smell at all. I know someone who, when asked whether he liked a particular perfume, said he could not smell it but tasted strawberries when he tried.

Balance of the body (vestibular processing)

Depth Perception
Problems with balance and body connectivity are common amongst people with autism. They struggle to understand the inter-connectivity of their body parts and how this relates to the space around them. This has implications for accidents at school, such as misjudging stairs or how far away a table is. The visual effects can be very frightening; for example, if a ball is coming towards me, I can only see it getting bigger, I don’t process the fact that it is getting nearer and only appears bigger because of this.

Processing pain

Under sensitivity to pain (analgesia)
I can remember dislocating my arm and having a tooth almost knocked out of my mouth and not connecting with the pain. I have also had drinks which were boiling hot, causing blistering, and baths which were too hot, leading to overheating, dizziness and nausea.

It’s important to recognise the differences in sensory processing systems in children on the autistic spectrum and the effects of the school environment. Reasonable adjustments can be made to reduce the impact of sensory issues in school and social settings, but first we need to understand how each individual child is affected. Sensory assessments should be an automatic part of SEN assessments for children with autism.

Further information

Paul Isaacs works for Autism Oxford’s Supported Employment Project as a part of a team of autistic men and women training health, social care and criminal justice professionals. He also works as a consultant and event speaker:
www.autismoxford.org.uk

Paul would like to acknowledge the work of Donna Williams on the terminology used in this article.

 

Comments   

#2 Stan Cripps 2014-09-07 16:14
Great article which reinforces all the information in the excellent book "The Reason I Jump" by Naoki Higashida. Naoki is a thirteen year old boy with Autism, the book is a must read for all educators and definitely Educational Psychologists! Sensory assessments are essential as long as the results of these produce some form of meaningful intervention strategies that will assist mainstream teacher,like myself, help these desperate children.
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#1 Fayhaff 2014-09-05 17:50
Excellent summary of Paul's sensory differences. I agree totally with him that 'Sensory assessments should be an automatic part of SEN assessments for children with autism'. I heard him speak at a NAS conference on Sensory Processing last year, along with several other excellent speakers and came away convinced that many autistic behaviours could be explained by sensory processing differences - and that good sensory assessments are essential if 'reasonable adjustments' are to be made to allow those with autism to be included and achieve their potential.
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