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The purpose of this article is to discuss sensory processing concepts and their application to the needs of children who have Asperger syndrome (AS). First we will outline the basic characteristics of the sensory systems, then discuss a model for sensory processing, and, finally, present a summary of the data supporting the application of this model in work with children who have AS. A framework is outlined for incorporating sensory processing concepts into practice and research programs that address the needs of children with AS. Finally, we will present case studies demonstrating the application of sensory processing principles.
The Diagnostic and Statistical Manual of Mental Disorders--Fourth Edition--Text Revision (DSM-IV-TR; American Psychiatric Association [APA], 2000) contains the most widely used diagnostic criteria for identifying Asperger syndrome (AS) as a category of Pervasive Developmental Disorders (PDD). This document contains three behavioral criteria--qualitative social impairment, repetitive and restrictive stereotyped patterns of behavior, and significantly decreased social function--and three exclusion criteria--language delays, cognitive delays, or other significant diagnoses, including schizophrenia or autism (APA, 2000).
It is interesting to note that these criteria do not contain any explicit reference to differences in sensory processing, even though the original work on this disorder by Hans Asperger (1944) contained descriptions about distinct sensory processing behaviors (Dunn, Myles, & Orr, 2002). Asperger studied four children and recorded the unique characteristics they exhibited (Frith, 1991; Wing, 1991), including a range of hypo-and hypersensitivities to taste, tactile, and auditory stimuli. For example, male children discussed in his case studies preferred very sour or strongly spiced foods. Similarly, they strongly disliked tactile input (e.g., textures of some fabrics, fingernail cutting) and were also very sensitive to noise in certain situations but oblivious to noise in other environments. Each of these sensory problems interfered with their daily routines.
More recently, consideration has been given to the possibility that sensory processing is an underlying feature of AS (Attwood, 1998; Fling, 2000; Myles & Simpson, 1998; Myles & Southwick, 1999; Stagnitti, Raison, & Ryan, 1999; Willey, 1999). Practitioners and scholars have anecdotally reported about the relationships between sensory processing functions in daily life, including learning, play, work, and socialization (e.g., Adreon & Myles, 2001; Anderson & Emmons, 1996; Ayres, 1972, 1979; Cook & Dunn, 1998; Fisher, Murray, & Bundy, 1991). There is some preliminary empirical evidence suggesting that there are significant differences in the sensory processing patterns of children who have AS (Dunn et al., 2002). Some authors view the specific criteria listed under the heading "Repetitive and Restricted Stereotyped Patterns of Behavior, Activities, and Interests" (p. 84) to be reflective of difficulty with sensory processing, including (a) a preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus; (b) inflexible adherence to specific, nonfunctional routines or rituals; (c) stereotyped and repetitive motor mannerisms; and (d) persistent preoccupation with parts of objects (Frith, 1991; Gillberg, 1992; Huebner, 2001; Zero to Three, 1994).
The purpose of this article is to discuss sensory processing concepts and their application to the needs of children who have AS. We will outline the basic characteristics of the sensory systems, discuss a model for sensory processing, and present a summary of the data supporting the application of this model in work with children who have AS. Then we will outline a framework for incorporating sensory processing concepts into practice and research programs that address the needs of children with AS. Finally, we will present case studies demonstrating the application of sensory processing principles.
Basic Characteristics of the Sensory Systems
The sensory systems provide the route for the brain to receive information. The function of the input mechanisms themselves produce sensory acuity (e.g., whether the person's eyes receive light, etc.). The brain is responsible for making meaning out of this information and for designing and implementing a response (i.e., processing). For children who have AS, the sensory input structures are usually intact; the difficulty with sensory processing occurs as the child tries to use that sensory input (i.e., process it) to respond to task and environmental demands.
A Model for Sensory Processing
The neurological thresholds continuum represents the amount of input the nervous system requires before responding. When a person has high thresholds, this means that it takes a lot of input for the nervous system to take notice and then generate a response. When a person has low thresholds, this means that it takes very little input for the nervous system to take notice, and lots of responses are generated.
The self-regulation continuum represents the range of strategies a person might use in responding to task and environmental demands. A person who resorts to passive strategies has a tendency to let things happen; a person who uses active strategies reveals a tendency to generate responses to control input.
The intersection of these continua creates four basic patterns of sensory processing: low registration, sensation seeking, sensory sensitivity, and sensation avoiding. Low registration represents the combination of high neurological thresholds with a passive self-regulation strategy. Sensation seeking represents the combination of high thresholds with an active self-regulation strategy. Sensory sensitivity is the combination of low neurological thresholds with a passive self-regulation strategy, and sensation avoiding represents the combination of low neurological thresholds with an active self-regulation strategy.
Reflection Exercise #2